Arrests for October 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 1-888-372-8369
CAUGHT!
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- NOT A MEMBER
Arrested on 10/21/11
Charged with insurance fraud in the 3rd degree and attempted grand larceny in the 3rd degree
An upstate woman was arrested following an investigation by the Insurance Frauds Bureau and the Olean Police Department involving an allegedly fraudulent homeowners claim. The suspect reported to New York Central Mutual Insurance Company that her home had been burglarized and four large-screen TVs and a number of game systems were stolen. She filed a $10,288 claim for the loss of her property. She had no receipts but claimed that she bought the items at BJ’s Wholesale Club using her membership card. However, investigators learned that the suspect did not have a BJ’s membership.
- NO-FAULT FRAUD MILL
Arrested on 10/20/11
Charged with conspiracy to commit health care fraud and mail fraud
Twenty-four defendants were charged with health care fraud for their participation in billing scams that defrauded insurers, Medicare and Medicaid out of millions of dollars. Twenty-two of the defendants were accused of causing no-fault insurers to pay out millions in reimbursements for medical treatment that was never provided or that was medically unnecessary. Two indictments charged doctors who faked ownership of medical clinics, concealing the fact that the true owners were not medical professionals. These “front” doctors and other health care providers and clinic employees caused fraudulent bills to be submitted to insurers. Charges were also brought against “runners” who were paid to recruit patients and patients who faked and exaggerated injuries from auto accidents. The patients allegedly were coached by clinic employees on how to describe their purported injuries if questioned by insurance companies. A third indictment named two operators of a medical supply company for allegedly forging doctors’ signatures and prescriptions to support fraudulent billing to Medicare and Medicaid for durable medical equipment. Twenty-two defendants were arrested on 10/20/11. Another defendant was previously arrested on a Complaint. The final defendant remains at large. All of the defendants face a maximum sentence of 20 years in prison. Six search warrants were executed and ten accounts were frozen in connection with this investigation which was conducted jointly by the Insurance Frauds Bureau, the Office of the U.S. Attorney for the Southern District, the FBI, the NYPD and U.S. Department of Health and Human Services.
- HE’S NOT HER HUSBAND
Arrested on 10/20/11
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
A Buffalo man reported to Encompass Insurance Company that his 1999 GMC Yukon was stolen from his residence and filed a claim for the loss. However, his ex-wife was contacted during an investigation by the Insurance Frauds Bureau and the DMV and she informed investigators that her ex-husband had reported the car stolen when in reality he had stored it at a friend’s rental property in Tonawanda where it was later recovered. Encompass had made payment on the claim.
- FRAUDULENT SUPPORT DOCUMENT
Arrested on 10/20/11
Charged with insurance fraud in the 3rd degree, falsifying business records in the 1st degree and attempted grand larceny in the 3rd degree
An investigation by the Insurance Frauds Bureau, the New Windsor Police Department and Allstate Insurance Company’s SIU led to the arrest of an Orange County resident who was accused of submitting an allegedly fraudulent invoice in support of a claim for losses incurred during a burglary at his home. The invoice listed items valued at $14,808. However, evidence uncovered during the investigation indicated that the business that purportedly authored the invoice was confirmed closed prior to the date of the reported purchase.
- PRIOR DAMAGE CLAIMED
Arrested on 10/20/11
Charged with insurance fraud
The defendant in this case filed a claim with Allstate Insurance Company stating that his car had been struck while parked and unoccupied. He reported that the adverse driver had fled the scene. However, an investigation by the Insurance Frauds Bureau and the NYPD’s Auto Crime Division revealed that some of the damages listed on the claim had occurred prior to the hit-and-run incident.
- TWO ARRESTS BY DEA TASK FORCE
Arrested on 10/13/11
Charged with criminal possession of a controlled substance in the 3rd degree
There were two additional arrests in an ongoing investigation being conducted by the Drug Enforcement Administration Task Force of which the Insurance Frauds Bureau is a member. Both of the suspects were charged with criminal possession of a forged instrument and criminal possession of a controlled substance.
- NO REPAIRS, NO SETTLEMENT DUE
Arrested on 10/12/11
Charged with grand larceny in the 3rd degree
A body shop owner was accused of cashing an $11,607 GEICO Insurance Company settlement check for repairs to a vehicle left at his shop. However, an investigation by the Insurance Frauds Bureau and the Suffolk County Insurance Crime Bureau revealed that the repairs were never made and the defendant attempted to place a mechanics lien on the vehicle.
- INVESTIGATION YIELDS 58 SO FAR
Arrested on 10/10 and 10/3/11
Charged with insurance fraud and grand larceny
An ongoing no-fault fraud investigation conducted by the Insurance Frauds Bureau and the NYPD’s Fraudulent Accident Investigations Squad led to two arrests in October. The first, a Brooklyn man, was charged with intentionally crashing his car for the purpose of personal monetary gain. He reported the “accident” to GEICO Insurance Company and subsequently sought medical treatment for nonexistent injuries under the no-fault portion of his auto insurance coverage. Based on fraudulent claims, GEICO paid out more than $15,000 in no-fault benefits. A second Brooklyn man was arrested on 10/3/11. He, along with others previously arrested, was accused of intentionally crashing a bicycle into a vehicle. He then sought and received medical treatment for which Allstate Insurance Company paid out more than $31,000 in no-fault benefits. The total number of arrests in this case currently stands at 58.
- NOTIFICATION FAILURE
Arrested on 10/7/11
Charged with violation of Section 114.1 of the Workers’ Compensation Law
The defendant in this case began collecting workers’ compensation benefits following a work-related injury. However, an investigation by the Insurance Frauds Bureau revealed that she had returned to work as an accounts payable clerk on 11/1/10 but failed to notify the State Insurance Fund. As a result of the fraud, she collected $3,451 in benefits to which she was not entitled.
- NOT ENTITLED
Arrested on 10/4/11
Charged with insurance fraud in the 3rd degree, falsifying business records in the 1st degree and grand larceny in the 3rd degree
Between 7/1/00 and 5/26/10, a Troy woman submitted applications to her employer, the City of Troy School District, for health, dental and prescription drug coverages for herself and her husband. However, after an audit was conducted by the school district, the defendant admitted that the man she named on the applications was not her husband. During the benefit period, the man received a total of $20,620 in benefits to which he was not entitled.
- SUCCESSFUL STING OPERATION
Arrested on 10/4/11
Charged with larceny
A sting operation was conducted to target a body shop known to be involved in damage enhancement. On 5/4/11, an undercover vehicle was sent to the shop with damage estimated at $3,394. The vehicle was subsequently appraised at the shop by Travelers Insurance Company with damages totaling $6,836. The defendant was charged with enhancing the damage to the vehicle by more than $3,400. The Insurance Frauds Bureau and the Suffolk County Insurance Crime Bureau collaborated on the investigation that led to the arrest.
- PRIOR SUPPLEMENTS
September 2011
- SENTENCED
On 9/29/11, Vitina Warner was sentenced to 30 months in prison and ordered to pay $2.6 million in restitution for orchestrating a scheme to defraud insurers by billing massages as physical therapy. Had the insurers known the nature of the services she actually provided, they would have denied the claims or paid significantly less than the amount that was billed. Warner had also billed for services not rendered. She was arrested on 11/11/03 and subsequently pleaded guilty to health care fraud and obstruction of justice. A second defendant in this case will be sentenced on 11/8/11.
- OWNER GIVE-UP
Arrested on 9/26 and 9/23/11
Charged with arson, criminal mischief, reckless endangerment and conspiracy
An investigation by the Insurance Frauds Bureau and the FDNY Fire Marshals resulted in the 9/26/11 arrest of a Brooklyn man who allegedly entered into a contract with another defendant in this case who agreed to pay him $1,500 to dispose of his 2009 SAAB because he could no longer afford the payments. The vehicle owner reported the car stolen to the NYPD on 6/29/11. However, the car had been recovered by the FDNY on 6/28/11 destroyed by fire. The investigation also uncovered a video that produced evidence of the arson. The vehicle owner was arrested on 9/23/11 and charged with insurance fraud, falsely reporting an incident, criminal facilitation and conspiracy. When faced with the evidence, he admitted to the scheme which led to the arrest of the second defendant who had disposed of the car. Two additional suspected are being sought as facilitators in this ongoing investigation.
