News

Connecticut woman steals ID to plot life-insurance murder
September 21, 2017, West Haven, CT -- West Haven woman was sentenced to more than a year in prison on Wednesday for her role in a fraud and identity theft scheme, the U.S. attorney’s office said. Lorena Coburn, 43, of West Haven was sentenced to 16 months followed by three years of supervised release. Last November, Coburn plead guilty to one count of bank fraud and one count of aggravated identity theft. According to court documents and statements made in court, Coburn and Jamila Williams-Stevenson worked together to steal personal information from people and use it commit fraud. Williams-Stevenson worked as a care companion at Yale-New Haven Hospital and ...

Pennsylvania chiro alleged bills for date patient had baby
September 21, 2017, Franklin County, PA -- A Franklin County chiropractor is again facing criminal charges, this time for defrauding three insurance companies out of approximately $150,000 in bogus billing scheme, according to authorities. On Tuesday, Lawrence Scott Herman, 51, who lives in Frederick, Md., and owns and operates Herman Chiropractic in Waynesboro, was indicted by a grand jury on charges of corrupt organizations, theft by deception and insurance fraud, according to paperwork filed in Cumberland County by the Pennsylvania Attorney General's office. The indictment contends Herman falsely billed Highmark, Capital Blue Cross and Erie Insurance for office visits and treatments from March 2010 to April 30, 2014. In December, ...

Mississippi man suspected of billing for fake healthcare
September 21, 2017, Lexington, MS -- A Lexington man is facing charges of insurance fraud, wire fraud, and attempted false pretense. Attorney General Jim Hood said authorities arrested 31-year-old Donald Adams this week. He is accused of attempting to defraud Progressive Insurance Company by submitting a false medical bill to the company to be paid for medical treatment he did not receive. Hood said Adams did not profit from his scheme; Progressive Insurance discovered the false bill before a payment was sent to Adams. A Holmes County grand jury indicted Adams in June. He was arrested Tuesday by deputies at the Holmes County Sheriff’s Office on a three-count indictment ...

New York man charged with stealing comp, playing hockey
September 21, 2017, Rome, NY -- A Rome man who worked as an aide at a state youth detention center has been charged with workers compensation fraud. The New York State Inspector General’s Office say 45-year old Samuel Spina allegedly played in a competitive hockey league while claiming a debilitating injury prevented him from working. Spina is accused of receiving more than $3,000 in improper benefit payments from September 2015 to January 2016. Spina was a Youth Division Aide at the State’s Taberg Residential Center for Girls. The Inspector General says Spina reported a knee injury that prevented him for working in September 2015, but in the weeks and months ...

Tennessee premium scam discovered when worker dies
September 21, 2017, Powell, TN -- A Powell woman who pleaded guilty to ripping off small businesses was sentenced Wednesday to serve eight years in federal prison and ordered to pay more than $15 million in restitution. A judge sentenced 38-year-old Andrea Ball Rudd to serve 60 months for tax evasion and 36 months for mail and wire fraud after she pleaded guilty to the charges in April. Assistant U.S. Attorney Frank Dale wrote in court records that Rudd, as owner of a Powell-based payroll services firm, HR Comp, LLC, took money from small businesses to cover payroll taxes and workers’ compensation insurance that she instead pocketed. Dale said ...

5 plead guilty to torching Ohio home for insurance
September 21, 2017, Collingwood, OH -- Five of the six people charged with setting fire to a Collingwood Boulevard home to collect insurance proceeds entered guilty pleas Thursday in Lucas County Common Pleas Court. Tazhianna Dean, 22, of the 2800 block of Kendale Dr.; Marcus Cosper, 24, of the 2000 block of Clinton St.; Matthew Merriweather, 44, of the 3200 block of Collingwood Boulevard, and Jennifer Parkhurst, 53, also of the 3200 block of Collingwood each pleaded guilty to insurance fraud. Jamel Gaines, 29, of the 2300 block of Chestnut Street pleaded guilty to complicity to aggravated arson, insurance fraud, and trafficking in heroin. Gaines, who prosecutors said arranged ...

5 Florida lawyers busted for allegedly brokering crash victims
September 21, 2017, Fort Lauderdale, FL -- Five South Florida attorneys and five of their accomplices were arrested earlier this month in an alleged patient-brokering scheme that earned them more than a half-million dollars in profits. Detectives from the Broward Sheriff's Office and Fort Lauderdale Police Department began investigating in May 2015, with the help of state and federal authorities. The investigation revealed that several personal injury attorneys were paying people to unlawfully solicit unsuspecting vehicle accident victims to make insurance claims for damages or personal injury benefits. Investigators said the attorneys paid the solicitors on a per-client basis and then referred the accident victims to a health care facility ...

Mental-health aide in New York charged with saying can’t work
September 20, 2017, Utica, NY -- An aide at a state mental health facility is facing felony and misdemeanor charges for allegedly submitting a false insurance claim. Duane C. Hayes, 40, of Utica, was charged with first-degree falsifying business records and second-degree criminal possession of a forged instrument, both felonies. He has also been charged with attempted petit larceny. The charges stem from an investigation conducted by the state inspector general's office. Hayes, a security hospital treatment assistant at the Central New York Psychiatric Center in Marcy, is accused of filing false documents to his personal supplemental insurance carrier claiming he was on workers' compensation and ...

Former New York broker gets jail for heisting client premiums
September 20, 2017, Long Island, NY -- A former insurance broker on Long Island who pleaded guilty to grand larceny and fraud has been sentenced to serve three to nine years in prison. Suffolk County District Attorney Thomas Spota said Tuesday that 44-year-old Kimberly Graziano, of Middle Island, must also pay $1.8 million in restitution to her victims. Newsday reports (http://nwsdy.li/2yp9wDi ) that Graziano was sentenced in a court in Riverhead Tuesday. Prosecutors say Graziano falsified contracts totaling more than $1 million in funds stolen from an insurance carrier. Spota says Graziano's schemes unraveled when her clients began having claims denied and had their drivers' licenses suspended for lapses in ...

8 ways Long Islanders can stop Jose contractor scams
September 20, 2017, New York, NY -- Long Islanders should stay alert for storm-chasing contractors who dangle fast and fraudulent home repairs that could cost them thousands of dollars out of pocket after tropical storm Jose batters low-lying areas, the New York Alliance Against Insurance Fraud warns. Jose could cause considerable flooding and home damage on Long Island and nearby low-lying areas. Con artist contractors could try to gouge homeowners with bogus repairs during the crisis aftermath. Homeowners should avoid being chased by storm chasers, NYAAIF warns. Most home contractors are honest. A small but disturbing number typically try to gouge anxious homeowners after storms such ...

Unqualified staff used therapist IDs 7,000 times in Tennessee
September 20, 2017, Morristown, TN -- Assistant U.S. Attorney David L. Gunn on Tuesday recommended 18 months in federal prison for Dr. Penaranda Tan, who owned Therapeutic Services of Morristown and pleaded guilty to a single count of health-care fraud, according to court documents. Tan, who has agreed to pay $200,000 in restitution to TennCare, Medicare and two private health insurance companies. He’s scheduled to be sentenced in federal court in Greeneville on Sept. 27. Tan’s fraudulent billing netted him nearly $400,000, according to Gunn. Most or all of Tan’s patients were children. Some juvenile patients came to him through contracts with the Hamblen and Hancock county school ...

Study: Fitbits can be hacked, inviting insurance scams
September 20, 2017, Washington, DC -- In the study by the University of Edinburgh, data transmitted between the Fitbit One and Fitbit Flex devices and cloud servers could be intercepted, giving the researchers access to personal information and the ability to create false activity records. The researchers also discovered a way of circumventing end-to-end encryption – built-in software designed to prevent outside access to sensitive data – by dismantling the devices and altering data stored on them. A data security lapse of this kind opens the door to issues like insurance fraud as false activity data sharing with insurance companies could result in cheaper insurance cover. The reverse situation ...

Irma task force seeks fraud tips from Florida citizens
September 20, 2017, Tallahassee, FL -- A task force created by the U.S. Attorneys’ offices in Florida and Puerto Rico and the National Center for Disaster Fraud has launched a 24-hour tip line to report storm-related fraud and scams. Among more than storm-related crimes already reported after hurricanes Harvey and Irma: impersonating law enforcement officials; identity theft; filing fraudulent insurance claims; bogus charities and investments that promise high returns on recovery and clean-up efforts; price gouging, theft and looting. The U.S. Department of Justice created the National Center for Disaster Fraud after millions of federal dollars for disaster relief poured into Louisiana and other gulf coast states after ...

Coalition flourishes after merger talks fizzle 11 years ago
September 20, 2017, Washington, DC -- As the Coalition prepares to celebrate 25 years of combating insurance fraud, let’s glance back and explore milestones, key successes and discuss the great progress the fraud-fighting community has enjoyed. But such wasn’t the case 11 years ago this month when plans were being drawn up to fold the three major anti-fraud organizations into one. A proposal to combine the Coalition, NICB and International Association of SIUs had been pursued aggressively for more than a year. The plan created controversy and deep distrust among the organizations. The idea for a single organization to focus on fraud in the property/casualty arena arose from ...

Long Islanders warned of contractor scams after Jose
September 20, 2017, Long Island, NY -- Long Islanders should stay alert for storm-chasing contractors who dangle fast and fraudulent home repairs after tropical storm Jose batters low-lying areas, warns the New York Alliance Against Insurance Fraud. Jose could cause considerable flooding and home damage on Long Island and nearby low-lying areas. Con artist contractors could try to gouge homeowners with bogus repairs during the crisis aftermath. Homeowners should avoid being chased by storm chasers, NYAAIF warns. Most home contractors are honest. A small but disturbing number typically try to gouge anxious homeowners after storms such as Jose, especially if there’s shortage of legitimate home contractors. Dishonest and ...

Ohioans burn house while firefighters attend service
September 20, 2017, Lucas County, OH -- Although their sentencing was delayed a week due to Hurricane Irma, a Miami couple who set fire to a home they owned in Toledo to collect insurance proceeds were sentenced Wednesday to local jail time and community control. Reinaldo Torna, 57, and his wife, Mayelin, 44, each were placed on community control for five years and ordered to spend the first six months at the Corrections Center of Northwest Ohio. Lucas County Common Pleas Judge Linda Jennings also ordered them to perform 100 hours of community service. On July 27, both had entered Alford pleas — not admitting guilt — to arson ...

California dentist suspected of practicing despite losing license
September 19, 2017, San Jose, CA -- He ignored a judge’s order, then the state Dental Board. Now, a former San Jose dentist, whose license has been revoked, is in trouble with Santa Clara County authorities for allegedly practicing anyway — and billing insurance companies for the prohibited work. Michael Marcus, 67, faces four counts of felony insurance fraud for allegedly defrauding two insurance companies for dental work he performed from late 2011 through early 2014. His case is set Wednesday for a status hearing in San Jose. Marcus, who was charged in May, is free on $40,000 bail, said Santa Clara County prosecutor Vonda Tracey. The former dentist ...

Three allegedly use electric range to burn Pennsylvania home
September 19, 2017, Elk County, PA -- Three people were arrested Monday night in connection to a 2015 house fire in Elk County. Renne Groeger, John Miller and Cody Miller, all of Ridgway, have been charged with arson, insurance fraud, criminal conspiracy, criminal attempt, theft by deception and criminal mischief. State police said the fire happened around 11 p.m. on Nov. 16 on Montmorenci Road, Ridgway Township. According to a criminal complaint, a state police fire marshal determined the fire originated on a ceramic cooktop of an electric range in the kitchen of the home. An empty can of lacquer thinner and a large amount of debris, including ceiling tiles, ...

Fraud authority figures big in Michigan no-fault reform proposals
September 18, 2017, Detroit, MI -- Relief from the highest auto insurance rates in the nation took on a bigger sense of urgency last week. From comments made by Michigan Attorney General Bill Schuette when he announced his run for governor to a plan offered by bipartisan group of lawmakers, calls to reform Michigan’s no-fault auto insurance rose to the top of the agenda. Add the two newest entries to the insurance debate to efforts being made by Speaker of the House Tom Leonard, R-Dewitt, who is working with Detroit Mayor Mike Duggan to come up with a way to reduce rates across Michigan and especially in Detroit, ...

Jersey eye doc bills for exams he never performed
September 18, 2017, Hazlet, NJ -- A New Jersey optometrist with several Pearle Vision centers in Pennsylvania has pleaded guilty to billing insurance companies for services he did not provide. The Pittsburgh Post-Gazette (http://bit.ly/2f5QSYu ) reports that 31-year-old Vincent Gamuzza of Hazlet, New Jersey pleaded guilty Monday in federal court to health care fraud. Prosecutors say Gamuzza billed one company for medical services he did not provide from December 2015 through July 2016. They say he also billed another company for eye exams that were never performed. Gamuzza operated a New Jersey eye clinic and ran 11 Pearle Vision centers throughout Pennsylvania, including several in the Pittsburgh area. He is ...

Brides scramble after Ohio banquet hall ducks comp, closes
September 18, 2017, Niles, OH -- The manager of the now-closed McMenamy’s Banquet Center in Niles was sentenced on Monday for attempted workers’ compensation fraud. Robert Leonard received two years of probation after pleading guilty in July to the criminal charges. The company that owned McMenamy’s was also charged with Workers’ Compensation fraud. Prosecutors say the business failed to pay more than $13,000 over three years for premiums to the Bureau of Workers’ Compensation. The company has since made restitution. Earlier this year, McMenamy’s closed, leaving brides scrambling to find a new wedding venue. Thrift Town Treasures has since moved into the former banquet hall on Youngstown Warren Road. ...

Jersey postal worker charged with zip lining while on disability
September 18, 2017, Lower Township, NJ -- A former postal worker who had claimed a wrist injury prevented him from working posted photos of himself zip-lining and rappelling, state authorities said Monday as they announced insurance fraud and theft charges. Robert McGeehan, of Lower Township, is accused of stealing more than $75,000 in federal workers’ compensation benefits by falsely claiming an on-the-job fall rendered him medically unfit to work as a letter carrier. Postal service investigators said they also recorded him doing strenuous yard work, including using a chain saw and a hand saw and throwing large logs. A telephone number for McGeehan could not be located Monday, and it ...

Deputy in San Diego claims comp, allegedly lifts weights
September 18, 2017, San Diego, CA -- A local sheriff’s deputy, who claimed he had suffered a back injury but may have been seen working out with heavy weights at a gym, has been charged with committing workers compensation insurance fraud resulting in $57,000 in losses, prosecutors announced Monday. Matthew Tobolsky, 40, faces 14 counts including insurance fraud, filing a false claim, attempted perjury and failing to disclose information that affects a payment, according to the District Attorney’s Office. The charges carry a potential sentence of up to 15 years in custody, which would most likely be served in county jail. Reached by phone Monday afternoon, Tobolsky denied the allegations. “I ...

Elderly couple injured by suspected Las Vegas crash ring
September 18, 2017, Las Vegas, NV -- Twenty-four people were indicted last week on racketeering, fraud and battery charges in a massive scheme to stage east valley car crashes, then file fraudulent insurance claims. Most of the crashes took place on Nellis Boulevard — an area with 45 mph speed-limit zones and heavy traffic, creating “dangerous conditions,” Senior Deputy Attorney General Michael Kovac said Thursday in a public hearing announcing the indictments. More than 20 fraudulent insurance claims were filed with more than a dozen providers, totaling around $500,000, the 40-page indictment alleges. At least one intentional crash sent an elderly couple to a hospital; in another, an 11-year-old child ...

Crusaders seek to stifle illegally owned Michigan med firms
September 17, 2017, Oakland County, MI -- The Michigan Radiological Society case against for-profit Oakland MRI and business owner Susan Swider is all about bringing attention to the state of Michigan's lack of enforcement of its corporate practice of medicine laws and shutting down an allegedly improperly incorporated medical business, according to the lawsuit filed last year against the Troy-based imaging center in Oakland County Circuit Court. Based on a variety of state statutes, the corporate practice of medicine doctrine was conceived to limit ownership of medical facilities to licensed physicians or legitimate nonprofit entities, according legal experts. There are exceptions for nonprofit hospitals and both nonprofit and ...