Insurance Fraud NEWS

Coalition Against Insurance Fraud

Massages allegedly inflated, billed on holidays in Washington

October 13, 2019, Kirkland, WA — Three people were charged in King County Superior Court with unrelated fraud charges after investigations by Insurance Commissioner Mike Kreidler’s Criminal Investigations Unit (CIU).

Jessica Gray, a licensed massage therapist in Kirkland, was charged with first-degree theft, filing a false insurance claim, money laundering and identity theft. According to the investigation, Gray billed Regence Blueshield for 382 fraudulent claims exceeding $54,000 in payments.

Regence discovered the fraudulent claims during an audit of Gray’s claims. Most of the claims were submitted on behalf of 11 clients who worked for the same employer and represented 70% of her income from Regence from 2016 through 2018. She is accused of billing for massages that were longer than the actual services and submitting charges for sessions she didn’t provide to policyholders. Some of the dates were on major holidays, including New Year’s Day, or during times that Gray or her clients were out of the state. Regence referred the case to Kreidler’s fraud unit, as required by law.

Nikki Hill was charged with one felony count of filing a false insurance claim. According to the investigation, Hill was in a collision on Interstate 405 in King County in August 2017. The day after the collision, she purchased Progressive insurance for her 2016 Jeep Cherokee and filed a claim four days later. The damage to her car was estimated to exceed $23,000. Washington State Patrol records showed the collision happened before she bought the insurance policy. Progressive denied the claim and referred the case to Kreidler’s fraud unit.

William Davis III was charged with one count of filing a false insurance claim. According to the investigation, Davis filed a claim with TOPA Insurance for damage to his 2010 Dodge Charger that was caused by a hit-and-run driver on Jan. 31, 2018. The car was declared a total loss with a damage estimate exceeding $11,000. TOPA’s investigators found evidence that the car was in two separate collisions on Jan. 30 while being driven by someone else and that Davis was in police custody at the time. TOPA Insurance denied Davis’ claim for misrepresentation and referred the case to Kreidler’s fraud unit.

Kreidler’s CIU investigates insurance fraud and works with the Washington State Patrol and state and local prosecutors on criminal cases. Insurance fraud costs the average family $400 to $700 per year in increased premiums. Insurance companies are required by law to report fraud to the commissioner.

Consumers can report suspected insurance fraud on the insurance commissioner’s website.

Source: My Columbia Basin

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