Arrests for November 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
On 11/14/08, a Nassau County chiropractor was arrested and pleaded guilty to health care fraud. During 2002 and 2003, he instructed his staff to submit claims to various no-fault and workers’ compensation insurers for treatments that were not provided. The fraudulent claims totaled approximately $23,000. An investigation by the Frauds Bureau, the FBI and the Office of the U.S. Attorney for the Eastern District resulted in his arrest.
- INFLATED CLAIM
Arrested on 11/25/08
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
A wind storm caused damage to the deck and hot tub of the defendant in this case. He submitted a claim to New York Central Mutual Insurance Company for the loss together with receipts for the repair work. However, an investigation by the Frauds Bureau revealed that he had altered the receipts to inflate the cost of repairs by $5,950.
- RUG ADJUSTMENT
Arrested on 11/25/08
Charged with insurance fraud in the 5th degree and attempted petit larceny
A 46-year-old man who claimed he was injured when he tripped and fell over a rug at the entrance to a Jamestown food market was charged with insurance fraud after a surveillance camera revealed that he staged the accident. The suspect claimed he was injured in a fall on 7/24/08. He was taken to a local hospital by ambulance and treated for a purported back injury. However, an investigation by the Frauds Bureau turned up the surveillance tape showing that the suspect simply lay down on the floor after adjusting the rug to make it appear he had tripped. He subsequently submitted a claim to the market’s insurer, Travelers Insurance Company, but later withdrew it after being informed of the video. He was charged with attempted petit larceny for submitting an $860 bill to the market for payment of the ambulance service.
- THEFT? NOT SO FAST
Arrested on 11/24/08
Charged with insurance fraud, grand larceny, falsifying business records, offering a false instrument for filing and falsely reporting an incident
The defendant in this case reported to the police and to her insurer, Response Insurance Company, that her car had been stolen on 12/10/07 from a parking spot in front of her home. However, the car was recovered during an investigation by the Frauds Bureau and the NYPD’s Auto Crime Division. A forensic examination concluded that the vehicle’s theft systems were not defeated and there was no damage to the ignition. It was further determined that the car was started and driven using the original key.
- FOUR YEARS LATER
Arrested on 11/20/08
Charged with insurance fraud in the 4th degree
An investigation by the Frauds Bureau, the Workers’ Compensation Board’s Office of the Fraud Inspector General and the Suffolk County DA’s Office led to the arrest of a chiropractor who allegedly continued to submit claims for treating a patient four years after the treatments ended. According to investigators, the suspect provided chiropractic treatments to the patient for ten years until 2004. However, he was charged with filing 96 fraudulent claims totaling $3,201 to CNA Insurance Company from 2004 until May 2008 for services that were never rendered. The fraudulent claims were discovered when the insurer contacted the former patient to verify whether she was still being treated.
- FORGED
Arrested on 11/19/08
Charged with insurance fraud in the 5th degree and criminal possession of a forged instrument in the 3rd degree
A Schenectady woman submitted a medical request form for disability benefits to CIGNA Insurance Company. The insurer suspected that the doctor’s signature on the form was forged and reported their suspicions to the Frauds Bureau. Investigators conducted interviews with the doctor and his staff and were able to verify that the signature was indeed forged.
- BROKER FRAUD
Arrested on 11/17/08
Charged with grand larceny, offering a false instrument for filing and petit larceny
A Rockland County insurance broker was accused of stealing $6,500 that two businesses gave him to pay for workers’ compensation and business liability insurance premiums. He allegedly kept $6,000 in premiums for liability insurance from one business and another $500 in premiums for workers’ compensation insurance from a second business. In addition, investigators also charged that he filed documents falsely stating that the second business was covered for workers’ compensation. The Frauds Bureau and the Workers’ Compensation Board’s Office of the Fraud Inspector General conducted the investigation that led to the arrest.
- “STOLEN” JEWELRY SOLD
Arrested on 11/14/08
Charged with insurance fraud in the 3rd degree and falsifying business records in the 1st degree
This suspect reported to the police that jewelry and coins valued at $6,700 were stolen from her home when it was burglarized on 8/27/08. However, an investigation by the Frauds Bureau uncovered evidence that she had sold several pieces of the allegedly stolen jewelry five days before reporting the break-in at her home.
- SAME INJURY
Arrested on 11/14/08
Charged with offering a false instrument for filing and violation of the Workers’ Compensation Law
The defendant in this case was accused of collecting $3,000 in workers’ compensation benefits from the State Insurance Fund while stating that he was not working as the result of a job-related knee injury. At the same time, he was employed by a private security business. He later collected $7,000 in workers’ compensation benefits from AIG Insurance Company, again claiming he was unable to work because he had injured the same knee. The Frauds Bureau, the State Fund and AIG’s Special Investigations Unit pooled resources in this investigation.
- FRAUDULENT CERTIFICATES
Arrested on 11/13/08
Charged with criminal possession of a forged instrument in the 2nd degree
A joint investigation conducted by the Frauds Bureau and the State Insurance Fund led to the arrest of a Poughkeepsie contractor. He was charged with submitting two fraudulent Certificates of Insurance as proof of workers’ compensation coverage when in fact no such coverage was in place.
- HIT AND RUN
Arrested on 11/12/08
Charged with insurance fraud and grand larceny
This suspect reported to the Buffalo Police Department that her 2000 Ford Mustang had been stolen sometime prior to 9:30 a.m. on 3/17/08. She subsequently filed a claim with Progressive Insurance Company for the loss. However, an investigation by the Frauds Bureau revealed that the car was involved in a hit-and-run accident two hours before it was reported stolen. The driver fled the scene, leaving the keys in the ignition.
- CAUGHT BY SURVEILLANCE
Arrested on 11/12/08
Charged with violation of Section 114-1 of the Workers’ Compensation Law
The defendant in this case sustained a work-related knee injury on 12/27/05 and began collecting workers’ compensation benefits. He subsequently certified to the State Insurance Fund that he was not working during the period from September 18, 2007 through March 3, 2008. However, surveillance conducted during an investigation by the Frauds Bureau and the Fund observed him working as a potato picker. As a result of the fraud, he collected $4,760 in benefits to which he was not entitled.
- PREMIUM FRAUD
Arrested on 11/10/08
Charged with grand larceny, criminal possession of a forged instrument, insurance fraud, falsifying business records and violation of Section 114-1 of the Workers’ Compensation Law
A Queens, NY, sub-contractor was hired to do roofing work. He subsequently presented Certificates of Insurance to the contractor as proof that he had the necessary workers’ compensation insurance coverage for the periods 2/10/07 to 2/10/08 and 2/10/08 to 2/10/09. However, an audit conducted by the State Insurance Fund found that the policy whose number appeared on both Certificates had been cancelled in September 2004 for nonpayment of premiums. The fraudulent Certificates resulted in the payment of $10,600 in additional premiums by the contractor. The Fund and the Frauds Bureau pooled resource in this investigation.
- RECYCLED
Arrested on 11/10/08
Charged with insurance fraud, grand larceny and falsely reporting an incident
The defendant in this case reported to the NYPD that he parked his car on a local street in Queens, NY, on 4/7/08, and when he returned on 4/12/08, the car was gone. He filed a claim for the loss on which Allstate Insurance Company paid out $5,787. However, an investigation by the Frauds Bureau uncovered evidence that the Department of Motor Vehicles had received a voucher indicating that the car was turned over to a recycling company for destruction on 4/4/08, three days before the defendant reported it stolen.
- NO COVERAGE
Arrested on 11/10/08
Charged with criminal possession of a forged instrument, grand larceny, insurance fraud, falsifying business records and violation of Section 114-1 of the Workers’ Compensation Law
A sub-contractor was accused of submitting fraudulent Certificates of Insurance indicating that he had workers’ compensation insurance as required by New York State Law for the periods 4/13/06 to 4/13/07 and 4/13/07 to 4/13/08. However, an investigation by the Frauds Bureau turned up evidence that the Certificates were fraudulent and no coverage existed for those time periods. The cost of the fraud to the Fund was more than $12,000 in premiums.
- ARSON
Arrested on 11/7/08
Charged with arson, criminal mischief, burglary and reckless endangerment
The home of a couple in Lancaster, NY, was destroyed on 8/15/07 by a fire that was determined to be arson. The damage was estimated at $400,000 to $500,000. A joint investigation by the Frauds Bureau, the Lancaster Police Department and the Erie County DA’s Office uncovered evidence indicating that the suspect in this case deliberately set the fire by igniting a flammable liquid. The motive in the case has not been determined.
- WORKERS’ COMP FRAUD
Arrested on 11/7/08
Charged with criminal possession of a forged instrument, offering a false instrument for filing, insurance fraud and resisting arrest
An investigation by the Frauds Bureau and the State Police led to the arrest of an upstate mason for his part in a workers’ compensation fraud scheme. The defendant submitted a Certificate of Insurance to a business owner as proof that he had the required insurance coverage to perform masonry work. However, investigators discovered that the Certificate was fraudulent and no such coverage existed.
- MOTHER/SON FRAUDSTERS
Arrested on 11/4/08 and 10/15/08
Charged with insurance fraud and attempted grand larceny
A woman and her son were arrested in connection with an allegedly fraudulent insurance claim submitted to GEICO Insurance Company. An investigation by the Frauds Bureau was initiated after police found the mother’s 2007 Yamaha lying unattended on the side of I-290 on 7/13/08. The motorcycle was recovered shortly before she called the police and reported it stolen. The son was charged with abandoning the motorcycle on the side of the expressway so his mother could file a $7,000 claim for the purported loss. When it was recovered, police found damage to the motorcycle similar to damage the mother had described in an accident claim to GEICO on 7/8/08. Neither that claim, denied because she did not have collision coverage, nor the later claim was paid. The mother was arrested on 10/15/08, the son on 11/4/08.
- ELDERLY DEFRAUDED
Arrested on 11/3/08
Charged with bank embezzlement
A bank insurance agent was arrested and accused of embezzling more than $700,000 from five elderly clients. Evidence found during the investigation indicated that, from 1/02 through 12/06, this New York State-licensee conducted 21 unauthorized withdrawals totaling $400,000 from the clients’ accounts. Another two transactions involved life insurance fraud in which he used the clients’ money to pay premiums for policies on which he was the beneficiary; he collected $200,000 on one of those policies. The Frauds Bureau and the FBI collaborated on this case.
PRIOR SUPPLEMENTS
October 2008
- LET’S GO TO THE VIDEO TAPE
Arrested on 10/31/08
Charged with insurance fraud in the 4th degree and falsely reporting an incident in the 3rd degree
A U.S. Postal Service mail carrier reported to the Haverstraw Police Department that her car was damaged in the parking lot of a local store. She subsequently filed a claim with Allstate Insurance Company for the loss. However, during an investigation by the Frauds Bureau, the Haverstraw PD and Allstate’s SIU, a review of a tape from the store’s video camera set up in the parking lot showed the defendant placing part of her damaged bumper on the ground so it would appear as if the incident had happened there. She admitted that she had done the damage herself while attempting to park her car on another day prior to the incident in the parking lot.
- BUSTED!
Arrested on 10/24/08
Charged with insurance fraud in the 3rd degree, attempted grand larceny in the 3rd degree, falsifying business records in the 1st degree, false written statement and conspiracy in the 5th degree
On 8/13/08, an Ulster County woman reported to the NYPD that her 2007 Nissan Pathfinder had been stolen in the Bronx. On 10/8/08, a detective from the New York City Department of Environmental Protection (DEP) recovered the car on the property of the Ashokan Reservoir with no plates. In addition, the entire interior of the car had been meticulously removed with no attendant damage to the rest of the interior. The DEP detective initiated an investigation and requested the assistance of the Frauds Bureau. Investigators canvassed the apartment complex where the woman and her husband lived. A number of tenants and employees said that they had seen the woman driving the car during September and October 2008. In addition, they had seen the car parked near the couple’s apartment during those months. On 10/10/08, the wife appeared at the DEP impound lot to claim the car. In answer to a question about the spare tire and before viewing the car, she stated that the spare tire had been mounted on the rear passenger side. That would not have been the case when the car was purportedly stolen two months earlier because the husband had been observed changing a flat tire on the rear passenger side on 10/6/08.
- ARRESTED TWICE
Arrested on 10/21/08
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
The owner/operator of a small trucking business reported to his insurance broker that a 2006 Mercedes Benz and a 2000 Mitsubishi Eclipse were stolen on 7/28/08 from one of his car carriers, a 1994 Freightliner, in Clayton, GA, where he had left it parked. He was informed that there was no cargo theft coverage on the Freightliner. There was, however, cargo theft coverage on a second car carrier he owned, a Peterbilt vehicle. The following day, he called the broker again to report that he had located the two purportedly stolen cars and requested that the cargo theft coverage be transferred from the Peterbilt to the Freightliner. On 8/1/08, he called 911 on Staten Island, NY, and reported that, while he was driving from Georgia to New York, he was robbed at gunpoint by two individuals he had observed following him through several states. He further stated that the alleged robbers took the Mercedes and the Eclipse from the Freightliner, which is what he was driving and which now had cargo theft insurance coverage. At the precinct, detectives from the NYPD Robbery Squad interviewed him and he eventually confessed that the cars had not been stolen at all. He was arrested and charged with falsely reporting an incident. After being released on his own recognizance from Criminal Court on 8/2, he went to his broker’s office in Nassau County and repeated the story about being robbed at gun point. The broker requested a notarized Affidavit of Theft which was submitted to the suspect’s insurer for reimbursement. An investigation by the Frauds Bureau led to his arrest on 10/21/08 for insurance fraud and attempted grand larceny.
