News

Florence DJJ Director arrested for insurance fraud
February 24, 2017, Lake City, SC -- The Florence Director of the Department of Juvenile Justice turned herself in to police Thursday morning in connection with filing a false insurance defrauding an insurance company out of thousands of dollars. The South Carolina Law Enforcement Division arrested Lacharda Burgess Green in connection with filing a false insurance claim following a 2016 car accident. The 36-year-old Lake City woman was charged with filing a false claim for insurance payment for a value more than $2000 but less than $10,000 and forgery of a value less than $10,000. This is a felony charge for Green who is facing up to five years in ...

North Carolina woman allegedly claims hit-and-run despite prior settlement
February 23, 2017, Guilford County, NC -- A Winston-Salem woman has been arrested on charges of insurance fraud. Ebony Phillips, 35, is charged with one count each of insurance fraud and attempting to obtain property by false pretense in Guilford County. Department of Insurance criminal investigators said Phillips provided false statements to support a claim at Safeco Insurance Company last August that the vehicle she was driving was involved in a hit-and-run accident. Investigators said Phillips previously settled a claim for the damages in February 2016. Phillips was arrested Feb. 10 in Davidson County by the Lexington Police Department and released under a written promise to appear in court. To report suspected ...

Woman allegedly claims prior water damage against policy in North Carolina
February 23, 2017, Orange County, NC -- Insurance Commissioner Mike Causey today announced the arrest of Tammi Nichole Chabot, 35, of 5001 Nicks Road, Mebane; she is charged with one count each of insurance fraud and attempting to obtain property by false pretense. Department of Insurance criminal investigators accuse Chabot of providing false statements to support a claim regarding the timing of the water damage to her residence with Homesite Insurance Company. Investigators allege Chabot activated water damage coverage after the damage occurred. Chabot was arrested on Feb. 8 in Orange County with assistance from the Orange County Sheriff’s Office and placed under a $5,000 bond. An estimated 10 cents ...

Cars scratched for inflated claims in plot by California body shop
February 23, 2017, Salinas, CA -- Two Salinas men have pleaded guilty to fraud charges related to their role in a “scratch out” scheme where a car is intentionally vandalized for insurance money. In 2015, investigators with the Multi-Agency Detail Commercial Auto Theft, the Monterey County District Attorney’s Office and the National Insurance Crime Bureau found that two auto repair facilities in Salinas were involved in the scheme. In a “scratch out” scheme, the owner or an associate fraudulently vandalizes the vehicle, and an insurance claim, often inflated, is filed for money to repair the damage. When the insurance company pays the claim, the money is shared between ...

California woman sets up U-Haul wreck to pay for prior damage
February 23, 2017, Sacramento, CA -- Paige Nolasco pled no contest to felony insurance fraud. The Honorable Laurel White sentenced Nolasco to 90 days in jail, 5 years formal probation and ordered her to pay $1,781 in restitution. On April 30, 2016, Paige Nolasco’s girlfriend rented a U-Haul truck and purchased insurance. Nolasco and her girlfriend intended to stage an accident and use the insurance money to repair Nolasco’s previously damaged car. The plan was for the girlfriend to run into Nolasco’s vehicle with the U-Haul and pretend they were strangers. The girlfriend backed out of the plan at the last minute. ...

Anesthesiologist sentenced for illegally prescribing oxycodone and other prescription painkillers
February 23, 2017, Atlanta, GA -- Dr. Romie Earl Roland has been sentenced to ten years, ten months for conspiring to distribute Schedule II controlled substances by illegally prescribing prescription painkillers for no legitimate medical purpose. Also indicted and sentenced for their respective roles in the operation of the pain clinic were seven other co-defendants: Anthony Licata, Charlyn Carter, Adrian Singletary, Dante Cummings, Anthony Ferguson, Danny Thompson and Joshua Gadd. Each co-defendant previously pleaded guilty and has been sentenced. “Physicians, like Roland, take an oath to do no harm, but he ignored his responsibility when he joined with a corrupt clinic owner to make money by ...

Fraud could push more people out of insurance market
February 22, 2017, Dublin, -- The founder of fast-food chain Supermacs has said if fraudulent claims persist in Ireland, more people will not be unable to afford insurance. It comes after Pat McDonagh posted a video, which he says shows two men staging a slip and fall in one of his outlets to get compensation. He told Newstalk Breakfast false claims are making a comeback. "It's a growing problem again - it had been a problem back 15 or 18 years ago and then we addressed it at the time and now it's growing again. But its not just the fraudulent claims increasing, it's the non-contesting of the awards ...

Car insurance fraud: What does 'fronting' mean and how can it affect you?
February 22, 2017, London, -- More than half of young drivers are willing to use the illegal practice of fronting to save money on car insurance, according to recent research. Fronting occurs when a driver chooses to cut the costs of another driver's car insurance - often their son or daughter. A driver does this by declaring themselves as the main driver in their place. Typically, the process is used by mums and dads, who have a car each, who buy their newly qualified son or daughter their first vehicle, but take out the policy in one of their names. But why do people do it? What are the ...

Three docs charged with Medicare scheme in Puerto Rico
February 22, 2017, San Juan, PR -- Federal officials in Puerto Rico say three doctors and the owner of a medical equipment company have been indicted in a $1.3 million Medicare fraud scheme. U.S. Attorney Rosa Emilia Rodriguez says the owner of Equipomed Care Corp. is accused of invoicing Medicare for equipment that people did not need or that he did not deliver. She said Wednesday that the doctors are accused of providing the company with prescription forms and Medicare documents for patients they had not seen or examined. The company owner was identified as Javier Siverio and the doctors as Dante Rodriguez, George Alcantara and Martha Nieves. It ...

Orlando contractor evades comp required for undocumented aliens
February 22, 2017, Orlando, FL -- U.S. District Judge Henry Lee Adams, Jr. has sentenced Orquidea Quezada (48, Orlando) to 18 months in federal prison for wire fraud and for operating as an unlicensed money transmitter. The Court ordered her to forfeit $136,886 in cash that was seized when she was arrested, $60,178.91 that was seized from her bank accounts, and a 2013 Honda Accord, valued at $11,500, that she had used while committing the offenses. The Court also entered a money judgment against Quezada in the amount of $584,435.09, representing the proceeds of the criminal conduct less the amount previously seized, and she was further ...

Virginia woman bills for phantom services for disabled son
February 22, 2017, Bristol, VA -- A Bristol woman admits to healthcare fraud involving her mentally and physically disabled son. Melissa Harr, 49, of Bristol, plead guilty to one count of conspiracy to commit healthcare fraud in federal court in Abingdon, Virginia. According to court documents, Melissa Harr, along with husband Bryan Harr Sr., 40, were submitting time sheets claiming that Deborah Branch, 64, assisted their child who suffers from disabilities, when in fact no services had been completed. The Harr’s and Branch collected more than $350,000 from Virginia Medicaid’s Department of Medical Assistance Services throughout a five year time period from January 2010 to September 2015. Bryan Harr ...

Buffalo man charged with stealing comp checks of girlfriend who died
February 22, 2017, Buffalo, NY -- New York State Inspector General Catherine Leahy Scott today announced the arrest of a City of Buffalo man who stole nearly $10,000 in Workers’ Compensation benefits meant for the woman he previously lived with and cared for but who had actually passed away two years earlier. Michael Barton, 57, of Buffalo, was charged today with Grand Larceny in the Third Degree, a felony. An investigation by Inspector General Leahy Scott found that Barton and an accomplice regularly cashed Workers’ Compensation benefit checks belonging to the woman he lived with and who passed away in July 2012. Nonetheless, Barton ...

No bail for Louisiana contractor accused of bilking homeowners
February 22, 2017, Baton Rouge, LA -- Twice-arrested contractor Matthew Morris of Baton Rouge was booked into the Livingston Parish Detention Center on Wednesday afternoon on 37 counts – including six felonies – involving post-flood contractor fraud. Total bail on 36 of those counts was $653,000, according to Detention Center booking records, but it was later changed to "no bail" for each charge. Morris, 39, owner of Complete Construction Contractors of Baton Rouge, had been arrested in Ascension Parish and East Baton Rouge Parish on fraud-related charges. The six felonies include five counts of misapplication of payments and one count of theft of assets of an aged/disabled person. The other charges ...

First Medicare fraud, now illegal Botox shots. Miami woman convicted of both
February 22, 2017, Miami, FL -- Gabriela Alegria was already headed to prison for Medicare fraud. Now, she’ll also be going for giving illegal Botox injections. The Miami woman pleaded guilty Wednesday to practicing medicine without a license and other felonies, and will be sentenced March 7. She faces at least one year in state prison. Alegria, a mother of two who was in school to be a nurse, last year pleaded guilty in Miami federal court to money laundering in a Medicare fraud case. She had been arrested in July in a scheme that is believed to have defrauded the government of more than $700,000. While she was ...

Doctor pleads guilty in sober home fraud, admits patients often used drugs in treatment
February 22, 2017, Wellington, FL -- Federal authorities on Wednesday identified a Wellington doctor as a defendant in a wide-ranging federal investigation into abuse inside some South Florida sober homes. Dr. Barry Gregory, 62, admitted he knew as many as 90 percent of the patients under his care continually tested positive for drugs while in treatment — and that his boss was “advising” them to do it — according to a plea agreement. Gregory pleaded guilty Thursday to conspiracy to commit health care fraud and knowingly falsifying a matter involving health care benefit programs. Defense attorney Valentin Rodriguez said Gregory surrendered himself to authorities. “He has accepted ...

Whiting man pleads guilty to social security fraud
February 22, 2017, Whiting, ME -- United States Attorney Thomas E. Delahanty II announced that Daniel Fitzsimmons, 54, of Whiting, Maine, pleaded guilty today in U.S. District Court to social security fraud. According to court records, the defendant began receiving Social Security Disability Insurance (“SSDI”) payments in 2002. SSDI benefits are paid by the Social Security Administration (“SSA”) to people with disabilities. From 2002 to 2013, the defendant and his dependents received over $157,000 in SSDI benefits. In order to obtain those benefits, the defendant was required to certify that he could no longer perform “substantial gainful work.” In numerous forms submitted to the SSA ...

Doctor pleads guilty to selling prescriptions of suboxone and klonopin
February 22, 2017, Philadelphia, PA -- Dr. Alan Summers, 78, of Ambler, PA, pleaded guilty to an indictment charging him in a scheme to sell commonly abused prescription drugs in exchange for cash payments. Dr. Summers pleaded guilty to conspiracy to distribute controlled substances, distribution of controlled substances, health care fraud, and money laundering, and was announced by Acting United States Attorney Louis D. Lappen, Drug Enforcement Administration Special Agent-in-Charge Gary Tuggle, and Special Agent-in-Charge Nick DiGiulio with Health and Human Services Office of Inspector General. Dr. Summers operated a medical clinic on South Broad Street in Philadelphia, and sometimes operated under the business name “NASAPT” (National ...

Fraud fighters to meet in New York for briefings from top officials
February 21, 2017, New York, NY -- Insurance investigators throughout New York State will gather next month to discuss strategies and hear from top regulators and other officials about fraud trends affecting the Empire State. The annual meeting of the New York Alliance Against Insurance Fraud also will include a preview of new television and radio advertising campaign to create greater awareness about fraud. The agenda for the March 8 program includes a briefing from the state's workers compensation fraud inspector general of New York's workers compensation. imageA representative from the N.Y. Department of Financial Services fraud bureau also will be on hand to discuss anti-fraud efforts ...

Bill would require Fla. insurers to submit fraud plans to state
February 21, 2017, St. Petersburg, FL -- St. Petersburg Republican Sen. Jeff Brandes filed a bill that would strengthen the state’s ability to fight insurance fraud. “Insurance fraud in Florida is evolving, and policyholders are forced to pay for it through higher premiums every year,” Brandes said. “This is a hidden tax on every Floridian who drives a car, owns a home, rents an apartment, or pays for health insurance.” In a Friday press release, Brandes noted that fraud cases can account for up to 10 percent of an insurance company’s yearly losses. SB 1012 would require insurers to develop and submit anti-fraud plans to the Division of Investigative and ...

New Jersey cop, sister admit defrauding health insurer
February 21, 2017, Asbury, NJ -- A suspended Asbury Park Police Department officer and his sister admitted Tuesday to committing insurance fraud, the Monmouth County Prosecutor said. Alix Antoine, 38, a 12-year veteran with the Asbury Park Police Department, and his 44-year-old sister, Patricia Louis -- also known as Patricia Antoine -- pleaded guilty to third-degree insurance fraud before Monmouth County Superior Court Judge Leslie-Ann Justus, said Prosecutor Christopher Gramiccioni in a statement released Tuesday. The duo committed the fraud on behalf of Louis and her son, Gramiccioni said. The siblings agreed to pay $189,645.84 back to insurance company Horizon Blue Cross Blue Shield in restitution, Gramiccioni said. Justus ...

Pittsburgh-area chiro works at pain clinic that illegally deals in opioids
February 21, 2017, Belle Vernon, PA -- A Belle Vernon chiropractor was sentenced Tuesday to serve seven years on probation for working at a Rostraver pain clinic that investigators said illegally gave prescriptions to patients. Jack Taylor Jr., 63, pleaded guilty last year to insurance fraud for continuing to receive state disability benefits after he returned to work at the clinic following a 2010 motorcycle crash. Judge Christopher Feliciani placed Taylor on probation and ordered him to pay $450,000 in restitution to the clinic's insurance carrier and the state. The judge said Taylor will be permitted to travel within the country for business purposes in the hope that he can ...

Deputy does CrossFit, collects workers comp in California
February 21, 2017, Orange County, CA -- A former Orange County sheriff’s deputy was sentenced to six months in jail and three years of probation on Tuesday for insurance fraud after engaging in heavy CrossFit exercises while collecting compensation for work-related injuries. Nicholas Zappas, 36, of Laguna Niguel pleaded guilty to six misdemeanor counts of insurance fraud, the Orange County District Attorney’s Office said. In addition to jail and probation, he must pay $34,838 in restitution to the county and also $1,000 to the Worker’s Compensation Fraud Assessment Fund, prosecutors said. Prosecutors said Zappas, a 14-year Sheriff’s Department veteran, was working in the Harbor Patrol division in April 2015 ...

Home repair fraud arrest in Baldwin County
February 21, 2017, Gulf Shores, AL -- Gulf Shores Police say a home repairman from Tennessee stole thousands from property owners in Gulf Shores and Orange Beach. Curtis Rowland was charged with home repair fraud and two counts of theft of property. Detectives say Rowland took down-payment cash fromhomeowners to install plantation shutters shobut neverwed up to do the workL. egitimate contractors say customers should always get references before hiring a contractor, check with the Better Business Bureau for complaints and ask to see the contractor’s business license and proof of insurance. Police say Rowland is also under investigation for home repair fraud in Florida. Additional charges are ...

Former OCSD deputy convicted and sentenced to six months in jail for committing insurance fraud
February 21, 2017, Orange County, CA -- A former Orange County Sheriff’s Department (OCSD) deputy was convicted and sentenced to six months in Orange County jail and three years informal probation today on charges for committing insurance fraud by failing to disclose his true physical abilities and activities to his health care providers. Nicholas Zappas, 36, Laguna Niguel, pleaded guilty to six misdemeanor counts of insurance fraud. In addition to his jail time and probation, Zappas was ordered to pay $34,838.97 in restitution to the County and $1,000 to the Worker’s Compensation Fraud Assessment Fund. The defendant is also required to dismiss his 2011 and 2015 worker’s ...

Police: 2 senior citizens targeted in Medicare phone scam in Virginia
February 21, 2017, Frederickburg, VA -- Two senior citizens received suspicious phone calls from "Medicare representatives" asking them to validate their account information in Fredericksburg, Virginia. Police say the two calls targeted the victims who have Medicare insurance and get their prescription medicine in the mail. Fredericksburg Police are asking anyone who may have received similar calls to contact 540-373-3122. ...