Insurance Fraud NEWS

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

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Indian-origin doc embroiled in healthcare fraud in US, freed on record $7m bond

February 21, 2019. Houston, TX-- Milbank Monitor : A 77-year-old Indian-American doctor, indicted in one of the largest healthcare fraud cases in the US history involving a USD 464 million conspiracy, was freed on a record-setting $7 million bond. Rajendra Bothra, who was awarded Padmashri, India‘s fourth-highest civilian award, was indicted along with five other physicians in the alleged USD 464 million healthcare fraud conspiracy, which the federal government said fuelled the . US District Judge Stephen Murphy granted the bond for him despite the government‘s concern that the doctor has hidden money that could bankroll an escape to his native India. Bothra, of Bloomfield Hills, who will be released on ...


Mississippi man accused of fake slip-and-fall in Walmart

February 21, 2019. Laurel, MS-- WLBT : Attorney General Jim Hood has announced insurance fraud charges against a Laurel man. Sixty-nine-year-old Bruce Edward Bayless was arraigned Wednesday, following his indictment in June 2018 by a Jones County grand jury, on one count of insurance fraud. The indictment states Bayles submitted false claims to Walmart, saying that he accidentally slipped and fell, when in fact it was not an accident and was an act orchestrated by him. The defendant later attempted to collect money from the liability insurance for his alleged injuries. The trial is set for June 3 in Jones County Circuit Court. If convicted, Bayless faces up to three years in ...


Deputy allegedly adds coverage after Mustang hits deer in Florida

February 21, 2019. Orange County, FL-- Click Orlando : An Orange County deputy is accused of lying on an automobile insurance claim after he crashed into a deer, according to Florida's chief financial officer Jimmy Patronis. Officials said deputy Wadih Ojeil was driving his 2012 Ford Mustang on July 6, 2018, when he hit a deer then and after the crash, called Geico to add comprehensive coverage to his existing insurance policy. He specifically asked if the addition to his policy would apply to a crash involving a deer, according to a news release. On July 10, the day after the new coverage went into effect, Ojeil called Geico to report ...


Georgian allegedly helps wreck 2 boats, plane for false claims

February 21, 2019. Athens, GA-- East Texas Matters : A man from Atlanta, Georgia has been indicted by a federal grand jury in an alleged insurance fraud scheme that took place in East Texas, Washington and Hawaii, according to U.S. District Attorney Joseph Brown. Daniel Driver was named in the indictment as a conspirator that involved obtaining insurance for a small plane and two boats. The objects were then intentionally destroyed and the conspirators filed fraudulent insurance claims. The plane was a 1971 Cessna 500 and the boats were a 1998 Hunter Passage and a 1987 West Coast 87. The other conspirators named were Theodore Robert Wright III, 33, formerly of Kemah, ...


NYC must pay $5.3M for unjust car claims after Hurricane Sandy

February 21, 2019. Albany, NY-- UPI : New York City will have to repay the Federal Emergency Management Agency $5.3 million after admitting transportation officials made fraudulent claims after Superstorm Sandy in 2012. The proposed settlement, which must be approved in U.S. district court, said city transportation officials submitted a list to FEMA of vehicles they said were damaged during the storm. Prosecutors said, however, some of those vehicles had been in need of repair before the storm. FEMA ultimately agreed to replace 132 department vehicles, which cost millions, a statement from the U.S. Attorney's office in New York City said. "Today's settlement is the successful outcome of a joint ...


Rep. Schroeder devoted to shedding light on car insurance fraud

February 21, 2019. Lansing, MI-- Michigan House Republicans : Fraud committed by insurers and individuals within the state’s no-fault car insurance system would be exposed under a new plan introduced this week by state Rep. Andrea Schroeder. Schroeder’s legislation calls for establishing a fraud authority to investigate unfair claims and settlement practices to help shed light on insurance providers and drivers committing fraudulent practices. Schroeder said her plan should be considered as part of a broader solution to end Michigan’s tenure as the state with the highest car insurance premiums in the nation. “Car insurance reform is a top priority shared by drivers back home and the 100th Michigan Legislature,” said ...


Michigan man shoots wife in marijuana grow room for $246K

February 20, 2019. Niles Township, MI-- South Bend Tribune : Friends and family of Carla Lewis held on to one another, trying to hold back their emotions while sitting inside a Berrien County courtroom Tuesday morning, but they couldn’t stop the tears from flowing. A jury had just found Carla’s husband, John Lewis, guilty of premeditated murder in her August 2017 shooting death. Finally, at the end of a two-week trial that had been postponed multiple times, there was justice, said Carla’s sister, Renee Burrington. Lewis, 49, was accused of shooting and killing his wife inside a small marijuana grow room in their Niles Township home and then calling 911, saying two ...


Carolina driver accused of double-dipping on collision claim

February 20, 2019. Kannapolis, NC-- Salisbury Post : North Carolina Insurance Commissioner Mike Causey on Wednesday announced the arrest of Stephanie Blackwood, 34, of 428 Settlers Ridge Drive, Kannapolis. Blackwood was charged with two counts of insurance fraud and two counts of attempting to obtain property by false pretense, all felonies. According to the arrest warrants, Blackwood filed two false claims with Progressive Insurance Co. for damage to a vehicle. The first claim was filed before the policy went into effect. The second involved a claim that had previously been reported. The offenses occurred between Aug. 16 and Oct. 23. Special agents with the Department of Insurance’s Criminal Investigations Division and officers ...


Photos allegedly show truck damaged before claimed Utah crash

February 20, 2019. Utah County, UT-- ABC4 : A Utah County man was charged with insurance fraud after the carrier found photos on social media that showed he bought the car already damaged. According to charging documents, police were contacted by an agent with American Family Insurance who said Jason Doyle Cook, 44, had filed a claim in June 2018 claiming he was driving in his 1995 Ford F350 while pulling his fifth wheel on I-15 when he collided with a wood post and a semi tire that was in the middle of the freeway. The agent said Cook reported the crash caused damage to the entire driver bedside ...


Body shop allegedly bilks Arizonan of $2M for repairs, lawsuit

February 20, 2019. Mesa, AZ-- ABC 15 : An auto repair company owner is charged after reportedly defrauding an elderly Mesa woman of $2,000,000. The Arizona Attorney General has charged Donaldo Parra, age 44, with fraudulent schemes and theft. Investigators say Parra owns and operates an auto body shop in Mesa. By: Joe Enea items.[0].image.alt Photo by: MCSO MESA, AZ — An auto repair company owner is charged after reportedly defrauding an elderly Mesa woman of $2,000,000. The Arizona Attorney General has charged Donaldo Parra, age 44, with fraudulent schemes and theft. Investigators say Parra owns and operates an auto body shop in Mesa. ADVERTISING Parra is accused of defrauding over $2,000,000 from an elderly Mesa woman ...


$140M awarded to settle 225 suits against New York ortho

February 20, 2019. Poughkeepsie, NY-- New York Law Journal : A New York arbitrator has released a long-awaited arbitration award totaling $140 million to resolve 255 medical malpractice lawsuits against ex-doctor Spyros Panos, who has already served one prison term and currently faces new criminal charges. The attorneys whose firm is handling 150 of the cases against the former Poughkeepsie orthopedist said the mass of lawsuits comprise the largest medical malpractice litigation in New York. “The long and short of it is that he engaged in a 10-year pattern of fraud and abuse, faking surgeries for people who didn’t need them or faking them for people who really needed surgery,” said John ...


Connecticut man charged with falsely reporting home thefts

February 20, 2019. Plainfield, CT-- WTNH : Police arrested a Plainfield man Wednesday afternoon for allegedly commiting insurance fraud and falsely reporting an incident. According to police, a suspect connected to an insurance fraud crime has been arrested on Wednesday at 4:39pm. The suspect was identified as Sawn Tatro, 44 of Plainfield, under charges of falsely reporting an incident, providing a false statement, and insurance fraud. Plainfield police say that in October, Tatro reported that some items were stolen from his residence in Moosup. After investigation, police discovered that the larceny reported by Tatro did not occur, and that Tatro made an insurance claim to Allstate reporting ...


Pain clinic doctor Orusa prescribed addictive pills over internet in 2009, health officials say

February 20, 2019. Clarksville, TN-- Leaf Chronicle : A Clarksville doctor and pastor who federal prosecutors say is a prolific drug trafficker once wrote suspicious prescriptions for an addictive muscle relaxer to patients on the other side of the country whom he appears to have never examined, according to health officials. Dr. Samson Orusa, who owns and operates a pain clinic, was indicted on charges of drug trafficking and health care fraud last year. Court records state that an undercover federal investigation found Orusa rarely examined patients and prescribed opioids to large groups through what authorities referred to as “cattle calls.” But now, additional documents obtained by USA TODAY Network-Tennessee ...


Hope Thomley pleads guilty to role in $200M fraud involving TRICARE, other providers

February 20, 2019. Hattiesburg, MS-- Hattiesburg American : Hope Thomley pleaded guilty Wednesday for her role in a $200 million scheme to defraud health care benefit programs, including TRICARE, a program that covers military service members, veterans and their families. Thomley, 52, pleaded guilty before U.S. District Judge Keith Starrett at William M. Colmer Federal Courthouse to one count conspiracy to commit health care fraud and one count conspiracy to commit money laundering and tax evasion. The government seized more than $15 million in cash and other assets from Thomley, which will be forfeited in connection with her guilty plea. “Today’s guilty plea in one of the largest health care ...


Couple pleads guilty to stealing $152,820 by filing false applications for federal relief funds following Superstorm Sandy

February 20, 2019. Trenton, NJ-- Insider NJ : Attorney General Gurbir S. Grewal announced that a Morris County couple pleaded guilty today to stealing $152,820 by filing fraudulent applications for federal relief funds related to Superstorm Sandy. Carmine Fusco, 50, and Lauri Fusco, 50, of East Hanover, N.J., each pleaded guilty to third-degree theft by deception before Superior Court Judge Linda G. Baxter in Ocean County. Under the plea agreement, the state will recommend that Carmine Fusco be sentenced to 180 days in the county jail and a term of probation, and that Lauri Fusco be sentenced to a term of probation. The couple must pay full ...


Ohio woman works as receptionist while collecting comp

February 19, 2019. Bellefontaine, OH-- WorkComp Central : A Bellefontaine woman who worked as a receptionist while claiming to be disabled owes the Ohio Bureau of Workers' Compensation nearly $19,000 following her conviction last month on a felony workers' compensation fraud charge. A Franklin County judge on Jan. 16 ordered Dawn M. Hattery, 50, to reimburse BWC $17,937 and pay $1000 in working while colleciting BWC benefits from January to November 2017. The judge also sentenced her to five years of probation after she pleaded guilty to the fifth-degree felony, BWC said in a news release. Hattery's conviction was one of six that BWC secured last month. In other ...


Floridian to start life sentence for husband’s shooting murder

February 19, 2019. Tallahassee, FL-- WCTV.tv : Denise Williams will be transported to prison to begin serving a life sentence for murder, while insurance fraud charges against her move forward. The judge announced the move Tuesday morning at a status hearing on the insurance fraud charges. Williams was convicted in December 2018 of murder in the December 2000 death of her husband, Michael Williams. She was sentenced to life in prison earlier this month. Her defense team has already filed a notice of its intent to appeal with the First District Court of Appeals. There are still insurance fraud charges pending against Denise Williams for cashing in on $1.75 million in ...


Trio arrested for alleged $20K trailer fire in Louisiana

February 19, 2019. Livingston Parish, LA-- WAFB 9 : Three people have been arrested in connection with a trailer fire in Walker back in 2017, the Louisiana Office of State Fire Marshal (LAOSFM) reports. All three were booked into the Livingston Parish Jail on charges of criminal conspiracy to commit arson with the intent to defraud, felony theft, and two counts of insurance fraud. LAOSFM says in December of 2017, firefighters responded to a fire in the 15000 block of Black Mud Road in Walker. Investigators with LAOSFM later received a tip, prompting them to look further into the incident. During the investigation, the Valentines (husband and wife), who were tenants ...


Scammer secretly enrolls insured Miami woman in health plan

February 19, 2019. Miami, FL-- WSVN.com : She filed her taxes and was hoping to get a refund, but instead, she got a letter saying she owed the IRS. As the Nightteam’s Patrick Fraser reports, it’s a scam we call “Money for Nothing.” Many South Floridians are excited to file their tax returns knowing a refund is on the way, and then there is Josette Cazzau. Josette Cazzau, tax refund seized again: “Not me. I am so not excited for tax season.” For three straight years, Josette has not gotten a refund because of a health insurance scam. Josette Cazzau: “Actually, the agent from the Marketplace. Unknown agent, destroying my life ...


Medical office employees charged with submitting false claims

February 19, 2019. Sacramento, CA-- WorkComp Central : Three employees of a Southern California medical office were arrested Wednesday on accusations that they submitted fraudulent claims to an insurer for treatment that they claimed they received from their employer, the California Department of Insurance said. The insurer, which was not identified, paid $540,311 out of $4 million in false claims submitted from 2010 to 2016, the department said. Three employees of ENT Medical Specialty Group in Diamond Bar were charged: The three claimed treatments including nasal surgeries, laryngoscopy biopsies, impaction removals, swallowing dysfunction, nystagmus tests, nasal injections and therapeutic vocal cord injections. They provided the insurance company with handwritten receipts and ...


You only live twice: The man who catches people who fake their own death

February 19, 2019. London, -- Sky News : You might be sick of your career, tired of your relationship, or you simply want to jet off somewhere and begin all over again. Others might feel more drastic action is required. Steve Rambam is a private investigator who specialises in locating missing people, including those who have faked their own death. He estimates he has solved up to 750 suspected fake death cases during his career, with the number standing at "about 550 when I last counted 12 years ago". Mr Rambam, who has been a private investigator for 36 years, told Sky News: "One reason people do it is because they are ...


Alleged fake adjuster steals down payments, bilks insurers

February 18, 2019. Orange City, FL-- The Daytona Beach News-Journal : An Orange City woman arrested in January for scamming Hurricane Irma victims was arrested a second time on Monday in Brevard County and accused of committing the same crime, state officials said. The office of Chief Financial Officer Jimmy Patronis issued a release stating that Mary Bruce, 50, was again arrested, accused of unlicensed practice of public adjusting and grand theft related to Hurricane Irma. Bruce attempted to steal more than $68,000 in fraudulent claims, the news release states. According to information from Patronis’ office, investigators discovered that Bruce approached homeowners whose homes sustained roof and interior damages from the storm. Bruce then ...


Louisiana seniors billed for back braces they didn’t want

February 18, 2019. Haughton, LA-- KTBS : It's free. I won't cost you a cent. Medicare will pay for it all. That's what predators tell the elderly over the phone when they're trying to get them to accept something about which they have absolutely no knowledge. That happened to a couple in Haughton and while they may not have incurred any out of pocket expenses, they know what happened to them was wrong. “And that is why I’m proud to stand with my colleagues and friends and support Medicare for all,” said freshman U.S. Sen. Kamala Harris (D-California). But maybe we already have Medicare for all. Sort of. Consider the case ...


Colorado hospital notifies patients of data breach

February 18, 2019. Colorado Springs, CO-- Becker's Health IT : Colorado Springs, Colo.-based Rocky Mountain Health Care Services sent letters to 971 patients alerting them of a recent data breach. The hospital became aware that an employee's laptop was stolen May 15, 2018. The laptop may have contained patient's health information. RMHCS immediately began investigating to determine what information was stored on the laptop. RMHCS determined patients' names, addresses, dates of birth, Social Security numbers and limited medical treatment information may have been affected in the incident. The hospital reported the incident to HHS and law enforcement. Since the incident, RMHSC has reviewed and updated its policies and procedures related to information security ...


Woman gets nearly four years in federal prison for Medicaid scam

February 18, 2019. Durham, NC-- The Laurinburg Exchange : A Durham woman is going to federal prison for bilking the Medicaid system out of more than $900,000, U.S. Attorney Robert Higdon announced on Friday. U.S. District Court Judge Louise Flanagan sentenced Tamara Perry McCaffity, 57, to 46 months in prison followed by three years of supervised release for filing false claims for reimbursement. She was ordered to make $523,783 in restitution, and surrender real estate properties on Empire Lakes Drive in Raleigh, Elmridge Court in Durham, and in Orlando, Florida. Criminal papers filed in July 2018 charged McCaffity with taking part in an elaborate conspiracy to commit health care fraud, Higdon ...