Masters of disaster inducted into Hall of Shame

No-Class of 2012 helps brand fraud as a socially deviant crime

HOS_blogCalvin Jones set a Detroit office building on fire for an insurance payday. The structure collapsed onto firefighters caught inside. Seven were seriously injured, including one who was paralyzed.

It’s best to don hazmat suits before reading about the eight extreme schemers like Jones who were elected to the Insurance Fraud Hall of Shame.

The Hall of Shame annually dishonors the year’s most brazen, vicious or plain klutzy convicted insurance criminals. These are the year’s barons of bleak.

Their induction into the No-Class of 2012 puts a human face on this supposedly victimless crime. It helps brand insurance fraud as a costly and socially deviant offense by detailing true-life cases — and the damage these masters of disaster cause.

All were convicted or had other legal closure in the last year.

Read the full Profiles of Discourage at the online cellblock — but buy smelling salts and avoid heavy meals before visiting. Here are several hints of things to come…

Crooks fingered. Two cohorts sliced off a mentally disabled man’s hand with a tree-trimming saw to collect more than $670,000 in insurance money. Porky Weaver trusted one cohort like a father figure, who exploited that friendship in a crime that Porky only dimly understood.

Airbag con deflated. Dai Zhensong tried to flood the U.S. with useless knockoff Chinese airbags from his base in Chattanooga, Tenn. He thus exposed innocent motorists to potential death or injury during crashes. Several of his airbags spewed flames and shrapnel at crash dummies in federal tests after Zhensong was busted. Crooked body shops and others typically install such knockoffs but charge insurers full price.

X-rated park romp. Modupe Adunni Martin said she had a bad ankle injury and started collecting workers comp money. But surveillance caught her strolling out of the doctor’s office without crutches. Then she ran to a public park — in high heals — to meet her boyfriend, and gave him oral sex in a position that was medically impossible with her supposed injury.

About the author: Jim Quiggle is director of communications for the Coalition Against Insurance Fraud.

Celebrating 20 years of uniting the fraud fight

Alerting consumers about fake health plans is a public-outreach priority.

twenty

The year: 1993

The setting: Insurers and consumer leaders gathered in a conference room to hammer out a new anti-fraud group, still waiting for a name.

The need: Insurers and consumer groups may not always see eye to eye about a range of issues. But insurance fraud cheated insurers and consumers alike — and raised premiums around the U.S. It made sense to join forces against this crime.

What happened next: The Coalition Against Insurance Fraud was founded as the nation’s only insurance anti-fraud group whose members include insurers, consumer leaders and government agencies.

It’s a unique role, a unifying role that adds credibility to America’s fraud fight.

It was an unusual and far-sighted idea in 1993, and risky. Could the founders pull it off?

In 2013, the Coalition is celebrating its 20th anniversary of impact. Successful fraudsters steal insurance money with urgency and purpose. The Coalition has pursued this crime with the same urgency and purpose for two decades.

The Coalition’s work has rested atop three pillars: Legislation, public outreach and research. The focus is on all forms and all lines of insurance fraud, though in the early years the emphasis was on property-casualty fraud.

Just one example: Passing state laws tightening the noose around shady medical clinics, staged-crash gangs and contractors has been a large target of our legislative operations. Numerous laws have gone onto the books since the Coalition began working with statehouses.

But fraud is rife everywhere. So as a unifying force, the Coalition has expanded deeper into health and other forms of insurance. The Coalition’s insights and credibility have opened numerous doors to collaboration with all levels of government.

The same cheaters, for instance, are robbing insurers with false medical claims in all lines of medical insurance, for instance. Co-founding and growing a formal partnership for government and private insurers to combat medical swindlers is just one key Coalition initiative underway.

And alerting consumers about fake health plans is a public-outreach priority. A Coalition media push helped spur a U.S. Senate investigation and GAO report.

This is a tall order. It’s cooking up a full plate that’s only getting fuller.

It’s also an energizing order. If you want to get something done then find the busiest person around, the maxim goes.

But large challenges abound. Leaner budgets are hampering more government anti-fraud agencies — most fraudsters have no such budget limits. Too many consumers also are indifferent that fraud is a personal threat. Organized crime is digging deeper into insurance as well.

But that leaves much more to achieve.

About the author: Jim Quiggle is director of communications for the Coalition Against Insurance Fraud.

6 mobile apps with fraud-fighting potential

BLOG_crashAppsA suspect vehicle suddenly swoops in front of you and jams on the brakes, causing a rear-end collision. Funny, you were going slow, and that car appeared out of nowhere. You think you’re being scammed, but what can you do? Having a smartphone may help. Not only do these devices make calls, track to-do lists, and help you find the nearest restaurant, a few recent apps may even help fight fraud. Some have been created for other purposes, but have fraud-fighting potential. Here we’ve chosen a few of our favorites.

1. iCarBlackBox 
What it is: This app turns your phone into a virtual black box. Using GPS, video, audio, and an impact sensor, iCar Black Box can record all the details of a crash as it takes place. Using the phoneʼs accelerometer, the app can tell when thereʼs been a sudden stop, and will verbally ask the user if they wish to save the footage of the incident. It only saves footage when instructed to do so, thereby conserving space. Users can check the speed of the moving vehicle, date and time, location, road conditions and more through audio/video.

Why it’s a fraud-buster: If you can show what really happened, you might have a better case of proving fraud.details of a crash as it takes place. Using the phone’s accelerometer, the app can tell when there’s been a sudden stop, and will verbally ask the user if they wish to save the footage of the incident. It only saves footage when instructed to do so, thereby conserving space. Users can check the speed of the moving vehicle, date and time, location, road conditions and more through audio/video.

2. iWrecked
What it is: iWrecked allows users to log all the details of a crash, including unlimited pictures, other driver’s insurance information, police information, even witness data and weather conditions. It allows users to create crash diagrams. The app can then generate a pdf report detailing the accident, and send directly from the app to the user’s insurance company.

Why it’s a fraud-buster: Knowledge is power. The app’s reminder to get witnesses’ contact info, capture photos, and take down all the details of a crash may help provide a more comprehensive report.

3. NICB fraud tips

What it is: Reporting fraud just got way easier. This app allows users to anonymously report fraud from the convenience of their phones, on the go. Users can have a chat-style conversation to explain their circumstances, or send an anonymous email-like message including pictures and descriptions.

Why it’s a fraud-buster: Convenience is key, and users are can now snap pictures on their phones, or discuss a fraud tip without making a sound.

4. DBPR Mobile
What it is: Floridians who are approached by shady contractors after storms now have an instant licensing check on their phone. Consumers can verify whether businesses and professionals are licensed, searching by name or license number.

Why it’s a fraud-buster: It’s the first step in determining who to work with. Consumers are still advised to contact their insurer to get referrals on trusted contractors, but turning to this app can give an instant read on what contractors are being honest about licensing.

5. Oklahoma Insurance Department app
What it is: An Android-based app, this allows users to carry important insurance information with them. Consumers can report fraud, search for seasonal insurance topics, check licensing, nominate an insurance professional of the month, and contact the department directly.

Why it’s a fraud-buster: Users can check key fraud info, and can report fraud if they catch it.

6. Scam Detector
What it is: An app that allows users to verify telltale signs of scams to protect themselves from being defrauded. Detailing more than 525 scams, organized by industry, it’s updated in real time. The search function also lets users browse based on their circumstances. Auto scams, internet scams, financial scams, property scams and more.

Why it’s a fraud-buster: Knowing about a fraud can stop the crime in its tracks, and allow users to take action.

Are there any similar apps you are using that should be on this list?
Let us know in the comments.

The science of saying ‘no’ to fraud

BLOG_ifpaTV

There’s a question about whether well-aimed doses of public outreach can persuade people that insurance fraud is a dead-end street.

We have little to go on, because almost nobody applies true science. First you need enough juice ― the money to launch a steady blitz of TV ads, radio spots and other tactics. Then you test your messages and commercials before they’re launched. Will people think the spots effectively gnaw at your sense of right and wrong? Next you measure if people’s attitudes have shifted after the campaign is over. Researchers swing back into action, polling consumers about the ads.

It’s a tall order, but that’s how you know if you moved the needle.

One state agency uses just this science. The promising result: Public outreach can make people decide they don’t want to commit fraud. Look to the Pennsylvania Insurance Fraud Prevention Agency (IFPA) for a glimpse at what’s possible.

IFPA recently finished an 18-month outreach campaign. The effort was aimed at everyday people who commit smalltime scams that add up to bigtime dollars. The commercials avoided bully pulpits and preaching against fraud. They took a subtle but hard-nosed approach called Know the Risks ― Know the Penalties. Several spots simply showed average people who did a dumb thing, got caught and paid a price they came to regret.

One woman, for example, lost a job she was applying for. The spot was called Permanent Record. The effort built on an earlier campaign. In one emotional spot, an angry kid called his busted father a liar.

The agency carefully measured the latest campaign results. More people realized fraud was a felony and one of the most serious crimes. So far so good.

But another telling stat showed up. People who said they’d likely commit fraud decreased two percent. That seems like a small number, but generalize that sample to the whole state: 160,000 Pennsylvanians aren’t likely to inflate or invent a claim.

How many millions of insurance dollars not stolen could that add up to? How many lives and families could be spared wreckage and ruin because of one stupid act? IFPA’s campaigns, cumulatively, are building results. Most state agencies can’t afford the kind of money IFPA spends, nor do results in one state necessarily speak for everyone else. But there’s some promise, here.

Public outreach, if done right, could be a profitable investment and steer people down the right path of life. Insurers and government budget directors, take note.

Set the prisoners free…and then what?

Prisoners

Fraud fighters funnel tremendous amounts of time and effort into detecting, investigating and helping to prosecute people who commit insurance crimes. That last step of the process — punishing people who defraud — is running up against a trend sweeping the nation: prison depopulation.

Grappling with crumbling budgets, state after state is facing the reality that they can no longer afford to incarcerate growing numbers of criminals, especially non-violent ones.

The number of prisoners in the U.S. is at an all-time high. The U.S. imprisons more people than even China, which has four times the number of citizens. Sooner or later, something has to give. That something, in part, is pressure to resist handing out prison sentences for white-collar crime, including insurance fraud.

Not only is there pressure on judges to resist incarcerating white-collar criminals, but sentences are becoming shorter. At least 19 states have taken action to cut their prison population by reducing sentences. Mississippi began allowing non-violent prisoners to be considered for parole 60% earlier than usual. New York, Rhode Island, Minnesota, Michigan, and New Jersey enacted similar sentence-cutting measures for low-risk inmates.

Budgets aren’t the only reason states are taking action. Overcrowding is another factor. California — under a Supreme Court order — will soon release at least 30,000 convicts to ease inhumane conditions. How many fraudsters currently locked up in California prisons will be let out to continue plying their trade?

This trend not only will put more white-collar criminals back on the streets, but likely will create a disincentive for prosecutors to take these cases in the first place. Plus, deterrence for committing fraud will diminish.

Michigan prosecutor Kym Worthy recently expressed her disappointment in Michigan’s prison system, pointing out that arsonists are keenly aware of the state’s lenient policies, and knowingly perpetrate these crimes because they “know they can get away with it.”

Fraud fighters and prosecutors need to meet this trend head on and come up with creative ideas as alternatives to long prison terms.

Out of necessity, some jurisdictions already are employing such measures. In Texas, one district attorney has cut plea bargains with auto giveup scammers to require them to appear in video PSAs talking about how dumb their crimes are and the impact on their lives. A prosecutor in Florida recently cut a deal with convicted clinic owners to fund a public outreach campaign about the cost of such crime and to alert citizens to report shady clinics.

Public service spots and public speaking mandates by remorseful fraudsters would further put a face on this crime, creating a lasting impression in the consumers’ experience, in a more direct way than reading about a conviction.

Public embarrassment is good, but much more thought needs to go into alternative sentencing. Increased fines on professionals who defraud would be a good start. Perhaps medical professionals who defraud should be sent to third-world countries for a couple years to provide free care. Convicted lawyers might be sentenced to long-term jobs at nonprofit legal centers providing services to the poor. Whatever alternatives, they must be sure, swift and somewhat painful to serve as deterrents.

If our criminal justice system fails to hand out effective punishment, deterrence will continue to diminish and fraud will continue to flourish.

Radio talker’s irresponsible advice

BonaduceThe Philadelphia area has its share of ethically challenged folks and surely doesn’t need anyone giving step-by-step instructions on how to commit insurance fraud . . . especially when that someone has a large megaphone and can reach thousands of people. That’s the scenario that played out last week on WYSP radio with talk show host (and former tv child star) Danny Bonaduce.

A caller sought advice on how to profit from a minor traffic accident and talker Bonaduce didn’t disappoint. Here’s a partial transcript:

Bonaduce: “Do you have any tingling or numbness in your foot?”
Caller: “[In] my knee.”
Bonaduce: “How about in the bottom or sole of your foot”
Caller: Nah.
Bonaduce: “Yes, you do. Let me ask you again. Do you have any numbness in the bottom of your foot?
Caller: Absolutely!
Bonaduce: “OK . . . So here’s what going to happen when you go to the hospital . . .”

The talk show host then goes into detail about how to fool the doctor into concluding the accident victim suffered nerve damage in his foot. Bonaduce admitted that the scam is illegal, and even boasted employing it himself in a workers comp claim that allowed him to sit home and collect for six months.

Bonaduce’s audience likely includes young and impressionable listeners who look up to this ‘shock jock.’ They now have another reason to think insurance fraud is cool, harmless and lucrative. His behavior is irresponsible.

The Coalition has filed a complaint with Bonaduce’s employer, WYSP, and its parent company, CBS Radio. Feel free to express your own outrage.

An audio clip of the show can be heard in the members-only section of the Coalition’s website (under Other Resources). We’re hesitant to upload it for public consumption and give it more play than it already has.

Thanks to the Pennsylvania Insurance Fraud Prevention Authority for alerting us to this story.

Stealing health benefits no minor crime

adStealing health insurance benefits is a type of fraud that doesn’t get much attention. It seems innocent to a lot of people. So you list your boyfriend as your husband and get him covered by your employer’s policy. What’s the harm?

People who get divorced often don’t alert their employers that their now-ex isn’t really qualified for health benefits. And then there’s all the people who sign up for Medicaid that really don’t quality, like the doctor and school teacher in Connecticut.

All the same, it’s still cheating. Honest people pay extra for this dishonesty. And it’s dumb to steal insurance benefits because with vast data resources, insurers can easily learn about whether people are really married or whether their income is low enough to qualify for state programs.

The first public outreach effort on the theft of health benefits has been launched by the Insurance Fraud Prevention Authority (IFPA) in Pennsylvania. They’ve created a brochure, TV and radio spots, plus a website describing varied opportunistic frauds committed by consumers and warning people about the consequences. Another fine job by our colleagues in the Keystone State.

Question the company and their plan

Nevada adHealth care reform has helped produce a new wrinkle on an old scam. Crooks are taking advantage of consumer confusion over health care to peddle fake plans and worthless policies or insurance consumers don’t need. Health & Human Secretary Kathleen Sebelius is the latest to jump on the public awareness bandwagon to warn consumers about these scams. During a speech at the National Press Club earlier this week she said scam artists were going door to door telling people there was a limited open-enrollment period to buy coverage and they needed to buy now.

Sebelius, a former state insurance commissioner, said states need to investigate and prosecute these scams.

This new wrinkle comes atop a growing wave of bogus health plans and shady medical discount programs that are defrauding consumers by the thousands. Some states are taking action, such as the recent action in Tennessee where two sham health plans were taken over by regulators. Law enforcement also has ongoing criminal investigations in several states.

This is a good start. But more prevention is needed. That’s where alerts like the one issued by Sebelius and others come in. The best awareness campaign we’ve seen was just launched in Nevada. The campaign is a joint project of the state’s department of insurance, the Nevada Surplus Lines Association and the Nevada Independent Insurance Agents Association.

The campaign features tv and radio spots, a robust website and an interactive system to help consumers verify health insurers and discount plans. The website — NVInsuranceAlert.com — also contains red flags and useful tips on choosing a health plan.

The ads carry a double tagline — “Question the company and their plan” and “Check before you write a check.” Solid advice both.

State regulators have shown up a bit late for this party, partly because many budgets have been cut back for such things as consumer assistance. Perhaps if more took the lead from Nevada and partnered with industry groups, we might find a way to final get ahead of this crime spree.

Getting fraud advice on the Net

blog questionYou file a phony burglary claim with your insurer and after they balk about paying, where do you turn for help? Well, the Internet, of course. That’s what this poster did this morning:

It’s interesting that it was posted on the blog “Fraud Protection & Detection,” so it’s not surprising most replies were less than helpful:

• “I hope they prosecute you…”

• “Let me get this straight. You are asking on a public forum how to commit fraud without it looking like you are attempting fraud? I hope they catch you.”

• “Definite Rhodes Scholar material here…”

I am looking for a way to fake out my insurance company and make it look like i really have the items i dont have my appartment was “broken into.” I filled out police report but the insurance company says that i need prooof of ownership of the items that i claimed how do i do this seeing as how i never owned them?

• “…You’re one of those horrible people that screw up good things for the rest of us.”

• “You will get in trouble for 2 things – filing a false report with the police – which, if you filed it already, you can’t ‘take it back’ & insurance fraud. Hope they send you to jail & throw away the key.”

• “I hope you like prison orange because insurance fraud is a felony.”

and my favorite:

• “You’re the reason everybody complains about their insurance premiums always increasing. I hope they catch you, you have to spend some quality time with “Bubba”, and end up having to sit on a donut the rest of your life. JACK ASS!!!”

The Coalition monitors blogs, Twitter, Facebook, chat rooms, bulletin boards and wherever people in cyberspace discuss insurance fraud. Some of the information shared is helping to spread scams that likely won’t get detected. That’s disturbing. But more and more, people — like the ones above —are voicing their opposition to committing fraud in the strongest terms. And that’s encouraging.

Full-blown consumer scam

consumer alertGood Morning America aired an excellent segment this morning warning viewers about bogus health discount plans and limited benefits plans. Scam artists are taking advantage of the perfect storm of high health care costs, people losing jobs (and thus, their health coverage) and consumer’s not knowing the difference between these plans and full-blown coverage.

The Coalition’s Jim Quiggle brought this story to GMA several weeks ago after our research started showing the number of cases surfacing around the country was growing at an alarming rate. This looks like a full-blown national scam that could rival the last wave of bogus health plans that defrauded more than 200,000 Americans.

Much more public awareness (and action by regulators and law enforcement) is needed to stem this wave.