Prosecutor of the Year
Combating insurance fraud requires a team effort that often culminates with the prosecutor's effort and skill. Often months or even years of intensive investigative work hang in the balance once a fraud case reaches the courtroom. A prosecutor's remarkable legal skills, persistence and ability to make often-complex cases seem clear and understandable are critical to earning fraud convictions.
The Prosecutor of the Year award is the only national award focusing solely on achievements in prosecuting insurance fraud. In bestowing this singular honor, the Coalition recognizes prosecutors whose remarkable efforts contribute immensely to combating insurance fraud and helping keep America safer from this crime.
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2017: SHADDI KAMIABIPOURMajor medical fraud rings are looking over their shoulders at prosecutor Shaddi Kamiabipour, who has stopped more than $500 million of workers-compensation medical scams throughout California in just the last year.
Kamiabipour is pursuing many of California’s largest complex workers-comp medical rings as senior deputy DA for Orange County. Her high impact has earned her the Prosecutor of the Year Award from the Coalition Against Insurance Fraud.
Medical scams against workers-comp insurers are a significant crime wave in California. The scams amount to $4 billion a year, state officials say. Doctors, attorneys, chiropractors, testing labs, billing services, pharmacies and others collude to over-bill workers-compensation insurers — often tens of millions of dollars at a time.
Kamiabipour is one of the nation’s pre-eminent prosecutors of these medical crime rings. Her convictions and charges have forced scammers and suspects out of business around the state.
A workers-compensation ring falsely billed insurers more than $70 million this year. The scammers charged for machines that worked as ice packs or heating pads to reduce pain and inflammation. Many employees didn’t even need the machines and had no idea how they worked. Kamiabipour convicted the ringleaders.
A baby died from a suspected scam by another major ring trafficking in criminally toxic compound creams falsely billed to workers compensation insurers, Kamiabipour charges. A mother took a compound cream for her injured knee. She made a bottle for her newborn baby with a tiny amount of the cream still on her hands. The baby died from contact with the toxic medicine, the coroner determined.
Some 22 doctors are defending their medical practices against charges in yet another suspected $40-million ruse involving useless and overpriced compound creams.
Kamiabipour already has convicted a leading doctor in that ring. More suspects stand charged. The alleged ring has hired 30 defense attorneys from large law firms. Kamiabipour is prosecuting with one investigator and a small support staff. Even so, she has assembled 20,000 trial exhibits.
Kamiabipour also supports the anti-fraud community. She speaks at conferences around the state, and nationally. She also advises insurers how to spot the warning signs of a major medical scam.
2016: LAURA URIARTE
Why did the same singed furniture keep appearing in large insurance claims for different rented homes that suspiciously caught fire? Why were closets stuffed full of sweaters in South Florida, of all places?
Strange. Such clues helped Miami-Dade Assistant State Attorney Laura Uriarte build airtight cases that shut down five of the largest insurance-arson rings in Florida history — halting an eye-opening $22-million insurance-fraud crime wave.
Uriarte was named Prosecutor of the Year by the Coalition Against Insurance Fraud.
Widespread fraud rings torched dozens of homes throughout South Florida — reinforcing the region as a hotbed of insurance scams.
At least 75 ring members pleaded guilty and more plea deals are expected. Uriarte was a lead member of state crackdowns coded Operation Candle Light, Operation Flames & Floods 1 & 2, and Operation Pro-Con.
Uriarte embedded herself with the task forces investigating the rings. Her steady legal guidance helped ensure investigators developed thorough evidence that meant certain convictions of ring members once she took them to court.
Uriarte also brandished state racketeering charges — which can carry long sentences.
Most ring members quickly pleaded guilty. They couldn’t contest the detailed evidence Uriarte helped develop. Potential racketeering sentences added an incentive to plead guilty for shorter sentences.
Corrupt public adjusters led the insurance-fraud rings. The adjusters exploited the insurance system to rubberstamp false claims for payment. The adjusters typically rented homes, often large ones. They recruited associates as straw renters on the insurance policies.
Fraud rings often filled homes with inexpensive old furniture and clothes. Many falsely blamed candles for starting home fires. The sham renters made inflated claims for the junk possessions. The same furniture, often burned, was recycled for other setup home fires. Closets sometimes were filled with sweaters, strangely, in a region known for year-around heat.
Some probes are ongoing. Multiple agencies have been involved including the Miami-Dade Police Department, State Fire Marshal, State CFO and the Miami-Dade State Attorney’s Office.
Home insurance arsons have fallen significantly in South Florida. Some would-be arsonists have fled the state rather than face prosecution and certain convictions, Uriarte says.
2015: LINDA MONTAG
Pedestrians kept saying they tripped and painfully hurt themselves on the sidewalks of a Philadelphia neighborhood.
Injury claims against the homeowners’ policies mounted suspiciously. Tips from concerned neighbors help jumpstart an investigation that revealed a $400,000 slip-and-fall ring. Dismantling one of the largest insurance-fraud schemes in Philadelphia history earned Linda Montag the 2015 Prosecutor of the Year award from the Coalition Against Insurance Fraud.
The Pennsylvania Insurance Fraud Prevention Authority nominated Montag, who’s a Philadelphia Assistant District Attorney.
The fraud ring was led by attorney Andrew Gaber. He was a sole practitioner who shot himself instead of facing certain conviction.
Gaber hired a small army of recruiters to bring him people he paid to act as phony injury victims. Many were homeless or drug addicts.
The phony victims were coached how to stage a seemingly painful fall, and act injured. The fake victims often pretended to trip on small cracks in neighborhood sidewalks. Gaber’s recruiters acted as witnesses and “injured” victims.
Gaber then filed false injury claims against the homeowner policies. The scam lasted seven years and bilked 21 insurance companies.
Montag worked closely with investigators from the Philadelphia District Attorney’s insurance-fraud unit to build the case for a grand jury. The investigation took two painstaking years.
The effort paid off. Some 47 ring members were charged. Gaber, his runners and fake injury victims were included.
Searches of bank transactions and Gaber’s files revealed crucial evidence. Secretly recorded conversations by ring members and Gaber were highly incriminating. Insurers and the National Insurance Crime Bureau provided case referrals that proved vital to exposing the fraud ring’s inner workings.
Montag assembled more than 350 exhibits for the grand jury. Dozens of witnesses testified. Grants of immunity gave many ring members an incentive to testify against other ring members.
The case was so complete that Gaber committed suicide before his trial began. Most remaining ring members pleaded guilty instead of heading to conviction and longer sentences.
Montag obtained $250,000 in restitution from Gaber’s law practice. Ring members were ordered to pay another $60,815 plus nearly $40,000 in penalties.
Award of Merit: Steven Gagne
Breaking open an automobile-premium evasion ring earned Massachusetts prosecutor Steven Gagne the Award of Merit.
Gagne’s an Assistant DA for the Northwestern District of Massachusetts. Helen Chen ran a large fraud ring that helped New York drivers register their vehicles in Massachusetts to illegally lower their auto premiums.
Gagne led the dismantling of Chen’s ring and her conviction. He partnered with the Massachusetts fraud bureau plus fraud fighters in New York in this effort.
2014: CYNTHIA KOWERT & CRYSTAL LITTRELL
A serial insurance thief faked injuries from minor crashes she set up to steal more than $275,000 worth of insurance money until two Colorado state prosecutors derailed her nearly 20-year crime spree with a fraud conviction.
Their hard-fought jury conviction, superior preparation and creative legal arguments earned Cynthia Kowert and Crystal Littrell the Prosecutor of the Year Award from the Coalition Against Insurance Fraud.
“Staged crashes raise auto premiums for honest drivers and place innocent motorists at risk. These prosecutors’ courtroom excellence made Colorado’s roadways safer and turned costly auto scams into an expressway straight to jail,” said Coalition executive director Dennis Jay.
The award honors distinction with insurance-fraud prosecutions. It stands as a model of best practices in courtroom skill that contributes materially to the fight against insurance fraud. The Coalition is a nonprofit alliance of consumer groups, insurers and government agencies combatting insurance fraud.
“...These prosecutors’ courtroom excellence made Colorado’s roadways safer and turned costly auto scams into an expressway straight to jail,” said Coalition executive director Dennis Jay.
Kowert and Littrell are prosecutors with the Colorado Attorney General’s office. They assembled a complex evidence into a clearly understandable case.
Briana Nguyen made 25 suspect claims for crashes that bilked auto insurers beginning in 1995. She typically jammed on her brakes, forcing drivers to rear-end her car. The damage usually was minor and the impact slight. Even so, Nguyen lied to auto insurers that she had painful injuries to her back neck, shoulders and other areas of her body. Soft-tissue injuries typically are difficult to medically challenge.
Many of Nguyen’s claims were identical. She often recycled the same small dents for prior crashes and claimed the same injuries. Nguyen used her young daughter as a passenger, once claiming the child suffered partial paralysis. She used them as passengers in setup wrecks and falsely claimed they were injured. Nguyen also used aliases to avoid detection.
Nguyen often highly exaggerated her “injuries.” After one small vehicle bump, she falsely claimed “pins and needles” in her arms, shortness of breath, nervousness, loss of taste, depression, insomnia, nausea, and inability to care for her children or drive to the store for groceries.
Nguyen made 53 insurer-paid visits to one doctor after another setup wreck. She also claimed extensive lost wages for a job at a fast-food restaurant. Yet Nguyen only worked there for one day cutting potatoes, and forged the manager’s signature to wage forms.
Kowert and Littrell meticulously in built a case that revealed Nguyen’s lengthy pattern of defrauding numerous auto insurers. At least 80 witnesses testified. Some 80,000 pages of evidence were assembled and 182 exhibits used. Kowert and Littrell worked deep into the evening and on weekends assembling and prosecuting the complex case.
Kowert and Littrelll were well-prepared. They won most of the dozens of Nguyen’s stalling motions. The prosecutors also won the objections Nguyen made for every witness the pair called to testify. They overcame the court’s excluding critical medical evidence as well.
The prosecutors also used creative legal arguments when Nguyen contended the statute of limitations prevented prosecuting of claims. The statute of limitations should run from the date the false claims were discovered, not when the claims were made, Kowert and Littrell successfully countered.
Nguyen was convicted of 21 felonies, and sentenced to 90 days of jail and restitution.
Kowert and Littrell credit the auto insurers, their own trial team and the National Insurance Crime Bureau. The Coalition, in turn, credits Kowert and Littrell with courtroom excellence that derailed a serial insurance scammer and made the roadways of Colorado safer.
2013: ANN MARIE VILLAFAÑA
Breaking up a major staged-crash ring with ringleaders ordered to repay more than $18 million has earned South Florida federal prosecutor Ann Marie Villafaña the Prsecutor of the Year Award by the Coalition Against Insurance Fraud.
Villafaña is an Assistant U.S. Attorney for the Southern District of Florida. She led a federal-state team that has charged 101 suspected insurance-fraud ring members as personally charged 57 individuals as the lead prosecutor for a highly publicized investigation called Operation Sledgehammer. Her ensuing convictions have earned ring members a collective 143 years in prison, with more prosecutions underway.
"Drivers in South Florida should be relieved. Breaking up a significant no-fault crash ring has made the roads of Palm Beach County safer. Marie Villafaña has stemmed a large-scale insurance theft that helped make no-fault premiums among the highest in America,” said Dennis Jay, executive director of the Coalition. Villafaña received her award recently in a ceremony at the Coalition’s annual member meeting in Washington, D.C.
Remarkably, this was Villafaña’s first no-fault takedown, let alone a major staged-crash ring. She normally prosecutes other crimes such as human rights violations.
Villafaña thus had to learn about no-fault and insurance fraud from scratch, and under pressure. Still, she built a large volume of complex evidence into cases that were so convincing that dozens of ring members pleaded guilty rather than face her in court. Villafaña managed the evidence, testimony and other logistics involving numerous agencies. The case was so important that dozens of federal, state and local agencies took part in the investigation. Among the players were the state Department of Insurance Fraud, a multi-agency Palm Beach task force, the FBI, U.S. Internal Revenue Service, U.S. Department of Defense, and National Insurance Crime Bureau.
The fraud conspiracy staged car wrecks throughout Palm Beach County. Street-level ring members maneuvered innocent motorists into crashes. Ring members also lightly bumped their own cars into each other at low speed. Often they banged their cars with sledgehammers to clumsily mimic crash damage. Hence Operation Sledgehammer.
Bogus car passengers then lied to insurers that they received painful whiplash injuries.
Chiropractors and other medical providers charged no-fault auto insurers millions of dollars worth of useless or phantom treatment. Most treatments were cookie-cutter duplicates.
Several ring members, including Ana Ovando, even used their children as crash passengers, endangering them on the roads. Ovando received 6½ years in federal prison. The Coalition Against Insurance Fraud is a nonprofit alliance of consumer groups, insurance companies and government agencies combatting all forms of insurance fraud.
2012: WENDY DERZAPH
This award winner is a deputy district attorney for Los Angeles. Her challenge as lead prosecutor was to dismantle a complex organized crime ring that was a vast international spiderweb of theft and deceit.
The ring set up headquarters in Dubai. The suspects came from around the planet. They were Palestinians, Iranians, Germans, Filipinos, Mexicans and Armenians. The crime ring took aim at the U.S. They defrauded seventy insurers, and the target was workers compensation money.
The ring made more than eleven million dollars in false claims for phantom diagnostic testing of phony injuries. The gang set up a large network of 19 sham clinics. The clinics were little more than Post Office boxes or empty storefronts. The medical identities of thousands of people were stolen to provide names for illegal billing of insurance companies. Doctors’ identities were stolen, and used to create false medical reports.
Bogus check-cashing firms were set up to help launder the insurance money through Dubai, Armenia and the Philippines. But the award winner went after this ring with force and precision. As lead prosecutor, she put together a thorough and rock-hard case for prosecution. Many thousands of pieces of evidence had to be carefully fitted together. She coordinated the efforts of more than a thousand law enforcement personnel. And she studied hundreds of surveillance videos to identify the crime ring’s recruiters and kingpins. The winner also reviewed nearly a thousand recorded interviews, including people who were victimized.
The stolen insurance money was carefully traced through the criminal underworld overseas. Just dealing with the insurance checks was a daunting project. She had to make sense out of a dozen boxes of checks! But with her courtroom game plan firmly in place, the award winner went after six gang members who were in custody. She charged them and several fugitives with fifty-five crimes.
Her case was so airtight and overpowering that the all six pleaded guilty. Facing her in cthet would’ve been pointless. Just as important, the winner made each of the gang members liable for nearly five million-dollars that were actually paid out. This dangerous crime ring was left in smoldering ashes. The positive aftermath is still being felt.
The insurance industry saved untold millions of dollars in continued losses. And thousands of innocent victims of medical identity theft were saved from being exploited further. These convictions also led to the founding of a major task force in Los Angeles to go after organized crime.
2011: KYSON JOHNSON
Kyson Johnson, the state's only dedicated insurance fraud prosecutor, has been named 2011 Prosecutor of the Year by the Coalition Against Insurance Fraud. Johnson received the award in ceremonies held today in Washington, D.C.
Johnson was honored for his successful record in prosecuting criminals involved with various forms of insurance fraud including staged car accidents, owner give up schemes, arson and theft of premiums. During his seven years as Special Prosecutor in the Dallas County District Attorney's Office, Johnson has prosecuted more than 250 cases of insurance fraud that have resulted in $250,000 in fines and $7 million in restitution.
2010: JOSEPH LICANDRO
Credited with prosecuting 77 cases worth more than $2.5 million. He helped take down an auto glass company that filed nearly 1,000 bogus claims. He also was cited him for his collaborative efforts in reaching out to other state agencies, federal law enforcement and insurers to investigate and prosecute fraud cases. As a result of his success, Joe is sharing his ideas and techniques with other state prosecutors to have a greater impact on curbing fraud in the Sunshine State.
2009: MARY LOWENBURG
Using innovative tactics to bust large staged- accident rings, chop shops and other major insurance cons has earned Queens County (N.Y.) assistant DA Mary Lowenberg the Coalition’s Prosecutor of the Year award. In one case, Ms. Lowenberg indicted 61 members of a staged-crash ring and medical mill that had bilked insurers out of millions of dollars in bogus injury claims. The ring had targeted Asian drivers, and Lowenberg took down key ring members by innovatively charging them with hate crimes. She also attached more than a million dollars worth of the insurers, according to the award presentation. Ms. Lowenberg also prosecuted yet another 61 members of a vehicle giveup ring. More than 70 vehicles were recovered that were falsely reported stolen. The total insurance payout would’ve been at least $1.7 million. In addition, she successfully prosecuted a large medical mill operating in New York City.
2008: ALBERT H. MACKENZIE
MacKenzie’s program earned 15 convictions in fiscal year 2007 involving swindlers who made more than $20 million in bogus claims. His conviction rate was 100 percent. He also has opened investigations of, or has identified, more than 200 other suspects who’ve made at least $300 million in bogus claims in health, auto and workers compensation insurance.