News
Six charged with staging auto crash in Louisiana
July 24, 2008, Monroe, LA -- State police uncovered an incident of insurance fraud that stemmed from a staged vehicle wreck on Lee Avenue in Monroe earlier this year.
Investigators identified Jacob Middleton, Akika Middleton, Shelia Braggs, Jason Braggs, Frank Green and Cornelius Smith as suspects.
On July 7, 4th District Court Judge Wendell Manning signed arrest warrants charging each of the six suspects with one count of insurance fraud. All but Green had been arrested on Wednesday.
A court document states an investigation led state police to determine Jacob Middleton planned the crash that occurred on Feb. 7. He along with Frank Green, the driver, Cornelius Smith and
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Mass. man who faked robbery now faces comp charges
July 24, 2008, Gardner, MA -- A Gardner man who pleaded guilty to faking the robbery of a gasoline station he managed now is facing charges in Worcester Superior Court for fraudulently obtaining workers’ compensation benefits as a result of injuries he suffered during the robbery he staged.
Erik Teong, 30, of 182 S. Main St., Gardner, was arraigned Tuesday on charges of workers’ compensation fraud and larceny over $250.
The attorney general’s office began an investigation in January after the matter was referred by the Insurance Fraud Bureau. Mr. Teong was the manager of a Shell gasoline station on Timpany Boulevard in Gardner. He also
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Claims adjuster in Georgia charged with insider fraud
July 24, 2008, Atlanta, GA -- Three metro Atlantans were sentenced to federal prison late Tuesday for running a $384,000 check fraud scheme against Underwriters Safety & Claims.
Susan Denise Harper, 43, of Lithonia, Ga., was sentenced to four years in federal prison, three years of supervised release. She also was ordered to perform 150 hours of community service and to pay $378,295 in restitution.
Kevian Bateman, 27, of Atlanta was sentenced to three years in federal prison, to be followed by three years of supervised release, and also ordered to perform 150 hours of community service, and pay $378,295 in restitution.
Ojineka Jones Godwin, 51, of Alpharetta, Ga.,
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Russian charged with $1M Medicare fraud in Oregon
July 24, 2008, Portland, OR -- An arrest warrant has been issued for a Russian citizen after a federal grand jury indicted him on Medicare fraud charges involving more than $1 million in sales of nonexistent equipment.
The indictment charged 23-year-old Amiran Aliyevich Abukov with wire fraud, health care fraud and aggravated identity theft.
Immigration records indicate Abukov entered the United States on a student visa which had expired at the time of the alleged fraud.
Federal prosecutors say Abukov set up a company called Quickmed Supply, which received more than $750,000 in payments for false claims before the fraud was discovered.
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Two in Kentucky charged with faking theft of big rig
July 24, 2008, London, KY -- Crime doesn’t pay. Just ask two men in London after police say they tried to rip off an insurance agency.
Glenn Turner and Cliston Proffitt were arrested after a month long investigation.
Police say they contacted a police informant to steal a tractor-trailer so they could collect the insurance money.
The informant told police, and unbeknownst to the suspects, detectives found the truck and took it into custody.
When the suspects reported the truck stolen they were then arrested and charged with insurance fraud.
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Feds indict Florida agent for defrauding condo groups
July 24, 2008, Ft. Walton Beach, FL -- A Ft. Walton Beach insurance agent is now facing a federal fraud indictment. The U-S Attorney's office has charged 37-year-old Ashley Hunnicutt Barkocy with one count of insurance fraud and 23 counts of wire fraud.
Barkocy is a vice president of "John M. Hunnicutt Insurance & Investments.
Authorities say Barkocy sold insurance policies to condominium associations, but never gave them the insurance coverage. They say instead, she spent the money on the agency or herself.
This left many of the condominium clients without any coverage during the 2002-2006 time period.
Ironically a number of insurance industry publications praised Barkocy for the way she
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Insurer employee admits stealing $1M from company
July 24, 2008, El Paso, TX -- An El Paso woman faces up to 20 years in prison and repaying nearly $1 million to an insurance company where she worked.
Prosecutors say 42-year-old Olivia Enriquez pleaded guilty to one count of wire fraud.
Sentencing is Oct. 7.
The U.S. Attorney's Office says Enriquez worked as an office manager and secretary at an insurance company in El Paso.
Investigators say Enriquez diverted money over a 5-year period, including funds from MassMutual Financial Group's headquarters in Springfield, Mass.
The guilty plea by Enriquez was announced late Wednesday by federal authorities, who say she could be required to pay restitution topping $940,000, plus a maximum
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Missouri hospital to pay $60M to settle fed investigation
July 23, 2008, Springfield, MO -- CoxHealth said Tuesday it will pay $60 million to the federal government to end a five-year civil investigation into alleged improper Medicare billing practices and prohibited financial arrangements with Ferrell-Duncan Clinic Inc.
The settlement could have been much larger, had Cox been forced to repay the full amount the government said it improperly billed. But Department of Justice auditors took into account Cox's ability to pay and still provide medical care to the community.
"Today's settlement furthers both our commitment to protecting patients from improper billing practices and the continued ability of Cox to provide quality medical care in Springfield and the
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Penn. woman pleads guilty to receiving chiro kickbacks
July 23, 2008, Leechburg, PA -- An Armstrong County woman has pleaded guilty to participating in a chiropractor's insurance fraud scheme.
Federal prosecutors in Pittsburgh say 55-year-old Susie Horning of Leechburg accepted kickbacks from Westmoreland County chiropractor Douglas Henderson, who submitted fraudulent claims for treatment under Horning's insurance policy.
Henderson of Lower Burrell has already pleaded guilty to defrauding Highmark out of more than $7 million by submitting false claims or having patients do it for him.
Horning pleaded guilty on Tuesday to health care fraud. She is scheduled to be sentenced Oct. 24.
Two other women were sentenced in January to probation and ordered to pay more than
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Health insurer to pay $225M to settle fraud civil suit
July 23, 2008, Virginia Beach, VA -- Amerigroup Corp., which faced $334 million of damage awards and court-imposed penalties from a Medicaid fraud suit in Chicago, said Tuesday that it will pay the U.S. government and state of Illinois $225 million to settle the civil case.
As part of an agreement struck with federal and state agencies, the Virginia Beach-based health insurer said it also will pay $9 million in legal fees, but it will not admit any wrongdoing.
However, Amerigroup said it also will enter into a corporate-integrity agreement with the inspector general of the Department of Health and Human Services, the federal agency that provides part of
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Medical supply company accused of fraud in Miami
July 22, 2008, Miami, FL -- Two brothers who founded a medical supply company are accused of participating in a scheme to bill a South Florida hospital for supplies it never received.
Jorge and Carlos De Cespedes, who founded Pharmed Group in Miami, were arraigned in federal court Tuesday. Jorge De Cespedes, president and director of the company, and Carlos De Cespedes, its chief executive officer, are each charged with conspiracy to commit health care-related wire fraud and tax evasion.
According to a news release by the U.S. Department of Justice, Jorge and Carlos De Cespedes are accused of conspiring with a former employee of Kendall Regional Medical
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Three workers indicted for comp fraud in Texas
July 22, 2008, Travis County, TX -- Texas Mutual Insurance Company reported today that three individuals were indicted, in separate cases, by a Travis County grand jury on workers’ compensation fraud-related charges. The individuals allegedly collected a combined $27,113 in workers’ comp benefits they were not entitled to.
The three cases involved a scam that investigators call double-dipping. Double-dipping occurs when claimants collect benefits for being too injured to work when they are, in fact, gainfully employed.
The individuals who were indicted and the amount of income benefits they allegedly collected are: Barry Davis of San Antonio, $5,969; Pamela McCoy of Splendora, $14,040; and Michael Burnett of Graham, $7,104.
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Two from Calif. body shop charged with false billings
July 21, 2008, Redwood City, CA -- Insurance Commissioner Steve Poizner announced that Department of Insurance investigators assisted in developing felony insurance fraud criminal complaints against Bita Imani, the owner of Redwood-city auto repair shop Group Specialists, and Mehran Baranriz, the general manager.
The two are charged with 56 counts of Presenting Fraudulent Claims in violation of Penal Code section 550(A)(1) and five counts of Grand Theft by False Pretenses in violation of Penal Code Section 487(A)/532. In addition, Imani is charged with four counts of Tax Fraud in violation of Revenue and Taxation Code Sections 19705(A) and 19706 and Baranriz is charged with two counts of
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Eight charged with staging ‘paper accidents’ in Mass.
July 21, 2008, Lawrence, MA -- Two insurance companies refused to pay the medical bills for five people who reported being injured in a two-car accident in the city more than six years ago.
Arbella Mutual Insurance Company suspected someone was trying to con them when two brothers, both named Jose Villa, said they were passengers in one car that crashed, but couldn't get their stories straight. Encompass, the insurer of the other car in the crash, suspected something was phony too.
It took police a long time to determine both insurers had cause to be suspicious. But in the end, eight people, all from Lawrence, were
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N.Y. cleaning contractor pleads guilty to billing scam
July 21, 2008, Harrison, NY -- A Harrison businessman who ran a company specializing in emergency clean-ups pleaded guilty yesterday to participating in an insurance scheme in connection with the flooding of several multimillion-dollar homes, federal authorities announced.
Louis Cordasco Jr., 44, is among four Westchester men charged in a case centered on a conspiracy to buy high-end homes in the county by using false documentation to dupe banks into financing the purchases.
Between 2003 and 2005, Cordasco, who owned Crystal Restoration Enterprises, and others schemed to submit false and misleading claims for water damage to several homes purchased by Cordasco's co-conspirators, according to the U.S. Attorney's Office
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Social worker in N.Y. sentenced to a year in jail
July 21, 2008, Tonawanda, NY -- Rhonn Gilchrist, 59, of the Town of Tonawanda, was sentenced to a year in jail Monday for defrauding health care insurance companies.
Gilchrist, a licensed social worker, was convicted Feb. 20 of submitting insurance claims for treatment he never provided and billing two companies for the same treatment.
While it’s legal to bill two companies for the same treatment, the health care provider must inform both companies and return funds received greater than 100 percent of the cost of the procedure, said Assistant U.S. Attorney John Rogowski.
Investigators from the Western New York Health Care Fraud Task Force discovered Gilchrist’s office at
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Louisiana man convicted of torching home for $100
July 21, 2008, Acadiana, LA -- Twenty four year old year old Billie Ray Ware Junior has been convicted on charges of simple arson.
According to court records ware was paid 100 dollars by Henry Lee Comeaux to burn down Comeaux's home so he could collect the insurance.
Firefighters say they found two empty bottles of lighter fluid inside the home. Police say Comeaux was living with his family in this house.
But when they asked him to move out, officers say he apparently got upset and plotted to burn the house down. Comeaux is still awaiting trial on arson and fraud charges.
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Life/health insurers to pay states $20M to settle claims
July 21, 2008, Olympia, WA -- Washington state has joined 29 other states in a $20 million national settlement against HealthMarkets, Inc. and its affiliated companies, MEGA Life and Health Insurance Company, Mid-West National Life Insurance Company, and Chesapeake Life Insurance Company. The settlement follows a three-year multi-state exam which found multiple problems involving consumer disclosure, oversight and training of agents, claims handling, and complaint handling practices.
HealthMarkets faces up to $10 million in additional penalties if it fails to meet performance standards outlined in the settlement.
The multi-state examination was initiated in 2005 by the National Association of Insurance Commissioners (NAIC) and led by Washington State
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Auto give-up scam foiled by LoJack in Pennsylvania
July 21, 2008, Philadelphia, PA -- A 2005 Ford Explorer’s LoJack Stolen Vehicle Recovery System recently led Pennsylvania police to arrest two men on charges of insurance fraud.
Joseph Schmidt, 23, of Philadelphia, Pa., and Deon Joseph, 35, of New Castle, Del., were allegedly involved in a plan to hide Schmidt’s Explorer and report it stolen so that Schmidt could collect the insurance money. Schmidt owed Joseph $500 and planned to use some of it to pay his debt.
Schmidt reported his vehicle stolen to the Philadelphia Police Department and Travelers’ Insurance Jan. 28, authorities said. The insurance claim was for about $14,000.
Once the vehicle identification number
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Ohio bar owners charged with filing 3 false auto claims
July 18, 2008, Pataskala, OH -- One of two local business owners indicted for the distribution of drugs in central Ohio was released on his own recognizance by a federal judge Thursday.
Joseph P. Marasco, 42, last known address 13023 Brandon Mill Road, Pataskala, was in federal court in Columbus to hear charges of drug conspiracy, money laundering and tax and insurance fraud as part of a 10-count indictment. Assistant U.S. Attorney Dan Brown said that Marasco would have to surrender his passport.
No initial appearance has been set for his co-defendant, Robert Fusner, 33, of Grove City, Brown added.
Fusner and Marasco would provide the cash proceeds from
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Ten charged with operating medical mill in Brooklyn
July 18, 2008, Brooklyn, NY -- Ten individuals associated with a Brooklyn-based medical clinic — including the clinic’s owners and several of its medical practitioners – have been arrested on charges of conspiracy to commit health care and mail fraud. Three other individuals remain at large, although one was expected to surrender later Thursday.
Samuel Vilshanetski, aka “Dima,” Sviatoslav Jadan, aka “Slava,” and a third individual owned and operated a medical clinic located at 3003 Avenue K in Brooklyn, New York. The Avenue K Clinic was primarily engaged in the treatment of individuals who filed no-fault automobile insurance claims with insurance companies. Under New York
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Wisconsin woman accused of putting dead rat in food
July 18, 2008, Appleton, WI -- A woman accused of planting a dead lab rat in restaurant food and demanding $500,000 to keep quiet was charged Monday with one felony count of extortion. Debbie R. Miller, 41, of Appleton, also faces misdemeanor counts of disorderly conduct and resisting an officer.
Miller claimed to find the rat in her lunch April 17 as she ate at the upscale Seasons Restaurant in Grand Chute, according to the criminal complaint.
She threatened to alert the media unless the owners paid her $500,000, the complaint said.
The owners turned the rat over to their insurance company. Investigators there determined the rodent was a
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Three in New Jersey charged with staging carjacking
July 18, 2008, Vineland, NJ -- Attorney General Anne Milgram and Criminal Justice Director Deborah Gramiccioni announced that three people have been indicted on charges they staged a phony carjacking in order to collect insurance claims money.
According to Insurance Fraud Prosecutor Greta Gooden Brown, Dennis Caraballo, 28, of Vineland, and his girlfriend, Kristen Smith, 30, also of Vineland, were each indicted on charges of conspiracy, insurance fraud, and attempted theft by deception, all in the third degree. Caraballo was also charged with fourth-degree false swearing and fourth-degree falsifying records. Craig T. Likanchuk, 43, formerly a resident of Vineland but currently incarcerated at the Zephyrhills Correctional Institution
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N.J. pharmacist sentenced for drug diversion, fraud
July 18, 2008, Little Silver, NJ -- Attorney General Anne Milgram and Criminal Justice Director Deborah Gramiccioni announced that a Matawan pharmacist was sentenced today for an insurance claims theft.
According to Insurance Fraud Prosecutor Greta Gooden Brown, Judith H. Leonard, 49, of Little Silver, was sentenced by Superior Court Judge Bette Uhrmacher in Monmouth County to serve one year probation, and to pay $1,210 in restitution to Horizon Blue Cross Blue Shield. Leonard previously paid a $2,500 civil insurance fraud fine. Leonard was sentenced pursuant to her May 16 guilty plea to an accusation charging her with theft by deception.
In pleading guilty, Leonard, who formerly was licensed
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Ohio woman found guilty to setting home on fire
July 17, 2008, Carey, OH -- A Carey, Ohio, woman charged with setting fire to her house to collect insurance money was found guilty Tuesday evening of arson and insurance fraud.
Lisa Gonzales, 41, was convicted on both counts after a two-day jury trial in Wyandot County Common Pleas Court. Judge Kathleen Aubry ordered a presentence investigation.
Gonzales faces up to 18 months in prison and a $5,000 fine on each count. She set fire to her High Street home in September, then filed a false insurance claim.
An investigator with the state fire marshal’s office testified during the trial that the fire originated in a corner of the
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