Arrests for May and June 2013
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 1-800-342-3736
- ARSON FOR PROFIT
Arrested on 5/30/13
Charged with arson in the 3rd degree, insurance fraud in the 2nd degree and conspiracy in the 4th degree
An investigation by the Insurance Frauds Bureau, the Otsego County Sheriff’s Office and the Otsego County Office Emergency Services resulted in the arrest of three defendants charged with conspiracy to commit arson for profit. On 5/1/13, the Otsego County 911 center received a report of a possible structure fire in the hamlet of Hartwick. The Hartwick Fire Department responded to the scene and immediately called for assistance from several nearby fire departments. After several hours, the fire was brought under control with no damage to other residences in the area. The subsequent investigation revealed that the three defendants had acted in concert to burn down the unoccupied residence of one of them in order to collect a $50,000 insurance payout. They face up to 15 years in prison if convicted of the arson charge and an additional 15 years if they are found guilty of insurance fraud.
A Queens woman was sentenced on 6/5/13 to 1-to-3 years incarceration at the Bedford Hills Correctional Facility after being convicted of grand larceny and falsifying business records. Over a period of four years from 12/06 through 2/11, while she was the patient of two doctors, she filed claims with United HealthCare Insurance Company for psychiatric services that she stated were provided by these doctors. However, during interviews conducted as part of an investigation by the Insurance Frauds Bureau, the doctors stated that they had not provided the services reported on 1,273 of the claims filed by the defendant and these claims were, in fact, fraudulent. The claims totaled more than $500,000, of which United HealthCare paid out $330,000.
- FRAUDULENT CLAIM
Arrested on 6/27/13
Charged with attempted grand larceny in the 3rd degree
On 1/23/13, an upstate man contacted Progressive Insurance Company to inquire about auto insurance coverage for his 2002 Mitsubishi. He reported that he had hit a guard rail and damaged the car. The insurer informed him that he did not have collision coverage and he terminated the call. About 30 minutes later, the defendant again called Progressive and added collision coverage to his policy. On 1/24/13, he reported that he had been in an accident. He brought the car to a collision shop and on 2/5/13 was given an estimate of $3,286.47 for repair of the damage. On 6/12/13, investigators interviewed the defendant who admitted that he had obtained collision coverage after the accident because he could not afford to repair the damage himself. An investigation by the Insurance Frauds Bureau and the Rochester Police Department led to his arrest.
- TASK FORCE INVESTIGATION
Arrested on 6/20/13
Charged with insurance fraud under Section 1347 of Title 18 of the U.S. Code
The owner and operator of two Queens pharmacies was arrested for his role in a scheme to bill Medicare, Medicaid and private insurers for fraudulent prescription drugs. Insurance Frauds Bureau investigators working undercover dropped off prescriptions at one of the pharmacies. However, the defendant continued to bill the insurers for approximately 20 prescriptions that were not legitimate using the personal medical information of the undercover investigators. An arrest warrant was executed at the defendant’s residence on 6/20/13 and search warrants were executed at both of the defendant’s businesses that same day. The amount of the fraud is estimated to be close to $1 million. This arrest was the result of an investigation by the FBI New York Health Care Fraud Task Force, of which the Insurance Frauds Bureau is a member.