Arrests for May 2006
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!
*********************************************
-
SENTENCED
Anthony Spinello of Rochester, NY, was sentenced on 5/22/06 in Monroe County Court to five years’ probation and 16 Saturdays on the Monroe County Sheriff’s Department work detail. He was also ordered to pay $208,000 in restitution to Nationwide Insurance Company. He pled guilty in February to 14 felony counts, including grand larceny in the 2nd and 3rd degrees and criminal possession of a forged instrument in the 2nd degree. A joint investigation by the Frauds Bureau, the Rochester and Irondequoit Police Departments and Nationwide revealed that Spinello, while acting in his capacity as a licensed insurance agent for Nationwide, misrepresented himself as two of his clients in order to implement changes of address so that all subsequent correspondence from the insurer would be sent to his own home address. Between July 2000 and July 2004, he systematically withdrew funds held in the individual retirement accounts and annuities of the two clients.
- UNSCRUPULOUS CO-WORKERS
Arrested on 5/30-31/06
Charged with insurance fraud in the 3rd degree, grand larceny in the 3rd degree and falsifying business records in the 1st degree
When the brother of a home health care worker was shot and seriously wounded in June 2001, her co-worker, who was also an agent for Combined Life Insurance Company of New York, persuaded her to take out an accident and disability policy and name herself as beneficiary. The insurance agent backdated the application to a date prior to the shooting and the policy was issued. The home health care worker filed a claim with Combined Life and was paid a settlement of $15,500. The agent was arrested and her accomplice on 5/30. The Frauds Bureau, the State Police and Combined Life pooled resources in the investigation that led to the arrests.
- DRUGGED DENTIST
Arrested on 5/30/06
Charged with insurance fraud, falsifying business records and criminal diversion of prescription medications in the 4th degree
A Suffolk County dentist was arrested following an investigation by the Frauds Bureau and the Suffolk County DA’s Office. The investigation revealed that he made demands on two of his employees to obtain prescriptions for drugs for his personal use for which he paid them their co-payment expenses. In addition, between December 2004 and March 2005, he allegedly billed for procedures that were not provided.
- BOGUS INVOICE
Arrested on 5/22/06
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
The owner and operator of an auto sales business was accused of conspiring with another man to defraud Erie Insurance Company by reporting a 1995 Oldsmobile Cutlass Supreme as stolen from the business’s lot. The car was purchased by the second defendant in this case and sold to the business owner for $1,150. Together, they filed a claim for $3,000 for the loss and backed it up with a fraudulent invoice. However, an investigation conducted by the Frauds Bureau and the Syracuse Police Department found that the invoice they submitted as proof of the $3,000 purchase price was totally bogus. In addition, the car was never stolen.
-
DOUBLE DIPPING
Arrested on 5/22/06
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
The defendant in this case reported that jewelry valued at $2,000 was stolen from her home on 7/16/05. She subsequently filed a claim with Liberty Mutual Insurance Company and was reimbursed for the loss. However, an investigation by the Frauds Bureau and the Syracuse Police Department uncovered evidence that on 3/6/04, she reported the same jewelry stolen at which time New York Central Mutual Fire Insurance Company made payment on the claim.
-
HE WAS WORKING
Arrested on 5/18/06
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
Following a work-related injury in December 1996, a Rochester resident began collecting workers’ compensation benefits. From that time until the time of his arrest, the suspect submitted benefit affidavits to Travelers Insurance Company stating that he was unable to work since the time of his injury. Affidavits submitted in 2001 led the insurer to initiate an investigation, during which the insurer obtained statements from several employers who reported that the suspect had done construction work for them. The suspect was also observed working as a carpet installer for a local furniture store. The Frauds Bureau obtained payroll records from the furniture store showing that the suspect had been employed during September-October 2003. The investigation was conducted jointly by the Frauds Bureau, the Rochester Police Department and Travelers.
- NO-FAULT FRAUD
Arrested on 5/18/06
Charged with Insurance fraud in the 3rd degree, offering a false statement for filing in the 1st degree and falsifying business records in the 2nd degree
An investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad led to the arrest of this suspect accused of falsely reporting that she had been in an auto accident on 1/30/06. In fact she was not a passenger in either car involved in the accident. She subsequently sought and received medical treatments for nonexistent injuries under the no-fault portion of her auto insurance.
-
LAPTOP LIE
Arrested on 5/16/06
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
The owners of a clothing store were summoned to the store on 9/1/05 after the Rochester Police Department responded to a burglar alarm. Following the burglary, the couple reported that the majority of their inventory had been stolen, along with a high-end laptop computer. Nationwide Insurance Company’s Special Investigations Unit found the claim suspicious and initiated an investigation. Investigators discovered that the receipt provided by the husband as proof of purchase of the laptop was bogus. In addition, during interviews conducted by the Frauds Bureau and the Rochester Police Department, the husband stated that he had purchased the computer through eBay. However, eBay’s records showed that the suspect had not purchased the computer through its online auction. In addition, the computer manufacturer provided evidence that the model number listed on the receipt was not issued until several months after the date on the receipt.
-
MEDICAL MILL
Arrested on 5/12/06
Charged with enterprise corruption, insurance fraud in the 1st and 2nd degrees, grand larceny in the 2nd degree, money laundering in the 1st degree, conspiracy in the 4th degree and scheme to defraud in the 1st degree
A Long Island neurologist was the latest suspect to be arrested in the ongoing investigation into the operations of a medical mill in Tuckahoe, NY. Of the 37 individuals who have been charged thus far, 29, including physicians and runners, have been convicted, 7 others await trial and a warrant was issued for another. An investigation by the Frauds Bureau, the State Police, the New Jersey Attorney General’s Office, the NYPD, the Yonkers and Westchester County Police Departments, the National Insurance Crime Bureau and numerous insurers led to the arrests. These defendants routinely filed claims for expensive treatments that were never provided and billed for medical services on behalf of patients who had not even been in an accident. The scheme defrauded insurers of more than $12 million in fraudulent claims.
- WORKERS’ COMP FRAUD
Arrested on 5/11/06
Charged with grand larceny in the 3rd degree
An investigation by the Frauds Bureau and the State Insurance Fund led to the arrest of a Brooklyn man on charges that he collected workers’ compensation benefits while he was gainfully employed.
-
CAR FIRE
Arrested on 5/11/06
Charged with arson in the 3rd degree, insurance fraud in the 3rd degree, grand larceny in the 3rd degree and falsely reporting an incident
On 2/21/06, the defendant in this case reported to the Yorktown Police Department and to Progressive Insurance Company that his 1999 Wolkswagen Passat had been stolen from a shopping mall where he had parked it at about 8:30 p.m. that night. However, he was unaware that at 11:00 p.m. the night before, 2/20/06, the FDNY responded to an alarm in Brooklyn where they found the Passat on fire. Because of the suspicious nature of the fire, the matter was referred to the Bureau of Fire Investigations which requested the assistance of the Frauds Bureau. Following an investigation, the suspect was interviewed at which time he provided both written and verbal statements admitting that he had arranged to have his car burned.
-
FRAUDULENT PAYOUT
Arrested on 5/7/06
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
An upstate woman reported to the Rochester Police Department on 12/6/05 that an acquaintance had stolen her 1992 BMW on 12/1/05. She subsequently filed a claim for the loss with GMAC Insurance Company. However, an investigation by the Frauds Bureau, the Rochester PD and GMAC uncovered evidence that she had actually signed over ownership of the car to another person and reported it stolen in an effort to collect more than $3,300 in an insurance settlement.
-
CITY WORKERS CAUGHT
Arrested on 5/2/06
Charged with mail fraud and Medicaid fraud under U.S. Code 18
Sixteen employees of New York City’s Human Resources Administration were accused of participation in a scheme to defraud the Medicaid system by using fraudulent Medicaid cards to obtain medical benefits to which they were not entitled. The investigation was conducted by the Frauds Bureau, the U.S. Postal Inspector’s Office, the U.S. Health and Human Services Inspector General’s Office and the New York City Department of Investigations.
-
FORGED SIGNATURE
Arrested on 5/2/06
Charged with forgery in the 2nd degree, offering a false instrument for filing in the 1st degree and insurance fraud in the 3rd degree
The Frauds Bureau and the State Police pooled resources in an investigation that resulted in the arrest of a woman for workers’ compensation insurance fraud. Evidence revealed that this suspect, after the death of her husband, forged his name on documents submitted to the State Insurance Fund indicating he was not working. The Fund continued to issue benefit checks in his name, on which she also forged his signature and thus collected more than $4,000 to which she was not entitled.
PRIOR SUPPLEMENTS
APRIL 2006
-
ARRANGED FIRE
Arrested on 4/6/06
Charged with insurance fraud in the 3rd degree, grand larceny in the 3rd degree, arson in the 3rd degree and falsely reporting an incident in the 3rd degree
A Pennsylvania woman reported that her 2001 Chevy Cavalier was stolen in New York City on 1/12/06 where she said she had last seen it the day before. However, an investigation by the Frauds Bureau and Nationwide Insurance Company revealed that the FDNY had responded to an alarm on 1/10/06 and found her car on fire in the Bronx. During an examination under oath, she admitted that she had arranged for two friends to burn the car so she could report it stolen and collect the insurance payment. The two friends were subsequently arrested, one on 4/13/06 and the other on 4/25/06.
MARCH 2006
-
NO ACCIDENT
Arrested on 3/23/06
Charged with insurance fraud
An investigation conducted jointly by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigation Squad led to the arrest of a Bronx man accused of insurance fraud. The defendant, acting in concert with another person previously arrested, filed a claim with Allstate Insurance Company stating that he was involved in an auto accident. He subsequently sought and received medical treatment for nonexistent injuries under the no-fault portion of his auto insurance coverage for which he was reimbursed by his insurer in the amount of $4,000.
