Arrests for January 2011
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
- GUILTY PLEAS
An investigation conducted by the Frauds Bureau and the New York Automobile Insurance Plan led to the arrest of Frank Caponi, a New York City insurance broker, in a case involving rate evasion. The defendant aided and assisted commercial livery owners to fraudulently obtain insurance at artificially reduced rates by providing their insurers with false addresses and vehicle classes. He surrendered voluntarily on 1/26/11 and pleaded guilty to a misdemeanor charge of criminal facilitation.
William Holley, a Buffalo podiatrist who was charged on 1/4/09 with 28 counts of health care fraud, pleaded guilty to one misdemeanor count of theft in connection with health care on 1/5/11. He admitted that in April 2005, he submitted a claim to Medicare stating that he had performed a procedure called a “wedge excision” when, in fact, he had not. He was originally charged with repeatedly billing Medicare and private insurance companies for expensive treatments when he was actually providing only routine foot care. The investigation that led to his arrest was conducted by the Western New York Health Care Fraud Task Force of which the Frauds Bureau is a member.
- NO RACING ALLOWED
Arrested on 1/26/11
Charged with perjury in the 1st degree and violation of Section 114.1 of the Workers’ Compensation Law
An upstate butcher began receiving workers’ compensation benefits after a work-related injury left him with a temporary partial disability. However, an investigation by the Frauds Bureau revealed that during the benefit period, he allegedly participated in competitive auto racing, an activity that was far in excess of what he claimed to be capable of performing. In addition, he denied under oath at a Workers’ Compensation Board hearing that he had raced during the time in question. As a result of the fraud, he collected $4,200 in benefits to which he was not entitled.
- 43 DEFENDANTS SO FAR
Arrested on 1/24/11
Charged with grand larceny in the 3rd degree, insurance fraud in the 3rd degree, falsifying business records in the 2nd degree and offering a false instrument for filing in 2nd degree
A Brooklyn man was charged with submitting a fraudulent application for no-fault benefits following an auto accident that he was not involved in. He was treated at a medical facility for nonexistent injuries for which Progressive Insurance Company was billed more than $16,000. He is the 43rd defendant to be arrested in this ongoing investigation being conducted jointly by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigations Squad.
- PRIOR DAMAGES INCLUDED
Arrested on 1/20/11
Charged with insurance fraud in the 5th degree
Following an auto accident, a Fulton County woman filed a claim with GEICO Insurance Company for the damage to her 1996 Chevy Suburban. In support of the claim, she included a repair estimate of $1,220. However, investigators from the Frauds Bureau found evidence that the estimate included repair of damages that were already present on the car before the accident.
- PAID BY MEDICAID
Arrested on 1/14/10
Charged with insurance fraud in the 4th degree, grand larceny in the 4th degree and falsifying business records in the 1st degree
An investigation by the Frauds Bureau resulted in the arrest of a Port Jervis, NY, waitress for defrauding Zurich American Insurance Company. She began receiving prescription medications following an injury on the job. She filed a $2,058 claim with the insurer and in support of the claim, she submitted receipts indicating that she had paid for the medications herself. However, she was arrested when investigators learned that Medicaid had paid for her medications and the receipts were in fact fraudulent.
- NINE FRAUDULENT REPORTS
Arrested on 1/13/11
Charged with insurance fraud in the 3rd degree, perjury in the 1st degree and violation of Section 114.1 of the Workers’ Compensation Law
The defendant in this case reported a job-related injury on 3/7/08 while she was employed at a local health care center and began collecting workers’ compensation benefits. On 6/18/08, she testified under oath before a Workers’ Compensation Board hearing that she was not working. In addition, during the benefit period she filed nine Work Activity Reports with the State Insurance Fund stating that she had not worked since her injury. However, an investigation by the Frauds Bureau uncovered evidence that she was working as a house cleaner at two local residences while fraudulently accepting $13,177 in benefits.
- STAGED THEFT
Arrested on 1/12/11
Charged with insurance fraud in the 3rd degree, grand larceny in the 3rd degree, falsely reporting an incident in the 3rd degree and making a punishable false written statement
In a case involving an owner give-up, a Saratoga County man reported to the Colonie Police Department that his 2009 Jeep had been stolen from a local Chevy dealership on 11/22/10. He subsequently filed a $22,000 claim with Travelers Insurance Company for the loss. Investigators discovered that the defendant had removed the car from the lot himself in an effort to avoid paying a $3,709 repair bill. He then parked the car at the Albany International Airport and filed the claim. The Jeep was recovered and the defendant provided a written confession to the faked theft. The investigation that led to his arrest was conducted jointly by the Frauds Bureau and the Colonie Police Department.
- DOUBLE DIPPING
Arrested on 1/11/11
Charged with three counts of insurance fraud in the 3rd degree
An investigation by the Frauds Bureau and the State Police led to the arrest of an Erie County man who subsequently confessed to submitting fraudulent documentation to Homesite Insurance Company on three separate occasions in order to collect claim payouts for the theft of his high-end bicycles. Moreover, in one instance he was paid by two insurers for the same claim. In addition, the suspect admitted that after he was reimbursed $20,000 by four insurers, the stolen bikes were returned.
- ENHANCED DAMAGES
Arrested on 1/10/11
Charged with with insurance fraud
The vice president and an office manager/bookkeeper of a roofing company, Defendants #1 and #2 in this case, were charged with insurance fraud in the 3rd and 5th degrees, respectively. An investigation by the Frauds Bureau and the State Police found evidence that from March 2010 to the time of their arrests, they engaged in a scam that defrauded a number of insurance companies. They allegedly contacted homeowners in several upstate communities asking if they wanted their roofs inspected for wind and/or hail damage. They told the homeowners that the company would complete the work for whatever the insurance settlement was, if the home required a new roof. Defendant #2 would then contact the insurer purporting to be the homeowner and set a date and time for an insurance company inspection. Prior to the inspection, Defendant #1 would cause or enhance damage by removing roof shingles so the insurer would approve the cost of a new roof. Defendant #2 gave a written confession stating that she had misrepresented herself as the homeowners when she contacted the insurers.
- ALTERED POLICE REPORT
Arrested on 1/6/11
Charged with insurance fraud in the 3rd degree and offering a false instrument for filing in the 1st degree
Two Brooklyn residents submitted no-fault applications for injuries allegedly sustained in an auto accident. However, an investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigations Squad revealed that neither defendant was involved in the accident in question but altered the Police Accident Report to make it appear that they had been. Both were treated for purported injuries and GEICO Insurance Company was billed $4,985 for one defendant and $3,468 for the second defendant.
Arrested on 1/6/11
Charged with violation of Section 114.1 of the Workers’ Compensation Law
The defendant in this case began collecting workers’ compensation benefits after injuring her foot, knee and back on 7/21/98 while employed directing traffic at a construction site. During the benefit period, she submitted documents to the State Insurance Fund stating that she had not worked since the accident. However, an investigation by the Frauds Bureau found evidence that she was working as part-time counter help and between 1/1/09 and 2/12/10, she accepted $20,300 in benefits to which she was not entitled. Had the State Fund been aware of her employment status, her benefits would have been reduced or terminated.
- FALSE REPORT
Arrested on 1/5/11
Charged with insurance fraud in the 4th degree
An investigation by the Frauds Bureau and the NYPD resulted in the arrest of a Queens man who falsely reported that his car had been stolen. Investigators learned that he had been involved in an accident while driving the car the day before filing the theft report.
- LET PD DO THE WORK
Arrested on 1/4/11
Charged with falsely reporting an incident
On 9/14/10, an upstate resident reported to the Rochester Police Department that his 2006 BMW had been stolen from his residence while he was out of town. During an initial investigation by the Frauds Bureau and the Rochester PD, investigators learned that the car was registered in California in October 2010. When interviewed, the suspect told investigators that he purchased the car new in 2006 for a friend. He agreed to title and insure the car as long as the friend forwarded the payments directly to him. In June 2010, the payments stopped. He admitted that he had known that the car was registered in California and that he reported the car stolen so the police would locate and recover the car for him.
- PRIOR SUPPLEMENT
- FRAUD VIA INTERNET
Arrested on 12/20/10
Charged with falsifying business records
The suspect in this case sought and received medical treatment for injuries she claimed were received in an auto accident. However, an investigation by the Frauds Bureau and the NYPD’s Fraudulent Accident Investigations Squad revealed that the accident was either staged or caused and the suspect was not injured. This ongoing investigation involves obtaining insurance policies through the Internet using false checking account routing numbers. No premiums are paid but no-fault claims are filed before the policies can be canceled for nonpayment and the insurers are on the hook for the medical bills.