Insurance Fraud NEWS

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Insurance Fraud News:
A selection of daily headlines from around the nation

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South Carolina driver inflates injury claim from phantom crash

December 13, 2018. Sumter, SC-- The Sumter Item : A Sumter woman was sentenced to 18 months of probation after she pleaded guilty to inflating a medical bill in a personal injury claim for a wreck that never happened. Kayla B. Payne, 26, entered a guilty plea on Dec. 5 for one count of making a false statement in the amount of $1,000 or more on Nov. 8, according to the S.C. Attorney General's Office. Judge R. Ferrell Cothran accepted the plea and set a three-year sentence, which will be suspended to 18 months of probation, according to a news release. As a part of her probation, Payne must repay $800 in ...


Washington man reports own alleged scam to falsely slash tires

December 13, 2018. Yakima, WA-- Washington Office of Insurance Commissioner : Eric Slade of Yakima was charged with first-degree theft in Kittitas County Superior Court after he reported committing insurance fraud and a subsequent investigation by Insurance Commissioner Mike Kreidler’s Criminal Investigations Unit (CIU). According to the investigation, Slade contacted Kreidler’s office in September 2017 to report that he fraudulently received more than $5,500 from two insurance companies for his car. In October 2014, he filed a roadside assistance claim with GEICO for towing and tire replacement and a theft claim with Liberty Mutual for items he reported stolen from the vehicle. At the time of the claims, he reported that his ...


Ohioans allegedly buy homes, burn for insurance payouts.

December 13, 2018. Warren, OH-- WKBN 27 : Three suspects are accused of a scheme to torch Warren homes to collect the insurance money. Daryl Evans, Maurice Evans and David White face federal charges for the alleged crime, according to an indictment filed in the Northern District Court of Ohio on December 4. That indictment was unsealed this week. According to the indictment, Daryl Evans purchased a house located at 1628 Hamilton St. SW, purchasing an insurance policy on the house shortly thereafter. Evans used the house as a rental property from 2011 to 2014. The indictment says Evans also purchased 267 Parkman Road and began renting out that property ...


Cell records implicate New Yorker who set up life murder

December 12, 2018. Schenectady, NY-- The Daily Gazette : Tarchand Lall hired hit men to come to Schenectady and kill Charles Dembrosky two years ago, a jury found Wednesday. The jury convicted Lall of first-degree murder and life settlement fraud, finding that he wanted Dembrosky dead for $150,000 in life insurance proceeds. The same jury acquitted Lall on related allegations that he tried to have a potential witness in the case killed, also for insurance money. The conviction on the first-degree murder count means Lall now faces up to life in prison without the possibility of parole. He is due to be sentenced in February. Peter Willis, who prosecuted the case with Jennifer ...


Uninsured Carolina driver allegedly falsifies collision date

December 12, 2018. Winston-Salem, NC-- Yes! Weekly : North Carolina Insurance Commissioner Mike Causey today announced the arrest of Deshon Tarez Oakes, 26, of 449 W. 24th St., Winston-Salem. Oakes was charged with felony insurance fraud and felony attempting to obtain property by false pretenses. Special agents with the Department of Insurance’s Criminal Investigations Division accuse Oakes of falsely telling Progressive Insurance Co., in an attempt to collect on an auto policy claim, that damage to his vehicle occurred on Dec. 9, 2017, when it actually occurred on Sept. 2, 2017. Oakes did not have insurance coverage on his vehicle at the time of the actual crash, according to ...


Michigan docs flee the U.S. after alleged $500M scam busted

December 12, 2018. Detroit, MI-- The Detroit News : More than a dozen doctors and medical professionals charged with federal crimes locally have fled the country in recent years amid a federal crackdown on illegal opioid use and health care fraud. Prosecutors used the fugitive status of 16 medical professionals who have fled since 2011 to keep Dr. Rajendra Bothra jailed Wednesday while he awaits trial in a nearly $500 million conspiracy, one of the largest health care fraud cases in U.S. history. U.S. Magistrate Judge Mona Majzoub cited the Bloomfield Hills doctor's lies, ties to India and riches, including overseas bank accounts filled with $3 million, before refusing to release ...


Floridian allegedly sells bogus trucking insurance

December 11, 2018. Miami, FL-- Insurance Journal : A South Florida trucking company owner was arrested last month after allegedly selling fraudulent insurance coverage with certificates of insurance totaling nearly $60,000 to local commercial truckers, according to a statement from Florida Chief Financial Officer (CFO) Jimmy Patronis. Investigators from the Department of Financial Services allege Kemny Niebla, owner and operator of Andoba Trucking Co. and Sea Trucking in Hialeah, collected monthly insurance premium payments from three victims between October 2017 and June 2018. Records indicated that Niebla had received $59,675 in premium payments from which were never applied towards any insurance policy as promised. DFS said Niebla instead kept the ...


Telemed firm in Utah settles after falely selling knee, back braces

December 11, 2018. Salt Lake, UT-- The Salt Lake Tribune : Federal prosecutors have reached a settlement for $1.6 million with an American Fork telemarketing company over accusations of Medicare fraud. The company, Western Medical Group, and its owners, Benjamin D. George and Jody C. Rookstool, have agreed to pay $1,634,844 to settle allegations under the False Claims Act, U.S. Attorney for Utah John W. Huber announced Tuesday. Western Medical — doing business under that name and also as Arizona Medical and Senior First Medical, among others — were accused of using a telemarketing scheme to sell knee and back braces to Medicare beneficiaries. The federal government argued that Western Medical violated Medicare’s ...


lllinois doc charged with doing unneeded in-home med tests

December 11, 2018. Chicago, IL-- Patch : A federal grand jury in Chicago has indicted a physician on fraud charges, according to the U.S. Attorney's Office for the Northern District of Illinois. The doctor approved medically unnecessary diagnostic tests that were billed to Medicare, the indictment alleges. While working for Chicago-based Grand Medical Clinic Inc. in the city's West Town neighborhood, Dr. Omar Garcia prescribed and authorized ultrasounds, percutaneous allergen tests and nerve transmission tests for numerous Medicare beneficiaries, knowing that the in-home tests were not medically necessary, the attorney's office said. In some instances, Garcia approved the tests after they had already been completed, the indictment states. Garcia ...


Unlicensed New York dentist allegedly treats patients in $2M con

December 11, 2018. Roselle, NY-- NJ.com : A Roselle man who worked as an unlicensed dentist in New York has been convicted of a healthcare fraud scheme that stole more than $2 million from taxpayer-funded insurance providers, federal authorities said Monday. Luis Omar Vargas, 46, worked at Dental Express Broadway on 161st Street in Manhattan and helped recruit patients who received Medicaid and other taxpayer-funded health insurance plans, according to Geoffrey S. Berman, the United States Attorney for the Southern District of New York. Once a patient came to the office, Vargas would perform minor dental procedures. The patients were then paid $25 cash for the visit by the ...


Wife allegedly has husband shotgunned for $1.75M in Florida

December 11, 2018. Tallahassee, FL-- CBS Miami : It’s a story that could easily have taken place in a movie theater instead of a courtroom. With a plot that echoes a well-known Hollywood masterpiece, a trial began Tuesday for a Florida woman accused of helping orchestrate the death of her husband in order to secure a massive insurance payout. Prosecutors contended that Denise Williams planned the December 2000 slaying of her husband with a man that she was having an affair with and later married. On a cold morning in north Florida, Mike Williams disappeared while duck hunting on a large lake near Tallahassee, and initially it was believed that ...


Georgia firm bills for med equipment never provided

December 11, 2018. Thomson, GA-- News Channel 6 : A federal jury has found the owner of a Thomson medical equipment company guilty of multiple counts of Medicare fraud and identity theft. The scheme charged the government insurance program for items that were never provided to patients and never ordered by a physician. Detra Wiley Pate was the owner and CEO of Southern Respiratory LLC. She was found guilty on 33 counts including health care fraud, conspiracy to commit health care fraud and aggravated identity theft for crimes dating back to 2014. The jury deliberated for less than five hours. A sentencing date has not been set. Pate faces a sentence of ...


Alabama agent steals life premiums from clients

December 11, 2018. Colbert County, AL-- Rocket City Now : Ronald Warren Powell pleaded guilty in the Colbert County Circuit Court on Monday to one count of Securities Fraud for engaging in an act, practice, or course of business which operated as a fraud or deceit upon investors and one count of Insurance Fraud. The plea was announced by Joseph Borg, Director of the Alabama Securities Commission (ASC) and Jim Ridling, Insurance Commissioner for the State of Alabama. The offenses are Class B felonies, punishable by up to 20 years in prison and up to a $30,000 fine per charge. Powell received a seven-year sentence for securities fraud and a five-year sentence ...


Trio charged with compound-med kickbacks in Oklahoma

December 10, 2018. Kingwood, OK-- Kingwood.com : A doctor from Kingwood was indicted in federal court in Tulsa today for his part in a healthcare fraud conspiracy. A grand jury returned an indictment today charging three men, including two physicians, with violations of the federal anti-kickback statute as well as conspiring to commit health care fraud, announced U.S. Attorney Trent Shores. "These defendants allegedly defrauded our government. Health care fraud is not a victimless crime. It has a costly effect on the taxpayer and beneficiaries enrolled in Medicare, TRICARE, and workers compensation coverage under the Federal Employees Compensation Act," said U.S. Attorney Trent Shores. "The Justice Department will ...


Jersey man allegedly fakes heart attack, stroke, Parkinson’s

December 10, 2018. Pompton Lakes, NJ-- New York Post : A New Jersey man faked a heart attack, Parkinson’s disease and other ailments to cheat his insurer, according to the state’s attorney general. Todd Eckel, 47, of Pompton Lakes forged a doctor’s signature to bilk American Heritage Life Insurance Company out of $60,000 in treatments he never received, according to state Attorney General Gurbir S. Grewal. He also lied about having a stroke, but never collected any money on that claim, prosecutors noted. Eckel gave “the false impression that he was treated for a heart attack, Parkinson’s disease, coronary artery disease, and a stroke,” Grewal said in a statement. He was indicted on fraud, ...


Homeowners urged to watch for crooked contractors in Illinois

December 10, 2018. Springfield, IL-- The State Journal-Register : Victims of recent tornadoes that ravaged central Illinois will soon start rebuilding damaged property. The Illinois Insurance Association urges residents to be on the alert for scam artists posing as legitimate building contractors. Illinois’ Consumer Protection Against Storm Chasers Act protects citizens from those who would prey on them following a natural disaster. The law applies to storm-related repairs linked to insurance settlements. Contractors are prohibited from rebating or waiving the policy deductible and cannot represent or negotiate on behalf of the homeowner in the claim process. In addition, contractors must let committed homeowners know the repair contract can be canceled ...


Florida woman rescued from home she allegedly lit up

December 10, 2018. Stuart, FL-- TC Palm : A 65-year-old Stuart woman is accused of purposefully setting her home on fire and then trying to defraud her insurance company. Joanne Konefal, of the 1000 block of Southwest Bromelia Terrace in Stuart, was arrested on two felony arson charges Friday afternoon. Martin County Fire Rescue said firefighters responded to Konefal's home Nov. 6 and saw Konefal was trapped inside her burning home. They said they forced their way into the home and took Konefal to safety. "I set my house on fire; I want to die," Konefal told firefighters. Konefal also told firefighters she used gasoline to set her master bedroom and ...


Irish Travelers allegedly scam life policies in South Carolina

December 08, 2018. Columbia, SC-- The State : An insurance agent was sentenced to five years in prison Friday for his role in a long-running scam that netted millions of dollars for members of Aiken County’s secretive Irish Travelers community. For years, Douglas Wade Williamson was a key player in that life insurance scam, a prosecutor told a U.S. district judge Friday. “What he did was set up a system for $54 million to be paid out to the Irish Travelers community,” Assistant U.S. Attorney Jim May said at Williamson’s sentencing hearing. “He was an active participant who made his living on fraud.” During a two-hour hearing at Columbia’s federal courthouse, ...


Florida pharma owner bills $2.5M for phantom prescriptions

December 07, 2018. Miami, FL-- United States Department of Justice : An owner of a now-defunct Miami pharmacy was sentenced today to 46 months in prison for his participation in a scheme that caused Medicare to pay $2.5 million in false and fraudulent claims for prescription drugs that were never purchased. Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Ariana Fajardo Orshan of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional ...


Jailed Texan bilks Medicaid to pay legal bills for prior scam

December 07, 2018. Tyler, TX-- United States Department of Justice : In 2015, Alexis C. Norman pleaded guilty to healthcare fraud. But while awaiting sentencing, she concocted another healthcare fraud scheme. Yesterday afternoon, Ms. Norman, 47, pleaded guilty once again, this time admitting one count of conspiracy to commit healthcare fraud and four counts of healthcare fraud – three committed before she was sentenced in the prior case and one committed while she was behind bars, announced U.S. Attorney for the Northern District of Texas Erin Nealy Cox. According to court documents, Ms. Norman approached co-conspirator Karen Jones in February 2015 with a business idea she hoped could help ...


Former football player bribed for referrals to Carolina clinic

December 07, 2018. Durham, NC-- The News & Observer : Former N.C. State football player Eric Leak is heading to federal prison for 18 months under terms of a plea agreement on federal bribery and money laundering charges. Charged for his role in a Medicaid fraud scheme, Leak agreed to plead guilty in March. His sentence was handed down during a hearing in the U.S. District Court for the Middle District of North Carolina in Greensboro, a spokeswoman for the U.S. Attorney Matthew Martin said Friday. In addition to his jail term, Leak must pay a $5,000 fine in addition to $420,115 in restitution. He’ll also be under three years of supervised ...


Texas couple adopts youth, who allegedly repays by shooting

December 07, 2018. Travis County, TX-- Insurancenews.net : Travis County sheriff's deputies have obtained an arrest warrant for a fourth suspect wanted in connection with an alleged murder-for-hire plot that left Austin jeweler Ted Shaughnessy dead in his home in southwest Travis County in March. Arieon Oneal Smith, 21, faces a charge of capital murder, according to an arrest affidavit filed on Thursday. Three others, including Ted Shaughnessy's son, Nicolas Shaughnessy, his wife Jaclyn Alexa Edison, and Johnny Roman Leon III, have also been charged in the case, according to court filings dating back to the time of the killing. READ MORE: Nicolas Shaughnessy was adopted by an Austin jeweler and ...


Illinois man allegedly burns house, lies that motorcycle stolen

December 07, 2018. Tonica, IL-- News Tribune : A Tonica man already charged with arson now is charged with insurance fraud for allegedly reporting the theft of a motorcycle that wasn’t stolen. David M. Willis, 36, of 515 S. First St., Tonica was indicted earlier this week on four counts of arson and one count of insurance fraud. Willis is accused of igniting an Aug. 3 fire that damaged a Tonica residence and was subsequently charged with making a false insurance claim. Arson is a Class 2 felony with a base sentencing range of 3-7 years in prison. Also indicted were: Ryan P. McCarthy, 35, of 111 S. 13th Ave., Apt. B18, ...


Most-brazen scammers dishonored for fraud Hall of Shame

December 07, 2018. Washington, DC-- Associated Press : The holiday season rang in with the year’s 9 most-brazen insurance-fraud grinches taking short sleigh rides for long prison terms after foisting outsized and elf-delusional insurance thefts. America’s extreme insurance schemers were inducted into the by the Coalition Against Insurance Fraud. Insurance scams are an $80-billion crime annually, raising everyone’s premiums. Stay alert for holiday insurance scams — and fraud grinches year-around: . Hang up on healthcare robocalls selling bogus “Trumpcare,” “Obamacare” and suspiciously low-priced health plans. . Avoid medical identity theft … protect your sensitive medical information — and good credit. . Steer clear of shady home contractors who steal your downpayment, ...


Pennsylvania driver allegely buys insurance after hitting tree

December 06, 2018. Coalport, PA-- The Progress : A Coalport man accused of insurance fraud in regard to a vehicle accident waived his right to a preliminary hearing yesterday at Centralized Court in front of District Judge James Glass. Jesse J. Finnegan, 54, is charged with one count of theft by deception—false impression and one count of false/fraud/incomplete insurance claim, both of which are felonies of the third degree. In the affidavit of probable cause filed by Special Agent James Kopera of the Attorney General’s office, the investigation was based upon a referral of information by Jessica Kolcun of Safe Auto Insurance Company. The investigation revealed that Finnegan filed a claim ...