News

Homeowner in Ohio indicted for arson and insurance fraud
August 21, 2014, Toledo, OH -- A Toledo woman charged with setting fire to a near-downtown duplex she owned has been indicted on a new charge of insurance fraud for allegedly filing a false claim for damages. Dominique Ballard, 28, of 4313 Walker Ave. is accused of setting a fire Nov. 6, 2013, at a duplex at 626 South Ave. then filing a claim for belongings she reported had been lost in the fire. Prosecutors said firefighters said the two-story structure appeared to be vacant at the time. Charges of aggravated arson and arson are pending against Ms. Ballard, who has a pretrial hearing in that case and ...

Erie Insurance funds purchase of car for DA to help combat fraud
August 20, 2014, Erie, PA -- Erie Insurance Group donated $23,524 to the Erie County District Attorney's Office Tuesday to fund the purchase of a vehicle for the Erie County Detective division. The award, facilitated by the National Insurance Crime Bureau, was given in appreciation of the District Attorney's Office's efforts in the investigation and prosecution of insurance fraud cases throughout the county. District Attorney Jack Daneri said he was grateful for the gift. "We have had a good working relationship with Erie Insurance and had some good cases. We look forward to continuing that work," he said. David Rioux, of Erie Insurance's corporate security, and John McCall, a special ...

Woman in Ohio convicted of torching rental house for insurance money
August 20, 2014, Youngstown, OH -- A Youngstown, Ohio, woman has been convicted of setting fire to a rental property in order to collect insurance money, said Steven M. Dettelbach, United States Attorney for the Northern District of Ohio. Latasha Curtis, 33, was convicted on one count of conspiracy, one count of use of fire during the commission of a felony, and one count of maliciously damaging and destroying, and attempting to damage and destroy, by means of fire, real property used in interstate commerce and in activity affecting interstate commerce following a trial before U.S. District Judge Benita Pearson. Curtis and others conspired to commit arson of ...

Virginia to study extent of misclassification in workers compensation
August 20, 2014, Richmond, VA -- Virginia Gov. Terry McAuliffe recently signed an executive order establishing an inter-agency task force that will target worker misclassification and payroll fraud. “Every Virginian who works hard and follows the rules should get the pay and benefits that they deserve,” Gov. McAuliffe said in a statement on Aug. 15. “This executive order will begin a process to ensure that employers throughout the Commonwealth follow the same rules when it comes to benefits and pay for their employees.” The executive order states that the misclassification of employees as “independent contractors” undermines businesses that follow the law, deprives Virginia of millions of dollars in ...

Agent in N.C. accused of using client IDs for commissions scam
August 20, 2014, Mount Olive, NC -- A Mount Olive insurance agent is accused of using his clients’ personal information to get bigger commissions, authorities said Tuesday. The North Carolina Department of Insurance said Manargo Victor Boykin, 52, of the 600 block of N.C. Highway West, used driver’s license numbers and dates of birth from several clients to write auto insurance coverage for other clients so they could obtain better rates. Boykin, who worked for Sentry Insurance Company, received about $55,000 in commission from the fraudulent applications between 2010 and 2014, authorities said. Boykin was arrested Aug. 15 and charged with obtaining property by false pretense, six counts of corporate ...

14 Ohionans convicted of workers compensation fraud last month
August 20, 2014, Columbus, OH -- Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer announced today that 14 individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in July 2014. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID). “Our fraud investigators are located in offices around the state,” Buehrer said. “They’re constantly thinking of ways that claimants, medical providers and employers could defraud the workers’ compensation system. Their efforts to deter, detect and prosecute workers’ compensation fraud protect the State Insurance Fund, which pays for the care of workers who are injured ...

Home health worker in Michigan pleads guilty to aiding $22M Medicare scam
August 20, 2014, Detroit, MI -- A greater Detroit-area owner of three home health agencies pleaded guilty today for his role in a $22 million home health care fraud scheme. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office and Acting Special Agent in Charge Jarod Koopman of the Internal Revenue Service – Criminal Investigation (IRS-CI) ...

Two drug store employees in Maryland plead guilty to prescription fraud
August 20, 2014, Baltimore, MD -- Vipinkumar Patel (V. Patel), age 30, of Edgewood, Maryland; and Jigar Patel (J. Patel), age 27, of Columbia, Maryland, have each pleaded guilty to making false statements relating to health care matters in connection with a scheme to defraud Medicaid, Medicare and the Federal Employees Health Benefits Program by submitting false claims for prescription refills. Vipinkumar Patel pleaded guilty on August 19, 2014 and Jigar Patel pleaded guilty today. The guilty pleas were announced by United States Attorney for the District of Maryland Rod J. Rosenstein; Maryland Attorney General Douglas F. Gansler; Special Agent in Charge Stephen E. Vogt of the ...

38 charged in massive auto underwriting scam in New York and Mass.
August 20, 2014, Northhampton, MA -- Nearly 300 indictments have been handed up following an multi-state insurance fraud investigation. Mary Carey, spokesperson for the Northwestern District Attorney’s office, explains that grand juries in Hampshire and Franklin Counties handed up 289 indictments against 38 people following a year-long investigation. That investigation – conducted by the D.A.’s office, along with the Mass. State Police, Department of Homeland Security, and the Insurance Fraud Bureau – involved an alleged insurance fraud scheme that investigators believe spanned six years. Carey adds those allegedly involved with the scheme were were primarily from the New York City area, but insured and registered vehicles in Massachusetts, by ...

Burgaw woman faces insurance fraud charges
August 20, 2014, Burgaw, NC -- A Burgaw woman has been charged with insurance fraud and obtaining property by false pretense, according to a release from the N.C. Department of Insurance. Cyretta Page, 48, was arrested and charged Friday. Investigators believe Page submitted nine fraudulent claims saying her dependents received treatment from Burgaw-area medical providers, according to the release. Page received $1,125 from AFLAC for the claims, the release said, before the medical providers told the insurance company Page's dependents hadn't received care at their facilities. – Adam Wagner ...

Health care aide arrested on grand larceny charges
August 20, 2014, Rochester, NY -- A home health care aide is accused of receiving money from Medicaid for work she didn't do. Alicia Santiago faces two felony counts of grand larceny. The state Attorney General's office says Santiago fraudulently billed her employer for more than 180 hours of home care services for a relative from November 2012 to April 2013. Officials say during that time, Santiago was actually working as a certified nurse’s aide at Brighton Manor Nursing Home. The office estimates she received $1,800 in taxpayer money from Medicaid that shouldn't have gone to her. "There has to be one set of rules for everyone and that ...

Mental health clinic owner in Louisiana ordered to pay $44M in restitution
August 18, 2014, Baton Rouge, LA -- The Baton Rouge owner of three mental health centers was sentenced Monday (Aug. 18) in U.S. District Court in downtown Baton Rouge to pay $43.5 million in restitution and serve 8-and-a-half years in federal prison for a Medicare fraud scheme. Hoor Naz Jafri, 54, owned and operated two community mental health centers in Baton Rouge and one in Houston, a press release from U.S. Attorney Walt Green's office says. Seventeen people who worked at the facilities in a variety of roles have also been indicted the fraudulent operation that stretched seven years. During that time, the center billed Medicare for ...

Hospital chain in Arizona agrees to pay $35M to settle fraud charges
August 18, 2014, Tucson, AZ -- A Tucson health-care network accused of Medicare fraud has agreed to pay a $35 million settlement — the largest penalty of its kind in Arizona — and a whistle-blower who exposed the case will receive nearly $6 million of that sum. The Carondelet Health Network, which runs Tucson's St. Mary's and St. Joseph's hospitals, did not admit to wrongdoing but agreed to the payout to end a civil complaint from the Department of Justice and a Tucson woman named Jacqueline Bloink. According to settlement papers, from 2004 to 2011, the hospitals charged state and federal health-care agencies for inpatient rehabilitation services that ...

California agent charged with selling bogus business policies in Louisiana
August 18, 2014, Los Angeles, CA -- A Los Angeles, California man was arrested in New Orleans on Friday for selling fraudulent Workers Compensation and Employers Liability insurance policies throughout the state of Louisiana, announced Attorney General Buddy Caldwell. 50-year-old Terry Francis Savoy is charged with five counts of theft by means of fraudulent conduct, four counts of forgery, seven counts of forgery of certificates of insurance, and six counts of illegal transmission of monetary funds. The arrest comes as a result of a joint investigation involving the Attorney General’s Investigations Division, Orleans Parish District Attorney’s Office, Houma Police Department, Los Angeles County Sheriff’s Department Fraud and ...

Daughter of Joan Orie Melvin to enter ARD to settle insurance fraud charge
August 18, 2014, Pittsburgh, PA -- The daughter of former Pennsylvania Supreme Court Justice Joan Orie Melvin is expected to enter a program that will allow insurance fraud charges against her to ultimately be dismissed if she completes it successfully. Casey Melvin, 26, was charged after investigators said she lied about the date of an accident so it would be covered under her policy, which had lapsed because of nonpayment. She is scheduled to appear before Common Pleas Judge Robert Gallo on Sept. 5 to enter the Accelerated Rehabilitative Disposition program, which generally includes a set period of probation. Ms. Melvin crashed her car into a utility pole in ...

Seven steps to tackle fraud – the insurance industry takes a stand
August 18, 2014, London, none -- Let’s first put fraud into perspective with some staggering statistics before we venture into how the industry can solve this plague. According to the UK’s Insurance Fraud Bureau, in 2011, insurers uncovered 138,814 fraudulent general insurance claims or 2,670 every week. Even more problematic are the estimates that undetected general insurance claims fraud averages £2.1 billion annually, causing losses to the UK economy of at least £73 billion. General Insurance is the highest of detected fraud with more than 10 per cent of total claims being fraudulent, increasing incrementally by more than 25 per cent year on year. Insurance is ...

Car insurance premiums fall 5.6% in three months
August 18, 2014, London, none -- Efforts to reduce car insurance fraud have helped premiums fall by 5.6% in the second quarter of 2014, the British Insurance Brokers’ Association has revealed. In real terms, with inflation factored in, it means car insurance is 7.5% cheaper for consumers than it was a year ago. The AA says the average UK car insurance policy now costs £504, £120 less than a year ago. However, a big regional divide in car insurance premiums remains, the AA has revealed. Car insurance in London, the most expensive region in the country, is four times more expensive than that in the cheapest region, the Isle ...

75-year-old Danville man charged with Medicaid fraud
August 18, 2014, Danville, PA -- A borough man has admitted defrauding Medicaid of $1,400, saying he did that so his family could pay bills and buy food, according to court documents. David L. Albertson, 75, of 24 Montour St., was charged with Medicaid fraud by submitting false information, misrepresentation, conspiracy and theft by deception, according to Veronica S. Bowers, a special agent with the state attorney general’s office. According to charges filed in the office of Montour County District Judge Marvin Shrawder, David Albertson received direct care workers services from Jan. 22, 2012, through April 13, 2012, from his son Randy Albertson through Community Resources for ...

Man, 28, arrested and charged with arson, fraud
August 18, 2014, Torquay, none -- A 28-YEAR-old Torquay man has been arrested and charged with three counts of arson after a fire which tore through three stores on the night of June 22. Crime Investigation Branch officers executed a search warrant at the man's home on Monday morning. Detective Sergeant Mick Polit said police seized documents, steroids and pepper spray. Brown is in custody and is expected to appear in the Hervey Bay Magistrates Court on Tuesday. Det Sgt Polit said police also seized forensic evidence and evidence on his conduct prior to and after the fire. The man was charged with three counts of arson after fire gutted Auto ...

Wheelchair fraud: A Medicare scam that keeps rolling along
August 16, 2014, Washington, DC -- In the little office where they ran the scam, a cellphone would ring on Sonia Bonilla’s desk. That was the sound of good news: Somebody had found them a patient. When Bonilla answered the phone, one of the scam’s professional “patient recruiters” would read off the personal data of a senior citizen. Name. DOB. Medicare ID number. Bonilla would hang up and call Medicare, the enormous federal health-insurance program for those over 65. BREAKING POINTS: WHERE GOVERNMENT FALLS APART Fourth in a series examining the failures at the heart of troubled federal systems. She asked a single question: Had the government ever bought this patient ...

Insurance Fraud Arrest
August 16, 2014, Texoma, TX -- A Texoma man is behind bars after a 10-month investigation to insurance fraud. Law enforcement said, 47-year-old Shawn Chamber is facing criminal charges of insurance fraud and misapplication of fiduciary property. Chamber has been forced to surrender his insurance licenses. Chamber was arrested yesterday in Clay County on Thursday, but he posted bail on Friday. The investigation led to the identification of 25 victims and businesses. If you are a victim, call law enforcement. ...

Woman in Texas pleads guilty to staging automobile crashes
August 15, 2014, Port Arthur, TX -- A 32-year-old Port Arthur, Texas woman has pleaded guilty to federal violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales Thursday. Shawnta Rene Bell Jones pleaded guilty to conspiracy to commit mail fraud Thursday before U.S. Magistrate Judge Keith F. Giblin. According to information presented in court, from November 2006 to August 2013, Jones was involved in a conspiracy with others to defraud insurance providers and other businesses by staging automobile collisions and then submitting claims for property damage and personal injury by U.S. mail and other carriers. On Mar. 4, 2012, Jones and others staged ...

Medical supplier in California pleads guilty to massive Medicare scam
August 15, 2014, Los Angeles, CA -- The former owner of a Van Nuys medical clinic management company pleaded guilty Friday to a scheme defrauding Medicare of millions of dollars. Mihran “Mike” Meguerian, 37, of Glendale, pleaded guilty to one count of conspiracy to commit health care fraud. According to court documents, Meguerian admitted his business, Med Serve Management, wrote prescriptions for medically unnecessary power wheelchairs and other durable medical equipment and sold the prescriptions to supply companies knowing the prescriptions were fraudulent. From July 2008 and February 2009, the durable medical equipment companies submitted $3,367,661 in fraudulent claims to Medicare using fraudulent prescriptions from Meguerian’s clinics. Medicare paid $1,438,760 ...

Little oversight of Medicare contractors seen hampering anti-fraud efforts
August 15, 2014, Baltimore, MD -- The ordinary looking office building in a suburb of Baltimore gives no hint of the high-tech detective work going on inside. A $100 million system churns through complicated medical claims, searching for suspicious patterns and posting the findings on a giant screen. Hundreds of miles away in a strip mall north of Miami, more than 60 people — prosecutors, F.B.I. agents, health care investigators, paralegals and even a forensic nurse — sort through documents and telephone logs looking for evidence of fraudulent Medicare billing. A warehouse in the back holds fruits of their efforts: wheelchairs, boxes of knee braces and other ...

Agent from California charged with selling a thousand fake policies
August 15, 2014, Orange County, CA -- Jacob Richard Bonzer, 27, formerly of Lake Forest, California was arrested Wednesday (Aug. 13, 2014) in Chicago by the Chicago Police Department and a U.S. Marshals Task Force on 96 felony counts including grand theft, forgery and denial of benefits. If convicted, Bonzer faces a maximum sentence of more than 87 years in state prison. "Bonzer allegedly created more than a thousand insurance policies based on fraudulent information, which allowed him to collect $285,000 in unearned commission payments," said Insurance Commissioner Dave Jones. "Agents who violate their fiduciary responsibility and rip off insurers or consumers for their own financial gain will ...