News

Agent steals $500,000 of premiums from Tennessee clients
May 23, 2017, Knoxville, TN -- The Tennessee Department of Commerce and Insurance (TDCI) has taken disciplinary action against Carey R. Carroll, Jr., a Knoxville-based former Tennessee insurance producer who was found to have violated multiple provisions of Tennessee law resulting in a $400,000 penalty and the revocation of his insurance producer license. After a hearing on Nov. 14, 2016, an administrative law judge issued an initial order which found that on multiple occasions between late 2010 and early 2013 Carroll improperly withheld and misappropriated over $500,000 in monthly premiums, annual renewal payments, and down payments on new policies he received in the course of performing his ...

Builder in New York allegedly seeks comp after accident
May 22, 2017, Brooklyn, NY -- The owner of a Bedford-Stuyvesant construction company and his businesses have been indicted on manslaughter and other charges after a wall collapsed at an excavation site, killing one construction worker and injuring two others. “Construction site deaths such as his are becoming all too common as builders ignore safety protocols and hire untrained workers to maximize profits,” said Acting Brooklyn District Attorney Eric Gonzalez in a statement. Gonzalez alleged in his statement that in this case, the builder went ahead with illicit excavation even after the New York City Department of Buildings (DOB) explicitly prohibited it. The District Attorney identified the defendants ...

New Yorkers urged to support contractor-fraud bills
May 22, 2017, Albany, NY -- Protect New Yorkers from storm-chasing roofers Write your legislator ... stop shoddy repairs & inflated claims Most roofers are honest ... yet too many crooked roofers prey on anxious homeowners and their insurers after storms. Stolen downpayments, inflated claims and shoddy repairs can cost trusting homeowners thousands of dollars. Homes can stay damaged for months — draining insurers after storms. Proposed legislation in Albany can stop dishonest roofers ... help us better protect trusting homeowners ... and save millions in false repair claims. Send a letter to your state legislators today. Urge them to vote “Yes” for these bills ...

Doc illegally charges for left-over meds in Missouri
May 22, 2017, St. Louis, MO -- Acting United States Attorney Carrie Costantin announced today that the United States, Sherry X. Ma, M.D., of Ladue, Missouri, and AIMA Neurology, LLC, reached a civil settlement that will resolve the United States= claims against Dr. Ma and AIMA Neurology under the False Claims Act for false Medicare billings related to Dr. Ma’s Botox® and Myobloc® injections. According to the United States’ allegations, Dr. Ma received vials of Botox® and Myobloc® at no charge that were supposed to be used for specific patients with private health insurance. After using a portion of the Botox® or Myobloc® on the specific patients, ...

People leap for lives to escape suspected Aussie store arson
May 22, 2017, Rozelle, -- APARTMENT residents were forced to leap for their lives from a balcony after a ground floor shopkeeper allegedly organised an arson attack on his business in a $1 million insurance scam, a court has heard. Up to 100 litres of petrol was allegedly used to cause a “vapour explosion” in the southwest Sydney supermarket, trapping residents in their apartments in circumstances frighteningly similar to the 2014 Rozelle fire which killed Bianka O’Brien her baby son Jude and neighbour, Chris Noble. Supermarket manager Josh Abraham and his co-accused Samer Ibrahim have pleaded not guilty to deliberately causing the fire at the Friendly Grocer ...

Ohioan works construction while taking in comp money
May 22, 2017, Marion, OH -- A Marion man who claimed to be permanently disabled owes the Ohio Bureau of Workers' Compensation (BWC) $160,000 after pleading guilty Wednesday to a fourth-degree felony charge of workers' compensation fraud. Appearing in a Franklin County courtroom, Jimmie Rankin, 45, was also sentenced to five years of community control for collecting BWC benefits after he had gone back to work in the construction industry and deliberately withheld that information from BWC. “We found Mr. Rankin working as a subcontractor and getting paid with cash and checks made out to other people so he could avoid a paper trail and stay beneath our ...

Illinois man burns farm equipment for insurance payday
May 22, 2017, Quincy, IL -- A Quincy man, convicted for his role in a fire that destroyed two pieces of farm equipment in 2014, has been sentenced to five months in federal prison. 53 year old Dean Mowen was in Federal District court in Springfield Monday, where he was sentenced to five months in federal prison, and three years' supervised release. The US Attorney's Office says that the first five months will be served as community confinement; then eight months of home confinement with electronic monitoring. Mowen was convicted in January on counts of mail fraud and conspiracy to commit mail fraud, for his involvement in ...

Florida couple steals sinkhole repair money, bilks home buyers
May 22, 2017, Tampa, FL -- Acting United States Attorney W. Stephen Muldrow announces that the United States Court of Appeals for the Eleventh Circuit has affirmed the convictions of Spring Hill residents Glenn and Kathryn Jasen. According to court documents, in 2009, the Jasens discovered a sinkhole beneath their home and filed a claim with their insurance carrier, Citizens Property. In compensation for their loss, Citizens paid them $153,745.37. Rather than using the money to repair the sinkhole, the Jansens kept it. The couple then made cosmetic repairs to the house and listed it for sale, keeping the sinkhole a secret from prospective buyers. A ...

Driver totals car in Washington, allegedly claims fake injury
May 22, 2017, Spokane, WA -- Dilan McCliggott, 39, of Idaho, failed to appear in Spokane County Superior Court to face charges of first-degree attempted theft and filing a false insurance claim, both felonies. The judge issued a bench warrant for his arrest on May 15 and bail is set for $10,000. McCliggott joins Insurance Commissioner Mike Kreidler’s insurance fraud most wanted. According to the investigation, McCliggott was driving a 2014 Dodge Challenger in Spokane that was insured by a family member. He hit a power pole, totaling the car. He then filed a claim on the car’s policy through Progressive for medical treatment expenses. Progressive ...

Medicare sending new cards, cons could surface
May 21, 2017, Washington, DC -- The Centers for Medicare and Medicaid Services (CMS) announced that it will be sending new Medicare Cards to more than 57 million enrollees over the next two years. With the passage of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 CMS is required to replace all cards that currently use a recipient’s Social Security Number with one that uses a new Medicare Beneficiary Identifier (MBI). This change was mandated by Congress to help protect citizens from identity theft and fraud. With these new security measures comes an opportunity for scammers to take advantage of unsuspecting Medicare recipients. If you are currently receiving ...

At-home caregiver being investigated in New Mexico
May 20, 2017, Albuquerque, NM -- Investigators with the New Mexico Attorney General's Office seized thousands of documents from an at-home caregiver business in Albuquerque this week. The business owners of Angel Touch Personal Care are under investigation for Medicaid fraud. The attorney general's office has been looking into Mina Sharifi and her partner Ali Reza Kazimi since 2014. The lead investigator believes Sharifi and Kazimi billed Medicaid for at-home caregiving even after their patients died. They are also accused of making money billing Medicaid for people who don't even need personal care. Investigators also found billing for people in hospice care at the hospital and billing based ...

Missouri lawmaker calls for prescription monitoring
May 20, 2017, St. Louis, MO -- U.S. Sen. Claire McCaskill has asked Missouri Gov. Eric Greitens to hold a special session of the state Legislature to pass legislation to create a prescription drug monitoring program (PDMP). Missouri is the only state in the country without a database. Should Gov. Greitens call a special session for a PDMP? Do you support legislation that would create a monitoring program? These questions were asked Thursday, May 18, at the Washington Public Library. Susan Brown, 70, Washington — “Oh my gosh, yes! We are the only state without this program and I think it’s very important. I think it would reduce the ...

Michigan doc gets 19 years for selling millions of painkillers
May 19, 2017, Farmington Hills, MI -- A Farmington Hills doctor was sentenced Thursday to 19 years in prison for participating in a conspiracies to distribute prescription pills and commit health care fraud, acting U.S. Attorney Daniel Lemisch announced. Adelfo Pamatmat, 71, was sentenced by U.S. District Judge Robert H. Cleland. Pamatmat and two co-defendants were found guilty after a seven-week jury trial. Pamatmat's involvement in both conspiracy to illegally distribute prescription drugs and conspiracy to commit health care fraud were felony charges. The United States Attorney's Office said the convictions arose from the operation of a fraudulent medical practice known as Compassionate Doctors. The medical practice purported to be ...

Cincy man says disabled, makes money doing tax returns
May 19, 2017, Cincinnati, OH -- A Cincinnati-area man who claimed to be permanently disabled from work while earning more than $100,000 preparing tax returns owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $57,000 in restitution. A judge ordered Fernando Cruz, of Maineville in Warren County, to pay BWC $2,000 up front, followed by payments of at least $150 a month, according to his May 12 sentence on a fifth-degree felony conviction for workers’ compensation fraud. “Mr. Cruz was supposed to be permanently and totally disabled from work, but we found evidence that he was working as a tax preparer from at least January 2011 through December ...

Washington driver files false injury claim after crash
May 19, 2017, King County, WA -- David Arnold Cook, 52, of Tacoma, pleaded guilty in King County Superior Court to a gross misdemeanor for filing a false insurance claim He was sentenced to four months of time he already served and to pay $500 in court costs. Cook was transferred to Pierce County Jail to face 13 felony charges in an unrelated case. Officials charged Cook with filing a false insurance claim after an investigation by Insurance Commissioner Mike Kreidler’s Criminal Investigations Unit (CIU). Cook and his nephew Anthony Jamal Scott, 38, of Kent, both filed injury claims after a collision with another driver in the parking ...

New Yorker burns home, kills friend for insurance
May 19, 2017, Steuben County, NY -- A Steuben County jury Friday afternoon convicted Joseph A. Meyers of first-degree murder, arson, conspiracy and lesser charges for the Feb. 15, 2016 fire death of 60-year-old David N. O’Dell in Wayland. The jury announced it had reached a verdict at 2:04 p.m. Meyers, eyes downward, listened stoically and shook his head once as the jury foreman announced verdicts of “guilty” to each count, including first and second-degree murder, two counts of arson, three counts of falsifying business records, attempted insurance fraud and conspiracy. The jury deliberated for about three hours, asking at one point to review text messages between Joseph ...

Arizona doc forges prescriptions for narcotics
May 18, 2017, Tucson, AR -- Attorney General Mark Brnovich announced Tucson podiatrist Dr. Loren Scott Wessel pleaded guilty to Forgery, a class four felony in Pima County Superior Court. This case stems from a joint investigation conducted by the Arizona Attorney General’s Office Health Care Fraud and Abuse Section and the Drug Enforcement Administration (DEA) Phoenix Division. In June of 2016, a veterinary supply company contacted the DEA after Dr. Wessel made a purchase of more than five thousand oxycodone tablets. Investigators quickly learned Dr. Wessel was filling forged prescriptions for narcotics at a Tucson pharmacy. DEA Agents and AZAG Special Agents determined Dr. ...

New York doc takes bribes in blood-test scam
May 18, 2017, Yonkers, NY -- An internal medicine doctor practicing in Yonkers, New York, today admitted taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced. Ricky J. Sayegh, 44, of Scarsdale, New York, pleaded guilty before U.S. District Judge Stanley R. Chesler in Newark federal court to an information charging him with accepting cash bribes in violation of the Federal Travel Act. According to documents filed in this case and statements made in court: Sayegh admitted accepting cash bribes in return for ...

California boots docs for illegal bribes, referrals
May 18, 2017, San Francisco, CA -- The Department of Industrial Relations (DIR) and its Division of Workers' Compensation (DWC) have suspended two more medical providers from participating in California's workers' compensation system. DWC Acting Administrative Director George Parisotto issued Orders of Suspension for the following providers, who had not appealed suspension notices issued in mid-April: • Michael R. Drobot operated California Pharmacy Management and Industrial Pharmacy Management, companies that participated in a scheme to illegally refer patients for spinal surgeries, which led to more than $580 million in fraudulent bills. He pled guilty in U.S. District Court last year to conspiracy and illegal kickback charges. He is ...

Homeowners urged to watch for Wisconsin contractors
May 18, 2017, Milwaukee, WI -- Storms pushed through on Monday, May 15th and again on Wednesday, May 17th — some of them strong-to-severe, and the storms left damage in their wake. Officials with the Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP) are asking homeowners to be alert, so as to not be taken advantage of by transient contractors, or so-called “storm chasers.” If you’re dealing with storm damage, you’re urged to seek trusted, local contractors for repair projects. “Already our agency is hearing from homeowners and law enforcement who have had contacts with out-of-state work crews canvassing neighborhoods in the aftermath of the recent storms,” ...

Hidden video catches suspected Florida disability cheats
May 18, 2017, Jacksonville, FL -- Lies and deceit by others can mean your hard earned money is being ripped right from your wallet. Florida's insurance fraud is mounting and you're paying for it. Everywhere from doctors' offices to our roadways, crooks are finding ways to make big bucks at your expense. The I-TEAM uncovered local cases that show how this growing problem is adding up to millions of stolen taxpayer dollars all across Florida. We obtained surveillance video from the US Department of Justice of Army veteran and Lake City resident Crystel Riedling at Disney World. Investigators says the 44-year-old lied to collect hundreds of thousands of ...

Ohio woman gets 10 years for bogus home healthcare
May 17, 2017, Cleveland Heights, OH -- A Cleveland Heights woman was sentenced to 10 years in prison for leading a $8 million healthcare fraud conspiracy in which participants provided forged documents and fraudulent forms to bill for services that were not provided, law enforcement officials said. Delores L. Knight, 71, was sentenced to a decade in prison and ordered to pay $8.1 million in restitution. She was one of four people sentenced Wednesday for their roles in a health care fraud conspiracy involving the company Just Like Familiee. Her son, Isaac R. Knight, 30, of Macedonia, was sentenced to more than seven years in prison and also ordered ...

Life agents allegedly steal IDs to buy coverage in California
May 17, 2017, Los Angeles, CA -- Two former insurance agents have been arrested and charged with multiple counts of theft and fraud in connection with a scheme to defraud nearly a dozen life insurers out of more than $300,000, authorities said. The two agents, Ali Kakande, 37, and Sulaiman Lutale, 35, living in Southern California, submitted about 70 fraudulent life insurance policy applications under another agent’s name before themselves becoming licensed in 2012, authorities said. The pair then submitted another 89 fraudulent life insurance applications between 2012 and 2014, authorities allege in a compliant. Both insurance agents had their licenses expire in 2014, records show. "I have zero tolerance for ...

Court steps on New York foot doc for plotting murder
May 17, 2017, Ramapo, NY -- Susan Bernstein said her husband was so driven to have her murdered that he was willing to kill his own daughter in the process. "Ira is evil," Bernstein said before her husband, Ira Bernstein, was sentenced today to five to 15 years in prison for plotting to kill her. Judge David Zuckerman sentenced Bernstein, a 43-year-old Ramapo podiatrist, as well as his lover and co-conspirator, 36-year-old Kelly Gribeluk, who got four to 12 years in prison. "You were cold and heartless," Zuckerman told Gribeluk before she was sentenced. Susan Bernstein spoke during a tense proceeding in which her family members and friends, police, and ...

Florida sober-home owner pimps addicts, gets 27 1/2 years
May 17, 2017, Palm Beach, FL -- They were sons and daughters who went to Kenneth Chatman’s sober homes when they were at rock bottom and finally, hopefully, ready to try to overcome their drug addictions. And in return, Chatman fed them illegal and prescription drugs to keep them vulnerable, prostituted the women to line his pockets, took bribes and kickbacks and raided their health insurance to pay for bogus treatments. He was sentenced Wednesday to 27 ½ years in federal prison and must register as a sex offender for being the ringleader of a massive fraud that abused people who were desperately trying to stop using drugs. Chatman, 46, ...