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Arrests for November 2009

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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

Photo of Insurance Frauds Investigator holding handcuffs

CAUGHT!
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  • SENTENCED

    On 11/23/09, Amir Tricic pleaded guilty to petit larceny and was sentenced to a $750 fine, forfeiture of workers’ compensation benefits and $9,000 in restitution. He began collecting benefits following a work-related back injury on 3/25/08. During the benefit period, he submitted documents and gave testimony under oath stating that he had not worked in any capacity since 10/28/08. He was arrested in 8/09 after being videotaped operating a power saw, carrying a ladder and using tools. Moreover, he was wearing a shirt that read “Golden Hammer,” which led investigators to suspect that he was employed as a carpenter. His arrest was the result of an investigation by the Frauds Bureau and AIG Commercial Insurance Company.

  • FRAUDULENT CERTIFICATE

    Arrested on 11/30/09

    Charged with insurance fraud in the 4th degree, offering a false instrument for filing in the 2nd degree and violation of the Workers’ Compensation Law

    While working as a sub-contractor at a flooring installation job in Pomona, NY, the defendant in this case submitted a Certificate of Insurance as proof that he had workers’ compensation insurance as required by law. However, an investigation by the Frauds Bureau and the State Insurance Fund revealed that the Certificate was fraudulent. As a result, the State Fund was defrauded of $1,573 in premium payments.

  • TOO LATE

    Arrested on 11/25/09

    Charged with insurance fraud in the 3rd degree

    On 10/23/09, an upstate woman added collision and comprehensive coverage to her auto insurance policy with Progressive Insurance Company. She subsequently reported to the insurer that her car had struck a deer on 10/27 and filed a claim for the damages. However, an investigation by the Frauds Bureau, the State Police and Progressive’s SIU found evidence that the accident had actually occurred on 10/22, the day before the additional coverage was purchased. Progressive denied the $3,100 claim.

  • 50 DATES ADDED

    Arrested on 11/19/09

    Charged with grand larceny in the 3rd degree and insurance fraud in the 3rd degree

    From 10/07 through 8/08, a Queens woman was treated by a psychologist on 30 occasions. She filed claims for those 30 treatments and received reimbursement from CIGNA Insurance Company. However, she filed claims for 50 additional treatments for dates of service through 8/09, a year after she was last treated. The allegedly fraudulent claims totaled $6,750 for which she received $3,800 from CIGNA. An investigation by the Frauds Bureau led to her arrest.

  • EMBEZZLEMENT

    Arrested on 11/19/09

    Charged with forgery in the 2nd degree and grand larceny in the 2nd degree

    A licensed life insurance agent was charged with embezzling $109,000 from 29 clients and using the money for personal gain. An investigation by the Frauds Bureau revealed that between 2007 and 2009, he changed the addresses on clients’ insurance policies to his address and then requested loans against those policies. The checks were made out to his clients but mailed to the agent. He forged the clients’ signatures and deposited the checks into accounts that he controlled. Records obtained by investigators indicated that the defendant used the money for gambling.

  • INACCURATE REPORTING

    Arrested on 11/19/09

    Charged with grand larceny, insurance fraud, falsifying business records and violation of the Workers’ Compensation Law

    An investigation by the Frauds Bureau resulted in the arrest of a business owner for failing to accurately report his company’s receipts, bank deposits and payroll to the State Insurance Fund for the period 8/1/06 through 3/31/09. Moreover, he submitted false supporting documentation in an effort to avoid paying the proper insurance premiums. As a result, he defrauded the Fund of $117,250.

  • MATERIAL MISREPRESENTATION

    Arrested on 11/18/09

    Charged with grand larceny in the 3rd degree, insurance fraud in the 3rd degree, falsifying business records in the 1st degree and violation of the Workers’ Compensation Law

    The owner of a construction company materially misrepresented information in an audit conducted by the State Insurance Fund. He reported only $11,946 in sales for the audit period. However an investigation by the Frauds Bureau found evidence that he had received $826,705 during the audit period in payment for work done for a development company. The premium fraud amounted to $67,496.

  • CORRECTION OFFICER CAUGHT

    Arrested on 11/18/09

    Charged with insurance fraud in the 3rd degree, offering a false instrument for filing in the 1st degree and violation of the Workers’ Compensation Law

    An investigation by the Frauds Bureau, the State Insurance Fund, the Workers’ Compensation Board’s Office of the Fraud Inspector General, the State Police and the Department of Correctional Services’ Workers’ Compensation Unit resulted in the arrest of a correction officer who began collecting workers’ compensation benefits following an injury on the job. During the benefit period, he submitted numerous Work Activity Reports to the State Fund stating that his injury prevented him from working in any capacity. However, investigators discovered that he was working as a general contractor while fraudulently collecting $13,666 benefits.

  • TATTOOED

    Arrested on 11/18/09

    Charged with insurance fraud in the 4th degree, falsifying business records in the 1st degree and violation of the Workers’ Compensation Law

    After sustaining a work-related injury to his hand, a tattoo artist filed a claim for workers’ compensation benefits from the State Insurance Fund. During the benefit period, he submitted a Work Activity Report to the Fund stating that he had not returned to work. However, an investigation by the Frauds Bureau revealed that he owned and operated a local tattoo parlor. As a result of the fraud, he collected more than $2,200 in benefits to which he was not entitled.

  • FORENSIC PROOF

    Arrested on 11/16/09

    Charged with insurance fraud and offering a false instrument for filing

    On 2/5/09, a Staten Island couple reported to the NYPD that their 2001 Jaguar had been stolen. They subsequently submitted a claim to Liberty Mutual Insurance Company for the loss. However, the car was recovered and a forensics examination of the vehicle proved that the ignition had not been compromised and a test of the fluid proved that the engine seized while running. The Frauds Bureau and Liberty Mutual’s SIU pooled resources in the investigation that led to the arrests.

  • UNLICENSED

    Arrested on 11/16/09

    Charged with insurance fraud, unauthorized practice of profession and scheme to defraud

    An investigation by the Frauds Bureau resulted in the arrest of the defendant in this case. He was accused of representing himself as a doctor and treating several patients at a Staten Island medical facility. He allegedly used the tax ID numbers of licensed physicians associated with the clinic with the knowledge of those physicians who were sometimes present during treatment. The defendant billed private insurers more than $3,000 for the purported treatments. One of the physicians was also arrested and the arrest of a second physician is pending.

  • ACTIVELY DISABLED

    Arrested on 11/13/09

    Charged with insurance fraud in the 3rd degree and violation of the Workers’ Compensation Law

    An Ulster County man was arrested for fraudulently collecting more than $35,000 in workers’ compensation benefits from the State Insurance Fund. He testified under oath at two workers’ compensation hearings and submitted to medical examinations by two physicians informing them as to his level of disability. He was subsequently declared to be permanently totally disabled. However, during the benefit period, he was observed through surveillance performing such activities as driving, power-washing and repairing vehicles and fishing waist deep in a running stream. An investigation by the Frauds Bureau and the State Insurance Fund resulted in his arrest.

  • VIDEOTAPED

    Arrested on11/9/09

    Charged with insurance fraud in the 4th degree and falsely reporting an incident in the 3rd degree

    An investigation by the Frauds Bureau led to the arrest of a customer service representative for a major insurance company for filing an allegedly fraudulent insurance claim. The defendant reported to New York Central Mutual Fire Insurance Company that her iPod, GPS and laptop computer were stolen from her car while it was parked on a local street in Albany and she filed a $1,620 claim for the loss. However, investigators reviewed a bank’s surveillance video which contradicted her contention that someone had taken the items from her car. The surveillance camera was located near her parking space. When shown the video, she admitted that she had lied.

  • “STOLEN” MOTORCYCLE SOLD

    Arrested on 11/6/09

    Charged with insurance fraud in the 3rd degree

    The defendant in this case reported to State Farm Insurance Company that his motorcycle was stolen. However, an investigation by the Frauds Bureau revealed that he sold the motorcycle five months after filing a claim with State Farm for the loss. The fraud was discovered when another person attempted to obtain a title and register the cycle. State Farm never paid the claim.

PRIOR SUPPLEMENTS

October 2009

  • SENTENCED

    After a jury heard three days of testimony, a couple who were charged with 3rd degree insurance fraud agreed to a plea bargain. The wife pleaded guilty to a reduced charge of insurance fraud in the 4th degree, a felony. She agreed to pay a $2,500 fine and provide a DNA sample for the State database. The husband pleaded guilty to insurance fraud in the 5th degree, a misdemeanor, and agreed to pay a $1,000 fine. The sentence doesn’t include jail time but both will pay crime-victims’ assistance fees. The Frauds Bureau’s Assistant Counsel prosecuted the case which stemmed from a claim filed by the couple stating that a June 2008 lightening strike caused extensive damage to electrical appliances in their home. The wife claimed that after the strike, she became unconscious when she tried to turn on one of the appliances. The couple gave an oral statement to the insurance company’s investigator but did not sign it. The Assistant Counsel offered the couple a plea deal in January. Their lawyer said that since there was no payout by the insurer, there was no crime and turned down the offer. The Assistant Counsel prosecuted the case in his capacity as a Special Prosecutor in a pilot program initiated in 2008 in which Frauds Bureau attorneys are cross-designated as assistant district attorneys and assist local DA’s Offices in all aspects of the cases to which they are assigned.

  • WORKING THE COUNTER

    Arrested on 10/21/09

    Charged with violation of the Workers’ Compensation Law

    The suspect in this case was injured in 1995 while working as a mason on Long Island and began collecting workers’ compensation benefits. However, an investigation by the Frauds Bureau and the State Insurance Fund uncovered evidence that he was working as a counter person at a local pizza parlor. A statement obtained from the owner of the pizza parlor confirmed his employment status. As a result of the fraud, the suspect collected $7,313 in benefits to which he was not entitled.

July 2009

  • AUTO GIVE-UP

    Arrested on on 7/21/09

    Charged with insurance fraud, theft by deception and falsifying records under the New Jersey Penal Law

    A New Jersey man reported to the NYPD that he had parked his 1994 Mercedes Benz on a local street in Staten Island at 10:40 p.m. on 10/28/05 and when he returned the next day, the car was gone. An investigation by the Frauds Bureau, the NYPD and the Ocean County Sheriff’s Office revealed that he had “given up” the car on 10/19/05 to an NYPD undercover. The auto insurance policy was written by a New Jersey insurer, N.J. Skylands Insurance Company, and the claim was made through the insurer’s New Jersey office. The Ocean County (N.J.) Sheriff’s Office made this arrest and will prosecute the case. This was a long-term investigation that resulted in 12 arrests.

It should be noted that arrests and indictments are merely accusations and that a defendant is presumed innocent until proven guilty.

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