Arrests for September 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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- INTENTIONAL FIRE
Arrested on 9/26/08
Charged with insurance fraud in the 2nd degree
Following a fire that destroyed his home, the defendant in this case filed claims for the loss. The house was insured through State Farm Insurance Company for $255,000 and the contents for $55,000. A 1967 Chevrolet Impala insured through Progressive Insurance Company was also lost in the fire. However, an investigation by the Frauds Bureau and the Delaware County DA's and Sheriff's Offices uncovered evidence that the defendant deliberately set the fire for the insurance payment. Progressive paid out $34,000 for the car. But State Farm denied the homeowners claim.
- FRAUDULENT CERTIFICATE
Arrested on 9/26/08
Charged with insurance fraud in the 4th degree, falsifying business records in the 1st degree and fraudulent practices under Section 114-(3) of the Workers' Compensation Law
An investigation by the Frauds Bureau, the State Insurance Fund and the State Police resulted in the arrest of an upstate sub-contractor for violation of the Workers' Compensation Law. On 1/2/07, he submitted a Certificate of Insurance to a Syracuse-based contractor indicating that he had the required liability insurance during the period 5/14/06 to 5/14/07. However, the investigation revealed that no such coverage existed.
- 12-HOUR DIFFERENCE
Arrested on 9/25/08
Charged with attempted insurance fraud in the 3rd degree, attempted grand larceny in the 3rd and 4th degrees, attempted offering a false instrument for filing in the 1st degree and attempted falsifying business records in the 1st degree
The defendant in this case reported to the NYPD and to GEICO Insurance Company that her car had been stolen from a local Bronx street where she had parked it at 10:00 p.m. on 8/2/08. She stated that when she returned at 3:00 p.m. on 8/3/08, the car was gone. Investigators reviewed FDNY documentation which disclosed that FDNY units responded to a vehicle fire at a location near the Cross Bronx Expressway at 8:01 a.m. on 8/2/08. The vehicle matched the identification of the car the defendant had reported stolen 12 hours before it was discovered on fire. Her arrest was the result of an investigation conducted by the Frauds Bureau, the FDNY's Bureau of Fire Investigations and the NYPD's Auto Crime Division.
- UNDER SURVEILLANCE
Arrested on 9/24/08
Charged with violation of Section 114-(a) of the Workers' Compensation Law
On 12/10/04, this suspect filed a claim with AIG, stating he had developed respiratory problems from breathing toxic fumes at his job in a rubber factory. In March 2004, he was classified totally disabled and began to collect workers' compensation benefits. On 6/16/07, he submitted a statement to AIG stating that he was not working. However, during surveillance ordered by AIG, he was observed performing home improvements. During an interview conducted by the Frauds Bureau, the suspect signed a confession admitting that he worked as a self-employed handyman. As a result of the fraud, he collected $32,000 in benefits to which he was not entitled.
- RATE EVASION
Arrested on 9/24/08
Charged with violation of Section 1341 of Title 18 of the U.S. Code
A federal grand jury in Buffalo returned a 46-count indictment charging two downstate women with mail fraud in a "rate evasion" scheme to defraud AIG and Progressive Insurance Companies. Evidence gathered in this case indicates that the pair counseled and assisted several New York City-area residents in obtaining lower-cost auto insurance by fraudulently claiming to live in Western New York. Auto insurance premiums are significantly lower in Western New York than in the downstate area. The indictment also alleged that the defendants provided the New York City residents with UPS Store addresses in Western New York that they fraudulently claimed were their residences. As a result, AIG and Progressive sold insurance policies at Western New York rates, rather than the truly applicable New York City rates. The indictment was the culmination of an investigation by the Frauds Bureau, the U.S. Postal Inspection Service and the National Insurance Crime Bureau.
- DOC SAYS NO
Arrested on 9/23/08
Charged with offering a false instrument for filing and violation of Section 114 of the Workers' Compensation Law
Following an on-the-job injury sustained while she was working in a hospital during 2006, the defendant in this case began collecting workers' compensation benefits from the State Insurance Fund. However, surveillance showed that she was working at a doctor's office in the Bronx. During an investigation by the Frauds Bureau and the Workers' Compensation Fraud Inspector General's Office, investigators obtained tax records that corroborated this information. In addition, medical reports the defendant submitted to the Fund contained statements by the doctor that the defendant did not work in his office. Subsequently, a search warrant was executed at the doctor's office during which documents related to the fraud were seized as possible evidence in the case.
- DOING BUSINESS
Arrested on 9/23/08
Charged with grand larceny in the 4th degree, falsifying business records in the 1st degree and violation of Section 114-(a) of the Workers' Compensation Law
As a result of a work-related injury, this suspect filed for workers' compensation benefits. However, an investigation by the Frauds Bureau revealed that she was the owner/operator of a lawn-care business while fraudulently collecting benefits.
- FROM THE BRONX TO QUEENS
Arrested on 9/18/08
Charged with attempted grand larceny in the 3rd degree, insurance fraud in the 3rd degree, offering a false instrument for filing in the 2nd degree and falsely reporting an incident in the 3rd degree
A Bronx man who reported his 2003 Cadillac Escalade SUV stolen was arrested after investigators found a surveillance video contradicting his claim. An investigation by the Frauds Bureau revealed that the suspect told police that his car, valued at $25,000, had been stolen from a local street in the Bronx where he had left it parked on 5/21/08 and subsequently filed a claim with GEICO Insurance Company for the loss. However, the SUV was discovered burning in Queens the day after the suspect reported it stolen. Investigators found no evidence of forced entry into the car. But they located a surveillance tape of the location where the suspect allegedly left it parked; the tape showed no sign of the suspect's SUV.
- OH, HER ACHIN' BACK
Arrested on 9/18/08
Charged with violation of Section 114-1 of the Workers' Compensation Law
A keyboard specialist employed by the New York State Department of Education sustained back injuries at work on 4/26/06, 3/2/07 and 4/11/08. At a Workers' Compensation Board hearing, she testified under oath that she had no prior history of back injuries. However, investigators interviewed her doctor who reported that he had treated her for a back injury years before she was employed by the Department of Education. In addition, the chiropractor treating her most recent back injuries stated that the return-to-work dates on a document she submitted to her employer were not the dates he assigned to her.
- NO COVERAGE
Arrested on 9/18/08
Charged with grand larceny in the 3rd degree, criminal possession of a forged instrument in the 2nd degree, insurance fraud in the 3rd degree, falsifying business records in the 1st degree and violation of Section 114-1 of the Workers' Compensation Law
A Nassau County insurance broker was accused of forging two Certificates of Insurance to show that a contractor had workers' compensation insurance during the periods 7/27/04 to 7/27/05 and 7/27/05 to 7/27/06. However, an investigation by the Frauds Bureau and the State Insurance Fund revealed that no such coverage existed during that time, causing a loss to the contractor of more than $20,000 in additional insurance premiums.
- A BARGAIN AT $750
Arrested on 9/17/08
Charged with arson in the 3rd degree, grand larceny in the 3rd degree, conspiracy in the 4th degree, reckless endangerment in the 2nd degree and criminal facilitation
An investigation by the Frauds Bureau and the FDNY Fire Marshals led to the arrest of a Long Island resident who was charged with entering into a contract with an unnamed person to dispose of his 2007 Nissan Altima. He allegedly paid the person $750 to burn his car and purportedly was present when the car was set on fire.
- KEEPING THE HOME FIRES BURNING
Arrested on 9/16/08
Charged with insurance fraud in the 2nd degree
On 9/10/08, the defendant in this case filed a claim with New York Central Mutual Insurance Company for the loss of his home due to a fire that occurred on 9/9/08. The fire was subsequently found to be incendiary. An investigation was initiated and during an interview by the State Police, the defendant admitted that he had set the fire in his home intentionally for the insurance payment. The State Police arrested him on a charge of arson and the Frauds Bureau charged him with insurance fraud.
- CAUGHT
Arrested on 9/16/08
Charged with criminal possession of a forged instrument in the 2nd degree
An unemployed upstate woman attempted to cash a workers' compensation check that was issued to her husband who was in prison. The check was forged and showed a greater face value than the check as originally issued. Her arrest was the result of a joint investigation conducted by the Frauds Bureau, the Binghamton Police Department and the State Insurance Fund's Division of Confidential Investigations.
- STOLEN IDENTITY
Arrested on 9/15/08
Charged with violation of the Workers' Compensation Law
An investigation by the Frauds Bureau and the State Insurance Fund led to the arrest of the defendant in this case. He was charged with collecting workers' compensation benefits while working and collecting a salary using his deceased brother's identification and social security number.
- NICE NEIGHBOR
Arrested on 9/15/08
Charged with forgery in the 3rd degree and petit larceny
This suspect allegedly stole two workers' compensation benefit checks from her neighbor, cashed them and pocketed the money. The Frauds Bureau, the Orange County Sheriff's Department and the Workers' Compensation Fraud Inspector General's Office pooled resources in the investigation that led to her arrest.
- NOT A GREAT HIDING PLACE
Arrested on 9/12/08
Charged with insurance fraud in the 3rd degree
An investigation by the Frauds Bureau led to the arrest of a police officer employed by the MTA on charges of filing a fraudulent $28,375 insurance claim for a diamond ring that he reported missing. The suspect, who is a lieutenant commander in the U.S. Naval Reserve, purchased the diamond for approximately $15,000 in July 2006 under a promotional program sponsored by USAA, an insurer that serves current and former military personnel. He reported the he had the stone set in an 18-karat gold setting valued at $2,200. In December 2006, he insured the ring through USAA for $28,375. The suspect reported the ring missing in 2007 and filed a claim with USAA stating that he lost the ring while taking it to a jeweler to be cleaned. Investigators later tracked the suspect's fiance - who was not implicated in the case - and photographed the ring on her finger.
- NOT ENTITLED
Arrested on 9/12/08
Charged with violation of Section 114-(1) of the Workers' Compensation Law
Following a work-related back injury that occurred on 8/7/88, the defendant in this case began receiving workers' compensation benefits. As recently as 7/15/08, she submitted a Work Activity Report to the State Insurance Fund stating that she had not worked since her accident. However, surveillance conducted during an investigation by the Frauds Bureau and the Fund observed her working as a food server in Pennsylvania on 2/7/08. As a result of the fraud, she collected at least $5,600 in benefits to which she was not entitled.
- ADDITIONAL PREMIUMS
Arrested on 9/10/08
Charged with possession of a forged instrument in the 2nd degree and falsifying business records in the 1st degree
A Nassau County construction company owner presented a Certificate of Insurance to a contractor as proof that he had workers' compensation and liability insurance as required by New York State law. However, an investigation by the Frauds Bureau and the State Insurance Fund uncovered evidence that the Certificate was forged and no such coverage was in place, causing a loss to the contractor of nearly $6,700 in additional insurance premiums.
