Insurance Fraud NEWS
Jersey man impersonates doc in $74K disability scheme
April 09, 2019, Essex County, NJ
Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor today announced that an Essex County man was sentenced to three years in state prison for a scheme to obtain $74,000 in disability payments by submitting dozens of forged documents to his insurance provider.
Major Smith, 49, a former teacher in the East Orange school district, also must pay $70,248 in restitution in under the terms of a sentence handed down by Superior Court Judge Alfonse J. Cifelli in Essex County yesterday.
Smith, who pleaded guilty to second degree insurance fraud on October 29, 2018,
admitted filing more than two dozen claims for disability with American Family Life Assurance Company of Columbus (“Aflac”) that contained forms purportedly filled out by his doctors and/or his employer. Smith filed the allegedly fraudulent claims between February 2012 and October 2015 in connection with injuries he purportedly sustained in several accidents.
“The sentence handed down to this defendant sends a message of deterrence to individuals tempted to file fraudulent insurance claims to illegally enrich themselves,” said Attorney General Grewal. “Insurance fraud is not a path to easy money, it’s a path to prison which is exactly where this defendant is headed.”
“We’re calling on New Jersey residents to help stop insurance fraud by reporting those whose false claims drive up insurance costs for everyone,” said Acting Insurance Fraud Prosecutor Tracy M. Thompson. “By blowing the whistle on criminals like this defendant, honest policy holders can help hold the line on their own insurance costs.”
The OIFP investigation revealed that Smith, who was employed by the East Orange Board of Education until June 2012, impersonated his doctors in claim forms documenting treatments he purportedly received on various dates for injuries he allegedly sustained in several slip and fall accidents. Smith also pretended to be a representative of the East Orange Board of Education in claim forms verifying his employment in the district, even after he no longer worked there.
Deputy Attorney General Jennifer L. Menjivar represented the State at sentencing. Detectives Wendy Berg and Grace Proetta coordinated the investigation.
Acting Insurance Fraud Prosecutor Thompson noted that important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting the Web site at www.njinsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.
Source: New Jersey Office of the Attorney General