Arrests for May 2004
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 5/17/04, Fabian Illera, a former insurance broker, was convicted of petit larceny and sentenced to three years probation and restitution of $1,714. Illera was arrested on 3/7/03 and charged with issuing fraudulent auto insurance identification cards to 25 individuals. 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.
- COMPUTER VIRUS
Arrested on 5/25/04
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
An upstate dental hygienist reported that a power surge at her home on 6/22/03 damaged some electrical equipment, including a K7-900 computer, beyond repair. She filed a claim with New York Central Mutual Fire Insurance Company for the replacement value of the computer, $1,608. However, an investigation by the Frauds Bureau and the Onondaga County Sheriff's Department turned up evidence that the computer was in the shop for repair of a virus from 6/9/03 to 7/25/03. The defendant allegedly altered the receipts to indicate that she had brought the computer in for repair on 6/29, rather than 6/9; and changed the invoice to allege that the cause of the damage was a power surge.
- WHO'S WHO?
Arrested on 5/21/04
Charged with insurance fraud in the 4th degree
An investigation conducted jointly by the Frauds Bureau, the Webster Police Department and Excellus Health Plan's SIU resulted in the arrest of two sisters from Rochester, NY. One of the women, a medical secretary, suffered an accident at home that required emergency dental treatment. However, she did not have dental coverage so she and her sister, a receptionist who did have coverage, agreed that the emergency treatment would be sought using the second sister's name and dental insurance identification. She was treated at the Rochester General Hospital Dental Unit and released. She then received follow-up treatments at a dental office from January through March 2003, again using her sister's name and insurance ID. Excellus paid out more than $2,100 for the treatments. The covered sister reported to the dental office and to the Webster Police Department that someone had stolen her identity and obtained the treatments without her knowledge. When confronted with the evidence turned up in the investigation, both sisters confessed to the fraud.
- [UN]STOLEN AUTO
Arrested on 5/20/04
Charged with insurance fraud in the 3rd degree and falsely reporting an incident in the 3rd degree
On 1/5/04, an upstate laborer reported to the Schenectady Police Department and Progressive Insurance Company that his 1995 Chevrolet Tahoe had been stolen from in front of his residence the previous day. The car was recovered but the defendant filed a claim in the amount of $7,088 for replacement of the auto's wheels and stereo equipment. The claim also included damage that he stated had occurred during the theft. During the course of the investigation, the defendant was interviewed and admitted that the vehicle and the attendant equipment had never been stolen. The Frauds Bureau, the Schenectady PD and Progressive's SIU pooled resources in this investigation.
- FRAUDULENT CERTIFICATES
Arrested on 5/17/04
Charged with forgery in the 2nd degree, possession of a forged instrument in the 2nd degree and offering a false instrument for filing in the 1st degree
The defendant in this case was accused of submitting forged Certificates of Insurance to the City of North Tonawanda indicating he had the required liability coverage to obtain building permits. However, an investigation by the Frauds Bureau and the North Tonawanda PD uncovered evidence that the Certificates were fraudulent and he did not in fact have the coverage reflected on the Certificates.
- FINANCIAL WOES
Arrested on 5/17/04
Charged with grand larceny in the 3rd degree
On August 13, 2002, a former insurance agent/broker accepted payment totaling $49,283 from the Fairmount Fire Department for two insurance policies with the Fire Districts of New York Mutual Insurance Company. He made initial payments of $24,642 but failed to remit the remaining $24,641 to secure the coverage. He subsequently admitted to Fairmount that he was in a financial bind and could not make the payments. His arrest was the result of an investigation by the Frauds Bureau and the Syracuse Police Department.
- ARRESTS AT THE TOP
Arrested on 5/16 and 5/14/04
Charged with insurance fraud, grand larceny, offering a false instrument for filing and violations of the Workers' Compensation Law
The president and vice president of a construction firm in Poughkeepsie filed applications with the State Insurance Fund stating that their company was a drywall contractor, engaged exclusively in wallboard and taping work. However, following an audit by the State Insurance Fund, an investigation by the Frauds Bureau and the New York State Police turned up evidence that the company was an asbestos removal contractor. Premiums for asbestos removal are significantly higher than those for drywall contractors because of the potential health risks involved. By claiming they worked only with wallboard, they defrauded the Fund of more than $24,000 in premiums in an eight-month period. The vice president was arrested on 5/16 and the president on 5/14.
- WORKERS' COMP FRAUD
Arrested on 5/13/04
Charged with insurance fraud in the 3rd degree, grand larceny in the 3rd degree and workers' compensation fraud
The defendant in this case began collecting workers' compensation benefits after incurring injuries to her neck and left arm in May 1994 working as a residential counselor. However, the charges against her alleged that in December 2002, she began working in her profession at a different facility in Utica. Moreover, she continued to collect benefits totaling $10,338 and an additional $13,050 in physical rehabilitation reimbursements when in fact these treatments were never provided. The investigation that resulted in her arrest was led by the Frauds Bureau working with the State Insurance Fund. The Otsego County Sheriff's Department processed the arrest; criminal prosecution is being conducted by the Otsego County DA's Office.
- ADJUSTERS CAUGHT
Arrested on 5/11/04
Charged with insurance fraud in the 3rd and 4th degrees, criminal bribe receiving in the 2nd degree and falsifying business records in the 1st degree
Three insurance claims adjusters were accused of receiving illicit payments - ranging from $50 to $200-from repair shop owners in Queens, NY, in exchange for submitting enhanced repair estimates that totaled $23,957. These criminal activities took place between December 2002 and March 2003. The carriers affected were Tri-State Consumer, Eveready and Empire Insurance Companies. The Frauds Bureau, the Queens DA's Office and the NYPD combined forces in this investigation.
- HER HIGHNESS
Arrested on 5/7/04
Charged with insurance fraud, attempted grand larceny and criminal possession of a forged instrument
An investigation by the Frauds Bureau and the Manhattan DA's Office resulted in the arrest of a Manhattan woman-who claimed to be a Saudi princess-for attempting to collect the proceeds of an insurance scam. The investigation revealed that on 10/16/03, the defendant obtained insurance from Chubb Insurance Company for jewelry valued at $492,000 that she claimed was inherited from her mother. The insured items included diamond bracelets, rings, and stud earrings from Bulgari, Cellini, Van Cleef & Arpels, and Erica Courtney. She submitted various bills of sale and appraisal forms to Chubb to prove the worth of the jewelry. The defendant initially received "in vault" coverage, which provided coverage only when the items were kept in her safe deposit box. However, on October 27, 2003, the defendant obtained "out of vault" coverage, which provided her with coverage when she removed the jewelry from the vault for restricted periods of time. On that same day, she removed 23 pieces of jewelry from the vault, left the bank and claimed she was mugged by an unknown assailant. She reported the incident to the NYPD and filed a claim with Chubb stating that $262,000 worth of jewelry had been stolen. The subsequent investigation revealed that one of the appraisal forms was forged and that one month prior to obtaining the insurance policy, she actually sold 12 of the 23 items she claimed had been stolen. After Chubb received the claim, they made follow-up inquiries and notified the Frauds Bureau of their findings. The investigation was subsequently referred to the Manhattan DA's Office for prosecution.
PRIOR SUPPLEMENTS
APRIL 2004
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GAMING THE SYSTEM
Arrested on 4/30/04
Charged with perjury in the 1st degree and workers' compensation fraud
This suspect began collecting workers' compensation benefits after he sustained a work-related injury. On 10/31/03, he testified under oath at a workers' compensation hearing that he was not working when in fact he had returned to work earlier that month. From 10/03 through 1/04 he continued to collect benefits to which he was not entitled. The Frauds Bureau conducted the investigation that led to his arrest.
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BOOKEEPER CHEATS
Arrested on 4/29/04
Charged with insurance fraud in the 3rd degree, offering a false instrument for filing in the 1st degree and workers' compensation fraud
On 1/3/97, the defendant allegedly sustained a back injury while employed by a home care company and began collecting workers' compensation benefits. However, in the fall of 2003 she took a job as a bookkeeper for a fuel company and submitted written statements to her insurer that she was not able to work. In all, she collected $3,377 to which she was not entitled. In March 2004, the Frauds Bureau received a statement from her employer stating that she was indeed in his employ and at the same time, received a written confession from the defendant.
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BAD TRIP
Arrested on 4/28/04
Charged with insurance fraud in the 3rd degree
An investigation by the Frauds Bureau resulted in the arrest of a Schenectady store owner accused of trying to defraud Combined Life Insurance Company of $30,000. He claimed that while he, his wife and son were visiting Pakistan, the three had become ill and had to be admitted to various hospitals for extended stays. However, during the investigation, it was learned that neither parent was admitted to a hospital or even seen by a doctor for any medical reason; the son was seen once and released.
