Arrests for July 2010
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
Mindy Burger of Kingston, NY, was sentenced on 7/26/10 to 30 days in jail for enabling an inmate to continue to receive workers compensation benefits while he was serving time in Ulster County jail. She was also ordered to serve five years probation and to pay a $300 reimbursement to the State Insurance Fund. An investigation conducted by the Frauds Bureau and the Fund revealed that she filled out and signed the inmates name on work status reports sent to the Fund falsely stating that the inmate was not serving a jail sentence. Before being incarcerated, the inmate had been receiving the benefits as a result of a job-related injury. However, New York State law forbids the payment of workers compensation benefits to anyone serving a jail or prison sentence.
Ronald Mancuso, the last family member to be sentenced in a case involving conspiracy and mail fraud-related charges, was given three years probation on 7/29/10. He testified against the other family members at trial. His father, Lester Mancuso, and two brothers, Steven and Paul, were sentenced on 6/9/10 in the same case after pleading guilty on 10/28/09 to conspiring to cover up an illegal asbestos removal operation throughout the Mohawk Valley region. Lester Mancuso was sentenced to a term of 3 years, Steven Mancuso to 3 2/3 years, and attorney Paul Mancuso, the mastermind behind the operation, to 6 years and a fine of $20,000. The fine was levied for allowing asbestos to be dumped in a field and washed down a drain at a Utica school. All three were also sentenced to three years of supervision once released from prison. Additionally, a hearing is scheduled for 9/8/10 to determine the amount of restitution they should be responsible for as a result of their shoddy work. The arrests were the result of an investigation by the Frauds Bureau, the Environmental Protection Agency and the Workers Compensation Boards Office of the Fraud Inspector General.
After pleading guilty to grand larceny, Jacqueline Jacob of Brooklyn, NY, was ordered on 7/14/10 to pay $40,622 in restitution to United HealthCare Insurance Company. She was arrested on 2/7/08 for submitting 82 fraudulent claims to the insurer for medical treatments that she never received.
- GUILTY PLEA
Kenneth R. Bullock, a former New York State resident, pleaded guilty on 7/9/10 to violation of the Workers Compensation Law. Following a back injury while he was employed as a truck driver in 1990, he began collecting wage-replacement benefits. During the benefit period, he submitted 13 Work Activity Reports stating that he was unable to work as a result of his injury. Many of these reports bore Florida postmarks, arousing suspicion that resulted in an investigation by the Frauds Bureau, the State Insurance Fund and the State Police. Through surveillance, investigators learned that the suspect was living and working full-time as a mechanic in Florida. Between 2005 and 2010, he collected $39,000 in benefits to which he was not entitled.
- NO WAGES LOST
Arrested on 7/30/10
Charged with insurance fraud in the 4th degree
An investigation by the Frauds Bureau led to the arrest of a Schenectady man accused of filing a fraudulent lost-wage benefit claim totaling $3,000 under the no-fault portion of his auto insurance coverage following an auto accident. A wage verification form was sent to the place of business listed on the defendants no-fault application which included a signature of the owner of the business. However, investigators learned that the signature was forged and that the defendant had not worked for that business for approximately one year prior to the date of loss. In fact, he was unemployed at the time of the accident.
- ALTERED DATES
Arrested on 7/30/10
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
An upstate contract laborer backed his pickup truck equipped with a rear Boss salter/sander into a pole on 2/26/10, damaging both the vehicle and the salter/sander. He then contacted his insurer to file a claim and was informed that he did not have coverage for the salter/sander. On 3/12/10, he purchased additional coverage for the salter/sander and filed another claim, stating that the accident had occurred on 3/24/10 in an attempt to defraud his insurer of $2,150. An investigation by the Frauds Bureau led to his arrest.
- POSSESSION IS NINE TENTHS OF THE LAW
Arrested on 7/30/10
Charged with insurance fraud in the 3rd degree
A Saratoga County construction worker reported to Selective Insurance Company that a large 72-inch sweeper tractor had been stolen and filed a $3,869 claim for the loss. However, an investigation by the Frauds Bureau revealed that the equipment was never stolen and was in fact found in the suspects possession.
- OWNER GIVE-UP
Arrested on 7/27/10
Charged with insurance fraud in the 3rd degree, falsifying business records in the 1st degree, false written statement and offering a false instrument for filing in the 1st degree
In a case involving an owner give-up, a Brooklyn man reported to the NYPD that he last saw his 2006 Mitsubishi Endeavor on 1/6/10 and discovered it missing the next day. He subsequently filed a claim with Farmers Insurance Group for the loss. However, an investigation by the Frauds Bureau, the FDNY Fire Marshals and the NYPDs Auto Crime Division uncovered evidence that on 1/4/10, units from the FDNY had responded to a passenger vehicle fire in the Bronx. The vehicle was identified as the Mitsubishi Endeavor reported stolen by the suspect.
- STOLEN COMMISSIONS
Arrested on 7/22/10
Charged with grand larceny in the 3rd degree and forgery in the 2nd degree
The owner of a Queens insurance brokerage was accused of stealing $22,349 in commissions from her former employer between September 2006 and January 2009. She allegedly typed her name on 17 commission checks made payable to the former employer, an insurance brokerage, while she was employed there as an agent. She then endorsed and deposited the checks into her personal account. The Frauds Bureau, the Queens DAs Office and the State Police pooled resources in this investigation.
- VIDEO TAPE EVIDENCE
Arrested on 7/23/10
Charged with insurance fraud in the 4th degree, grand larceny in the 4th degree and offering a false instrument for filing in the 1st degree
Following a bus accident involving the Niagara Frontier Transportation Authority, an Erie County man reported that while a passenger on the bus, his head struck a pole when the accident occurred, causing injuries to his back, neck, forehead and shoulders. However, video surveillance on the bus during the accident showed that the suspect never struck any pole. An investigation conducted jointly by the Frauds Bureau and the NFTA resulted in the arrest of this defendant.
- UNDERREPORTING
Arrested on 7/15/10
Charged with insurance fraud, grand larceny and violation of the Workers Compensation Law
An investigation by the Frauds Bureau and the State Insurance Fund led to the arrest of the owner of a general contracting company who was accused of underreporting sales of approximately $4 million, as well as the number of employees on his payroll in order to avoid paying the appropriate premium for his workers compensation insurance coverage. The allegedly fraudulent act resulted in a loss of approximately $100,000 in premium payments due to the State Insurance Fund.
- STRIKE FORCE STRIKES AGAIN
Arrested on 7/14-16/10
Charged with violation of Section 1349 of Title 18 of the U.S. Code
In a continuing Medicare Fraud Strike Force operation, 11 defendants, including medical professionals, were charged with conspiring to commit health care fraud. Three suspects, arrested on 7/14, were charged for their involvement in a $3.5 million scheme in which they submitted fraudulent claims for durable medical equipment. Those involved included the owner of an oxygen equipment services company and two others who served as patient recruiters. Some recruiters targeted local churches for beneficiaries whose personal information the defendants used for fraudulent billings. A search warrant was executed at the oxygen equipment services company at the time of the arrests.
Eight other defendants were arrested on 7/16 at a separate location for submitting allegedly fraudulent claims for physical therapy and other medical services that were medically unnecessary or were not provided to beneficiaries at all. The Strike Forces investigation included the use of a court-ordered camera and microphone hidden in a room at the clinic, identified in the complaint as the Kickback Room, in which the conspirators allegedly paid cash kickbacks to corrupt beneficiaries. The purpose of the kickbacks was to induce the beneficiaries to receive unnecessary medical services or to remain silent when services not provided were billed to various insurance carriers. The conspirators obtained the money for the kickbacks by cashing checks drawn on clinic accounts that had been made payable to a nonexistent corporation. A search warrant was executed at the clinic at the time of the arrests. Together, the 11 defendants defrauded the insurers of more than $25 million.
The Medicare Fraud Strike Force supplements the criminal health care fraud enforcement activities of the U.S. Attorneys Offices by targeting chronic fraud as well as emerging or migrating schemes perpetrated by criminals operating as health care providers or suppliers. The Strike Force members include the Department of Justice Criminal Divisions Fraud Section, law enforcement partners in the Department of Health and Human Services (HHS), the New York Insurance Frauds Bureau and other state and local law enforcement agencies.
- MATERIAL MISREPRESENTATION
Arrested on 7/14/10
Charged with falsifying business records in the 3rd degree
An Elmira man applied for and was issued a disability insurance policy through CUNA Insurance Company. However, an investigation by the Frauds Bureau and the Chemung County Sheriffs Department subsequently revealed that the insured had a long history of heart disease and was taking heart medication, a fact that he denied on his application. Had the insurer been aware of his medical condition, the policy would not have been issued.
- TWOFER
Arrested on 7/14/10
Charged with insurance fraud, offering a false instrument for filing and attempted grand larceny
In separate occurrences, two individuals were charged with insurance fraud, offering a false instrument for filing and attempted grand larceny when they falsely claimed injuries related to accidents involving the Niagara Frontier Transportation Authority. One defendant reported that while waiting for a bus, he was struck in the head by a lighting fixture after the bus collided with a light pole. However, an investigation conducted jointly by the Frauds Bureau and the NFTA turned up video surveillance tapes showing the lighting fixture never struck the defendant.
In the second incident, the defendant reported that while she was a passenger on a bus, an accident caused her to strike her head numerous times on poles. During an investigation by the Frauds Bureau and the NFTA, video surveillance tapes again showed the incident reported by the suspect never occurred. In fact, she did not hit her head nor did she move at all during the accident.
- FLED THE SCENE OF THE CRIME
Arrested on 7/13/10
Charged with insurance fraud in the 3rd degree and falsely reporting an incident in the 3rd degree
The defendant in this case reported to the NYPD and to State Farm Insurance Company that his 2002 Nissan Pathfinder had been stolen. However, an investigation by the Frauds Bureau and the NYPDs Auto Crime Division found evidence that he actually had been involved in an auto accident and fled the scene.
- FRAUDULENT CHECK
Arrested on 7/9/10
Charged with grand larceny
A Westchester County woman was charged with attempting to negotiate a fraudulent check in the amount of $3,300 which appeared to be issued by GEICO. The defendant, who had been insured with GEICO in 2007, presented the fraudulent check to a check-cashing service where she was a registered client. The check-cashing service determined that the check was suspect and contacted GEICO which confirmed that the check was fraudulent. GEICO contacted the Frauds Bureau which conducted the investigation jointly with the insurers SIU.
PRIOR SUPPLEMENT
June 2010
- BASED ON THE EVIDENCE
Arrested on 6/18/10
Charged with insurance fraud in the 2nd degree
An investigation by the Frauds Bureau led to the arrest of the owner of an upstate manufacturing company. The suspect filed a $2.6 million claim with Lloyds of London for drill bits and shipping labels that he reported were damaged as a result of a fuel oil spill. Investigators learned that many of the labels the suspect claimed were damaged were either not damaged or did not exist. As a result, Lloyds denied the entire claim. However, during an interview, the suspect confessed to submitting $83,000 in fraudulent inventory claims. Based on that evidence, a grand jury indicted him on a charge of insurance fraud.
- DOUBLE DIPPING
Arrested on 6/15/10
Charged with violation of Section 114.1 of the Workers Compensation Law
The defendant in this case reported to the State Insurance Fund that he had not received his workers compensation benefit check and submitted a document affirming his statement in writing. The Fund issued a replacement check. However, an investigation by the Frauds Bureau and the Fund revealed that he had in fact received and cashed the original check and the second one as well.
- IN HIDING
Arrested on 6/3/10
Charged with insurance fraud in the 3rd degree
In a case involving an owner give-up, a Suffolk County resident reported to the police department that his 2002 Dodge Durango had been stolen from his residence. He then filed a $6,000 claim with Hartford Insurance Company for the loss. However, an investigation by the Frauds Bureau and the Suffolk County PD uncovered the car at a location where the suspect had allegedly hidden it in an effort to fraudulently obtain the insurance payment.
- WHAT ARE FRIENDS FOR?
Arrested on 6/3/10
Charged with insurance fraud in the 4th degree
Defendant #1 in this case reported to the Suffolk County Police Department and to Progressive Insurance Company that his 2005 Harley Davidson had been stolen. However, an investigation conducted by the Frauds Bureau and the Suffolk County PD revealed that the suspect had asked a friend, defendant #2, to store the motorcycle until the insurance claim was settled. Both were charged were insurance fraud.
