Arrests for August 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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- ATLANTIC CITY, HERE I COME
Arrested on 8/27/08
Charged with insurance fraud in the 2nd degree, falsifying business records in the 1st degree and workers' compensation fraud under Section 114(a) of the Workers' Compensation Law
The defendant in this case began receiving workers' compensation benefits in 2003, after claiming that he suffered on the job neck and back injuries that left him unable to stand, walk or drive. His insurer, First Cardinal LLC, reported the case to the Frauds Bureau when it became suspicious of medical expenses the defendant had claimed. During an investigation by the Frauds Bureau with the assistance of the Town of Colonie Police Department, evidence was gathered showing him walking and taking a bus trip to Atlantic City casinos. When independent medical examiners who had earlier examined the defendant were shown the surveillance tapes, they stated that the tapes contradicted the physical condition the defendant presented when he was examined. In addition, investigators charged that the tapes contradicted written and verbal statements the defendant made to the Workers' Compensation Board.
- BOUNCED
Arrested on 8/21/08
Charged with offering a false instrument for filing in the 1st degree and committing a fraudulent practice in the 5th degree under the Workers' Compensation Law
An investigation by the Frauds Bureau and the Tompkins County Sheriff's Department led to the arrest of a bar owner after authorities discovered she employed five workers off the books, including a bouncer injured when he tried to escort a patron out of the bar. The investigation revealed that the suspect filed fraudulent workers' compensation payroll reports with the State Insurance Fund stating that the bar had no employees other than herself as owner. This fraudulent statement significantly reduced her workers' compensation premiums. However, on 4/14/08, she filed an injury report with the Fund stating that a newly hired employee - the bouncer - had been injured his first day on the job. The bouncer had actually been employed at the bar for two years.
- FLIMSY PLAN B
Arrested on 8/19/08
Charged with insurance fraud in the 3rd degree and falsifying business records in the 1st degree
This suspect filed a claim with State Farm Insurance Company, reporting that someone had smashed the rear window of his 2001 Mitsubishi Eclipse. He submitted a $3,298 repair estimate to the insurer with an affidavit claiming the car had been vandalized. An insurance adjuster subsequently inspected the car and when he found the window intact, he took photos as proof. The insurer contacted the suspect, who insisted the window was broken, and asked that the adjuster return to take another look. This time the adjuster found that the window had been smashed. Witnesses later told investigators that the suspect himself broke the window before the adjuster's second visit.
- CANCELLED
Arrested on 8/19/08
Charged with falsifying business records in the 2nd degree
An upstate painting contractor was accused of altering a Certificate of Insurance in an attempt to show that he had the required general liability and workers' compensation insurance for his business. However, an investigation conducted by the Frauds Bureau revealed that the Certificate had been issued on 8/16/06 and cancelled on 12/2/06 for nonpayment of premiums. On 12/17/07, the contractor presented the fraudulent Certificate indicating that coverage was in place from 8/16/07 through 8/16/08. He turned himself in to the Warren County's Sheriff's Office on 8/19/08.
- DRIVING A BUS IS A JOB
Arrested on 8/14/08
Charged with insurance fraud in the 3rd degree, offering a false instrument for filing in the 1st degree and violation of Section 114-1 of the Workers' Compensation Law
Following a work-related injury on 9/30/05, the defendant in this case began collecting unemployment benefits. On several occasions during the benefit period, he submitted work status reports to the State Insurance Fund in which he indicated that he had not worked since his injury, nor had he received any compensation other than his benefits. However, an investigation by the Frauds Bureau, the Workers' Compensation Board Inspector General's Office and the State Fund uncovered evidence that the defendant was working as a bus driver. As a result of the fraud, he collected $27,089 in benefits to which he was not entitled.
- CONCOCTED
Arrested on 8/12/08
Charged with insurance fraud in the 3rd degree
A joint investigation conducted by the Frauds Bureau and the Delaware County Sheriff's Office led to the arrest of a couple whose home was destroyed in a March 2007 fire. They were charged with submitting forged receipts in an unsuccessful attempt to collect an additional $30,400 as part of their insurance settlement. Investigators discovered that the suspects filed a claim with Broome Cooperative Insurance Company for contents damaged or destroyed in the fire and were paid $37,000. They sought the additional $30,400 for items that were allegedly purchased to replace other property lost in the fire. However, evidence indicates that these replacement items were never purchased.
- WITNESSES BLOW THE WHISTLE
Arrested on 8/8/08
Charged with insurance fraud in the 3rd degree
A self-employed logger and stone cutter allegedly accepted $20,000 in no-fault insurance benefits after claiming he was disabled and unable to work as the result of an auto accident on 1/3/08. He was accused of filing fraudulent lost-wage claims in order to collect benefits to cover alleged lost earnings. However, witnesses to the accident disputed the suspect's claim that injuries from the accident left him totally disabled. If convicted, he could be sentenced to seven years in prison.
- COOKING THE BOOKS
Arrested on 8/8/08
Charged with forgery in the 3rd degree
Evidence gathered during an investigation by the Frauds Bureau indicated that on 10/31/07, the defendant in this case altered several Certificates of Insurance as proof that workers' compensation was in place for her husband's trucking business. She subsequently admitted to investigators that she was unable to make the insurance payments and had altered the Certificates so that her husband could continue to work. She also stated that she handled all the books for the business and her husband was unaware that she had submitted forged Certificates.
- FABRICATED DATE
Arrested on 8/7/08
Charged with insurance fraud in the 4th degree
An upstate truck driver was charged with presenting an altered Disability Status Report to Utica National Insurance Company in support of his workers' compensation claim in an attempt to collect $1,504 in benefits to which he was not entitled. The Report stated that his disability had occurred a month earlier than it actually had. When confronted with the evidence, the suspect gave a full and complete confession. The Frauds Bureau, the Monroe County DA's Office and Utica National pooled resources in this investigation.
- ENHANCED CLAIM
Arrested on 8/5/08
Charged with insurance fraud in the 3rd degree, attempted grand larceny in the 4th degree and falsely reporting an incident in the 3rd degree
On 1/20/08, this suspect reported to the West Seneca Police Department that his apartment had been burglarized and some of his property stolen. He then filed a claim with State Farm Insurance Company for the loss, including a Personal Property Inventory indicating that the cash value of the items stolen was $8,432. However, an investigation by the Frauds Bureau, the West Seneca Police Department and the insurance company's SIU found that the items had not been stolen, but were either sold or given to others.
- FORGED RECEIPT
Arrested on 8/5/08
Charged with criminal possession of a forged instrument in the 2nd degree, insurance fraud in the 5th degree and attempted petit larceny
A joint investigation by the Frauds Bureau, the Lewiston Police Department, the Niagara County DA's Office and Liberty Mutual Insurance Company's SIU led to the arrest of the defendant in this case. On 5/23/08, he filed a claim with Liberty Mutual for vandalism to the front and back windshields of his 1993 Cadillac. He included a receipt from a local auto body shop purportedly showing that he had paid $690.98 for replacements. However, during the investigation statements were taken and interviews were conducted that uncovered evidence the receipt had been forged.
- CAR DUMPED IN LAKE
Arrested on 8/4-5/08
Charged with insurance fraud, attempted grand larceny and conspiracy to commit insurance fraud
An Erie County woman and three people who helped her dispose of her SUV so she could collect an insurance settlement were arrested following a joint investigation by the Frauds Bureau, the Buffalo Police Auto Theft Squad and the State Police. The woman subsequently admitted that she recruited a man to help her dispose of her leased 2005 Chevrolet Trailblazer so she could buy a less costly vehicle with better gas mileage. The man, in turn, recruited his two cousins to help with the job. The Buffalo Police Underwater Recovery Team found the vehicle submerged in Lake Erie on 7/9/08, less than a month after the woman reported the vehicle stolen from her place of employment. The vehicle was found with the keys in the ignition and a rock attached to the gas pedal. The man was arrested on 7/29, the woman on 8/4 and the cousins on 8/5.
- PRIOR DAMAGE
Arrested on 8/4/08
Charged with insurance fraud in the 5th degree
After his son was involved in an accident, the defendant in this case filed a claim with Progressive Insurance Company to which he attached receipts for new tires and repair to damages allegedly sustained in the accident. However, an investigation by the Frauds Bureau turned up evidence indicating that the damages to the car occurred and were repaired, and the tires placed on the vehicle, before the accident.
