Arrests for April 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 4/7/03, Dale A. Clegg, a self-employed painter, pled guilty in Chili Town Court to criminal possession of a forged instrument and was sentenced to a one-year conditional discharge and ordered to pay a court surcharge of $125. Clegg was arrested in October 2002 for submitting to a general contractor two forged Certificates of Insurance as proof of workers’ compensation and general liability insurance when no such coverage existed.
- GUILTY
Tammy Turpin of Amherst, NY, pled guilty on 4/17/03 to attempted grand larceny and possession of a forged instrument. Turpin was injured in an auto accident in July 2002 and 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 at Brewster Glass Company of Virginia Beach, VA, earning $750 a week at the time of her accident. In support of her claim, Turpin submitted a wage verification form purportedly from Brewster Glass. However, 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 Brewster earning $6.25 an hour, she did not work there at the time of the accident. Moreover, no one at Brewster was familiar with the "wage verification form."
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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. Because there is a crossover between insurance fraud and charity fraud in some instances, that link has proven invaluable in that it fosters the exchange of information that can be critical to an investigation. The Bureau has tracked more than 65 suspected fraudulent WTC-related claims thus far and a number of arrests have been made.
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THAT’S A LOT OF DAMAGE
Arrested on 4/30/03
Charged with insurance fraud in the 3rd degreeAs a result of a joint investigation by the Frauds Bureau and the Suffolk County District Attorney’s Insurance Crime Unit, a body shop owner was accused of submitting a fraudulent estimate for the repair of a Mack dump truck owned by a road construction company. The truck was in a collision with another truck that sustained $600 in damages. The shop owner’s repair estimate for the Mack truck totaled more than $27,000. A reconstruction engineer for heavy equipment hired by Utica Mutual Insurance Company determined that most of the damage to the Mack truck was unrelated to the accident.
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MAKING A PROFIT
Arrested on 4/29/03
Charged with insurance fraud in 3rd degree and attempted grand larceny in the 3rd degree
A Brooklyn man purchased auto insurance coverage with five different insurers (Amica Mutual, Travelers, AIG, GEICO, and Great American) for one car. In an attempt to make a profit, he filed a claim with each of these insurers following an accident that purportedly occurred on 10/29/01. His arrest was the result of an investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad.
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NO-FAULT FRAUD
Arrested on 4/23/03
Charged with grand larceny in the 3rd degree, insurance fraud in the 3rd degree and falsifying business records in the 1st degree
An investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad led to the arrest of a New York City woman accused of allowing her name to appear on a fraudulent police accident report in an effort to collect medical benefits from Nationwide Insurance Company under the no-fault portion of her auto insurance coverage.
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ADD ONs
Arrested on 4/23/03
Charged with insurance fraud
Three Queens residents were charged with adding their names to a police accident report following an accident in which none of the three was involved. An investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad led to the arrests.
- THIS AIN’T NEW JERSEY
Arrested on 4/22/03
Charged with possession of a forged instrument, insurance fraud and falsifying business records
This investigation began when State Farm Insurance Company informed the Frauds Bureau that a Bronx man had provided a State Farm insured with bogus insurance coverage. A Frauds Bureau investigator, acting undercover, visited the suspect at an insurance brokerage and requested insurance for a car. The suspect, who is not a licensed broker, informed the investigator that he could provide New Jersey auto ID cards for a fee of $700, although the investigator had a New York driver’s license and New York ownership papers. The investigator produced the money and the transaction was completed. The suspect was later arrested.
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DEEP POCKETS
Arrested on 4/17/03
Charged with scheme to defraud and insurance fraudA joint investigation by the Frauds Bureau and the Suffolk County District Attorney’s Office resulted in the arrest of a former independent insurance salesman charged with issuing temporary auto insurance identification cards and pocketing the premiums. He was also accused of accepting premium payments for homeowners coverage but failing to remit the money to the appropriate insurers. More than 20 customers were involved in the misappropriation of $8,000.
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WHAT ARE FRIENDS FOR
Arrested on 4/17/03
Charged with insurance fraud in the 4th degree, attempted grand larceny in the 4th degree and falsifying business records in the 2nd degree
On 2/10/03, the defendant in this case filed a claim with State Farm Insurance Company stating that he had left his van running in the parking lot of a local mini-mart where it was stolen. The van was later involved in a hit-and-run accident. An investigation conducted by the Frauds Bureau, the New York State Police and the DMV revealed that the defendant had illegally placed the car on his policy when his friend, the real owner, was unable to obtain insurance coverage because of a bad driving record.
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NOT VERY NEIGHBORLY
Arrested on 4/16/03
Charged with grand larceny in the 4th degree, forgery in the 2nd degree, falsifying business records in the 1st degree and insurance fraud in the 3rd degree
A building superintendent from Brooklyn was accused of selling fraudulent auto insurance identification cards to two of his neighbors and pocketing $3,400 in premiums. Both Nationwide and Allstate Insurance Companies, whose names appeared on the cards, confirmed that the cards were fraudulent. The suspect is not licensed to sell insurance. His arrest was the result of an investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad
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MORE NO-FAULT FRAUD
Arrested on 4/16/03
Charged with grand larceny in the 3rd degree, insurance fraud in the 3rd degree and falsifying business records in the 1st degree
An investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad resulted in the arrest of a New York City man on charges that he generated a fraudulent police accident report in an attempt to collect no-fault medical benefits from Progressive Insurance Company.
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CAN YOU HEAR ME NOW?
Arrested on 4/15/03
Charged with falsifying business records in the 1st degree and insurance fraud in the 5th degree
An Elmira audiologist and owner of an audiology services company was charged with performing audiogram tests after his license to practice was suspended in 2002 for conviction of grand larceny and tax evasion. He allegedly forged the initials of other licensed audiologists on the test records and then billed the patients’ Medicare coverage for the procedures. Following an investigation by the Frauds Bureau, the suspect was arrested on a warrant by the Broome County Sheriff’s Department.
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FRAUDULENT CERTIFICATES
Arrested on 4/15/03
Charged with forgery in the 2nd degree
An investigation by the Frauds Bureau and the Orange County Sheriff’s Office led to the arrest of a Newburgh, NY, man for presenting fraudulent Certificates of Insurance to his customers, claiming that workers’ compensation and liability insurance were in effect when no such coverage existed. In some instances, he submitted false information to insurers about the number of workers employed by his customers or the nature of the risk involved in the work. Conducting business as both a general contractor and a sub-contractor, the defendant not only exposed his customers to increased liability but was also responsible for some of his customers experiencing significant rate increases once the material misrepresentations were corrected.
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SUGAR, SUGAR
Arrested on 4/13/03
Charged with insurance fraud in the 4th degree
Two unemployed upstate residents – one the former owner of an auto service shop and the other a former employee – were accused of falsely informing a customer that her truck’s engine problems were caused by sugar in the gas tank. They told her that because this constituted vandalism, her insurer would pay for a new motor. On their word, the customer filed a $2,300 claim with Progressive Insurance Company. However, an investigation by the Frauds Bureau, the New York State Police and the Niagara County District Attorney’s Office uncovered evidence that it was the two defendants who actually put the sugar in the tank in an effort to collect the insurance settlement.
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NO COVERAGE
Arrested on 4/10/03
Charged with offering a false instrument for filing
An investigation by the Frauds Bureau and the Westchester County District Attorney’s Office led to the arrest of a licensed insurance broker charged with filing a false Certificate of Insurance with the County of Westchester in an effort to secure a construction project for his client. The Certificate falsely indicated that the client had the workers’ compensation and liability insurance required for the job when in fact no such coverage existed.
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PHONY BILLING
Arrested on 4/8/03
Charged with insurance fraud
A former billing clerk at an Albany optical company was accused of submitting fraudulent billing forms to Capital District Physicians Health Plan by changing dates of service and the attending doctor’s name. The forms she submitted for the month of February 2002 alone billed CDPHP for $23,665. The defendant’s arrest is part of an ongoing investigation being conducted by the Frauds Bureau with the assistance of the Albany County District Attorney’s Office. On 3/27/03, Dierdre Wolberg, the co-owner of the optical company—State Opticians—pled guilty to insurance fraud and grand larceny. Wolberg was arrested on 3/4/03 and charged with defrauding the Capital District Physicians Health Plan of $37,000 in bogus claims. Evidence was uncovered 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, the company may have 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 sentencing will be to return the $37,000 in fraudulent claims settlements she received from CDPHP.
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DOCTORED CLAIM
Arrested on 4/7/03
Charged with insurance fraud in the 3rd degree
An investigation conducted by the Frauds Bureau and the State Police led to the arrest of a paramedic who claimed that her husband hit her car while it was parked in the driveway. She filed a claim for the damage with New York Central Mutual Fire Insurance Company and received a settlement of $3,200. However, evidence showed that the damage was caused when she rear-ended another car. She subsequently returned the check to the insurance company.
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REPOSSESSED
Arrested on 4/7/03
Charged with falsifying business records in the 2nd degree
An Otsego County woman was arrested for using a forged Certificate of Insurance in order to reclaim a snowmobile that had been repossessed. This arrest was an offshoot of an investigation conducted by the Frauds Bureau, the Cooperstown Village Police Department and the New York State Police that led to the arrest of a licensed insurance agent on 3/26/03 charged with stealing premiums and forging insurance documents.
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HUSBAND AND WIFE
Arrested on 4/4/03
Charged with insurance fraud, attempted grand larceny and falsely reporting an incident
The husband in this case, a licensed life insurance agent, reported to the Webster Police Department that after returning home from a get-away weekend in January 2003, he and his wife discovered that their home had been broken into and a number of personal belongings stolen. They filed a claim for $35,000 with Allstate Insurance Company for the loss. However, an investigation by the Frauds Bureau, the Webster Police Department and Allstate’s Special Investigations Unit revealed that their home had not been burglarized and the claim was fraudulent. The investigation was initiated after the Webster Police Department became suspicious of a possible staged burglary.
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NO LICENSE
Arrested on 4/1/03
Charged with forgery in the 1st degree and petit larceny
An investigation by the Frauds Bureau, the City of Beacon Police Department and the New York Auto Insurance Plan led to the arrest of the owner of an auto insurance agency for accepting insurance premiums but failing to remit the money to an insurer. The suspect would assign customers to an insurance company or the New York Auto Plan and issue fake auto identification cards printed on his own computer. These customers were unaware they were driving without insurance until problems with the bogus cards arose in routine police checks or, as in one case, when a customer switched from one insurer to another. During the investigation, it was determined that the insurance agency was not licensed to operate an insurance business and further, that the agency had no relationship with any insurance carrier. A report of suspected fraud sent to the Frauds Bureau by Progressive Insurance Company sparked the investigation.
- WORKERS’ COMP FRAUD SWEEP CONTINUED
Arrested on 4/1/03
Charged with violations of the Workers’ Compensation Law
Three more arrests were made as part of a sweep conducted during two separate days, April 18 and 26, 2003. The suspects were charged with defrauding the workers’ compensation system by claiming they were unable to work due to injuries sustained on the job when they were actually employed. The Frauds Bureau, the Queens District Attorney’s Office, the Workers’ Compensation Fraud Inspector General’s Office and New York City Transit conducted the investigation that brought about the arrests. Another arrest is pending in this case.
PRIOR SUPPLEMENTS
MARCH 2003
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GUILTY
Timothy Walters, a former New York State-licensed insurance agent for Combined Life Insurance Company, pled guilty on 3/3/03 to criminal possession of a forged instrument in the 3rd degree in full satisfaction of all charges. Walters conspired with a Watkins Glen couple arrested on 1/30/03 to backdate an application for a sickness income policy in order to cover a loss that occurred before the application was submitted. An investigation by the Frauds Bureau and Combined Life’s Special Investigations Unit resulted in the three arrests.
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FORGED SIGNATURE
Arrested on 3/28/03
Charged with grand larceny in the 4th degree, criminal possession of a forged instrument and criminal possession of stolen property
An investigation by the Frauds Bureau and the Queens District Attorney’s Office led to the arrest of a Jamaica, NY, man charged with forging the signature of the rightful beneficiary to a workers’ compensation benefit check in the amount of $2,550 and pocketing the money.
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MURDER
Arrested on 3/27/03
Charged with murder in the 2nd degree, manslaughter in the 2nd degree, criminally negligent homicide and conspiracy to commit insurance fraud
A Brooklyn man was accused of attempting to stage an accident that resulted in the death of a Queens grandmother. It was alleged that the defendant intentionally drove his car into the car being driven by the victim, causing her to lose control and crash into a tree. Also arrested was a woman accused of assisting the Brooklyn man in fleeing the scene of the accident. She also allegedly had a fraudulent driver’s license and welfare card. She was charged with forgery in the 2nd degree, criminal possession of a forged instrument in the 2nd degree, criminal possession of forged devices and hindering a prosecution in the 2nd degree. The Frauds Bureau, the Queens District Attorney’s Office and the NYPD’s Fraudulent Accident Investigation Squad pooled resources in this investigation.
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WHILE THEY WERE SLEEPING
Arrested on 3/21/03
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
An investigation by the Frauds Bureau, the Seneca County Sheriff’s Department and Progressive Insurance Company’s SIU brought about the arrest of a couple from Romulus, NY, on suspicion that they tried to defraud Progressive of $6,350. During the early morning of 7/26/02, the Seneca County Sheriff’s Department found the couple’s car on fire in nearby Waterloo. Evidence revealed that the cause of the fire was arson. The couple reported to the Sheriff’s Department that their home was broken into while they slept and their car keys and car were stolen. However, the couple subsequently produced the only two sets of keys that existed to their car and turned them over to Progressive. The defendants allegedly made material misrepresentations about the theft and subsequent fire on the claim they filed with Progressive.
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AT THE SCENE
Arrested on 3/1/03
Charged with possession of a forged instrument in the 2nd degree
The defendant in this case produced a fraudulent insurance identification card at the scene of an auto accident on 6/7/02. His arrest was the result of the joint efforts of the Frauds Bureau and the Mt. Pleasant, NY, Police Department.
