Arrests for November 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!
*********************************************
- SENTENCED
On 11/24/10, Salvador Resendez of Binghamton pleaded guilty to insurance fraud and was sentenced to 21 days in jail. He was arrested on 11/3/10 after fraudulently reporting that his car had been stolen. He stated that he subsequently recovered the car which allegedly sustained damages while in the possession of the thief. However, a witness reported seeing the defendant repeatedly ramming his car into a brick wall, causing the damages himself. His arrest was the result of an investigation conducted jointly by the Frauds Bureau and the Binghamton Police Department.
Michael, Akyuz, a former podiatrist, was sentenced on 11/3/10 in U.S. District Court to serve two concurrent five-year terms of probation for falsely billing Medicare for services he did not provide. In addition, he was ordered to repay more than $660,000 in restitution, perform 100 hours of community service and undergo six months of electronic monitoring. He pleaded guilty in March 2010 to health care fraud and mail fraud. He billed Medicare for complicated procedures when he had only provided routine foot care to elderly patients at nursing homes and retirement homes. He has surrendered his license. The judge granted a request for leniency because of his “exceptional” family circumstances. Four of his five children have autism. Numerous medical professionals submitted documents to the court stating the children would suffer greatly if their father could not dispense their medications or financially care for them. Sentencing had been postponed in September amid allegations that the defendant was practicing medicine without a license when he started a toenail-trimming business. He testified under oath that he told clients he was no longer a physician and the allegations were withdrawn. His arrest was the result of an investigation by the Frauds Bureau, the FBI and the U.S. Attorney’s Office.
- CONVICTED
Michael Palmieri, an orthopedist who was arrested on 5/28/09, was convicted on 11/19/10 of insurance fraud, offering a false instrument for filing and petit larceny in connection with a scheme to defraud the workers’ compensation system. From 2001 to 2006, the doctor filed 55 reports stating a patient (former correction officer Leo Coletti) was totally disabled, was not working and should continue to receive benefits. In exchange, the patient, who owned a general contracting and home repair business, agreed to do renovations on the doctor’s home and office. Coletti pleaded guilty in 2006 to grand larceny and filing a false tax return and was ordered to pay $131,853 in restitution. Palmieri’s sentencing is scheduled for 2/12/11. An investigation by the Frauds Bureau, the Workers’ Compensation Board and the Westchester County DA’s Office led to the arrests in this case.
Following a two-and-a-half week trial, Matthew Romano was convicted on 11/4/10 of 17 counts of mail fraud for attempting to defraud the Village of Johnson City, the Public Employer Risk Management Association and the New York State Retirement System of salary and benefits. Romano claimed that on 12/30/06, while working as a police officer for the Village of Johnson City, he was assaulted and injured by two unknown persons in a local cemetery. However, an investigation revealed that no such assault occurred and Romano actually inflicted the injuries on himself. The Frauds Bureau teamed up with the State Police, the FBI, the Broome County Sheriff’s Office and the Police Departments of Johnson City, Binghamton, Endicott and Vestal in the investigation the led to the arrest of this defendant.
- FAILURE TO PAY
Arrested on 11/24/10
Charged with grand larceny in the 2nd degree, insurance fraud in the 2nd degree, falsifying business records in the 1st degree and violation of Sections 96.1 and 114 of the Workers’ Compensation Law
State Insurance Fund records showed that two associated construction businesses paid the defendant in this case, a Queens contractor, a total of $1,616,157 for work done during the period from 6/28/07 through 6/12/10. However, an audit of the defendant’s business conducted by the State Fund showed only $25,014 in reported sales for that period. As a result, the defendant avoided paying the State Fund $220,871 in premiums owed, plus a total of $25,376 in penalties. An investigation by the Frauds Bureau and the State Fund resulted in the arrest.
- NO-FAULT FRAUD
Arrested on 11/23/10 and 11/18/10
Charged with insurance fraud in the 3rd and 4th degrees, grand larceny in the 3rd degree, falsifying business records and offering a false instrument for filing in the 2nd degree
Two defendants were arrested in an ongoing no-fault fraud investigation being conducted by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigations Squad. The first defendant, arrested on 11/23, was charged with intentionally crashing his vehicle into another vehicle and then fraudulently filing a claim with Progressive Insurance Company for the loss under the no-fault portion of his auto insurance coverage. The second defendant, arrested on 11/18, conspired with another person previously arrested to deliberately ram his car into another vehicle and then reported the “accident” to 21st Century Insurance Company. In addition, he used fake identification to falsely report that a third person was a passenger in the car at the time of the accident.
- BROKER CAUGHT
Arrested on 11/22/10
Charged with grand larceny in the 2nd degree, criminal possession of stolen property in the 2nd degree, scheme to defraud in the 1st degree and 43 counts of issuing a bad check
An investigation conducted jointly by the Frauds Bureau and the Queens DA’s Office led to the arrest of a licensed insurance broker who was the president and owner of two insurance brokerages in Queens. According to the charges, the defendant failed to remit $606,770 in premium payments that she had received from more than 400 clients between 1/1/09 and 12/31/09. Her actions defrauded four insurance companies – Maya Assurance, American Transit, Hereford and Fiduciary Insurance Company of America – of premiums owed. In addition, she submitted 43 checks totaling $121,750 to two of the insurers in an attempt to conceal the crime. The checks were returned because of insufficient funds.
- AUTO GIVE-UP
Arrested on 11/19/10
Charged with insurance fraud in the 3rd degree, conspiracy in the 4th degree and arson in the 3rd degree
An investigation by the Frauds Bureau, the Mt. Kisco Police Department Detective Squad and the Westchester County Arson Task Force led to the arrest of two defendants in a case involving an auto give-up. Investigators uncovered evidence indicating that defendant #1 paid defendant #2 to destroy his 2008 Saturn Astra by fire because he could no longer afford the payments. Defendant #1 left the car in the parking lot at his work place with the windows open. Defendant #2 allegedly poured gasoline through the open windows and set the car on fire. Defendant #1 was charged with insurance fraud and conspiracy. Defendant #2 was charged with arson.
- MOTEL MAID
Arrested on 11/17/10
Charged with insurance fraud in the 3rd degree, offering a false instrument for filing in the 1st degree and violation of Section 114.1 of the Worker’s Compensation Law
Following a work-related back injury in 1990, an upstate woman began collecting wage-replacement benefits. On numerous occasions between 2007 and 2010, she submitted Work Activity Reports to the State Insurance Fund stating that she had not worked in any capacity since her injury. However, an investigation by the Frauds Bureau, the Workers’ Compensation Board’s Office of the Fraud Inspector General and the State Fund revealed that the defendant had been working as a maid at a local motel since 2007. As a result of the fraud, she collected $11,932 in benefits to which she was not entitled.
- DATES CHANGED
Arrested on 11/17/10
Charged with criminal possession of a forged instrument in the 2nd degree, offering a false instrument for filing in the 1st degree and violation of Section 114.1 of the Workers’ Compensation Law
An upstate correction officer injured his knee on the job in January 2009 and received a $31,680 award for 20 percent scheduled lost of use (SLU). He was still eligible for workers’ compensation coverage and began collecting benefits. On 7/15/10, he was treated for swelling in the injured knee. He returned to work on 7/23/10 and submitted a doctor’s note to his employer stating that his injury caused his absence from 7/9 through 7/18/10. At the same time, he submitted a Documentation of Workers’ Compensation Leave Form. He was arrested when investigators learned that the return-to-work dates on both documents had been changed from 7/16/10 – the day after he was treated by the doctor – to 7/18/10 in an effort to have his absence paid for by the workers’ compensation system. The attending physician confirmed that the dates had been changed. The investigation that resulted in his arrest was conducted by the Frauds Bureau, the Department of Correctional Services’ Workers’ Compensation Unit, the Workers’ Compensation Board’s Office of the Fraud Inspector General and the State Insurance Fund.
- DEER, DEER
Arrested on 11/17/10
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
On 5/20/10, an upstate couple added insurance to their auto policy that would cover a vehicle-deer accident. Thirty minutes after the coverage was in place, they reported to Progressive Insurance Company that their son had just struck a deer while driving the car. However, an investigation by the Frauds Bureau, the State Police and Progressive’s SIU uncovered evidence that the accident had actually occurred on 5/19/10 when no deer-related coverage existed.
- POLICE OFFICER NABBED
Arrested on 11/16/10
Charged with insurance fraud and fleeing the scene of a personal injury accident
A City of Newburgh police officer was arrested on charges that while off duty at 12:20 a.m. on 10/11/09, he slammed his truck into the back of a car on a road in Marlboro, a hamlet in upstate New York, and fled the scene. The car rolled, trapping one of the four occupants inside. When police and firefighters arrived at the scene, they freed the trapped passenger who had suffered broken vertebrae and serious cuts. He and another passenger were taken to a nearby hospital for treatment. Nineteen hours later, the defendant reported having had an accident but stated that his car had struck a deer in the Town of Newburgh, a few miles south of the true accident scene. He subsequently filed a claim for the damage to his truck. However, an investigation by the Frauds Bureau, the Marlboro Police Department, the DMV, the State Police and the Ulster County DA’s Office tracked the truck to the body shop that had done the repair work and that, together with a forensic examination and numerous interviews, led to the arrest.
- BAIT AND TACKLE BUSINESS
Arrested on 11/12/10
Charged with perjury in the 1st degree and violation of Section 114 of the Workers’ Compensation Law
An investigation by the Frauds Bureau led to the arrest of an upstate man for workers’ compensation fraud. He began collecting benefits following an injury sustained on the job. During the benefit period, he submitted medical documents stating that he was unable to work. In addition, he testified at a Workers’ Compensation Board hearing that he was not employed. However, investigators discovered that he owned and operated a bait and tackle business while fraudulently collecting $2,700 in benefits.
- ADDITIONAL CHARGES SOUGHT
Arrested on 11/11/10
Charged with falsifying business records in the 1st degree
After being treated for a broken ankle at an orthopedic care facility in Westchester, the defendant in this case phoned two pharmacies and ordered pain medications, using the name and Drug Enforcement Administration identification number of the physician who had treated her. She also allegedly changed the dosages on actual prescriptions. The defendant’s insurer, MVP Health Plan, was notified by the orthopedic care facility after a comparison of the physician’s records and the pharmacy reports. The Frauds Bureau and the State Police conducted the investigation the led to the arrest. The State Police are seeking additional charges, including forgery, against the defendant.
- LOJACK TRACKED
Arrested on 11/9/10
Charged with offering a false instrument for filing in the 2nd degree
A Staten Island man reported to the NYPD that his car had been stolen and filed a claim with Allstate Insurance Company for the loss. However, he had bought the car used and was unaware that it was equipped with a Lojack security system. The police tracked the car and recovered it in a locked garage at the defendant’s work place. When he was interviewed, he admitted that he falsely reported the car stolen and withdrew the claim. The Frauds Bureau pooled resources with the NYPD in this investigation.
- MATERIAL MISREPRESENTATION
Arrested on 11/8/10
Charged with violation of Section 114.1 of the Workers’ Compensation Law
After sustaining a work-related injury, the defendant in this case submitted an employee claim for benefits to the Public Employer Risk Management Association on 6/9/10 that contained materially false information. The document stated that she was not working when in fact she was fully employed at the time. As a result of the fraud, she collected $1,414 in benefits to which she was not entitled. An investigation by the Frauds Bureau and the State Police led to her arrest.
- OWNER GIVE-UP 2
Arrested on 11/5/10
Charged with attempted grand larceny in the 4th degree
A Monroe County man reported to New York Central Mutual Insurance Company that his 2001 Ford Taurus had been stolen while he was inside a gas station. During an initial investigation by the insurer’s SIU, the suspect stated that he gave up the car in exchange for crack cocaine. In a subsequent interview, he admitted to investigators from the Frauds Bureau and the Irondequoit Police Department that he falsely reported the car stolen in an attempt to collect a $3,000 payout.
- IDENTITY THEFT
Arrested on 11/3/10
Charged with grand larceny in the 2nd degree
An investigation by the Frauds Bureau and the NYPD’s Identity Theft Unit resulted in the arrest of a Brooklyn woman accused of grand larceny. She admitted to investigators that she stole the identity, including medical insurance information, of a patient at the clinic where she was employed. She gave the information to another person who fraudulently caused Healthfirst to be billed for medical treatment totaling $125,000.
- IN BUSINESS
Arrested on 11/3/10
Charged with offering a false instrument for filing in the 1st degree and violation of Section 114 of the Workers’ Compensation Law
The defendant in this case began collecting benefits after being classified as having a permanent partial disability resulting from a work-related injury. He submitted documents to the State Insurance Fund stating that he was unable to work. However, an investigation conducted by the Frauds Bureau and the State Fund uncovered evidence that indicated he owned and operated a home repair business. As a result, he fraudulently collected nearly $7,500 in benefits.
- FRAUDULENT DOCTORS NOTE
Arrested on 11/2/10
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
Following an auto accident, a Binghamton woman filed for benefits under the no-fault portion of her insurance policy with New York Central Mutual Insurance Company. During the benefit period, she submitted a doctor’s report to the insurer stating that she was unable to work. However, an investigation by the Frauds Bureau, the Binghamton Police Department and the Broome County DA’s Office revealed that she, not a doctor, produced the fraudulent document, thus allowing her to collect $1,591 in no-fault benefits to which she was not entitled.
- PRIOR SUPPLEMENT
September 2010
- PREMIUM FRAUD
Arrested on 9/9/10
Charged with grand larceny in the 2nd degree, insurance fraud in the 2nd degree, falsifying business records in the 1st degree and violation of Sections 96.1 and 114.1 of the Workers’ Compensation Law
The owner of a painting business reported to the State Insurance Fund that his sales for the 2006-2008 period totaled $956,827 and was charged accordingly for workers’ compensation coverage. However, an investigation by the Frauds Bureau and the State Fund revealed that his sales for that period actually totaled $2,621,757. As a result of the fraud, he avoided paying the Fund $180,191 in additional premiums due.
