Fraud: Why worry?

Good question ... Yes, you should worry about insurance fraud.

Insurance crooks are picking your pocket to line theirs. Insurance fraud is one of America's largest crimes — at least $80 billion is stolen each year.

We pay. Honest consumers like you pay. Lives, families, businesses and careers are wrecked. ... Your money is stolen. ... Your insurance premiums rise. ... People are maimed, crippled and murdered. Some harmless prank.

Scamming worth it? Committing fraud’s tempting. Careful — is easy money that easy? Trained investigators ... jail ... big fines ... permanent criminal record ... lose your job ... great role model for your kids and community.

You can fight back and win. We’ll show you how.

Real cases, real victims

Fight back and win

Hunting down scammers

Why is fraud so big?

 

Real cases ... real crimes

Here’s how scammers operate ... in the streets. Check out the Insurance Hall of Shame for more about America’s masters of mayhem.

Crash gang crashes. A crash ring tried to steal $279 million with thousands of false claims for treating fake whiplash injuries in the New York City area. Mikhail Zemlyansky hired crash “passengers” to fake whiplash. Crooked doctors forged medical records. Zemlyansky received 15 years in federal prison.

Botched arson. Mark Leonard torched his Indianapolis home for $300,000 of insurance money. The house exploded, destroying much of the neighborhood. Dion Longworth lived next door. He was burned alive in his searing basement. Leonard received life without parole.

Agent of fraud. Insurance agent Monica Smart was anything but. The Topeka, Kans. agent stole tens of thousands of dollars in client premiums without buying clients any coverage. She left them dangerously uncovered. Smart must repay $160,000, and received more than two years in federal prison.

Contractor con. Jack and Ryan Thayer trolled neighborhoods after storms, offering to fix damaged homes. The Bristol Township, Pa. duo stole more than $770,000 in down payments from storm-traumatized homeowners — without fixing the homes. Many victims were elderly. At least the Thayers have a new roof: They received up to 20 years in prison.

Slip & fall tripped up. Dozens of people tripped and were badly hurt on damaged sidewalks in a quiet Philadelphia neighborhood. The falls were fake. Lawyer Andrew Gaber coached them how to sit down and act hurt. His gang made $400,000 in false injury claims against innocent homeowners. Gaber committed suicide, and his gang members were convicted.

Injury plot rocked. NYPD cop Christopher Inserra said he hurt his right arm while taking an injured employee to see a doc. Inserra couldn’t bend or use the arm, he lied. He collected thousands in workers-comp money. So why was he cavorting onstage with his punk band — flailing and fist pumping? Inserra was convicted, booted from the force and lost his career.

Chemo con. Dr. Farid Fata pumped 550 patients with painful chemo drugs — yet many patients had no cancer. The Detroit-area cancer doc billed insurers $225 million. One cancer-free patient received 155 chemo treatments in just two years. Another patient’s teeth fell out. Fata was dosed with 45 years in federal prison.

Sick health plan. A fake health insurer stole $28 million in premiums from 17,000 trusting people. Some victims were acutely ill, even cancer. Yet William Worthy refused to pay their claims. A Houston man had emergency back surgery. Worthy stuck him with a $105,000 bill. Worthy was stuck with nearly seven years in federal prison.

Lethal love. A hike in the Rocky Mountains was fatal. Harold Henthorn pushed his devoted wife Toni off a sheer cliff to steal $4.5 million of life-insurance money. The Colorado man was unemployed and sponging off doctor Toni. Henthorn said Toni slipped and fell. His murder plot fell ... apart. Henthorn received life in prison.

 

Fight back and win

You can keep scammers away. Protect your family, bank account and yourself from crooks: Stay alert, ask questions and go slow.

Also check out the Coalition’s consumer alerts for more helpful ideas. Here are some general tips ...

  • Be wary of door-to-door or telephone sales people.
  • Contact your state insurance department to make sure your insurance agent or unfamiliar insurer are licensed.
  • Keep your Medicare ID number secret. Crooks can steal it and make scams against your coverage.
  • After a vehicle crash ... Take photos of the vehicles, damage and passengers. You can prevent fake injury and damage claims.
  • Contact your state insurance department or National Insurance Crime Bureau (1-800-835-6422) to report a scam.

 

Hunting down scammers

Anti-fraud units. Most insurance companies combat fraud with trained investigators. Cool fraud software can spot scams — before they happen.

Sue swindlers. Some insurers courageously sue fraud ringleaders to recover stolen money. Civil suits relay a strong message: Cheating that insurer is a path to ruin.

Join forces. Insurers sponsor national groups that are putting pressure on scammers.

Fraud bureaus. These state agencies investigate suspected schemes for potential prosecution. You’ll find them in 41 states.

Tougher fraud laws. Fraud is a specific crime in nearly all states. Tough fraud laws also are made every year. They clamp down on shady contractors, bogus airbags, staged-crash rings and other insurance crimes.

Medicare cracks down. Medicare strike forces are hunting down schemers in hotspots such as South Florida. Medicare also is booting more crooked medical providers from the system — and keeping them out.

 

Why is fraud so big?

America’s fraud fight needs to improve, despite much progress. Gaps need closing — and fraud fighters are working hard on it.

Health system an easy target. Medical providers exploit automated billing systems with cleverly disguised treatment claims.

Low-risk crime. Cheaters view insurance fraud as a low-risk, high-reward gambit. Even drug dealers have entered insurance fraud.

Insurers back off. Most insurers actively combat fraud. But some still pay certain suspicious claims. They believe it's cheaper than going to court.

Low legal priority. Prosecutors often give top priority to combating drugs, violence and other high-profile crimes.

Too much tolerance. Some people mistakenly think insurance fraud is a harmless prank.

 

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