Arrests for May 2002
These arrests were made possible through the cooperation of the Frauds Bureau, law enforcement, the insurance industry and the public.
To report suspected incidents of insurance fraud, call 1-888-FRAUDNY
CAUGHT!
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GUILTY!
- Bamidele Ajayi was convicted on 3/1/02 of mail fraud, wire fraud and tax fraud and sentenced on 5/29/02 to three years jail time and three years probation. He was arrested on 12/5/00 on charges that he submitted a fraudulent accidental death claim for $500,000 to Prudential Life Insurance Company, stating that his brother had died in Nigeria from a head injury sustained in a fall. He also submitted a death certificate signed by a doctor associated with General Hospital Isolo in Nigeria as well as a burial certificate to substantiate the claim. An investigation conducted by the Frauds Bureau and the U.S. Postal Inspection Service revealed that both documents were counterfeit. The doctor and a cemetery attendant later admitted that they had concocted the story of the death. Furthermore, DMV records indicated that Ajayi and the brother on whose life he had taken out the Prudential policy were one and the same.
- John Biagini Sr. was sentenced on5/28/02 to 37 months in prison and $80,900 in restitution to Nationwide, Allstate, Electric and Progressive Casualty Insurance Companies. Biagini pled guilty on 8/27/01 to charges of conspiring to defraud these insurers through his auto repair business. He admitted that between 1995 and 1999 he routinely caused the submission of fraudulent claims for repairs purportedly performed. However, the damage to an auto was often intentionally enhanced by Biagini and his employees, at his behest, in order to inflate the amount of the claim. In many cases, he falsely claimed that his shop performed repairs or supplied new parts when that was not the case. The Frauds Bureau, the New York State Organized Crime Task Force, the New York State Police, the Oneida County Sheriff’s Department and the FBI participated in this investigation.
- Drake J. Vandyne, a self-employed painter from Rochester, pled guilty on 5/13/02 to criminal possession of a forged instrument in the 3rd degree for submitting a forged insurance policy declarations page to a contractor. The declarations page indicated that he had workers’ compensation and general liability insurance when in fact no coverage existed. However, the coverage was necessary in order for Vandyne to be paid $1,600 for a painting job he had performed. He was sentenced to one-year conditional discharge and ordered to pay a court surcharge of $125. The Frauds Bureau and the Brighton Police Department brought this case to a successful conclusion.
- A Pittsford dentist, Dr. Richard Levin, pled guilty on 5/9/02 to health care fraud for defrauding Excellus Health Plan of more than $100,000 in claims for services that either were not covered or were not performed. Levin must pay Excellus more than $132,500 in restitution. He also agreed to surrender his dentistry license for a two-year period and to place ads in trade publications informing readers of the consequences of health care fraud. An anonymous tip to the insurer from a patient, whose explanation of benefits included a root canal that she did not receive, provoked the investigation that led to his arrest. The Frauds Bureau, the U.S. Attorney's Office, the FBI and the Department of Health combined efforts in this case.
- WORLD TRADE CENTER FRAUD
Since the tragic events of September 11, the Frauds Bureau has been fast-tracking World Trade Center claims to ensure that they receive prompt attention. A number of arrests have been made in WTC-related cases. The Bureau is investigating additional complaints involving possible fraud in connection with the attack on the World Trade Center and more arrests are anticipated.
- DAUGHTER TO THE RESCUE
Arrested on 5/30/02
Charged with grand larceny and criminal possession of a forged instrument
A former insurance agent from Harrison, NY, was arrested on charges that between 7/2/97 and 8/29/97 he stole more than $91,000 from Federal Home Life Insurance Company by forging the signature of an elderly client on an annuity refund check and keeping the proceeds. The theft was discovered by the victim’s daughter when she reviewed her family’s financial records. The arrest was the result of a joint investigation by the Frauds Bureau and the Westchester County District Attorney’s Office.
- WELL ABLE
Arrested on 5/30/02
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
The defendant in this case filed a disability claim on 8/11/00 with The Hartford Insurance Company supported by documents allegedly from his doctor stating that he was disabled due to cancer. An investigation by the Frauds Bureau and the New York State Police revealed that the doctor’s signature was forged and the defendant does not have cancer. Before his arrest, he collected nearly $3,300 in benefits to which he was not entitled.
- PRIVATE INVESTIGATOR, PUBLIC
INVESTIGATION
Arrested on 5/29/02
Charged with forgery in the 2nd degree, offering a false instrument for filing in the 1st degree and fraudulent insurance practice under the Workers’ Compensation Law
The owner of a private investigation company was charged with falsely reporting to the Workers’ Compensation Board that his workforce consisted of fewer workers than he actually employed in order to reduce his premium payments. His arrest was the result of an investigation by the Frauds Bureau and the Workers’ Compensation Fraud Inspector General’s Office.
- WHO CARES?
Arrested on 5/29/02
Charged with grand larceny in the 3rd degree, insurance fraud in the 3rd degree, forgery in the 2nd degree and falsifying business records in the 1st degree
An investigation by the Frauds Bureau and the New York State Police led to the arrest of an upstate resident on various fraud-related charges. It was alleged that between 1997 and 2001 the defendant submitted numerous fraudulent insurance claims to UniCare Insurance Company stating that she and other members of her family received daily home health care. However, an investigation revealed that no such care was provided. As a result of the scam, she received $30,000 in fraudulent claim benefits.
- STAGED ACCIDENT
Arrested on 5/24/02
Charged with insurance fraud, mail fraud and conspiracy
The defendant in this case was charged with participating in a staged accident. The Frauds Bureau and the FBI combined efforts in the investigation that led to his arrest.
- OPERATION FRAUD FOOLS
Arrested on 5/23/02
Charged with grand larceny in the 3rd degree, insurance fraud in the 3rd degree, falsely reporting an incident in the 3rd degree and conspiracy
As a result of an investigation know as "Operation Fraud Fools," the latest in a series of undercover operations begun in 1991 to target auto insurance fraud, 12 car owners, including a doctor, a physician’s assistant and a licensed stockbroker, were arrested in a $500,000 auto insurance fraud scheme. This investigation began in July 2000 when the NYPD started to purchase autos from an unapprehended third party who was buying autos "given up" by their owners and disposing of them. According to the charges, the car owners falsely reported their autos stolen and based on allegedly fraudulent claims, the owners received settlements ranging from $15,000 to more than $33,000. However, the vehicles were already in police custody as part of Operation Fraud Fools. Among the insurers that were defrauded in this case are USAA Property & Casualty, MetLife and Nationwide. The investigation was conducted jointly by the Frauds Bureau, the NYPD Auto Crime Division and the Queens District Attorney’s Office.
- OH, BARTENDER
Arrested on 5/22/02
Charged with insurance fraud in the 4th degree, workers’ compensation fraud and falsifying business records in the 1st degree
The charges in this case alleged that this defendant, beginning in 11/95, was collecting workers’ compensation benefits. Sometime thereafter, according to the charges, she returned to work as a bartender/waitress at several upstate establishments. However, on a number of occasions, she submitted written statements to the State Insurance Fund indicating that she was not working. An investigation by the Frauds Bureau, the Albany County Sheriff’s Department and the State Insurance Fund produced video evidence that she was indeed employed during the period in question.
- ARSON
Arrested on 5/21/02
Charged with arson in the 3rd degree
Following an arson fire at his home in January 2001, a Niagara Falls laborer filed a claim with Travelers Insurance Company for $108, 447 in damages. However, during the course of an investigation by the Frauds Bureau and the North Tonawanda Police Department, witnesses were located that placed the defendant at the scene. Faced with this evidence, the defendant confessed to setting the fire.
- PROCESSED
Arrested on 5/20/02
Charged with insurance fraud in the 2nd degree, grand larceny in the 2nd degree and falsifying business records in the 1st degree
A claims processor for Blue Cross Blue Shield of Central New York was accused of submitting 138 fraudulent claims from 11/00 through 3/02 using the names of various family members. As a result of these fraudulent claims, she received payments from Blue Cross Blue Shield of more than $103,000. The Frauds Bureau and the Onondaga County District Attorney’s Office joined forces in this investigation.
- WORKING
Arrested on 5/18/02
Charged with fraudulent practices
The manager of a mobile home park, while receiving workers’ compensation benefits for a 1991 work-related injury, reported to her insurer in written statements and in sworn testimony that she was not employed. Evidence uncovered during an investigation conducted by the Frauds Bureau and the Workers’ Compensation Fraud Inspector General’s Office revealed that she had been working as manager of three mobile home parks since January 2000.
- TOO MUCH THERAPY?
Arrested on 5/13/02
Charged with health care fraud
An investigation by the Frauds Bureau, the FBI and the U.S. Attorney’s Office led to the arrest of a licensed psychiatrist for allegedly overbilling Fortis Insurance Company in the amount of $60,000. The defendant claimed treatments occurred six times a week when treatments actually occurred only two or three times a week. He was also accused of billing for treatments that were never provided because the patient had completed therapy.
- IMPOUNDED
Arrested on 5/12/02
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
A nurse’s assistant from Buffalo was arrested on charges that she defrauded State Farm Insurance Company of $13,000 in benefits and expenses associated with a car she reported stolen on 6/14/01. An investigation by the Frauds, the Buffalo Police Department, the Town of Cheektowaga Police Department and the State Police, with the assistance of the U.S. Attorney’s Office, revealed that the car had been seized by the police on 6/1/01 and impounded as evidence in a narcotics investigation involving the defendant’s husband.
- FABRICATION
Arrested on 5/10/02
Charged with insurance fraud in the 3rd degree, falsifying business records in the 1st degree and conspiracy in the 6th degree
Following an investigation conducted by the Frauds Bureau and the NYPD Fraudulent Accident Investigation Squad, the defendant in this case was arrested for allegedly fabricating a police accident report in order to receive medical benefits under the no-fault portion of her auto insurance.
- NO TREATMENT NECESSARY
Arrested on 5/10/02
Charged with insurance fraud in the 3rd degree, conspiracy in the 5th degree, attempted grand larceny, falsifying business records in the 1st degree and falsely reporting an incident in the 3rd degree
This defendant was accused of submitting a fraudulent police accident report to Nationwide Insurance Company and subsequently receiving more than $1,000 in benefits for unnecessary medical treatment. Her arrest was the result of an investigation by the Frauds Bureau and the NYPD Fraudulent Accident Investigation Squad.
- IS IT LEGIT?
Arrested on 5/10/02
Charged with conspiracy in the 6th degree, falsifying business records in the 2nd degree and insurance fraud in the 3rd degree
The Frauds Bureau and the NYPD Fraudulent Accident Investigation Squad pooled resources in an investigation that led to the arrest of an unemployed Brooklyn man on charges that he altered a legitimate police accident report in order to receive medical benefits for nonexistent injuries.
- I DO, I DO
Arrested on 5/6/02
Charged with grand larceny in the 2nd degree
Following the work-related death of her husband in 1980, a Long Island woman became the beneficiary of his worker’s compensation benefits, provided she did not remarry. On numerous occasions during the benefit period, she submitted written statements to the State Insurance Fund that she had not remarried. However, an investigation by the Frauds Bureau and the Suffolk County District Attorney’s Office turned up evidence that she had remarried in 1990 and subsequently received nearly $110,500 to which she was not entitled.
- MOUNTIES GET THEIR MAN
Arrested on 5/3/02
Charged with insurance fraud in the 3rd degree, making a punishable false statement, falsely reporting an incident in the 2nd degree and attempted grand larceny
A Bronx man was accused of falsely reporting to the NYPD and Allstate Insurance Company that his 2002 Mitsubishi had been stolen on 2/19/02. However, an investigation conducted by the Frauds Bureau and the NYPD uncovered evidence that on 2/19/02, the car had been seized in Canada by the Royal Canadian Mounted Police.
- NOT PRACTICAL
Arrested on 5/3/02
Charged with workers’ compensation fraud
While this defendant was collecting workers’ compensation benefits, an investigation by the Frauds Bureau and the State Insurance Fund revealed that she was employed as a licensed practical nurse at a facility in Binghamton. She had supported her claim for lost wages with a sworn statement that falsely stated she was not working.
- IT’S SOMEBODY’S
FAULT
Arrested on 5/2/02
Charged with insurance fraud, falsifying business records and offering a false instrument for filing
The charges in this case alleged that the defendant, acting in concert with three others not arrested at this time, presented a false police accident report to GEICO Insurance Company in order to receive medical benefits under the no-fault portion of his auto insurance policy. His arrest followed an investigation by the Frauds Bureau and the NYPD Fraudulent Accident Investigation Squad.
- CLOSED
Arrested on 5/2/02
Charged with insurance fraud in the 3rd degree, grand larceny in the 3rd degree and falsifying business records in the 1st degree
A Clifton Park man was arrested for allegedly filing a no-fault claim that stated he was employed up until the date of his auto accident and that as a result of the accident he could no longer work. Evidence uncovered in an investigation by the Frauds Bureau and the Albany County Sheriff’s Department revealed that the business at which he had been employed closed prior to the date of his accident.
- OUT OF BUSINESS
Arrested on 5/2/02
Charged with insurance fraud in the 3rd degree and grand larceny in the 4th degree
The charges in this case alleged that a Rochester resident filed a claim with State Farm Insurance Company for the theft of a one-carat diamond ring valued at $5,000. To support his claim, the defendant submitted a receipt dated 6/3/99 for the purchase of the ring and was paid his policy limit of $2,500. An investigation by the Frauds Bureau and the New York State Police revealed that the jewelry store where he allegedly bought the ring had gone out of business in 1995.
PRIOR SUPPLEMENTS
APRIL 2002
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GUILTY
Charles H. Eggelton Jr. of Wallkill, NY pled guilty on 4/29/02 to attempted workers’ compensation fraud and was sentenced to $3,360 in restitution and a fine of $800. Eggleton was accused of collecting workers’ compensation benefits while he was employed. His arrest was the result of an investigation conducted jointly by the Frauds Bureau and the State Insurance Fund.
- THE PRICE OF ALTERATIONS
Arrested on 4/30/02
Charged with falsifying business records in the 2nd degree, insurance fraud in the 5th degree and conspiracy in the 5th degree
The defendant in this case was charged with altering a police accident report in order to fraudulently collect benefits under her no-fault insurance coverage. The Frauds Bureau worked with the NYPD Fraudulent Accident Investigation Squad on this investigation.
- WINE, ANYONE?
Arrested on 4/30/02
Charged with workers’ compensation fraud
An investigation by the Frauds Bureau resulted in the arrest of an upstate woman for workers’ compensation fraud. Since sustaining an on-the-job injury in October 1986, the defendant submitted numerous Work Activity Reports to the State Insurance Fund – the most recent on 1/11/02 – stating that since her injury she was not able to return to work. Further investigation revealed that the defendant was actively employed at a local Wine & Liquor Store.
- A FRAUD GROWS IN BROOKLYN
Arrested on 4/23/02
Charged with insurance fraud, falsifying business records and possession of a fraudulent instrument
Two Brooklyn men were charged with altering a police accident report by adding their names to a legitimate report in order to receive medical benefits for nonexistent injuries under no-fault auto insurance coverage.
