Arrests for July 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 7/30/04, Willie J. Wilson Jr. was sentenced to 1 to 3 years in prison and $72,192 in restitution for threatening his former girlfriend after she reported him for auto insurance fraud. Wilson falsely claimed he was a passenger in a car that was involved in a one-car accident. The fact is he was the driver and he was intoxicated. Because he claimed to be the passenger, he received no-fault benefits to cover his medical expenses, coverage that would have been void had the authorities known he was driving while under the influence. Wilson received a one-year conditional discharge after pleading guilty to 3rd-degree insurance fraud. Monroe County Court Judge Richard A. Keenan ordered the prison sentence for his guilty plea to the charge of 1st-degree criminal contempt for his attempts to prevent his former girlfriend from testifying against him. Wilson was one of 25 upstate residents arrested in an auto insurance fraud sweep conducted by the Frauds Bureau and the Attorney General's Office Auto Insurance Fraud Unit in the fall of 2003.
- FALSE BILLING
Arrested on 7/29/04
Charged with insurance fraud in the 3rd degree
The arrest of this defendant was the result of an investigation by the Frauds Bureau that disclosed that the defendant filed a fraudulent insurance claim under the no-fault portion of his auto insurance coverage for an accident that never occurred. As a result, Clarendon Insurance Company received fraudulent billing totaling $28,000.
- SUGAR BLUES
Arrested on 7/28/04
Charged with insurance fraud in the 4th degree, attempted grand larceny in the 4th degree and falsely reporting an incident
On 6/6/03, the defendant in this case reported to Progressive Insurance Company that someone had put sugar in the gas tank of his car. He reported the incident to the Batavia Police Department as a case of criminal mischief and filed a $1,700 claim for the damage. However, an investigation by the Frauds Bureau, the Batavia PD and Progressive revealed that the engine in the car had actually been blown and the sugar placed in the tank afterwards.
- ARSON
Arrested on 7/28/04
Charged with arson in the 3rd degree, grand larceny in the 4th degree, falsifying business records in the 1st degree, insurance fraud in the 4th degree and falsely reporting an incident
The suspect in this case reported to the NYPD that his car was stolen from his driveway in Queens on 11/11/03. He stated that he last saw the car at 11:00 p.m. on the night of 11/10/03. However, at about 11:40 p.m. on 11/10/03, the FDNY responded to a vehicle fire in Brooklyn. A Cause and Origin Examination disclosed that the fire had been purposely set and the Fire Marshals classified the incident as arson. An investigation by the Frauds Bureau and the Fire Marshal's Office led to the arrest of this suspect.
- LIFE INSURANCE FRAUD
Arrested on 7/28/04
Charged with scheme to defraud
An investigation conducted by the Frauds Bureau with the assistance of the U.S. Postal Inspector's Office led to the arrest of a physician assistant at Kings County Hospital Center accused of obtaining a $250,000 life insurance policy in the name of a seriously ill patient without the patient's consent. The defendant applied for the policy from Guardian Life Insurance Company in September 2000, posing as the insured's aunt, having someone representing herself as the insured take the medical exam and naming herself as beneficiary. She then paid about $43 a month in premiums. In December 2002, an investigator with Guardian discovered significant inaccuracies in the application and reported his findings to the Frauds Bureau. If convicted, the defendant faces up to 20 years in prison.
- DOUBLE TROUBLE
Arrested on 7/23/04
Charged with insurance fraud, grand larceny, falsifying business records, falsely reporting an incident and making a false punishable written statement
An upstate business owner reported that his Dodge Ram pick-up truck was stolen from a parking lot at the New York State Fair in Syracuse in September 2002. He filed a claim with Allstate Insurance Company and subsequently received a settlement of $14,500. However, based on information received by the Frauds Bureau that he had actually buried the car somewhere on his property, the State Police were asked to conduct an aerial survey during which a large water-filled pit was discovered on the property. Further investigation revealed that the defendant's truck had severe mechanical problems and that he had not buried it as was first suspected but had arranged with others to have the truck "stolen." In the meantime, the New York State Department of Environmental Conservation Police were called to inspect the pit on the ground and determined that the defendant was operating a construction and demolition landfill on his property without the permit required by the DEC. During questioning by the Frauds Bureau, the defendant confessed to filing the false claim and fraudulently collecting the insurance settlement. The defendant is also scheduled to answer charges of polluting the waters of the State in contravention of water quality standards and operating a solid waste management facility without a valid permit. These charges will be answered at a later date at Department of Environmental Conservation headquarters. The defendant has agreed to cooperate in the investigation and in the clean-up of his property.
- INFLATION
Arrested on 7/22/04
Charged with offering a false instrument for filing in the 1st degree
An upstate business owner reported to Atlantic Mutual Insurance Company that his home had been burglarized and expensive property stolen. He filed a homeowner's insurance claim for the loss. However, an investigation by the Frauds Bureau and the Town of Highland Police Department revealed that he had inflated the fraudulent claim by more than $22,000.
- MECHANIC[AL] DIFFICULTIES
Arrested on 7/15/04
Charged with perjury in the 1st degree
An investigation by the Frauds Bureau and the Suffolk County DA's Office led to the arrest of a Long Island mechanic charged with perjury. The defendant was accused of testifying under oath at a workers' compensation hearing that he was not working when in fact he was employed at a local gas station.
- "GIVE-UP"
Arrested on 7/13/04
Charged with insurance fraud, falsely reporting an incident, attempted grand larceny and offering a false statement
On 4/29/04, an account manager from New Jersey reported that his 1999 Ford Expedition had been stolen from a shopping mall in Woodbury, NY. During the course of the investigation by the Frauds Bureau and the New York City Fire Marshal's Office, the suspect admitted to "giving up" his car to be disposed of so that he could collect the insurance settlement.
- STAGED ACCIDENT
Arrested on 7/13/04
Charged with medical fraud under Title 18 USC
An investigation by the Frauds Bureau led to the arrest of two Brooklyn residents suspected of participating in a staged accident scheme.
- OVERBILLING
Arrested on 7/8/04
Charged with insurance fraud in the 3rd degree, grand larceny in the 3rd degree and falsifying business records in the 1st degree
The Frauds Bureau and the Oneida County DA's Office pooled resources in an investigation that resulted in the arrest of a Certified Social Worker. During the 2000-2001 period, she allegedly billed Excellus Blue Cross/Blue Shield-Utica Region for more than $30,000 in services that were not rendered.
- DISABLED?
Arrested on 7/6/04
Charged with committing a fraudulent practice and offering a false instrument for filing in the 1st degree
The defendant in this case was classified by the Workers' Compensation Board as totally and permanently disabled. While collecting benefits, she provided the State Insurance Fund with information about her employment status that she knew was materially false. However, an investigation by the Frauds Bureau, based on information provided by the Fund, uncovered evidence that the defendant was actually self-employed and working as a home health care provider at numerous locations in her home town.
- LEAKY BLEACH
Arrested on 7/1/04
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
A Rochester woman submitted a $4,800 claim to Wal-Mart for damage to clothing and carpeting in her home that she stated was the result of a leaky bottle of bleach she had purchased at Wal-Mart on March 13, 2004. She submitted photos of the damaged property and replacement estimates in support of her claim. However, an investigation conducted jointly by the Frauds Bureau and the Greece Police Department revealed that she had been paid $3,500 for a similar incident that occurred at a Wegman's Store on January 6, 2004. In fact, the photos were the same ones she had used to support the earlier Wegman claim and the dates on the estimates had been changed to coincide with the March 2004 Wal-Mart claim. New carpets had been installed at her home after the January 2004 incident but she claimed that the bleach had leaked in the same spots as in the earlier incident and the photos were current. A statement by the bottling company determining that the lip of the bleach bottle had been deliberately cut to cause the leak added to the evidence that led to her arrest.
- UNWARRANTED BENEFITS
Arrested on 7/1/04
Charged with grand larceny in the 4th degree and violation of the Workers' Compensation Law
Following a work-related injury in April 2002, a Buffalo bus driver began collecting workers' compensation benefits. However, during an investigation by the Frauds Bureau and the Erie County Sheriff's Department, it came to light that this suspect was employed from 9/13/02 through 8/1/03. As a result, he collected $5,240 from First Cardinal Insurance Company to which he was not entitled.
PRIOR SUPPLEMENTS
JUNE 2004
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SENTENCED
On 6/24/04, New York City resident Judith Lopez was sentenced to two years probation, restitution of $28,000 and a $100 fine following her 2/25/04 conviction on a charge of health care fraud. An investigation by the Frauds Bureau resulted in her arrest in November 2003 for submitting numerous fraudulent claims to Aetna Insurance Company for medical services she never received. As a result, between April 1999 and February 2001, she collected $28,000 to which she was not entitled.
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BOGUS HEALTH PLANS
Arrested on 6/16/04
Charged with grand larceny in the 3rd and 4th degrees and scheme to defraud in the 1st degree
The charges in this case accused a registered nurse of operating an unlicensed health maintenance organization in the Bronx. The defendant sold bogus health plans to a number of individuals and collected premiums but failed to pay the claims for medical services legitimately rendered. The Frauds Bureau conducted an undercover operation to gather evidence that was brought to the AG's Office for prosecution.
MAY 2004
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REVOKED BROKER
Arrested on 5/19/04
Charged with grand larceny in the 3rd and 4th degrees, scheme to defraud in the 1st degree and petit larceny
An investigation by the Frauds Bureau and the Manhattan DA's Office led to the arrest of a revoked broker who was charged with collecting $57,000 in premiums from numerous clients but failing to forward the money to an insurance company.
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HIGH RISK
Arrested on 5/17/04
Charged with insurance fraud, forgery, grand larceny, falsifying business records and offering a false instrument for filing
The owner/operator of a construction company in Utica, NY, applied for workers' compensation insurance coverage, stating that the company was involved in residential and small commercial carpentry. However, an investigation by the Frauds Bureau, the State Insurance Fund and the Oneida County DA's Office turned up evidence that the company was actually in the business of asbestos removal. As a result of the false information, the company paid $15,000 less in premiums than was warranted by the true nature of the work.
APRIL 2004
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WORKERS' COMP FRAUD
Arrested on 4/28/04
Charged with violation of the Workers' Compensation Law
An investigation by the Frauds Bureau and Zurich Insurance Company led to the arrest of a Buffalo, NY, fitness services technician on a charge of workers' compensation fraud. He began collecting benefits after sustaining an on-the-job injury and on several occasions denied that he was working at workers' compensation hearings. However, the investigation revealed that between 7/9/02 and 1/15/03 he was employed as an independent contractor. Payroll records and surveillance videos obtained by Zurich were used as evidence in this case.
FEBRUARY 2004
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SENTENCED
Angelo Cassarino, a former insurance agent, was sentenced on 2/24/04 to six months in jail, five years probation and restitution of $135,000 following his 7/29/03 conviction of scheme to defraud. The Frauds Bureau pooled resources with the Suffolk County DA's Office to bring about his arrest in September 2002 for collecting premiums but failing to remit them to any insurers. His insurance license had expired in June 2001.
