Arrests for June 2009
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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- SENTENCED
William Raymond Miller, former chief underwriting officer of Upper Hudson National Insurance Company in Monticello, NY, was sentenced to ten years and one month in federal prison on 6/18/09 for selling $535 million in fraudulent surety bonds and stealing $22.5 million in premiums. The court also ordered a personal money judgment of $22 million against Miller who has already forfeited $22.5 million to the government, along with real estate in Maryland and Florida. The Frauds Bureau began investigating Miller in early 2008 after he was fired by Upper Hudson. The insurance company contacted authorities after learning that Miller had sold a worthless $38 million performance bond purportedly authorized by Upper Hudson. He was accused of keeping $1.9 million in premiums paid for the bond by a construction company engaged in a project in Nebraska. Under a plea agreement with federal authorities, Miller admitted that from 2005 to April 2008 he used the names of several corporations to sell the worthless bonds on construction projects throughout the U.S. Besides the New York investigation which was conducted by the Frauds Bureau and the U.S. Postal Inspection Service, Miller was also investigated by state authorities in Maryland and Florida and the FBI.
- FRAUDULENT CERTIFICATE
Arrested on 6/30/09
Charged with violation of Section 114.1 of the Workers’ Compensation Law
A subcontractor was arrested and charged with submitting a fraudulent Certificate of Insurance to a Suffolk County general contractor as proof that he had workers’ compensation insurance through the State Insurance Fund when in fact no such coverage existed. His arrest was the result of an investigation by the Frauds Bureau and the State Fund.
- NOT DISABLED
Arrested on 6/25/09
Charged with insurance fraud in the 3rd degree and falsifying business records in the 1st degree
An investigation by the Frauds Bureau led to the arrest of an upstate woman charged with cashing five disability checks totaling $5,600 issued to her sister. The defendant was the care-giver for her disabled sister and had power of attorney. However, she failed to inform American International Group that her sister died on 3/17/07 and she continued to cash the checks meant for her sister.
- TRUCK DRIVER NABBED
Arrested on 6/25/09
Charged with insurance fraud in the 3rd degree and violation of the Workers’ Compensation Law
The defendant in this case began collecting workers’ compensation benefits following an on-the-job injury. During the benefit period, he submitted documents to National Interstate Insurance Company indicating that he was not working in any capacity. However, an investigation by the Frauds Bureau and the State Police revealed that he was employed as a truck driver for a company in Troy, NY, while fraudulently receiving $6,286 in benefits.
- PAID IN FULL
Arrested on 6/24/09
Charged with criminal possession of a forged instrument in the 2nd degree, falsifying business records in the 1st degree and insurance fraud in the 5th degree
The suspect in this case was involved in an auto accident in April 2009. She submitted a claim for no-fault benefits to her insurance carrier. As part of her treatment, the doctor issued several prescriptions. The suspect had the prescriptions filled at three local pharmacies where she made a co-payment of either $1 or $3 for each prescription. The remainder of the cost was billed to Medicaid. However, an investigation by the Frauds Bureau found evidence that she had submitted receipts for the prescriptions to her insurer, with information about the amounts of the co-pay and the billing to Medicaid deleted. She also enhanced the amount of each prescription for which she stated that she had paid cash. As a result of the fraud, she was paid more than $788 to which she was not entitled.
- CLAIMED TWICE
Arrested on 6/24/09
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
A Troy woman submitted a claim in April 2009 to Erie Insurance Company for $1,686 in damage to her 1999 Dodge Durango that resulted from an auto accident. However, an investigation by the Frauds Bureau revealed that she had submitted a claim for the same damage to GEICO Insurance Company two months earlier.
- BMW BURNED
Arrested on 6/24/09
Charged with with attempted grand larceny, insurance fraud, offering a false instrument for filing, falsifying business records, falsely reporting an incident and false written statement
This defendant reported to the NYPD and GEICO Insurance Company that his 2002 BMW had been stolen. He stated that he had last seen the car when he parked it on a Bronx street at 12:30 a.m. on 1/15/09 and found it gone when he returned at 9:30 a.m. that same day. However, the FDNY responded to a vehicle fire in Brooklyn at 8:45 p.m. on 1/14/09 and on 1/22/09, the New York City Department of Sanitation impounded the car as a derelict vehicle. The car was subsequently identified as the BMW the defendant had reported stolen. The Frauds Bureau and the New York City Fire Marshals conducted the investigation that led to his arrest.
- ALTERED ACCIDENT REPORT
Arrested on 6/23/09
Charged with insurance fraud in the 5th degree
A Brooklyn man was involved in an accident while driving his mother’s car. Police responded to the scene and filed an accident report which showed that the Brooklyn man was at fault. However, several days later, the mother submitted an amended accident report. Examination of the amended report showed that it contained erasures. In addition, some information had been whited out to make it seem that her son was not at fault in the accident. The Frauds Bureau and the NYPD conducted the investigation that led to the arrest of the mother.
- UNDER SURVEILLANCE
Arrested on 6/23/09
Charged with perjury in the 1st degree, offering a false instrument for filing in the 1st degree, insurance fraud in the 3rd degree and violation of the Workers’ Compensation Law
The defendant in this case began collecting workers’ compensation benefits after incurring an injury while working as a carpenter. However, during an investigation by the Frauds Bureau, the State Insurance Fund and the Workers’ Compensation Board’s Office of the Fraud Inspector General, surveillance conducted by investigators between January and July 2008 observed him working at the same time he was fraudulently collecting $10,200 in benefits. Moreover, during the benefit period he submitted numerous Work Activity Reports to the State Fund stating that he was unable to work.
- DOCTOR CAUGHT
Arrested on 6/19/09
Charged with health care fraud, conspiracy to commit health care fraud and income tax evasion
An investigation by the Frauds Bureau and the Internal Revenue Service resulted in the arrest of a Bay Shore, Long Island, doctor who, together with others, filed $800,000 in allegedly fraudulent claims with numerous health care programs, including Medicare, for services that were never provided. Court papers also alleged that he evaded almost $1.3 million in income taxes from 2001 to 2003.
- MOTHER/DAUGHTER SCAM
Arrested on 6/17 and 6/23/09
Charged with insurance fraud in the 5th degree
On 11/13/08, a Rochester woman was involved in an auto accident while driving her daughter’s car. Because her driver’s license had been revoked, she called her daughter and asked her to come to the scene of the accident and state that she was driving the car and her mother was a passenger. However, when the two women asked the driver of the other car involved in the accident to tell the police that the daughter was the driver, he refused. So the mother left the scene and the daughter told police that she had been driving when the accident occurred. She submitted a claim to New York Central Mutual Insurance Company on which she reported injuries she allegedly sustained in the accident. Her mother submitted a signed statement to the insurer naming her daughter as the driver. However, during the investigation by the Frauds Bureau and the Rochester Police Department, the daughter admitted that she had lied to the police at the scene and to her insurer about injuries allegedly sustained in the accident. The daughter was arrested on 6/17 and the mother on 6/23/09. Both were charged with insurance fraud in the 5th degree. Neither woman received any payment from New York Central Mutual or from Progressive Insurance Company, the insurer for the driver of the other vehicle.
- OWNER GIVE-UP
Arrested on 6/17/09
Charged with insurance fraud in the 3rd degree, grand larceny in the 3rd degree, falsifying business records, and conspiracy in the 5th degree
The defendant in this case reported to the NYPD that his 2001 Acura MXD had been stolen. However, an investigation by the Frauds Bureau and the NYPD’s Auto Crime Division uncovered evidence that the car was taken into police custody as part of an owner give-up sting operation before it was reported stolen. The defendant moved out of state before the sting operation was completed. But he was indicted, an arrest warrant was issued and on 6/17/09 he was arrested and returned to New York on the warrant.
- OVERBILLED
Arrested on 6/15/09
Charged with violation of Section 114.1 of the Workers’ Compensation Law
A joint investigation by the Frauds Bureau and the State Insurance Fund led to the arrest of a Staten Island registered nurse for home care that was not provided. The nurse was employed by a health care facility to provide three home care visits a day to an injured worker. However, evidence indicated that he made only one visit a day and as a result, the provider was overbilled by nearly $4,300.
- CHECKS CASHED
Arrested on 6/15/09
Charged with 16 counts of forgery in the 2nd degree, 8 counts of criminal possession of a forged instrument in the 2nd degree and 1 count of petit larceny
A Queens man was charged with falsely claiming that he had not received eight workers’ compensation benefit checks totaling $1,144. Based on affidavits he submitted to the State Insurance Fund claiming signatures on the checks were not his, the checks were reissued. However, an investigation by the Frauds Bureau and the State Fund found evidence that he deposited four of the checks into his personal account and cashed the other four at a local check-cashing company.
- WORKING? YES
Arrested on 6/12/09
Charged with insurance fraud and offering a false instrument for filing
This suspect sustained a work-related injury in 2004 and began receiving workers’ compensation benefits from the State Insurance Fund. However, surveillance conducted during an investigation by the Frauds Bureau and the State Fund showed the suspect working as a glass/mirror installer. During the benefit period, he completed and submitted a questionnaire to the Fund in which he answered “No” when asked if he had worked since the date of his accident. As a result of the fraud, the suspect collected more than $52,000 in benefits to which he was not entitled.
- REISSUED CHECKS
Arrested on 6/10/09
Charged with grand larceny in the 3rd and 4th degrees, criminal possession of stolen property in the 3rd, 4th and 5th degrees, insurance fraud in the 3rd, 4th and 5th degrees and petit larceny
An investigation by the Frauds Bureau led to the arrest of a Bronx woman accused of defrauding GHI of $3,152. On five occasions, the woman sought treatment from a nonparticipating provider, paid the provider and filed claims for reimbursement from GHI. However, she subsequently reported to the insurer that she had moved and never received the checks and GHI issued replacement checks. But before GHI could stop payment on the original checks, she received them and cashed these checks as well.
- GAINFULLY EMPLOYED
Arrested on 6/10/09
Charged with insurance fraud, grand larceny and offering a false instrument for filing
Following an injury sustained on the job in 1993, the defendant in this case began receiving workers’ compensation benefits. During the benefit period, he submitted documents to the State Insurance Fund stating that he was unable to work since the date of his accident. However, during an investigation by the Frauds Bureau and the State Fund he was observed working as a carpenter. Records indicated that he earned over $14,000 in 2005 and more than $59,000 in 2006. As a result, he fraudulently received $32,000 in benefits while gainfully employed.
- ALTERED DATE
Arrested on 6/9/09
Charged with criminal possession of a forged instrument and violation of Section 114.1 of the Workers’ Compensation Law
Following a period of collecting workers’ compensation benefits, this defendant’s doctor issued a Return-to-Work note. However, an investigation by the Frauds Bureau found evidence that the defendant had altered the date on the note from 4/1/09 to 4/13/09 in order to extend the benefit period.
- CONFESSED
Arrested on 6/4/09
Charged with insurance fraud in the 4th degree and attempted grand larceny
On 12/13/08, two days after the effective date of his auto insurance policy, this suspect filed a $1,734 claim with GEICO Insurance Company for damage to his 2008 Mitsubishi Galant. However, upon examination of the car and the claim, GEICO discovered that the suspect had filed a claim with AutoOne Insurance Company for the same damage. GEICO reported the incident to the Frauds Bureau and on 3/30/09, following an investigation conducted jointly with the Rochester Police Department, the suspect signed a voluntary written confession stating that he wanted to use the insurance payment to have the car painted.
- WORKERS’ COMP FRAUD
Arrested on 6/2/09
Charged with violation of Section 114.1 of the Workers’ Compensation Law
The defendant in this case suffered burns to his back and his left arm and leg on 2/6/03 while using a deep fryer at his job in a snack bar and began collecting workers’ compensation benefits. During the benefit period, he submitted several Work Activity Reports stating that he was not working. However, an investigation by the Frauds Bureau uncovered evidence that the defendant was employed as the superintendent at a number of properties, including the one in which he resides. From approximately January 2004 to the time of his arrest, he collected $44,539 in benefits to which he was not entitled.
