Arrests for March 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
- Isaias R. Soto was sentenced on 3/26/03 in Monroe County Court to five years’ probation. In addition, he agreed to withdraw the $13,020 claim he filed with State Farm Insurance Company. When Soto was notified by the Rochester Fire Department that his van was found on fire on a Rochester street, he claimed the van contained electronic equipment and had been stolen from his driveway. An investigation by the Frauds Bureau and State Farm, with the assistance of the Rochester Fire Department and the DMV, resulted in his arrest in November 2002. He pled guilty on 2/26/03 to insurance fraud in the 4th degree.
- On 3/25/03, R. Hal Kemp, a former licensed insurance agent, was sentenced in Henrietta Town Court to a one-year conditional discharge and 100 hours of community service in full satisfaction of all original charges. In accordance with a stipulation signed at the time of his guilty plea in December 2002, Kemp surrendered all his New York State agent licenses. Kemp was arrested on 4/26/02 on charges that he took premiums from nine clients but failed to remit them to the appropriate insurers. He was also charged with issuing six fraudulent auto insurance identification cards and providing documents to a business owner indicating that the business had proper insurance coverage when in fact no coverage existed. An investigation by the Frauds Bureau and the Monroe County Sheriff’s Office led to his arrest.
- Following a guilty plea on 1/29/03, Pamela L. Goodfriend was sentenced in Rochester City Court on 3/12/03 to a one-year conditional discharge, restitution of $500 and $120 in court costs. 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.
- Terry Magee was sentenced on 3/11/03 in Kiantone Town Court to three years’ probation and restitution of $9,623 to the State Insurance Fund. Following an injury sustained on the job in 1999, Magee began collecting workers’ compensation benefits. Evidence uncovered in an investigation by the Frauds Bureau and the State Insurance Fund showed that he had returned to full-time employment but continued to collect benefits from January 1999 until his arrest in December 2002.
- GUILTY
- Dierdre Wolberg, the co-owner of State Opticians in Albany, pled guilty on 3/27/03 to insurance fraud and grand larceny. She was arrested on 3/4/03 and accused of defrauding the Capital District Physicians Health Plan of $37,000 in bogus claims. An investigation by the Frauds Bureau with the assistance of the Albany County DA’s Office uncovered evidence that State Opticians sent 832 claims to CDPHP with the forged signature of a doctor who had died. State Opticians backdated the claims to coincide with the period when the doctor worked for the company and had a contract with CDPHP. In addition, it is alleged that the company inflated some of its claims and submitted bills for services never rendered. Wolberg is scheduled to be sentenced on May 15. One of the conditions of her sentence will be to return the $37,000 in fraudulent claim settlements she received from CDPHP.
- Extensive teamwork was credited for building a solid case against Eric Parsons of Romulus, NY, who was found guilty of five counts of arson in the 1st degree and five counts of murder in the 2nd degree by a Seneca County jury on 3/19/03. Parsons was arrested on 11/28/02 for setting fire to his home in which his wife and four children died. The Frauds Bureau was asked to participate in a Task Force established to investigate the case. The Task Force also included the New York State Police Violent Crime Investigation Team, the Seneca County Sheriff’s Department, the Seneca County DA’s Office, the Seneca County Fire Investigation Team, and the New York State Office of Fire Prevention and Control Arson Unit. At the trial, the defense called an arson expert to try to refute New York State fire investigators about the cause of the fire in an effort to cause doubt in the minds of the jurors. Investigators from the Frauds Bureau and the State Police were asked to conduct an extensive examination of the expert’s resume and spent a week reviewing every facet of his education, training and experience. They uncovered evidence to show that virtually every statement in his resume was fabricated. They obtained certified letters from two colleges stating that the degrees in chemistry he claimed to have received were never received at those colleges. In fact, he took only a few courses at each of the colleges – including badminton and square dancing – and did not earn a degree at either. In addition, the professional organizations of which he claimed to be a member had no record of his membership. Together, the Task Force put in thousands of hours of investigative work and assisted the District Attorney in preparing for cross-examination of the expert witness. The prosecution used the evidence gathered in the investigation to destroy his credibility on the stand and he subsequently admitted that he had "embellished" his resume. Consequently, Parsons faces 25 years to life on each of the ten guilty verdicts. Sentencing is scheduled for May 6, 2003.
- In a continuing investigation, Michael Puzan of Warsaw, NY, was arrested on 3/13/03 and as part of a plea bargain pled guilty to arson in full satisfaction of all charges. Puzan admitted that in June 2000 he and his girlfriend, Victoria Walczak, set fire to their half of a duplex home while five occupants slept in the other half. No one was harmed in the fire. Walczak pled guilty in October 2002 and was sentenced to a term of two-to-six years in prison for arson. Puzan had been arrested previously for filing fraudulent claims in connection with the duplex fire. The investigation is being conducted by the Frauds Bureau, the Genesee County DA’s Office and the Genesee County Sheriff’s Office.
- 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.
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FALSE REPORT
Arrested on 3/28/03
Charged with grand larceny in the 3rd degree and insurance fraud in the 3rd degree
A Yonkers woman, and a man arrested on 3/19/03, were charged with falsely reporting that they were involved in an auto accident. They subsequently filed a claim with St. Paul Insurance Company for no-fault benefits and received a settlement check for $9,100. An investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad brought about their arrest.
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AGENT FRAUD
Arrested on 3/26/03
Charged with grand larceny and forgery
A licensed insurance agent from Cooperstown was charged with stealing nearly $5,000 in premiums and forging insurance documents. The defendant allegedly collected cash premium payments and then altered the policies to indicate that the policyholders had credits for defensive driving courses or vehicles that were for farm use. These credits lowered the premium owed to the insurers and she was accused of pocketing the difference. An audit by the insurance agency at which she was employed revealed the theft and they reported their findings to the Frauds Bureau and the Cooperstown Village Police who conducted the investigation with the New York State Police. The forgery charge relates to documents she prepared noting that traffic tickets she received were resolved. She submitted these documents to Nationwide Insurance Company in an effort to maintain her own insurance coverage.
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EVERYBODY OUT OF THE POOL
Arrested on 3/24/03
Charged with insurance fraud in the 3rd and 4th degrees
A self-employed real estate agent from Albany was charged with filing a fraudulent claim with State Farm Insurance Company under her homeowners policy. She claimed that her pool had been damaged as a result of vandalism during a burglary at her home and submitted estimates for its repair. However, an investigation by the Frauds Bureau and the New York State Police Special Investigations Unit uncovered evidence that the pool was in such a state of disrepair that it was uninsurable and, therefore, not covered under her homeowners insurance.
- PARTNERS IN CRIME
Arrested on 3/24/03
Charged with insurance fraud in the 3rd degree and falsifying business records in the 1st degree
A contractor was charged with conspiring with a homeowner (arrested on 3/17/03) to defraud Liberty Mutual Insurance Company. The two agreed on some contracting work on the homeowner’s garage and the contractor submitted two estimates for the work. The first in the amount of $5,800 was an estimate for the actual work agreed on. The second for $9,500 was submitted to Liberty Mutual with a claim stating that the garage had been damaged by a motor vehicle. An investigation by the Frauds Bureau and Liberty Mutual’s SIU led to both arrests.
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IS THERE A DOCTOR IN THE HOUSE?
Arrested on 3/24/03
Charged with criminal possession of a forged instrument in the 2nd degree, falsifying business records in the 1st degree and insurance fraud in the 4th degree
An investigation by the Frauds Bureau and the Syracuse Police Department led to the arrest of a couple charged with defrauding The Hartford Insurance Company of nearly $2,100. The man allegedly submitted a fraudulent application for disability benefits falsely stating that he had cancer and forged the signature of a local physician to support his claim. In addition, the woman, misrepresenting herself as a member of the medical staff of the physician whose name was forged on the application, submitted additional fraudulent medical reports to support the fraudulent application.
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LET’S GO TO THE VIDEOTAPE
Arrested on 3/24/03
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
An upstate laborer surrendered to the Depew Police Department on an arrest warrant obtained by the Frauds Bureau. An investigation revealed that on 8/3/02, he filed for lost wage benefits under his no-fault coverage. He reported to Progressive Insurance Company that he was unable to work as a result of injuries sustained in an auto accident. However, the insurer hired a private investigator who videotaped him working for a concrete company. He denied the charged even when shown the videotape. He was accused of attempting to defraud the insurer of $4,480 in lost wages.
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DON’T LIE
Arrested on 3/21/03
Charged with criminal possession of a forged instrument in the 2nd degree, falsifying business records in the 1st degree and insurance fraud in the 5th degree
A Syracuse woman was accused of submitting a fraudulent statement to UnumProvident Corporation in order to lengthen her disability leave following the birth of her child, thus allowing her to receive extended disability benefits. The statement included a false date of birth and the forged name of a doctor reported to have delivered her child. The Frauds Bureau and the Syracuse Police Department pooled resources in this investigation.
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WORKERS’ COMP SWEEP
Arrested on 3/18 and 3/26/03
Charged with violations of the Workers’ Compensation Law
In a sweep conducted during two separate days, six Queens residents, including a bus driver, an insurance agent and a bus maintenance worker, were arrested on charges that they defrauded the Workers’ Compensation system by claiming they had been injured and unable to work when in fact they were gainfully employed. They allegedly cheated the system of more than $68,000. The investigation was conducted by the Frauds Bureau, the Queens DA’s Office, the Workers’ Compensation Fraud Inspector General’s Office and New York City Transit. More arrests are expected.
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FAIR TRADE?
Arrested on 3/18/03
Charged with insurance fraud in the 3rd degree and falsifying business records in the 1st degree
An investigation by the Frauds Bureau and the Onondaga County Sheriff’s Department uncovered evidence that a livery car driver traded his personal car to an unknown drug dealer in exchange for illegal drugs. The car was subsequently involved in a hit-and-run accident while in the possession of the drug dealer. When the defendant learned about the accident, he reported to the Onondaga County Sheriff’s Department that his car had been stolen and then filed an allegedly fraudulent claim with Progressive Insurance Company.
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OH, DAD
Arrested on 3/17/03
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
A Schenectady man was accused of using his son’s medical benefits identification number to fraudulently obtain health care services and prescription drugs from Capital District Physicians Health Plan. The father, who bears the same name as his son, would visit doctors’ offices and emergency rooms at local hospitals where he would receive services, provide his son’s identification number and sign his name to the billing form. As a result, CDPHP was fraudulently billed for $13,000.
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SENIOR SCAM
Arrested on 3/11/03
Charged with scheme to defraud in the 1st degree and grand larceny in the 3rd and 4th degrees
An investigation by the Frauds Bureau, the New York State Police and the Erie County DA’s Office resulted in the arrest of a former insurance agent. It is alleged that between July 25 and December 7, 2000, the ex-agent took a total of $31,729 from four elderly clients, all of whom were in their 70’s. Acting as their financial advisor, the defendant was supposed to reinvest the money but instead he deposited it into his personal account.
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WHOSE FAULT?
Arrested on 3/10/03
Charged with insurance fraud, falsifying business records, conspiracy and grand larceny
A Middletown, NY, woman was charged with allowing her name to appear on a fraudulent police accident report in an effort to receive medical benefits from Utica National Insurance Company under the no-fault portion of her auto insurance coverage. The Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad combined efforts in this investigation. A number of arrests have been made in this case.
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DEAL ME OUT
Arrested on 3/7/03
Charged with insurance fraud, forgery, criminal possession of a forged instrument, falsifying business records and grand larceny
The defendant in this case was charged with issuing fraudulent auto insurance identification cards to 25 individuals and collecting about $20,000 in premiums that he never forwarded to an insurer. He worked with a car dealer to secure customers and all his transactions went through the dealership. His arrest was the result of an investigation by the Frauds Bureau and the Queens County DA’s Office.
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LOST WAGES?
Arrested on 3/6/03
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
The defendant in this case filed a claim with Progressive Insurance Company for no-fault lost wage benefits following an auto accident in June 2001. He stated that before the accident, he had been employed since November 1998 as a roofer earning about $750 a week. An investigation by the Frauds Bureau produced a document signed by his employer stating that the defendant began employment in November 1999, not 1998, that he earned $10 an hour, and that he worked 60 hours a week at most. The employer stated that he continued to employ the defendant after his accident and paid him in cash. The investigation revealed that the defendant was also operating a jewelry business from a storefront as well as on the Internet. From June 13, 2001 to May 2002, the defendant fraudulently collected $18,464 in lost wage benefits.
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A TRIO OF FUNDS
Arrested on 3/5/03
Charged with insurance fraud in the 3rd degree
Following a work-related injury in February 1995, a Utica man allegedly began collecting workers’ compensation benefits from the State Insurance Fund, the Workers’ Compensation Board and AIG Insurance Company simultaneously. During this time, the suspect maintained he was unable to return to work. However, an investigation by the Frauds Bureau, the Workers’ Compensation Board, the State Insurance Fund and AIG revealed that he was employed as a construction worker earning $472.79 a week. As a result, he collected nearly $5,300 to which he was not entitled.
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THAT’S A LOT OF LOOT
Arrested on 3/4/03
Charged with grand larceny, insurance fraud, falsifying business records, attempted grand larceny and scheme to defraud
A joint investigation by the Frauds Bureau, the Queens DA’s Office, the State Insurance Fund and the Workers’ Compensation Fraud Inspector General’s Office led to the arrest of a Queens truck driver accused of falsely claiming he was unable to work due to a 1997 job-related injury. The investigation began in August 2002 when the Workers’ Compensation Board received an anonymous complaint alleging that the suspect was ripping off the system. The investigation disclosed that the defendant was employed as a truck driver in Brooklyn earning about $40,000 a year. He submitted a claim for workers’ compensation in March 1997 in which he asserted that on January 10, 1997, he was struck by a hand truck while loading a shipment of bakery goods and sustained an abdominal injury that left him unable to work. The investigation further revealed that in November 1998, he took a job driving a truck for a company in Queens. He was charged with fraudulently collecting more than $78,000 in benefits from 1998 to February 2003. Investigators learned that the defendant evaded detection by allegedly using two different Social Security numbers and two separate addresses in documents submitted to the State Insurance Fund.
PRIOR SUPPLEMENTS
FEBRUARY 2003
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FRAUDULENT ACCIDENT REPORT
Arrested on 2/11/03
Charged with insurance fraud in the 3rd degree, falsifying business records in the 1st degree, conspiracy in the 1st degree and grand larceny in the 3rd degree
An investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad led to the arrest of a Queens man accused of allowing his name to appear on a fraudulent police accident report for the purpose of receiving medical benefits from GEICO Insurance Company under the no-fault portion of his auto insurance coverage.
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FALSE PRETENSES
Arrested on 2/10/03
Charged with insurance fraud in the 3rd degree, falsifying business records in the 1st degree, conspiracy in the 5th degree and grand larceny in the 3rd degree
The defendant in this case allegedly allowed her name to appear on a fraudulent police accident report in order to receive medical benefits from GEICO Insurance Company under her no-fault coverage. Her arrest was the result of the efforts of the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad.
JANUARY 2003
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A COUPLE OF CHEATERS
Arrested on 1/22/03
Charged with insurance fraud in the 3rd and 5th degrees, grand larceny in the 3rd degree, conspiracy in the 5th degree and falsifying business records in the 1st and 2nd degrees
Two Manhattan women were arrested on charges that they attempted to fraudulently collect medical benefits under the no-fault portion of their auto insurance coverage. One of the women, along with several others, was charged with generating a false NYPD police accident report. The second woman, with several others, allegedly allowed her name to appear on a fraudulent accident report. Their arrests were the result of an investigation by the Frauds Bureau and the NYPD.
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NO-FAULT (AGAIN)
Arrested on 1/7/03
Charged with insurance fraud in the 3rd degree, falsifying business records in the 1st degree and grand larceny in the 4th degree
An investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad led to the arrest of a Brooklyn man on charges that he allowed his name to appear on a fraudulent police accident report for the purpose of collecting medical benefits from Travelers Insurance Company under his no-fault coverage.
DECEMBER 2002
- AND AGAIN
Arrested on 12/3/02
Charged with insurance fraud in the 3rd degree, grand larceny in the 4th degree and conspiracy in the 5th degree
This suspect was accused of allowing his name to appear on a fraudulent police accident report in an effort to receive medical benefits from Utica National Insurance Company under the no-fault portion of his auto insurance coverage. His arrest was the result of an investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad.
NOVEMBER 2002
- AND YET AGAIN
Arrested on 11/1/02
Charged with insurance fraud in the 3rd degree, grand larceny in the 4th degree and conspiracy in the 5th degree
The Frauds Bureau joined forces with the NYPD’s Fraudulent Accident Investigation Squad to bring about the arrest of a Brooklyn man accused of allowing his name to appear on a fraudulent police accident report in an attempt to receive no-fault medical benefits from North American Risk Services.
