News

Florida storm victims warned about hiring fake public adjusters
November 24, 2014, Jacksonville, FL -- A severe storm struck the Jacksonville, Florida, area earlier this week, causing significant damage to many properties. The majority of this damage was caused to roofs, which may present a major problem for those that fell victim to the storm. The Florida Association of Public Insurance Adjusters has issued a warning to those affected by the storm, cautioning them against fake insurance adjusters. In the wake of major storms, fraudulent adjusters often seek to take advantage of those that have had their properties damaged. The organization notes that some fraudulent roofers attempt to convince consumers that they can also act as ...

Owners of three pharmacies in New York charged with Medicaid fraud
November 24, 2014, Brooklyn, NY -- Seven owners and employees at three Brooklyn pharmacies face charges that they participated in a $5 million Medicaid fraud scheme. New York state Attorney General Eric Schneiderman announced the indictments Monday. Prosecutors say the businesses — Central Pharmacy, Hastings Drug Corp. and Buffalo Drugs — billed Medicaid for prescriptions that were never filled. Prosecutors say documents indicated that two pharmacies were owned by a New Jersey woman named Beenish Daha and the third by her brother, Muhammed Khan of Queens. In actuality, authorities say Daha's pharmacies were owned by her father, Munir Khan, who was deported to Pakistan in 2008 following convictions for adulterating ...

Doc in New York agrees to pay $2.35M to settle Medicaid fraud charges
November 24, 2014, Staten Island, NY -- A former Staten Island University Hospital doctor who was famously accused of forcing Beatle George Harrison to sign a guitar on his deathbed has agreed to pay out $2.35 million to resolve a Medicare fraud lawsuit. Dr. Gil Lederman -- who used to run SIUH's radiation oncology department -- on Monday settled a decade-old lawsuit filed by whistleblower Elizabeth Ryan, a Florida Realtor and the widow of a former SIUH cancer patient. The federal government joined Ms. Ryan's lawsuit in 2008. The lawsuit alleged that Lederman and SIUH violated the False Claims Act from the mid-1990s to 2003, advertising that the hospital's ...

Insurance agent in Louisiana accused of stealing $40K from 17 clients
November 24, 2014, Mobile, LA -- A Mobile insurance agent is suspected of cheating 17 of his clients out of more than $40,000, according to federal court records. The 17 people paid for insurance polices that were never issued or were canceled for nonpayment, according to the records. One count of fraud was filed Monday against Anthony Stutts in federal court in Mobile. Stutts has reached a deal with prosecutors and is expected to plead guilty Dec. 10 when he appears before U.S. District Court Judge Callie Granade. The fraud charge stems from when Stutts, who was working as a Farmers Insurance agent, faxed a finance agreement to an ...

Three years in prison for physician's assistant in California for $3.5M scam
November 24, 2014, Montebello, CA -- A physician’s assistant who defrauded Medicare by signing phony prescriptions for medical equipment while working at two Los Angeles-area medical clinics was sentenced Monday to three years in prison. Erasmus Kotey, 78, of Montebello, was also ordered to pay $3.5 million in restitution to the Medicare program. Kotey pleaded guilty in March before U.S. District Judge Margaret M. Morrow to one count each of health care fraud and conspiracy to commit health care fraud. Kotey worked at medical clinics at 866 N. Vermont Ave. in Los Angeles and 943 S. Atlantic Blvd. in Monterey Park. From about November 2007 through December 2008, Kotey signed ...

Neurosurgeon in Michigan accused of performing unnecessary spinal surgeries
November 24, 2014, Bloomfield Hills, MI -- A Bloomfield Hills neurosurgeon allegedly defrauded the Medicare health care program for seniors of millions of dollars by performing unnecessary spinal surgeries on patients, according to a complaint unsealed Monday in federal court. Dr. Aria Sabit is accused of performing lumbar spinal fusions on numerous patients and billing insurers despite failing to install medical devices in patients whose pain continued after surgery. The 40-page criminal complaint caps a lengthy investigation by the Federal Bureau of Investigation and U.S. Department of Justice that spanned at least two states, and involved multiple patients and tens of millions of dollars. A disheveled, unshaven Sabit, dressed in ...

Five in North Carolina arrested for staging crash with a U-haul truck
November 24, 2014, Fayetteville, NC -- State investigators arrested five Fayetteville residents accused of staging a vehicle crash with a rented U-Haul truck May 23, according to the N.C. Department Of Insurance. Investigators said the group defrauded State National Insurance, Repwest Insurance and State Farm Insurance of more than $10,000 after one of the suspect's vehicles crashed into the U-Haul. Investigators are still searching for 23-year-old Antonisha Raeneal Chavis, who is accused of conspiring with the group. Those arrested were: Omar Rhashaud Bradley, 35, of Ellis Street; Timothy Robinson, 44, of the 1100 block of Morgan Street; Laterryica Chantel Wright, 30, of the 400 block of Plantation Road; Lecretia ...

Appeals court overturns insurance fraud acquittal of Miss Montana
November 24, 2014, Missoula, MS -- The 9th U.S. Circuit Court of Appeals on Monday reinstated the insurance fraud conviction of a former beauty queen who once owned and lived in the historic Somers mansion. Christin Didier was convicted by a federal jury in March 2013 of seven counts of mail fraud and one count of conspiracy to commit mail fraud. However, on July 30 last year, U.S. District Court Judge Donald W. Molloy of Missoula acquitted Didier on a defense motion to overturn the verdict. The appeals court ruled that Molloy had erred in acquitting Didier, reversed his order and remanded the case to U.S. District Court ...

Adjuster in Washington pleads guilty to helping steal claims money
November 22, 2014, King County, WA -- Former Nationwide Insurance claims associate Fariborz Romeo Rahrovi, 40, today pled guilty in King County Superior Court to two counts of theft, criminal conspiracy and money laundering related to the theft of an accident victim’s $525,000 insurance settlement. Rahrovi is scheduled to be sentenced at on Dec. 19 in King County Superior Court. He faces up to 12 months in prison. Rahrovi was charged after an investigation by Insurance Commissioner Mike Kreidler’s Special Investigations Unit (SIU). Rahrovi worked in cahoots with Seattle private law attorney Edward Joseph Callow, who represented the victim. Nationwi de paid Callow’s client a $25,000 advance and a $500,000 ...

Insurance agent in Florida accused of stealing $140K in client premiums
November 21, 2014, Pensacola, FL -- A Pensacola insurance agent is facing federal charges for allegedly defrauding his clients of about $140,000, according to a news release from the U.S. Attorney's Office. Kevin D. Webster, 44, has been indicted on 11 counts of felony wire fraud, according to the release. Webster allegedly contacted numerous clients between 2008 and 2011 and told them he secured umbrella insurance policy premiums for them. The policies did not exist, according to the release. Webster has pleaded not guilty to the charges, and he is scheduled for trial Jan. 15 before Senior U.S. District Judge Roger Vinson. The charges result from an investigation by ...

GEICO: Fraud has 'enormous impact' on premiums drivers pray
November 21, 2014, Washington, DC -- A little exaggeration of an accident here, a little white lie on a medical bill there—such activity doesn’t actually make a difference when it comes to insurance rates, right? If only that were true. The reality is that insurance fraud of all kinds has an enormous impact on all drivers and the insurance rates they pay. This International Fraud Awareness Week, which runs through Nov. 22, GEICO is reminding people to remain vigilant in the fight against fraud, which costs consumers billions of dollars every year. Staged accidents, exaggerated injuries, inflated medical bills and phantom medical treatments are common forms of ...

Insurance agent charged with defrauding city of Hartford of $1.5M
November 21, 2014, Hartford, CT -- An insurance agent already charged in several criminal investigations now has been charged in a federal case involving charges he defrauded multiple victims of a million and a half dollars. Earl O’Garro, Jr. of Marlborough, has been the subject of an investigation into what happened to hundreds of thousands of dollars in city of Hartford money paid to him to pass on in payment to the city’s insurance companies. He also faces charges of failing to pay workers at a Middletown restaurant owned by his wife. On Friday, U.S. Attorney for Connecticut Deirdre Daly and Special Agent ...

Four charged in arson and fraudulent mortgage ring in Connecticut
November 21, 2014, Litchfield County, CT -- Four Litchfield County residents have been indicted in connection with a series of fraudulent real estate and insurance deals, along with the alleged arson of a vacation home, the U.S. Attorney’s office said Friday. On Thursday, a grand jury in New Haven returned a seven-count charging the four men — Ryan Geddes, 41, of Litchfield; Jason Calabrese, 43, of Watertown; Richard Geddes, 41, of Bethlehem; and Dustin Whitten, 31, of Thomaston — with multiple conspiracies involving bank, mail and wire fraud, prosecutors said. The four men were arrested Friday morning and appeared before U.S. Magistrate Judge Joan Margolis. All four were released ...

Traffic cam in Florida helps nab Medicare fraud fugitive
November 21, 2014, Hialeah, FL -- After months of hiding out in a Hialeah apartment during the day and cleaning office buildings at night, Luis Marin was arrested late Wednesday in Sunny Isles Beach for his role in what federal agents say was a $16.5 million Medicare fraud scheme. Though he never held a license, Marin posed as a physical therapist in a criminal ring that from 2011 to 2014 billed Medicare for home health services that were either unnecessary or never provided, said Omar Perez-Aybar, supervisory special agent in Miami for the U.S. Department of Health and Human Service’s Office of Inspector General. Marin became a fugitive ...

Business man in New York accused of staging burglary
November 20, 2014, Fort Plain, NY -- A former Fort Plain business owner is accused of a felony charge of insurance fraud for allegedly filing false claims. Dennis Todd, who is currently serving a state prison sentence for sex crimes against a child, allegedly sought insurance money for $50,000 allegedly stolen in 2013 from his residence at 24 Willett St., and at Dennis' Daylight Donuts, his former business. In February, Todd's power of attorney filed the complaint on his behalf seeking monetary recovery of damages, which he did not actually incur, police said. During an investigation, officers located all of the alleged stolen property in various parts of the state, ...

Chiro in Idaho, crony charged with torching strip mall
November 20, 2014, Coeur d’Alene, ID -- A Coeur d’Alene chiropractor and another man pleaded not guilty Wednesday to setting fire to a Spokane Valley strip mall after plans to open a pot business there fell through. Pavel Shevchenko, 24, and Burk A. Thomas, 33, pleaded not guilty Wednesday to charges of conspiracy to commit arson and malicious use of fire to damage property. Thomas additionally pleaded not guilty to wire fraud and use of fire to commit a federal felony, after investigators learned he sought additional insurance coverage for two strip mall suites at 9827 E. Sprague Ave. in the days before the Sept. 27 fire. Shevchenko was ...

Baldwin Man Sentenced for $75K Insurance Scam
November 20, 2014, Long Island, NY -- A Baldwin man was sentenced Wednesday to 1 ⅓ to 4 years in prison for posing as an insurance agent in order to fleece his “clients” out of $75,000 in application fees. Darren Downes pleaded guilty at Nassau County court in July to felony charges of scheme to defraud, identity theft and grand larceny. “All New Yorkers pay a price for insurance fraud, which drives up premiums across the board,” Attorney General Eric Schneiderman said. Prosecutors said a 33-year-old wannabe insurance salesman charged customers hundreds of dollars each to submit policy applications on their behalf to companies such as Progressive and GEICO, promising ...

Oklahoma Attorney General Charges Man in Worker’s Comp Fraud Case
November 20, 2014, Lawton, OK -- Oklahoma Attorney General Scott Pruitt has filed a worker’s compensation fraud charge against a Lawton man who allegedly submitted multiple timesheets to receive payment for hours he didn’t work. Pruitt charged James Dorman Jackson with the crime. It wasn’t immediately clear whether Jackson had an attorney. Pruitt’s office alleges that Jackson was allegedly injured while working for a Lawton business. While injured, the state claims, Jackson agreed to participate in a temporary transition employment program. An insurance company arranged for Jackson to work weekends at the Fort Sill Military Museum. Even though Jackson only worked at the museum twice, he allegedly submitted 16 ...

Chiro’s dream mansion being auctioned after six-year fraud sentence
November 19, 2014, Mansion, NJ -- The unfinished mansion of a chiropractor convicted of fraud is going up for auction. Boasting an art gallery, a spa, a wine-tasting room, and a rooftop terrace overlooking the 32-acre estate, the 16,800-square-foot mansion on Cherry Valley Road in Montgomery Township is an “architectural showplace,” according to the auction house. It’s also the unfinished dream home of Scott Greenberg, a 54-year-old chiropractor who stopped work on the home in 2011, when he was arrested and accused of employing runners to bilk insurance companies of hundreds of thousands of dollars, according to authorities. Potential buyers walked through the house Tuesday, in advance of the ...

11 in Florida charged with defrauding Medicare and Medicaid
November 19, 2014, Cora Gables, FL -- Federal agents raided Florida Healthcare Plus in Cora Gables Wednesday for allegedly running a more than $25 million Medicare, Medicaid, and wire fraud scheme. Authorities said eleven people were involved in the schemed to defraud the government. According to the federal indictment, Florida Healthcare Plus (FHCP) was authorized by Medicare and Medicaid to offer plans to the beneficiaries, which was then allegedly taken advantage of by the defendants. The indictment said the group recruited people living in the Dominican Republic and Nicaragua to fraudulently sign up for Medicare and Medicaid by saying they lived in Florida. Medicare and Medicaid then made monthly ...

Pharmacist in Texas convicted of billing for drugs never dispensed
November 19, 2014, El Paso, TX -- A federal jury this week convicted a former West El Paso pharmacist of health care fraud. Peter Victor Ayika, 58, had pleaded guilty to health care fraud, wire fraud and mail fraud in 2012. A federal appeals court earlier this year vacated Ayika's convictions after ruling U.S. District Judge Frank Montalvo improperly participated in plea negotiations. Jurors convicted Ayika of the same charges on Monday. Ayika's trial began last week before Senior U.S. District Judge David Briones. Ayika's sentencing hearing has been scheduled for Feb. 5. Briones allowed Ayika to represent himself during the trial, and appointed local criminal defense attorney Joseph Vasquez ...

Honduran in Florida busted for $1M-plus worker comp premium scam
November 18, 2014, Kissimmee, FL -- A Kissimmee man was arrested in Palm Beach County after deputies say he ripped off an insurance company of more than $1 million in an elaborate case of worker's compensation fraud. Arturo Santos Zuniga, who also went by the name David Hernandez, was busted as part of an investigation led by the Broward Sheriff's Office in conjunction with the Palm Beach County Sheriff's Office and the Miami-Dade Police Department, according to his arrest report. The 40-year-old man is an undocumented immigrant from Honduras, according to the report. He is accused of being involved in a ploy in which laborers are paid in ...

Insurance agent in South Carolina accused of $580K theft of client premiums
November 18, 2014, Summerville, SC -- A former Summerville insurance salesman who spent more than $580,000 of his clients' money on business and personal expenses pleaded guilty in federal court Tuesday under a deal with prosecutors. Timothy David Mays, 50, faces up to 23 years in prison, four years in a supervised release program and $500,000 in penalties. He also agreed to pay restitution to his victims, mostly retirees, and to the Internal Revenue Service. He was indicted in early 2013, when he pleaded not guilty. He changed his plea to guilty to one count each of wire fraud and willfully filing a false income tax return. Federal prosecutors will ...

Body shop owners in Fla. allegedly cheated with repair shortcuts
November 18, 2014, Quincy, FL -- The owner of a Quincy body shop, along with his wife, were arrested Tuesday after a customer's insurance company paid the shop to replace several parts on a car, and instead, the shop made shortcuts to cut the cost of repair on their end. The Florida Department of Insurance Fraud arrested Russell D. Owens, owner of Rusty’s Wreck-O-Mended, and his wife, Cassandra Owens. Rather than replacing the appropriate parts, according to the Chief Financial Officer's office, Owens kept the nearly $2,000 given to him by Progressive Insurance Company. The office says that money was supposed to be used for the replacement ...

Dragnet in Calif. nabs 195 suspects for bilking insurers after crashes
November 18, 2014, Bay Area, CA -- A widespread auto insurance fraud investigation that spanned the state of California has now resulted in the arrest of 54 people in the Bay Area, after an alleged rash of falsified claims were submitted to insurers. According to the announcement that was made by the state department officials, the claims from this insurance fraud bust could have led to over $250,000 in losses in the Bay Area, alone. In order to conduct this investigation, detectives from the department worked alongside the district attorney’s offices in several parts of the state – Santa Clara, San Francisco, Contra Costa, Alameda, and Solano – ...