Arrests for February 2008
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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- GUILTY PLEA
A licensed clinical social worker, Rhonn Gilchrist of Tonawanda, NY, pleaded guilty on 2/20/08 to felony health care fraud. Gilchrist admitted that from 2002 until 2007, he defrauded numerous insurers and the New York Workers' Compensation system of $102,000 by engaging in double billing and billing for services he did not provide to his patients. He has agreed to forfeit $90,000 in cash to the federal government, as well as ownership of a condominium in Florida valued at $450,000. His arrest was the result of an investigation conducted by the Western New York Health Care Fraud Task Force, whose members include the Frauds Bureau, the FBI, the U.S. Departments of Health and Human Services, Labor and Defense, the IRS, the Federal Drug Administration, the U.S. Attorney's Office and the Medicaid Control Fraud Unit.
Anthony Dexter Cox, a licensed massage therapist and owner/operator of a clinic in Rochester, pleaded guilty on 2/11/08 to felony insurance fraud in full satisfaction of the charges against him. As part of his plea agreement, he will spend eight weekends in the Monroe County jail when he is sentenced in March. He was arrested on 3/27/07 and accused of overcharging GEICO Insurance Company by $2,730 for treatments that were never provided to a patient who sought massage therapy following an auto accident. His arrest was the result of an investigation by the Frauds Bureau and the Rochester Police Department. The State Police Auto Theft Unit assisted in the execution of two search warrants at the suspect's home and business that uncovered evidence that led to his arrest.
- ALTERED CERTIFICATE
Arrested on 2/27/08
Chargedwith criminal possession of a forged instrument in the 2nd degree
The case against this suspect alleged that on 6/8/07 he presented a Certificate of Insurance to a homeowner who had contracted with him for work at her home. However, an investigation by the Frauds Bureau and Nova Insurance Company's SIU revealed that the suspect allegedly altered the Certificate to show that he had the required commercial general liability insurance coverage when in fact no such coverage was in place.
- FRAUDULENT SS CARD
Arrested on 2/21/08
Chargedwith criminal possession of a forged instrument in the 2nd degree
Following a work-related injury on 4/20/07, an upstate laborer filed a claim with the State Insurance Fund for workers' compensation benefits. A routine check of his Social Security number revealed that the number had been issued in 1936 to an Arizona woman now deceased. He allegedly changed the name on the card to his own and presented the fraudulent card to gain employment at a sheet metal factory in Newburgh. In addition, it was learned that the suspect was living in the United States illegally. An investigation by the Frauds Bureau and the Orange County Sheriff's Office led to his arrest.
- BOGUS ALIBI
Arrested on 2/20/08
Chargedwith insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
The defendant in this case reported to Progressive Insurance Company that her 1999 Cadillac was stolen from a shopping center parking lot in Buffalo. She reported that the theft had occurred between 12:45 p.m. and 2:30 p.m. on 7/3/07. However, an investigation by the Frauds Bureau revealed that the car was discovered burning at 11:46 a.m. on 7/3, an hour before she said she had last seen it. Further evidence indicated that the defendant had been at work on the day of the alleged theft and did not have possession of the car. When questioned, the defendant admitted that she had lied to her insurer. She stated that when she returned from work, her brother told her the car had been burned and, according to her statement, he told her what to tell the police and the insurance company to cover herself.
- ILLEGAL
Arrested on 2/12/08
Chargedwith insurance fraud and offering a false instrument for filing
An investigation by the Frauds Bureau and the Ulster County Sheriff's Department led to the arrest of a junkyard dealer for allegedly insuring and registering cars for illegal immigrants. He was accused of making use of used cars with high mileage that he fraudulently insured, registered and then sold to unlicensed drivers who were also undocumented immigrants. The investigation began when the Sheriff's Department noticed an unusually high number of traffic stops and accidents involving cars registered to the suspect's junkyard. Over a four-year period, the suspect allegedly insured and registered about 40 cars through American Transit Insurance Company at a premium loss to the insurer of nearly $523,000. According to New York State Law, only U.S. citizens or legal residents may apply for a driver's license and applicants must have a valid Social Security card. The investigation revealed that none of these customers had valid cards.
- NO WAGE LOSS
Arrested on 2/11/08
Chargedwith insurance fraud in the 2nd degree and grand larceny in the 2nd degree
After a work-related accident, a truck driver from Amsterdam, NY, began receiving workers' compensation benefits in December 2002. On his Application for Wage Payment, the suspect stated that he was unable to work and had not earned any wages since his accident occurred. He said he did construction-type work to help friends and family occasionally for which he received gas money for his truck, rather than wages. However, an investigation by the Frauds Bureau revealed that he was receiving wages for the construction work he was performing. In all he collected more than $50,000 in benefits to which he was not entitled.
- ACCIDENT PRONE
Arrested on 2/11/08
Chargedwith insurance fraud in the 5th degree and falsifying business records in the 1st degree
On 3/7/07, an upstate vocational counselor submitted a claim under an accident policy issued through Sterling Insurance Company for treatment of an injury sustained in an auto accident on 3/6. On 4/10/07, she submitted a second claim for an auto accident she purportedly was involved in on 3/26/07. In December 2007, she submitted yet another claim stating the on 12/11/07 she slipped on ice and fell in her driveway. In support of each of the claims, she submitted a discharge report from a local hospital where she claimed to have been treated for her injuries. Sterling paid her $250 on the first claim but after receiving claims 2 and 3, the insurer contacted the local hospital and was told that the suspect had not been treated on any of the three dates she said she had received medical care. Investigators from the Frauds Bureau and the State Police contacted the suspect's auto insurance carrier, GEICO, and were told that the suspect had not reported any of the alleged accidents. Investigators also checked police records and found no Police Accident Reports to substantiate the suspect's claims. In an interview on 2/1/08, the suspect stated that she had submitted the three claims. And while she admitted that the paperwork appeared to be altered, she could not explain how it happened or recall the dates on which she had been to the emergency room. She was arrested and charged on 2/11/08. Additional charges are pending as the investigation continues.
- CASE OF THE MISSING CAR
Arrested on 2/11/08
Chargedwith criminal possession of stolen property in the 3rd degree
In January 2007, an upstate man reported to the Rochester Police Department that his leased 2003 Nissan Murano had been stolen from his father's house where he had parked it before leaving town for a week. When he returned, his car was gone and his father could not account for its whereabouts. Progressive Insurance Company subsequently paid the lien holder $22,463 for the loss. However, in November 2007, the State Police received a tip about a possible stolen car being hidden in a barn several counties away. The car turned out to be the Nissan Murano reported stolen 11 months earlier in Rochester. The owner of the barn had tried to conceal the identity with spray paint and was in the process of dismantling the vehicle. During questioning, he stated that the owner of a nearby auto repair shop had given him the car to be rid of it. The repair shop owner told investigators that in January 2007, the father of the car's lessee, who was a friend, had asked to leave the car at the shop "for two weeks." But he never returned to reclaim the car despite repeated phone calls to his home. The vehicle was recovered and the father was arrested. On 2/11/08, the owner of the barn where the car was hidden was arrested on a charge of criminal possession of stolen property. The owner of the repair shop cooperated with the investigation and has not been charged. The Frauds Bureau, the State Police Bureau of Criminal Investigation and Auto Theft Unit and Progressive's SIU conducted this investigation jointly.
- INCARCERATED
Arrested on 2/4/08
Chargedwith insurance fraud in the 3rd degree, offering a false instrument for filing in the 1st degree and workers' compensation fraud
After sustaining an injury on the job on 2/11/06, the defendant in this case began collecting workers' compensation benefits. On a number of occasions, he submitted Employment Status Reports to the Workers' Compensation Board on which he answered "no" when asked if he had been convicted of a crime and was serving a prison sentence. However, an investigation by the Frauds Bureau and the New York State Workers' Compensation Fraud Inspector General's Office uncovered evidence that he had pleaded guilty to an unrelated crime on 7/13/07 and was sentenced to one year in jail. As a result of his misrepresentations on the Employment Status Reports, he received $7,760 in benefits while serving time in the Oneida County Correctional Facility.
