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workers in New York charged with defraud comp insurer
November 18, 2005, Farmingdale, N.Y. -- Nassau County District
Attorney Denis Dillon recently announced that the DA's Criminal
Frauds Bureau has arrested three individuals who collected workers'
compensation benefits totaling more than $76,939 that they were
not entitled to receive. "Working with the New York State Insurance
Department, the New York State Insurance Fund, and the Inspector
General of the New York State Workers Compensation Board, my office
brought charges against three people for fraudulently claiming $76,939
in Workers' Compensation benefits," said Dillon. "Far
from being a victimless crime," Dillon continued, "insurance
fraud is a crime against consumers, who pay the price when they
take out a policy and pay the premium.
Mastermind
of auto give-up scam headed to prison
November 18, 2005, Town of Newburgh, N.Y. -- A Town of
Newburgh man was sentenced yesterday in Orange County Court to 31⁄2
to seven years in state prison for running a scheme that defrauded
insurance companies out of roughly $180,000 in two years. Rudy Turner,
24, pleaded guilty on Sept. 28 to four felonies: scheme to defraud,
possession of a weapon, possession of stolen property and forgery
of a vehicle identification number. He faced a maximum of five to
10 years after striking a plea-bargain deal last month. Turner admitted
that he masterminded a "give-up" scheme, in which drivers
who wanted to get rid of their cars would arrange for the vehicles
to be taken by Turner or one of his middlemen. The drivers would
then report the vehicles stolen and collect from their insurance
company.
Feds
charge New York man with faking a liability claim
November 11, 2005, Marksville, N.Y. -- The United States Attorney
for the Northern District of New York, yesterday announced the indictment
of Albert Walter, 42, of Colton, New York, in connection with an
insurance fraud scheme. Walter was charged by a federal grand jury
in Syracuse with conspiracy, mail fraud, and conducting financial
transactions with the proceeds of fraud. These charges relate to
a fraudulent insurance claim based on a false representation that
Walter was in jured in an accident occurring on a property insured
by against Selective Insurance Company of America. If convicted
on all four counts in the pending indictment, Walter would face
a total of up to 30 years in prison and fines of up to $1 million.
Accused
New York dentist surrenders to police
November 9, 2005, Hempstead, N.Y. -- The Hempstead school board
member who has been missing since he failed to surrender last week
for insurance fraud charges, turned himself in this morning. Dr.
Terry Grant, 49, of Hempstead, has been wanted on charges of insurance
fraud since Nov. 3 when he was scheduled to surrender to Nassau
County District Attorney Denis Dillon, but failed to appear. Grant
has been a member of the Hempstead School Board since 2004. Previously,
he was a practicing dentist with an office called Gentle Dental
located at 6 Main Street in Hempstead. He also, at one time, acted
as the school district dentist. According to Dillon’s office,
during his time at Gentle Dental, in October and December of 2003,
Grant filed several false insurance claims.
New
York dentist resigns school board amid fraud charges
November 3, 2005, Hempstead, N.Y. -- A Hempstead school board member
who was expected to surrender today on charges of insurance fraud
in connection with his dental practice failed to appear in court
this morning and is now considered a fugitive, authorities said.
Terry Grant, who was elected to the school board in May 2004, had
agreed to turn himself in to investigators from the Nassau County
district attorney's office this morning. "Investigators have
been assigned to locate and arrest Dr. Grant," Nassau County
District Attorney Dennis Dillon said in a release. Instead, he failed
to show up. His lawyer, Harry Kutner, of Mineola, said his client
was "distraught." As of noon today, the district attorney's
office was is seeking a warrnt for Grant's arrest.
New
York fraud fighters cited for helping to lower rates
October 26, 2005, Albany, N.Y. -- Ten New York State Insurance Department
(NYSID) employees and five from the New York State Division of Criminal
Justice Services (DCJS) were presented today with the Governor's
Office of Employees Relations' (GOER) Workforce Champions Award,
which recognizes New York State employees who have worked together
to improve significantly state governmental operations. The NYSID
and the DCJS professionals were honored for their successful efforts
to reduce New York State's automobile insurance rates. The two agencies
employed a multi-faceted strategy in recent years to bring cost
savings to millions of drivers statewide. The regulatory initiatives
included:
Medical
mill in New York charged with PIP billing fraud
October 26, 2005, White Plains, N.Y. -- Authorities announced the
results of a three-year investigation into the systematic fraudulent
billing of no-fault accident claims by a major medical mill operating
in Westchester County. It is alleged that Elm Street Medical, PC
operating out of One Elm Street, Tuckahoe, New York, bilked insurance
companies by exploiting the no-fault provisions of the New York
State Comprehensive Motor Vehicle Insurance Reparations Act.(This
act entitles persons injured in automobile accidents to a minimum
of $50,000 of medical coverage regardless of who is at fault.) Over
a period of approximately three years, Elm Street Medical bilked
dozens of insurance companies by upcoding (i.e. the submission of
claims containing codes for expensive medical services never provided)
or by submitting bogus claims for medical services on behalf of
patients who had not been in a car accident.
Two
New York men arrested in auto give-up scheme
October 26, 2005, Utica, N.Y. -- Two Utica men have been charged
with insurance fraud following an investigation by the state police
in Herkimer and NYS DMV Investigation Unit. James Winston Jr., 28,
of 118 Riverside Drive North Utica and Richard Borowiec Jr., 26,
of 723 Plant St., Utica, were both charged with third-degree insurance
fraud, a Class D felony. State Police in Herkimer report that on
May 1, Borowiec reported to them that his 1999 Mercury Cougar had
been stolen from the parking lot of the Backstreets Brewing Company
at Charlestown while he was working there as a DJ. A police information
revealed that the vehicle was hidden under a tarp at an unlicensed
repair shop on Tilden Avenue being operated by Winston.
A.G.
Spitzer to turn his guns on Medicaid cheats
October 25, 2005, Albany, N.Y. -- Attorney General Eliot Spitzer
is seeking the same kind of power he used to prosecute Wall Street
firms to go after Medicaid cheats, aides said Monday. Earlier this
month a Spitzer aide sent a letter to key senators asking for their
support for a plan that would dramatically expand his power to investigate
health-care fraud, as well as stiffen penalties and make the cases
easier to prosecute. “We all can agree that any level of fraud
is unacceptable, and that stealing health care dollars intended
for the poor warrants swift and certain punishment,” Kathy
Bennett, chief of Spitzer's legislative bureau, wrote in the letter.
Spitzer is asking for a health-care version of a New York law known
as the Martin Act, which gives the attorney general unusual power
to prosecute fraud in the financial-services industry.
28
people, 6 firms named in New York medical fraud ring
October 19, 2005, White Plains, N.Y. -- Investigators said Wednesday
that they have taken down a sophisticated medical fraud ring that
used doctors, emergency room workers, homeless people and New York
Police Department employees to bilk insurance companies out of $12
million. Six corporations and 28 people, including four physicians
and a dentist, have been charged in the alleged three-year scam,
said Westchester District Attorney Jeanine Pirro. "These were
doctors, professional men who took oaths to help people and instead
they stole from people," said Charles Bardong, director of
the state Insurance Frauds Bureau. The scheme took advantage of
New York's "no-fault" auto insurance system and recruited
real and phony car-accident victims to submit bogus claims for medical
procedures that were never performed.
Chiro,
10 others busted in NYPD auto fraud sting
October 19, 2005, Queens, N.Y. -- A crooked Queens chiropractor
and a psychologist were charged with ripping off insurance companies
by pretending to treat phony accident victims, authorities said
yesterday. The pair was among 11 people nabbed in an NYPD undercover
investigation into insurance fraud. Todd Levine, 36, a chiropractor
at Jamaica Comprehensive Medical, allegedly offered an undercover
cop money to stage fake car accidents and send the purported victims
to him for treatment, according to the Queens district attorney's
office. The undercover agent pretended to arrange an accident, and
then Levine falsely billed Nationwide insurance more than $3,000
for treating the "victims," prosecutors said.
New
York superintendent prods lawmakers on fraud laws
October 18, 2005, Liverpool, N.Y. -- Superintendent of Insurance
Howard Mills joined Assemblyman Jeff Brown (R-Manlius) today to
call on the New York State Assembly to pass tougher no-fault auto
insurance fraud legislation and build upon Governor Pataki's success
in fighting insurance fraud across the state. "When the Assembly
returns to Albany next January, it is imperative that they finally
pass tougher anti-fraud legislation," said Superintendent Mills.
"Despite our great strides on behalf of policyholders and our
fraud-fighting accomplishments, even more can be done to combat
auto insurance fraud." The New York State Insurance Department
has approved this year a record number of auto rate reductions,
saving policyholders almost $400 million.
Chiro
accusing of billing for treatment on dead man
September 30, 2005, Fulton, N.Y. -- Fulton chiropractor Dr. Mark
Wegerski was arrested Thursday on charges of falsely billing for
medical treatment of workers' compensation clients. Bills for one
patient covered treatment that couldn't have been provided because
the patient had died, according to the New York State Workers' Compensation
Board and the State Insurance Department. The allegedly phony billing
took place from 2001 through 2004. Wegerski was arrested by the
Onondaga County Sheriff's Department and arraigned in Onondaga County
Court. The Onondaga County District Attorney's Office charged Wegerski
with third-degree grand larceny; fourth-degree grand larceny; first-degree
scheme to defraud; fourth-degree insurance fraud; and fifth-degree
insurance fraud.
Transport
company admits defrauding feds of $400K
September 27, 2005, Westchester, N.Y. -- A Westchester County transportation
company has admitted to stealing more than $400,000 from the Medicaid
program by fraudulently billing for hundreds of rides that never
took place and for rides that were not authorized by medical practitioners.
Meir Sassoon, President of Saswitz Corporation, appeared before
Westchester County Court Judge Rory J. Bellantoni, on September
1, 2005 and pleaded guilty to every count of an indictment which
charged him with one count of Grand Larceny in the Second Degree
and twenty five (25) counts of Offering a False Instrument for Filing
in the First Degree.
New
York counties going high-tech to detect health scams
September 25, 2005, Albany, N.Y. -- With pressure building to fight
Medicaid fraud, some counties in New York plan to begin high-tech
audits of phony reimbursement claims. The New York Association of
Counties struck a deal that will allow individual counties to ship
Medicaid reimbursement data from providers to IBM for computer analyses.
County officials said the computer checks open a new front in the
battle against fraud in New York's $44.5 billion Medicaid program.
"There are millions of dollars we feel have been spent fraudulently,"
said Erie County Executive Joel Giambra. Erie and Rockland counties
recently signed up for the service, which is being offered through
the county group. Stephen Acquario, the group's executive director,
said 10 more counties are expected to sign up by the end of the
year.
New
York driver pleads guilty to faking car theft
September 14, 2005, Newburgh, N.Y. -- One player in a Newburgh-area
car-insurance scam pleaded guilty yesterday, and the accused ringleader
may be next. Dominic Calderone, 37, of Newburgh, pleaded guilty
in Orange County Court to insurance fraud, a felony. He admitted
that he submitted a phony insurance claim last year for a car, after
reporting it stolen. The car was actually what police call a "give-up"
car, given up by Calderone to a thief. The accused mastermind of
the give-up scheme, 22-year-old Rudy Turner of Newburgh, also appeared
in court yesterday.
Caremark
to pay $137.5 million to settle fraud suit
September 8, 2005, New York, N.Y. -- Caremark Rx Inc. (CMX.N: Quote,
Profile, Research) on Thursday said it will pay the U.S. government
$137.5 million to settle a lawsuit over allegations of improper
business practices by AdvancePCS, a rival pharmacy benefits manager
that Caremark acquired last year. The settlement involves no admission
of wrongdoing and AdvancePCS denied that it had engaged in any wrongful
or inappropriate conduct, Caremark said. The settlement resolves
allegations that arose from an investigation by the U.S. Attorney's
office for the Eastern District of Pennsylvania that began in November
1999. Caremark said the probe related only to activities that took
place prior to its March 2004 acquisition of AdvancePCS.
New
York social worker jailed for fraudulent billing
August 30, 2005, Rockland, N.Y. -- A social worker with offices
in Rockland has admitted stealing $274,431 from Medicaid and Medicare
by filing fraudulent bills during a five-year period, the state
Attorney General's Office said yesterday. Allen Steven Levy was
sentenced in County Court last week to six months in jail and five
years' probation on his June guilty pleas to two counts of second-degree
grand larceny. As part of his plea agreement, Levy paid $274,431
in restitution and surrendered his license to practice psychotherapy
in New York. The conviction was Levy's second on charges of stealing
money through fraudulent billings. In 2003, he admitted stealing
more than $4,000 from an insurance company in Rockland.
New
York clinic owner charged in medical fraud case
August 29, 2005, Bay Ridge, N.Y. -- A Bay Ridge medical clinic owner
charged with defrauding insurance companies of more than $200,000
was sentenced last week to 57 months in prison. Victor Tsekhanovich,
27, was convicted of heading a health care fraud scheme out of his
office, ROV Management, at 565 85th St. He was arrested last year
in an FBI-assisted insurance-scam sweep in which 22 defendants were
charged in Manhattan Federal Court. "Health care fraud costs
United States taxpayers billions of dollars each year," said
David Kelley, the U.S. attorney for the southern district.
New
York City may license medical providers to curb fraud
August 17, 2005, New York, N.Y. -- Blaming fraud by "medical
mills" for the city's sky-high car insurance rates, some Council
members are introducing a bill today to help the city fight back.
The measure would require health care providers who receive more
than half of their income from no-fault auto insurance claims to
obtain special licenses from the city Health Department. The licenses
would be accompanied by rigorous reporting requirements and with
stiff fines and a possible one-year jail sentence for violations.
"I'm trying to drive the bad guys out of business so the good
providers can continue to operate," said Councilman David Yassky
(D-Brooklyn), the bill's chief sponsor.
New
York man sentenced for fake theft of building supplies
August 15, 2005, Colton, N.Y. -- A Colton, NY man has been sentenced
in connection with a 1999 insurance fraud case. Randy LaValley,
39, had pleaded guilty on February 28, 2005 to felony conspiracy
charges arising from a fraudulent insurance claim with respect to
a tractor trailer load of building supplies that was falsely reported
as stolen. He was now sentenced in US District Court in Utica to
serve eight months in prison, pay a $3,000 fine over $72,000 in
restitution to Royal and Sun Alliance. LaValley operates a trucking
company named LaValle Transportation, Inc. of Potsdam, New York
and other businesses in that area.
New
York grand jury investigating broker bid-rigging
August 12, 2005, New York, N.Y. -- A New York grand jury is investigating
whether a former top insurance broker at Marsh Inc., helped rig
bids for corporate clients and steer business to insurers that paid
the brokerage firm special commissions, a newspaper report said
Friday. Citing four people familiar with the matter, The Wall Street
Journal said that the grand jury impaneled by New York Attorney
General Eliot Spitzer is reviewing materials and hearing from witnesses
as it examines the role played by William Gilman, the former Marsh
broker. The jury is also looking at the activities of other former
Marsh brokers and managers at some insurance companies, the Journal
said.
11
busted in New York for running auto fraud ring
August 8, 2005, Newburgh, N.Y. -- Eleven people were indicted today
in connection with an investigation into auto theft and insurance
fraud in Orange County. So far, the investigation has resulted in
22 people being indicted and 25 arrested. The arrests were the result
of a joint investigation conducted by the state Attorney General's
Office and the State Police Special Investigations and Automobile
theft Unit. The defendants were charged in three separate indictments,
which cover conduct that allegedly took place between June 2004
and April 2005 and involved 10 vehicles. Of the 10 vehicles, six
were allegedly stolen from auto dealerships. The other four were
falsely reported stole to insurance carriers and police to avoid
remaining loan or lease payments.
Four
more execs plead guilty in New York AG's probe
August 4, 2005, New York, N.Y. -- New York Attorney General Eliot
Spitzer continues to amass guilty pleas from insurance executives
as his year-and-a-half-long probe into bid-rigging and price-fixing
abuses builds steam. Three executives from Marsh & McLennan
Cos., the world's largest insurance brokerage, and one from Zurich
American Insurance Co., pleaded guilty this week to fraud and restraint
of trade charges before New York Supreme Court Judge James Yates.
In all, 14 executives have entered pleas to criminal charges since
October last year.
Staged
accidents increasing in Western New York
August 3, 2005, Buffalo, N.Y. -- In the world of automobile insurance
fraud, they are sometimes known as "crash test dummies."
They are the drivers and passengers in cars used in staged auto
accidents. According to experts, they are part of a massive pattern
of fraud that increases the annual car insurance bill of every motorist
in New York State by as much as 10 percent. They also contribute
to a health care fraud problem that reportedly costs the state's
Medicaid program billions of dollars annually. On Tuesday, federal
and state investigators charged 30 people with staging fake auto
crashes in Western New York. The arrests are the first step in a
crackdown that is now examining the conduct of doctors, lawyers
and operators of medical clinics involved in processing false insurance
claims.
New
York pharmacist accused of defrauding $4 million
August 3, 2005, Tarrytown, N.Y. -- A trusted pharmacist in Tarrytown
cheated customers and insurance companies out of as much as $4 million
in recent years by undercutting prescriptions, overcharging and
replacing expensive medications with generic brands, authorities
said. Neil Norwood, owner of Russell & Lawrie Pharmacy, was
arraigned in Village Court this morning on a felony charge of third-degree
insurance fraud and ordered held on $750,000 bail. "No comment,
other than I am absolutely not guilty," Norwood, 50, said as
he was led in handcuffs from the court on his way to the Westchester
County jail.
16
state employees in New York accused of claims fraud
August 3, 2005, Bronx, N.Y. -- Sixteen employees of New York State
have been arrested and charged with grand larceny and other offenses
for allegedly submitting numerous fraudulent medical claims to their
insurance company. According to the Bronx district attorney’s
office, 12 individuals have been charged in the Bronx, while cases
against four other State workers are being prosecuted by the Office
of Manhattan District Attorney because of jurisdictional issues.
Prosecutors said investigators expect to make at least one additional
arrest for prosecution in the Bronx.
30
indicted in Buffalo for staging nine car crashes
August 2, 2005, Buffalo, N.Y. -- The U.S. Attorney's office Tuesday
announced a 19-count indictment, charging 30 defendants with conspiracy
to commit health-care and mail fraud after allegedly staging automobile
collisions to collect insurance payments. Assistant U.S. Attorney
John Rogowski, who presented the case to the Grand Jury, said the
case also involves payments made for medical equipment to a company
controlled by one of the defendants. The 30 face penalties of five
to 10 years in jail or a fine of at least $250,000, or both. Fourteen
defendants, also charged with mail fraud, face additional jail time
and/or fines.
'Saudi
princess' pleads guilty to $262K fraud scam
August 2, 2005, Manhattan, N.Y. -- A former investment banker who
posed as a Saudi Arabian princess was told to check into a mental
hospital Tuesday after admitting she tried to cheat an insurance
firm and that she stole from a credit card company. Antoinette Millard,
42, of Manhattan, pleaded guilty to second-degree insurance fraud
and second-degree grand larceny in exchange for the prosecution’s
recommendation that she receive at least a year of inpatient psychiatric
care. Her lawyer said his client suffered a breakdown after the
Sept. 11, 2001, terror attacks. Assistant District Attorney Diana
Lawrence told the judge that at least four psychiatrists had examined
Millard, and while her mental troubles would not present a viable
psychiatric defense at trial, they were severe enough to recommend
treatment.
Ten
arrested in New York auto give-up scheme
July 29, 2005, Goshen, N.Y. -- A reputed member of a $6-million-a-year
drug gang and the owner of a towing company were among 10 people
accused yesterday of participating in a Newburgh-based auto insurance
scam. The suspects were arraigned yesterday in Orange County Court.
One of them, 22-year-old Rudy Turner of Newburgh, was already under
indictment in the scam. Last month, Turner was accused of orchestrating
the fraud, which police called a "give-up" scam. Turner
would arrange for the pickup of a "give-up" car and the
owner would report it stolen and collect insurance money for the
car, police said.
California
agent pleads guilty in $4 mil. fraud case
July 27, 2005, Manhattan, N.Y. -- A former California insurance
broker/agent faces up to 20 years in prison after pleading guilty
in New York to conspiracy charges related to insurance fraud. The
case stems from the findings of a joint investigation by the California
Department of Insurance Investigation Division, and United States
Postal Inspection Service. On July 19, Richard Peterson, of San
Francisco, pleaded guilty to charges of conspiracy to commit wire
and mail fraud, engaging in the business of insurance after having
been convicted of a federal felony, and using a fictitious name
in a scheme to defraud. The case revolved around his fraudulent
sale of $4 million worth of fake insurance policies, purportedly
underwritten by Lloyd's of London. His plea was entered in Manhattan
at the United District federal court, southern district of New York.
Former
agent in New York City accused of selling fake policies
July 27, 2005, Queens, N.Y. -- A Queens man is being charged with
running a phony insurance brokerage that provided insurance cards
and registrations to motorists. Queens District Attorney Richard
Brown says 59-year-old Willie Fulmore Junior of South Ozone Park
had once been a licensed broker, but he lost his license. He then
hung around a Queens gas station and solicited motorists to buy
insurance. He sold fake policies - complete with the forged insurance
cards. The DA says Fulmore called his business Feel Welcome Brokerage.
He's being charged with 71 Counts of Forgery and Criminal Possession
of A Forged Instrument, Criminal Possession of Forgery Devices,
Scheme to Defraud, Attempted Offering of a False Instrument, Insurance
Fraud, Possession of Stolen Property and violating New York State
Insurance Law.
New
York lawmakers chided for failing to pass fraud laws
July 20, 2005, Albany, N.Y. -- State Attorney General Eliot Spitzer,
under fire along with Gov. George Pataki for not doing enough to
combat Medicaid fraud, called Wednesday for the state Legislature
to return to Albany and immediately pass legislation that could
help him do a better job. Spitzer's letter to state Assembly Speaker
Sheldon Silver and Senate Majority Leader Joseph Bruno came after
The New York Times began an investigative series this week faulting
Pataki, Spitzer and other state officials for failing to match the
success of many other states in catching those who cheat the health
care program for the poor. New York's $44.5 billion Medicaid program
is the nation's largest.
Fraudsters
stealing billions from Medicaid in New York
July 18, 2005, New York, N.Y. -- It was created 40 years ago to
provide health care for the poorest New Yorkers, offering a lifeline
to those who could not afford to have a baby or a heart attack.
But in the decades since, New York State's Medicaid program has
also become a $44.5 billion target for the unscrupulous and the
opportunistic. It has drawn dentists like Dr. Dolly Rosen, who within
12 months somehow built the state's biggest Medicaid dental practice
out of a Brooklyn storefront, where she claimed to have performed
as many as 991 procedures a day in 2003. After The New York Times
discovered her extraordinary billings through a computer analysis
and questioned the state about them, Dr. Rosen and two associates
were indicted on charges of stealing more than $1 million from the
program.
New
York pulls license of foot doc who defrauded
July 7, 2005, Nanuet, N.Y. -- A podiatrist who lives in Nanuet has
been stripped of his license to practice by the state after he was
convicted of felony health care fraud, according to court records.
Alan S. Katz, 45, of Yorkshire Court surrendered his license to
practice podiatry, according to the state Department of Education.
Katz practiced podiatry with Citywide Foot Care in New York City.
He was convicted in February 2004 on one felony count of health
care fraud and one felony count of conspiracy to commit mail fraud,
to commit health care fraud and to make false statements relating
to health care matters, according to state records.
Fraud
cases in New York dropped 17% last year
July 5, 2005, Albany, N.Y. -- When it comes to car insurance fraud,
things are finally looking up. That's according to Bernard Bourdeau,
president of the New York Alliance Against Insurance Fraud. For
years, fraud cases have been blamed for New York's skyrocketing
car insurance rates. New York's insurance rates are second highest
in the nation behind New Jersey. But new figures from the state
Insurance Department show the number of suspected fraud cases dropped
statewide last year by 17 percent. The average cost of personal
injury claims in New York also dropped.
Man
charged for using friend's health insurance ID
July 1, 2005, Liberty, N.Y. -- State Police at Liberty have arrested
two men on charges of insurance fraud in the fourth degree. Police
arrested Ivan Maradiaga, 26, and Walter Barahona, 35, both of south
Fallsburg. They also charged Maradiaga with grand larceny in the
fourth degree, criminal impersonation in the second degree and forgery
in the third degree. An investigation revealed that on June 19,
Maradiaga went to Catskill Regional Medical Center in Harris and
used Barahona’s name and health insurance card to receive
medical services. When he was told he was going to be admitted,
he told hospital staff of his real name. Both men were arraigned
and remanded to the Sullivan County Jail without bail pending a
court appearance.
New
York fraud penalties 'a joke,' says insurance regulator
June 22, 2005, Newburgh, N.Y. -- State Insurance
Superintendent Howard Mills heard the concerns of the business community
yesterday as he spoke with the Orange County Chamber of Commerce
in the Town of Newburgh. Workers compensation and health insurance
were among the issues raised by the local entrepreneurs as well
as the cost of auto insurance. While the Mills’ office is
working to bring those auto rates down, there is still a long way
to go. “The problem is that we really need to toughen the
penalties for insurance fraud in New York State,” he said.
“Frankly, the penalties for fraud on insurance are a joke.”
Mill also expressed concern over federal legislation that provides
a terrorism insurance backstop. If it expires without being renewed,
“it would have a devastating impact on our economy.”
10
docs charged for billing fraud in New York sweep
June 20, 2005, New York , N.Y. -- Nearly a dozen
medical and dental professionals are under indictment in Manhattan
and Brooklyn today charged with fraud. They are accused of cheating
insurance companies out of millions of dollars. Ten people entered
not guilty pleas today in what's described as a medical insurance
scam against private insurance companies and the New York Transit
Authority, which is self-insured. Search warrants were issued for
records at a location on Coney Island Avenue as well as offices
on Ocean Avenue and in Greenwich Village on University Place.
Reports
of fraud down 17 percent in New York
June 19, 2005, Buffalo, N.Y. -- Efforts to fight
auto insurance fraud in New York state seem to be working, with
fraud reports to the state down 17 percent last year, according
to the New York Alliance Against Insurance Fraud. Citing statistics
from the industry-funded Insurance Information Institute, the insurer
group said the cost of no-fault personal injury protection claims
is down 32 percent since 2000. It also said the frequency of those
claims, while still above the national average, is down 21 percent.
Even more, the average cost of such claims in New York, at $5,867,
is now below the national average of $7,060. The improving situation
is in contrast to 2000, when no-fault claim costs in the state were
growing faster than in any other no-fault state, rising 28.5 percent
annually, with losses increasing by 121 percent - twice the national
average.
Bronx
dentist charged with defrauding 20 insurers
June 17, 2005, Bronx, N.Y. -- Federal officials
yesterday announced that Barry Litt, 56, a dentist in the Bronx,
was arrested yesterday on charges of health care fraud and false
statements relating to health care matters. He lives in Pomona,
NY. A criminal complaint unsealed yesterday in Manhattan federal
court charges LITT with submitting numerous false claims for reimbursement
to Medicaid and approximately 20 different private insurance companies
for a dental procedure known as periodontal scaling and root planing.
Also according to the complaint, due to the difficulty of the procedure
and the pain associated with it, dentists typically perform PSRP
on no more than two quadrants of the mouth in a single patient visit,
and a patient’s mouth generally needs time to heal before
the procedure can be done again.
New
York psychologist admits to false billing scam
June 16, 2005, Mineola, N.Y. -- A Long
Island psychologist has pleaded guilty to insurance fraud, admitting
he submitted bills for treatment sessions that never occurred. Melvon
Swanston of Baldwin admited he gave bills to Liberty Mutual Insurance
Company for approximately 30 psychotherapy and treatment sessions
that never occurred. Nassau D.A. Denis Dillon says that as part
of his plea, Swanston has agreed to pay thirty-six hundred dollars
in restitution to Liberty Mutual Insurance Company. Swanston will
be sentenced on August 16 by Nassau County Court Judge Jeffrey Brown.
He faces up to four years in prison.
Viatical
fraudster's suit against prosecutors rejected
June 12, 2005, Lexington, Ky. -- A federal judge
has dismissed a lawsuit filed by a convicted Lexington insurance
executive against two prosecutors. U.S. District Judge Jennifer
Coffman last week denied all motions made by Stephen L. Keller in
his suit against U.S. Attorney Greg Van Tatenhove and Assistant
U.S. Attorney Patrick Malloy. Keller, 42, said in his suit, filed
May 12, that prosecutors had illegally obtained evidence against
him. Keller, who sought $3 billion in damages, is being held at
the Federal Medical Center in Lexington. Coffman said Keller had
failed to make the case that he was entitled to compensation.
Russian
taxi owner charged in $1M claims scam
June 10, 2005, New York, N.Y. -- Nearly four years
ago an AllState investigator saw something suspicious in an accident
report filed by S. Shimon Wolkowicki, a major player in the city's
yellow taxi industry, according to police. The investigator called
the state Insurance Department, which in turn notified the NYPD.
Thursday morning, with the police probe complete, Wolkowicki, 58,
turned himself in and was charged with insurance fraud for allegedly
filing more than $1 million in false insurance claims for taxi accidents
that never happened. Wolkowicki, a Russian immigrant who started
in the taxi business as a cab driver, is the former owner of S &
R Medallion, one of the city's largest leasing corporations with
a fleet of more than 300 yellow cabs on West 51st Street.
Queens
contractor erects alleged comp scheme
June 2, 2005, Queens, N.Y. -- A Queens man has
been indicted for collecting Workers' Compensation benefits while
receiving $16,350 for contracting jobs and posing as a licensed,
insured home improvement contractor. According to the Manhattan
district attorney’s office, the investigation leading to the
indictment revealed that on July 16, 1986, James Fasos of Bayside,
now 62, was working as a manager for Space Makers Furniture Inc.
when he fell backwards on the basement stairs at a job site. Fasos
claimed that he hurt his back in the fall and began receiving Workers'
Compensation benefit checks.
AIG
suit also touches on work comp, viaticals
May
27, 2005, New York, N.Y. -- Former
AIG (AIG) boss Maurice Greenberg pushed the insurer into a controversial
line of death benefits known as "viaticals" in late 2001
that grew into a $1 billion business for the insurer with the promise
of big profits but also the possibility of bad publicity. It has
delivered both. The New York attorney general's office and the state's
insurance superintendent alleged Thursday that AIG and its former
CEO and chairman erected an elaborate fraud to avoid associating
their names with the controversial death benefit, and to get around
the accounting rule that requires the contracts to be booked initially
at a paper loss.
Former
New York police chief charged with comp fraud
May
20, 2005, Glens Falls, N.Y.-- The private law client of a
Glens Falls city court judge, already on probation for felony filing
a false written instrument in connection with his employment application
to be a police chief, has been charged with four more felonies.
Jacob W. Sabo, 57, of Whitehall, was represented by Glens Falls
City Court Judge Gary C. Hobbs, when he was found guilty following
jury trial of lying on his employment application to the town of
Fleischmanns in Delaware County. Sabo, a former police officer for
Lake George in Warren County and Whitehall in Washington County
has now been charged with counts of grand larceny, insurance fraud,
falsifying business records and falsely making an application for
worker compensation benefits.
Ex-NYPD
cop convicted in auto fraud billing scam
May
20, 2005, New York, N.Y. --
A former police officer was convicted of official misconduct Friday
for his role in an auto insurance fraud scam, the Bronx district
attorney said.Irvin Maldonado, who was a 13-year veteran assigned
to the housing bureau at the time of his arrest in 2003, faces up
to a year in jail when he is sentenced June 10.Maldonado and three
other officers were charged in the scam, which resulted in hundreds
of thousands of dollars in insurance claims being paid out, prosecutors
said. Prosecutors contended the officers filed false accident reports
and collected money from insurance companies.
NYC
hospital to pay feds $76M for Medicaid fraud
May 18, 2005, New York, N.Y. --
Staten Island University Hospital will return $76.5 million that
prosecutors say it fraudulently billed New York State's Medicaid
program over recent years.It's the largest settlement with a health
care provider in the program's history.The frauds were allegedly
conducted through part-time clinics that do minor procedures in
neighborhoods without sufficient medical care, according to a criminal
complaint against the hospital to be released Wednesday by Attorney
General Eliot Spitzer's office.To take advantage of the higher rates
the Department of Health pays for services done in these clinics,
the hospital operated many of them far beyond the state-permitted
60 hours a month.
Fraud
crackdown slashes auto premiums in New York
May 16, 2005, New York, N.Y. --
New York state drivers now have something to honk about besides
gridlock. Ten major auto insurers have reduced their rates —
saving 6 million policyholders an average of $50 a year, for a total
of $350 million. The cuts are due to a statewide crackdown on fraud
that has sharply reduced claims, according to a report in today's
Crain's NY Business. Also, the average payment on a personal-injury
claim fell 27 percent, to $6,229, last year, when the state Insurance
Department reported a record 814 fraud arrests.
Ninth
insurer cuts New York rates: cites lower fraud
May 2, 2005, Albany, N.Y. --
The state's largest auto insurer, Allstate Corp., has agreed to
cut rates in New York state this year by at least 3 percent, saving
customers $50 million, state regulators will announce today. With
the agreement, Northbrook, Ill.-based Allstate becomes the ninth
insurer to agree to a rate cut since state regulators began a campaign
to lower auto insurance premiums in New York in November. Last month,
New York Central Mutual agreed to cut rates by a statewide average
of 5.1 percent, to save consumers an estimated $15 million for 2005.
New
York pharmacies to pay $6.7M for overbilling state
April 28, 2005, Rochesterd, N.Y. --
Attorney General Eliot Spitzer said Thursday that 11 New York pharmacies
agreed to reimburse the state Medicaid program nearly $6.7 million
for overbilling and documentation problems. The pharmacies provided
medications to nursing homes and the state Office of Mental Retardation
and Developmental Disabilities. Assistant Attorney General Jerry
Solomon, who heads the Medicaid Fraud Control Unit in Rochester,
said audits from 1997 to 2003 found the following problems: filling
prescriptions that lacked the signature of the prescribing physician,
refilling telephone orders without written support, dispensing drugs
in strengths that differed from written orders, dispensing drugs
in quantities exceeding the quantity ordered in prescriptions, and
dispensing drugs without written orders.
Phantom
passenger pleads guility in Brooklyn, New York
April 21, 2005, Brooklyn, N.Y. --
Queens District Attorney Richard Brown announced Tuesday that a
Brooklyn man pleaded guilty to bilking over $32,200 from State Farm
Insurance following a fictitious auto accident in Richmond Hill
in January 2001. David Smith, 45, of Bedford-Stuyvesant, pleaded
guilty to auto insurance fraud in Queens County Supreme Court. He
will next appear in court on May 5th, when Justice Barry Kron has
said he will be sentenced to three to six years in prison. Brown
said Smith acted as a “jump-in” for the fraud scheme,
posing as an accident victim in return for the promise of free medical
treatment and a cash payout.
New
York factory owner denies fraud from five fires
April 13, 2005, Long Island, N.Y. --
A defense attorney for a prominent Willamsburg man charged with
arson and fraud after a series of fires at his upscale women's clothing
factory said yesterday that prosecutors had made "a federal
case" out of blazes caused by the inherent combustibility of
materials in a garment manufacturing plant. Attorney Douglas Burns,
of Garden City, said Nathan Schlesinger, 68, of 234 Marcy Ave.,
Brooklyn, has been charged for five fires at the plant since 1989,
but prosecutors failed to note there were about 15 other fires at
the plant that did not result in any charges. Cloth at the plant,
at 750 Kent Ave., in Williamsburg, could easily catch fire, and
there was evidence that employees smoked on the job, said Burns,
a former federal prosecutor, at the opening of Schlesinger's trial
in U.S. District Court in Central Islip.
Owners
of New York ambulette firm guilty of billing scam
April 8, 2005, Albany, N.Y. --
Attorney General Eliot Spitzer and Acting State Insurance Superintendent
Howard Mills yesterday announced guilty pleas by two owners of an
ambulette company for submitting fraudulent transportation bills
to insurance carriers. The schemes involved false billings stemming
from no-fault insurance claims made by motor vehicle accident victims.
Among the charges the defendants pled guilty to were scheme to defraud,
insurance fraud, forgery, criminal possession of forged instruments,
larceny and attempted larceny. As part of their guilty pleas, both
individuals - Staten Island residents Alla Bronshteyn, 58, and her
husband, Vitaly Tsimerman, 61, are expected to be sentenced to a
year in jail.
Feds
accuse New Yorker of running bogus insurance scam
April 7, 2005, Lake Success, N.Y. --
The former president of a Lake Success-based health-benefits company
has been indicted by a federal grand jury on charges of embezzling
premiums and defrauding small businesses, the U.S. Labor Department
said yesterday. Dwayne Samuels, 47, of Elmont, who was president
of Vanguard Asset Group Inc., was charged with embezzling health
insurance premiums and devising a scheme to defraud members of the
Wedding & Event Videographers Association and the American Financial
Management Association Group, the Labor Department said.
NYPD:
"25% of NYC auto thefts are owner give-ups"
April 3, 2005, Bronx, N.Y. --
Thieves made off with more than 20,000 cars in New York last year,
with the Bronx and southern Brooklyn hit the hardest, a Daily News
analysis shows. The Parkchester-Castle Hill area in the Bronx and
Starrett City in Brooklyn were the neighborhoods most favored by
boosters, who all but ignored Breezy Point and Rockaway Park, Queens,
according to NYPD data ranking theft by police precinct. The neighborhood
ranking does not correspond to rates for other crimes, such as murder
and rape, or even neighborhood personal income patterns. For example,
205 cars were stolen in the city's wealthiest precinct, the 19th,
whose borders are 59th to 96th Sts. and Fifth Ave. to the East River.
New
York woman accused of killing mate for life insurance
March 31, 2005, Queens, N.Y. --
A 19-year-old Queens woman has been arrested in the beating death
of her husband, police said. Lory Scott and another person had conspired
to kill Nubian Knight, 37, in December 2003 in an attempt to commit
insurance fraud, police said. The couple had been married about
two months when the killing took place. Scott was arrested Wednesday.
Knight was found dead in his apartment with his throat slashed and
blunt trauma to his head. He had worked as a security officer at
a Brooklyn hospital.
New
York psychiatrist accused of imagining treatment
March 30, 2005, New York, N.Y. --
A Long Island shrink has been busted for insurance fraud after billing
a "patient" for 30 sessions that were all in the therapist's
head — because he never actually met the person, authorities
said. Melvon Swanston, 58, of Baldwin, kept detailed records of
the imaginary symptoms, treatment and progress of the man —
whom he claimed to have treated for a full five months, said Nassau
County prosecutor Kristen Fexas. The patient is a real person: a
Long Island man who was in a car accident in 2003. He went to Liberty
Medical facility and received acupuncture, chiropractic treatment
and therapy — but no psychiatric care. Swanston, who worked
at the same facility, but never treated the man, allegedly billed
$3,677 for the phony sessions.
60
insurers defrauded by medical billing ring in New York City
March 23, 2005, New York, N.Y. --
A Manhattan grand jury has indicted 15 people, including four doctors
and a dentist, on charges of stealing millions of dollars from New
York City Transit and numerous insurance companies through fraudulent
medical billing. The indictment also named six companies, which
included a medical billing firm, a psychologist's office, an acupuncture
clinic and three medical clinics, as participants in the fraud.
The companies had offices in Brooklyn, Manhattan, or both.
New
York bridge painter charged with comp premium fraud
March 15, 2005, New York, N.Y. --
Attorney General Eliot Spitzer, New York State Workers' Compensation
Board Fraud Inspector General John Burgher, Jr., State Insurance
Fund Chief Executive Officer Kenneth Ross, and State Police Superintendent
Wayne Bennett today announced the guilty plea of a Williamsville
man for stealing funds from the New York State Insurance Fund. Leon
Hatzipetros, 41, of 339 Sunrise Boulevard, Williamsville, co-owner
of Marine Steel Painting Corp. ("Marine Steel"), located
at 2064 Zoeller Road in the Town of Alden, entered a guilty plea
today before Erie County Court Justice Sheila A. DiTullio to Insurance
Fraud in the Third Degree, a class "D" felony.
Six
comp claimants nabbed in New York City fraud sweep
March 11, 2005, New York, N.Y. --
A group of municipal employees receiving workers' compensation actually
had jobs while bilking the city out of more than $100,000 in disability
funds, authorities charged yesterday. Brooklyn DA Charles Hynes
announced the arrest of six people — who worked for agencies
such as the Transit Authority and the Housing Authority —
for illegally taking on jobs while still receiving benefits. An
arrest warrant was issued for a seventh man living in Florida. They
were slapped with charges ranging from grand larceny and insurance
fraud to falsification of business records. They all face up to
seven years in prison if convicted.
New
York awards $5.3M to local police for fraud, auto theft
March 10, 2005, Albany, N.Y. --
New York state will award $5.3 million in grants to law enforcement
and police agencies for motor vehicle theft and insurance fraud
programs. A total of 29 grants have been awarded in this round of
funding. That includes $313,500 in Erie County -- $180,000 to the
district attorney, $93,500 to the Buffalo Police Department and
$40,000 to the Town of Cheektowaga Police Department. The Niagara
County district attorney's office was awarded $140,000.
Immigrants
targeted in fake auto policy scam in New York
March 6, 2005, Newburgh, N.Y. --
Orestes Latorraca plunked down $2,800, thinking he was getting a
good deal on insurance for his car and two taxi cabs. Latorraca,
45, arrived in Newburgh from Peru in 1999, determined to make enough
money to send for his family. He worked construction jobs from 6
a.m. to noon and drove cabs in the evening. A few months after he
got his insurance cards, Latorraca got a letter from the state Department
of Motor Vehicles. The letter told him to yank his cars off the
road. Latorraca had been fleeced. He was one of 1,400 insurance
scam victims from the Hudson Valley to the Adirondacks, police say.
That's more people than live in the Village of Otisville.
More
signs that New York anti-fraud efforts are effective
February 28, 2005, Albany, N.Y. --
State Farm Mutual will become the seventh auto insurer to cut premiums
voluntarily in New York state since November 2004 under a rate filing
approved by state insurance regulators Monday. The filing will give
rate reductions averaging 5 percent starting April 1 for new State
Farm customers and May 1 for motorists renewing State Farm policies.
State Farm insures about 1.1 million passenger vehicles in the state,
about 11 percent of the market share in New York.
The reductions will save State Farm customers about $47 million
in 2005, regulators estimated. Acting state Insurance Commissioner
Howard Mills attributed the reductions to state and local efforts
to reduce fraud in the insurance industry.
Brooklyn,
New York 'lost' 76,245 cars in recent years
February 27, 2005, Brooklyn, N.Y. --
Lost, Brooklyn vicinity: 76,245 cars, trucks and buses. Incredible
as it might seem to anyone who has inched along the Gowanus Expressway
lately or cruised for a parking spot in Brooklyn Heights, the state
Department of Motor Vehicles says the number of automobiles registered
in Brooklyn fell by almost 16 percent from 2000 to 2003 - or 76,245.
Queens, Manhattan and the Bronx had similar drops (but not Staten
Island, which registered a small increase) so that, citywide, the
number of vehicles registered dropped 8.5 percent to 1.9 million
in 2003, the last year for which figures are available.
Another
Marsh exec pleads guilty to bid rigging
February 24, 2005, New York, N.Y. --
A former senior executive at Marsh & McLennan Cos. <MMC.N>
pleaded guilty to criminal charges on Thursday in a wide-ranging
probe of fraud and bid-rigging in the insurance industry. Kathryn
Winter, a former senior executive of Marsh, Inc., admitted that
during a period from 2001 to 2004, she instructed insurance carriers
to submit noncompetitive bids for insurance business, the office
of New York Attorney General Eliot Spitzer said in a press release.
The former broker and managing director pleaded guilty before Justice
James Yates in New York County Supreme Court to the crime of scheming
to defraud in the first degree — which carries a maximum sentence
of four years in prison.
Editorial:
Keep up fraud fight in New York
February 24, 2005, Poughkeepsie, N.Y.
-- Howard Mills was a good political soldier last
fall, running against U.S. Sen. Charles Schumer after Republicans
with more name recognition declined. Mills was trounced in that
race, but now the former state Assemblyman and Marist College graduate
has been appointed by Gov. George Pataki to a $127,000-a-year position
-- that of state insurance superintendent. There are ways he can
earn his keep. New Yorkers will likely gauge Mills' effectiveness
on one critical issue -- can he help hold down the cost of auto
insurance in New York?
Saga
of a 'Saudi princess' and fake theft of jewels
February 24, 2005, New York, N.Y. --
The phony princess who ran up a $1 million American Express bill
says she was trying to shop until she dropped dead. "I went
on a spending spree. I went berserk. I didn't care. I just wanted
to die. It was suicide by spending," Antoinette Millard claims
in court papers where she blames her shop-aholism on a mental disorder
— and trauma from the Sept. 11 terror attacks. Millard —
currently awaiting trial on insurance-fraud charges — said
in an affidavit that her wild spending sprees and claims of being
a Saudi princess were preceded by "a series of traumatic events
in my life," including being sexually harassed at her workplace
and witnessing "people jumping out of the Twin Towers"
while she was "en route to work on 9/11/01."
New
York doc charged with thousands of bogus surgeries
February 23, 2005, New York, N.Y. --
A dermatologist has been convicted of illegally prescribing drugs
to a patient who died of an overdose. Upper East Side doctor David
Wexler was also found guilty of fraud for filing false insurance
claims for thousands of bogus surgeries, Manhattan U.S. Attorney
David Kelley announced yesterday. Wexler faces 20 years to life
in prison. In the most egregious case, Wexler submitted almost 2,000
claims for surgeries that he claimed to perform on Barry Abler,
and was paid $425,000 through Medicare.
1
Marsh, 2 AIG execs plead guilty in New York broker scam
February 16, 2005, New York, N.Y. --
A former senior executive at Marsh & McLennan Companies Inc.
and two American International Group Inc. employees pleaded guilty
Tuesday to criminal charges in a New York State probe of bid-rigging
and price-fixing in the insurance industry. Joshua Bewlay, 39, of
Tuxedo Park, N.Y., a former managing director at Marsh; John Mohs,
36, of Manhattan, a vice president in a unit of AIG; and Carlos
Coello, 33, of Teaneck, an AIG underwriter, entered their pleas
Tuesday in Manhattan's state Supreme Court. All three defendants
admitted to participating in a scheme that allowed Marsh, the nation's
largest insurance broker, to protect incumbent insurance carriers
when their business was up for renewal.
Workers
comp premium fraud 'out of control' again
February 15, 2005, New York, N.Y. --
Jorge Gomez was helping to build a two-story house on a Jacksonville,
Fla.-area construction site owned by D.R. Horton in 2003 when a
24-foot wood beam fell and broke his neck. Gomez, who had crossed
into the U.S. from Mexico illegally, was being paid $400 a week
in cash from a subcontractor. Now a quadriplegic, the 23-year-old
has amassed more than $1 million in hospital bills but has no way
to pay them. Companies are supposed to cover all workers, even illegal
ones. But his disability claims to the subcontractor and the home
builder were denied.
Britney
Spears not arrested for insurance fraud
February 9, 2005, New York, N.Y. --
Pop singer Britney Spears is waiting to be bailed out of jail after
being arrested Tuesday on charges of insurance fraud. Several international
insurance companies are cooperating in the investigation against
the 23 year-old singer. It appears that not only did Britney Spears
lie about pre-existing injuries to her knee when she applied for
insurance coverage, she also neglected to reveal that she had undergone
a complete skin transplant to treat a raging acne condition, broke
two wrists and a foot in a bar-room brawl, and had three botched
breast implant procedures.
'Corporate
watchdog' unit proposed for NY DOI
February 7, 2005, Albany, N.Y. --
Acting State Insurance Superintendent Howard Mills expects to face
Senate confirmation in the next couple of weeks and the Orange County
resident plans to propose a new division in his department at that
time. Mills told MidHudsonNews.com yesterday that he would like
a corporate watchdog unit established. “We have a consumer
services bureau within the New York State Insurance Department;
that’s the group that would look into regular routine types
of insurance problems that constituents have,” he said.
Blind
justice: 4 weekends in jail in $500K fraud
February 2, 2005, Dobbs Ferry, N.Y. --
A Dobbs Ferry man who claimed that he was blinded in four separate
cruise-ship accidents — all in the same eye — pleaded
guilty yesterday to charges he fraudulently tried to get $500,000
in insurance for the latest "mishap." Brian Calen faced
up to 15 years in state prison for second-degree insurance fraud
and second-degree attempted grand larceny. Westchester County Judge
Sam Walker said he would give the 48-year-old day trader shock probation
— five years' probation that would include up to four weekends
in the county jail — when he sentences him April 20.
Marsh
to pay NY $850M to settle fraud charges
January 31, 2005, New York, N.Y. --
Marsh & McLennan Inc. has agreed to pay $850 million to settle
charges of bid rigging, price fixing and using hidden incentive
fees. New York state officials, lead by the attorney general and
insurance superintendent, had brought suit against the insurance
brokerage amid allegations of fraud and anti-competitive practices.
Terms of the settlement, state officials said, call for Marsh to
pay $850 million in restitution to policyholders and issue a public
apology for its "unlawful" and "shameful" conduct.
Ohio
man pleads guilty to torching homes for cash
January 27, 2005, Albany, N.Y. --
An Albany man Friday pled guilty in Athens County Common Pleas Court
to setting several residential properties in Athens County on fire.
The arsons by Kevin Dalton caused nearly $250,000 in damages, according
to a news release from the Ohio Department of Insurance. Dalton
has been sentenced to eight years in prison. Had Dalton, 34, not
taken the plea bargain, he was scheduled to go to trial last Monday.
After a joint investigation by the Ohio Department of Insurance,
the Athens County Sheriff's Office and the State Fire Marshal's
Office, Dalton was indicted by a county grand jury in April.
Brooklyn
DA urged to get tough on auto fraud
January 24, 2005, Brooklyn, N.Y. --
If you drive a car in Brooklyn, chances are you've encountered many
headaches during that endless search for a parking spot. What, you
might ask, could be worse? How about this: People in Brooklyn pay
the highest car insurance rates in the state. Someone who lives
in Brooklyn and drives a 2004 Chevy Malibu would be charged an average
of more than $3,000 for six months of required insurance coverage,
while the average cost for the same car in the Bronx is about half
that amount. Why is this so? It is largely due to auto insurance
fraud.
New
York eye doc charge with $1 million Medicare fraud
January 20, 2005, Brooklyn, N.Y. --
A prominent eye doctor whose Meiers Corners office was raided by
the FBI four months ago has been indicted in Brooklyn federal court
for allegedly bilking Medicare of $1 million. Dr. Joseph Mermelstein,
an ophthalmologist with an office on Victory Boulevard, was one
of seven people charged yesterday in four separate cases in connection
with schemes that allegedly stole $7.9 million from Medicare and
Medicaid, according to published reports. Dr. Mermelstein, who is
the medical and surgical director of the Eye Institute of Staten
Island, is said to have been accused of performing unnecessary surgery
on the elderly and disabled, and causing serious injury to several
patients.
4
docs, dentist indicted in fraud sweep in New York
January 19, 2005, New York, N.Y. --
Seven people, including four doctors and a dentist, were charged
Wednesday in a crackdown on health care fraud that allegedly bilked
the Medicare and Medicaid programs out of $7.9 million, officials
said. Investigators said they uncovered four separate cases of medical
fraud that led to various charges being unsealed in federal court
in Brooklyn. In one case, a joint FBI and Postal Inspection Service
investigation led to the arrest of four people connected to a clinic
in Brooklyn, which investigators charged was a "no-fault insurance
fraud mill."
Adjuster
in New York arraigned for stealing $100,000
January 13, 2005, Greenwich, N.Y. --
A former insurance adjuster from Greenwich was arraigned in federal
court Thursday on conspiracy charges and wire fraud. John Roney
worked for the former CNA insurance company in Glens Falls. He's
accused of creating fictional claims for automobile accidents that
actually happened. Investigators say Roney issued checks totaling
more than $100,000 and sent the checks to the main office in Chicago
where fellow workers shared the proceeds with him. Roney was arrested
in Florida two weeks ago and transported back to Albany by U.S.
marshals.
New
York pulls license of dentist for $100K in overbilling
January 8, 2005, Albany, N.Y. --
A Guilderland dentist was stripped of his license to practice Friday
for cheating patients out of the pearly whites they expected and
for bilking insurance companies out of thousands of dollars. Leonard
Berl, 43, of South Loudon Heights Road, Loudonville, was sentenced
in Albany County Court to felony charges of grand larceny, insurance
fraud and falsifying records after pleading guilty to duping 24
patients and 12 insurance companies out of nearly $100,000 worth
of services and funds. Berl did not receive any jail time, but he
did lose his license to practice in New York state. According to
Albany County District Attorney David Soares, the fraudulent dental
procedures occurred between July 14 and 22 in his office at 1443
Western Ave. in Guilderland.
Marsh
senior vp pleads guilty to criminal fraud
January 6, 2005, New York, N.Y. --
An executive at US insurance firm Marsh & McLennan has pleaded
guilty to criminal charges in connection with an ongoing fraud and
bid-rigging probe. New York Attorney General Elliot Spitzer said
senior vice president Robert Stearns had pleaded guilty to scheming
to defraud. The offence carries a sentence of 16 months to four
years in state prison. Mr Spitzer's office added Mr Stearns had
also agreed to testify in future cases during the industry inquiry.
"We are saddened by the development," Marsh said in a
statement.
Editorial
praises New York's anti-fraud effort
January 6, 2005, New York, N.Y. --
A pleasant surprise: At least one facet of state government is working
to benefit the average citizen. Car insurance providers around the
State of New York are announcing rate reductions in the range of
6 percent. That's right: Car insurance rates for many companies
are dropping. The reason for the rollbacks is related to what state
Insurance Superintendent Gregory Serio has called an "anti-fraud
dividend. "Serio and other state officials have been battling
phony medical and damage claims that criminals have filed in relation
to car accidents. The cost of such fraud was as high as $1 billion
per year by some estimates.
Adjuster
returns to New York to face insider fraud charges
January 6, 2005, Albany, N.Y. --
A former insurance adjuster faces charges that he created more than
100-thousand dollars in false claims. Federal authorities say 37-year-old
John Roney was arrested last month by sheriff's officialas in New
Port Richey, Florida. A judge has ordered U-S Marshals to transport
Roney to Albany for arraignment on January 13th.Roney is formerly
from Greenwich (GREEN-witch), 30 miles northeast of Albany. He worked
for the former C-N-A Insurance Company in Glens Falls, now Encompass
Insurance.
Woman,
daughter filed 192 bogus claims in New York
January 3, 2005, Yonkers, N.Y. --
A Yonkers woman has been found guilty of grand larceny in the third
degree, insurance fraud in the third degree and offering a false
instrument for filing in the first degree for her part in stealing
approximately $40,000 from the New York State Insurance fund between
April 1998 and April 2002. Evelyn Walder Bray’s daughter,
Debbie Bray Collazo, 27, of Yonkers, was found guilty last July
2004 on similar charges, Westchester County District Attorney Jeanine
Pirro announced. Evelyn and her daughter, Debbie, a nursing student
at a college in the Bronx, collected approximately $40,000 by submitting
192 false insurance claims to the New York State Insurance Fund.
New
York fraud fight a victory for insurers & policyholders
January 3, 2005, Troy, N.Y. --
Chalk one up for the good guys.
Although people in New York state still pay among the top car-insurance
rates in the country, the price of that insurance is being reduced
anywhere from 2-9 percent in 2005 by a number of insurance leaders.
The 2 percent reduction will be going to risk-pool insurees, with
the larger savings going to drivers with good records, which strikes
us as eminently fair. The main reason seems to be the state's rigorous
campaign against insurance fraud, a despicable practice that was
costing the insurance industry an estimated $1 billion annually.
That's right, billion, not million. |
2005
News Stories |