Arrests for January 2003
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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- SENTENCED
On January 17, 2003, U.S. District Judge Michael A. Telesca sentenced Dr. Richard A. Levin, a Pittsford dentist, to five years’ probation, a $3,000 fine and restitution of $138,515. As special conditions of the probation, Judge Telesca ordered Levin to serve the first six months in home confinement, to perform 200 hours of community service, and to place and pay for an advertisement in two professional publications, recommended and approved by the U.S. Attorney’s Office, that acknowledges his guilt and details the consequences of health care fraud. The sentencing follows Levin’s guilty plea on May 9, 2002. According to the information, from August 21, 1996 through October 28, 1999, Levin submitted reimbursement claims to BlueCross BlueShield of the Rochester Area (BCBSRA) that fraudulently sought payment for dental procedures he did not perform. He also falsely described services that were excluded from coverage in order to have them appear compensable. Levin’s scheme defrauded BCBSRA of $102,000. He will make restitution to Excellus Health Plan, Inc., BCBSRA’s parent organization. The restitution includes the amount of the loss stemming from this charge and from fraudulent activity that occurred prior to the time period included in this charge. Levin is voluntarily surrendering both his license to practice dentistry in any jurisdiction in which he is currently licensed and his Drug Enforcement Administration controlled-substance registration for a period of not less than two years. The investigation was conducted jointly by the Frauds Bureau, the FBI, BlueCross BlueShield of the Rochester Area’s Special Investigations Unit and the New York State Department of Health.
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GUILTY PLEA
Pamela L. Goodfriend, a Licensed Practical Nurse from Rochester, pled guilty on January 29, 2003 to criminal possession of a forged instrument. Goodfriend was arrested in December 2002 on charges that she submitted a letter to the DMV stating that she had auto insurance coverage with State Farm Insurance Company dating from 1/26/01. However, an investigation by the Frauds Bureau and the Rochester Police Department uncovered evidence that she forged the letter using the letterhead stationery of a legitimate insurance agent and in fact no coverage existed.
- 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. The Insurance Department has actively coordinated with other law enforcement agencies to make certain that a strong line of communication exists among all agencies involved in this issue. That link has proven to be invaluable because in some instances, there is a crossover between charity fraud and insurance fraud.
The Bureau has tracked more than 65 suspected fraudulent September 11-related claims thus far and a number of arrests have been made.
Eliot Sashe was convicted of forgery in the 2nd degree and sentenced on 1/17/03 to a jail term of one to three years. Sashe was arrested in March 2002 for fraudulently reporting that his estranged wife died in the World Trade Center attack. He made a false application for an expedited death certificate which he subsequently used to file a $250,000 death benefit claim with Midland Insurance Company. An investigation by the Frauds Bureau, the Manhattan DA’s Office, the Attorney General’s Office, the NYPD, the New York City Corporation Counsel, and the Social Security Administration Inspector General’s Office revealed that his wife is alive and was not in New York City on September 11.
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CRAFTY COUPLE
Arrested on 1/31/03
Charged with insurance fraud in the 3rd degree
An investigation by the Frauds Bureau led to the arrest of an upstate college student accused of knowingly making a fraudulent theft and damage claim to Metropolitan Property & Casualty Insurance Company for $7,500. Evidence revealed that the student’s boyfriend had allegedly wrecked her car, abandoned it, and persuaded her to report it stolen. She was arrested on a warrant issued by the New York State Police who have also issued an arrest warrant for the boyfriend.
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INFLATED CLAIM
Arrested on 1/31/03
Charged with insurance fraud in the 3rd degree
A Long Island body shop manager was accused of bribing an adjuster to inflate a damage appraisal on a Suffolk County police vehicle. The suspect also allegedly submitted fraudulent receipts for replacement parts in support of his claim. He subsequently received a settlement of $3,590 from Suffolk County, a self-insurer. His arrest was the result of an investigation by the Frauds Bureau and the Suffolk County Insurance Crime Unit.
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BACKDATED
Arrested on 1/29/03
Charged with insurance fraud in the 4th and 5th degrees, falsifying business records and criminal possession of a forged instrument
In a continuing investigation being conducted jointly by the Frauds Bureau and the Special Investigations Unit of Combined Life Insurance Company of New York, a couple from Watkins Glen, NY, were charged with insurance fraud in the 5th degree. The defendants allegedly conspired with a licensed agent for Combined Life to file a claim for benefits on a fraudulently issued sickness income policy. Acting in concert with the agent, the couple backdated an application for the policy in an effort to cover a loss that occurred before the application was submitted. The agent has also been arrested on charges of insurance fraud in the 4th degree, falsifying business records and criminal possession of a forged instrument. All three suspects were issued appearance tickets to reappear in court in February 2003.
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NO PROTECTION
Arrested on 1/28/03
Charged with falsifying business records and workers’ compensation fraud
Five Rockland County landscapers were accused of operating businesses without securing workers’ compensation and other insurance coverage for their employees. The Frauds Bureau and the Workers’ Compensation Board conducted a sting operation that included video surveillance showing the landscapers hiring and using about 20 immigrant day laborers. The landscapers fraudulently affirmed in forms submitted to the Workers’ Compensation Board that they had no employees in an effort to bypass New York State Law requiring all business owners to provide insurance to protect workers injured on the job. The Workers’ Compensation Inspector General’s Office, the Rockland County DA’s Office and the Clarkstown Police Department also provided assistance in the investigation.
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ROUTINE
Arrested on 1/27/03
Charged with insurance fraud in the 3rd degree
In an ongoing investigation being conducted by the Frauds Bureau and the Suffolk County DA’s Insurance Crime Unit, an insurance adjuster was charged with accepting bribes from an auto body shop for inflated damage estimates. Investigators obtained information that adjusters were routinely paid off by this body shop for inflating estimates. In one case, New York Central Mutual Insurance Company paid out more than $23,000 on four claims involving inflated estimates. More arrests are expected.
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YOU CAN RUN
Arrested on 1/24/03
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
An investigation conducted jointly by the Frauds Bureau, the Albany County Sheriff’s Department and State Farm Insurance Company led to the arrest of a former New Yorker currently living in North Carolina. Investigators uncovered evidence that the defendant, while a resident of New York, filed a fraudulent auto theft claim with State Farm in the amount of $25,328 for the car and $4,100 in lost personal property. He turned himself in to the Albany County Sheriff’s Office where he was arraigned.
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REPAIRED?
Arrested on 1/24/03
Charged with insurance fraud
An investigation by the Frauds Bureau and the Suffolk County DA’s Office led to the arrest of an auto body shop manager from West Babylon, NY. The investigation revealed that a customer brought a car to the body shop with $1,000-$2,000 in damages. However, when the insurer, Safeco Insurance Company, inspected the car it had more than $6,000 in damages. Safeco issued a check for $5,900 to the body shop for the repairs. However, when the car was released, it was not repaired correctly and had to be sent to a second body shop for an additional $6,000 worth of repairs. The original body shop had certified that the repairs were done in accordance with Safeco’s appraisal but in fact they were not, leading to a charge of insurance fraud.
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MR. PRESIDENT
Arrested on 1/23/03
Charged with grand larceny in the 2nd degree, insurance fraud in the 2nd and 5th degrees, illegal possession of a vehicle identification number and offering a false instrument for filing in the 2nd degree
The president of a fuel oil company in Brooklyn reported on 4/7/02 that a 1995 fuel oil tanker was stolen from his yard. He stated that the tanker was loaded with 5,500 gallons of home heating oil valued at $6,875. He notified the NYPD and filed a claim with Westport Insurance Company in the amount of $53,948 for the loss. An investigation by the Frauds Bureau and the NYPD revealed that the tanker was still in the defendant’s possession. The vehicle identification number had been removed and replaced with the VIN from a 1978 model tanker which was also the property of the fuel oil company.
- THIS WON’T WORK
Arrested on 1/21/03
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
An upstate woman was injured in an auto accident on July 2002. She filed a claim with New York Central Mutual Insurance Company for $6,000 in lost wages under the no-fault portion of her insurance coverage. She claimed to have been employed as a district manager earning $750 a week at a glass company in Virginia at the time of the accident. In support of her claim, the suspect submitted a wage verification form purportedly from the glass company. An investigation by the Frauds Bureau and New York Central Mutual revealed that while she had been employed at one time as a sales associate at the glass company earning $6.25 an hour, she did not work there at the time of the accident. Moreover, no one from the glass company had ever seen the wage verification form.
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NO ACCIDENT
Arrested on 1/21/03
Charged with insurance fraud in the 5th degree
The defendant in this case submitted an accident report for an accident that never occurred in an effort to receive benefits under her no-fault insurance coverage. This arrest is the most recent of a total of 65 arrests in this ongoing investigation by the Frauds Bureau and the Brooklyn DA’s Office.
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NO-FAULT
Arrested on 1/16/03
Charged with conspiracy to commit insurance fraud and tax fraud
A fourth suspect was arrested in connection with a no-fault fraud scheme in which he conspired to commit insurance fraud by setting up a management company that managed MRI facilities. He allegedly used telemarketers to contact doctors and offer to pay them fees for referring patients involved in no-fault cases to the MRI facilities under his management company. One of the suspects previously arrested was also charged with tax fraud for failure to report his profits from the scheme to the IRS.
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NO, TEACHER
Arrested on 1/14/03
Charged with insurance fraud in the 3rd degree, attempted grand larceny, falsifying business records in the 1st degree and falsely reporting an incident in the 3rd degree
A Queens, NY, school teacher reported her car stolen on 10/17/02 and submitted a claim to Utica National Insurance Company for the loss. However, an investigation by the Frauds Bureau and the NYPD’s Auto Crime Unit revealed that the car had been recovered by the New York City Department of Sanitation on 10/3/02 totally destroyed by fire.
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NO COVERAGE
Arrested on 1/10/03
Charged with violation of the Workers’ Compensation Law
An investigation by the Frauds Bureau and the Suffolk County DA’s Office resulted in the arrest of the defendant in this case. He was accused of submitting two Certificates of Insurance to the State Insurance Fund that he knew contained false information.
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DO YOU DRIVE?
Arrested on 1/8/03
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
A South Colonie bus driver was arrested and accused of filing statements with Travelers Property & Casualty Insurance Company that contained materially false information in support of a no-fault claim. An investigation by the Frauds Bureau, the Albany County Sheriff’s Department and Travelers uncovered evidence that the defendant had taken a job as a school bus driver during the period in which he stated he was not working.
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23-COUNT INDICTMENT
Arrested on 1/7/23
Charged with insurance fraud, grand larceny, scheme to defraud, falsifying business records and petit larceny
An investigation by the Frauds Bureau, the Nassau County DA’s Office, the Department of Motor Vehicles and a number of insurers led to an indictment against a Long Island body shop, its owner/operator and its manager. According to the indictment, the defendants engaged in systematically enhancing the damages to vehicles or failing to do the repair work for which they were paid. The nine incidents covered by the indictment include five claims involving vehicles insured by Progressive Insurance Company, in which the damages claimed by the defendants were inconsistent with the accidents those vehicles were involved in. In several instances, parts on the autos appeared to have been cut with a sharp object, while others seemed to have been damaged by repeated blows rather than the impact of an accident. Progressive estimates that the claims from these five incidents were inflated by more than $10,000. The other incidents included two claims on vehicles insured by USAA Insurance Company totaling more than $11,000 for repairs that were never done; a charge of over $3,000 to CGU Insurance Company to replace a custom-made bar on a Lincoln Town Car although the bar had not been damaged in the accident; and a charge of $2,000 to Liberty Mutual Insurance Company for repairs on a Jeep Cherokee that were not done.
- WORKERS’ COMP FRAUD
Arrested on 1/7/03
Charged with grand larceny in the 3rd degree, insurance fraud in the 3rd degree, falsifying business records in the 1st degree and violation of the Workers’ Compensation Law
The suspect in this case was allegedly collecting workers’ compensation benefits for several years during which she was employed. An investigation by the Frauds Bureau, the Workers’ Compensation Inspector General and the Spring Valley Police Department led to her arrest.
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DEAL THE CARS
Arrested on 1/6/03
Charged with falsifying business records in the 1st degree and insurance fraud in the 5th degree
A used-car dealer was accused of filing a fraudulent claim with Erie Insurance Group stating that a 1995 Ford Explorer had been stolen from his lot. He also stated that just prior to the theft, he had $600 worth of repair work done on the car. However, when our investigators questioned the repair shop owner about the repairs that the defendant claimed were done there, he knew nothing about it. An investigation by the Frauds Bureau and the Syracuse Police Department led to his arrest.
