Fools garden claimed?

Insurance fraud has become big business in the recession. Insurers are currently getting more than 2,000 false claims a week while around 107,000 claims worth 730m were discovered to be false last year, according to the Association of British Insurers. That was a leap of 30 per cent in value over 2007.

Let's be honest about this, the figures don't suggest that an army of fraudsters has sprung up to rip-off the big insurance companies. No, the reality is that false claims come from normal folk like you and me. And as money gets tighter as the recession bites the temptation will grow to add a little extra to a claim, or even make up a fictitious accident or theft.

Insurers know that policyholders are more likely to be creative with claims in a recession. Roy Hebburn, claims manager at Allianz, told me: "The number of fraudulent claims increases as people struggle to cope financially. People fail to acknowledge that committing insurance fraud is a serious offence."

It's easy to pretend that there are no victims of insurance fraud, only the faceless insurance companies. But we all lose out by having to stump up for more expensive premiums. And people who do put in fraudulent claims are breaking the law. Worringly, research by the ABI shows one in five people would consider making a fraudulent insurance claim in the future, despite the threat of a criminal conviction. To my mind, anyone taking that risk is a fool.

Which brings me nicely to the Chancellor of the Exchequer, Alistair Darling, above, who will be announcing this year's Budget next Wednesday. I've been awash with Budget predictions and wish-lists for some time, but there's very little anticipation of good news for struggling families this year.

However, there are a couple of simple actions Darling could do which would be cheered by millions. For starters he could help the stagnant housing market by switching the onus for Stamp Duty from the buyer to the seller. This wouldn't cost the Treasury a penny but would save first-time buyers from having to pay the tax, encouraging many to move ahead with buying plans.

Then he could encourage savers by increasing the amount they can stash away tax-free each year in an Individual Savings Account. "The Chancellor should increase the amount of annual investment in an ISA to 12,000 with half being in cash," suggested Andrew Jupp, head of tax at Tenon Group. "With rates of return on most savings being so low at the moment, there needs to be a real incentive for people to save. Permitting half of the investment to be in cash will allow people easy access to their savings if they need it in the future," he said.

It's a dead cert that Darling won't adopt either of those suggestions. Instead he's likely to bring bad news in the form of increased personal taxation. "We are likely to see a dramatic hike in taxes," warns George Bull, head of tax at Baker Tilley. "The Irish have already proposed dramatic tax increases for middle-earners in their Budget. We must now wait to see whether our own Chancellor will follow suit, perhaps announcing new higher rates of tax or accelerating the increase to 45 per cent already in the pipeline."

Oh joy!

s.read@independent.co.uk

Lower Burrell office manager to pat $12 Million For Fraud Case

The former office manager for the chiropractor who admitted masterminding a massive health insurance fraud case was sentenced Friday and ordered to pay more than $12 million restitution.

Kendra Huddleston, 42, who worked at Burrell Chiropractic Clinic in Westmoreland County, also was sentenced by U.S. District Judge Gary L. Lancaster to serve two years in prison for her conviction of helping to defraud Highmark Blue Cross/Blue Shield between 1995 and 2002.

Prosecutors said Huddleston supervised billing and submitted the false claims at the direction of her boss, Dr. Douglas Henderson. She also recruited patients for the scheme by offering them financial kickbacks as high as $70,000, prosecutors said.

Lancaster, who ordered Huddleston to pay $12.1 million in restitution, acknowledged that Huddleston's guilty plea and cooperation with prosecutors was important.

However, he also said that he believed a jail sentence was required because of the magnitude and venality of the scheme.

Huddleston, the mother of a 6-year-old who now lives in Littleton, N.C., is a former resident of Lower Burrell.

Henderson, 47, of Lower Burrell admitted masterminding what investigators said is the largest health insurance fraud case every prosecuted in Western Pennsylvania.

Investigators said he devised the complex scheme that involved 31 conspirators and insurance billings in excess of $21 million.

Thirteen other conspirators have been prosecuted. Three received prison sentences and the others probation. They also were ordered to make varying amounts of restitution.

In December, Lancaster sentenced Henderson to four years in prison and pay $12.1 million in restitution.

http://www.pittsburghlive.com

Reno Music Pleaded Guilty For Insurance Fraud

The owner of a Reno music store pleaded guilty Tuesday to staging a burglary and submitting forged documents to collect a hefty insurance settlement.
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Thomas Lee Deatherage, 45, faces up to eight years in prison after pleading guilty in Washoe District Court to insurance fraud and forgery. A July sentencing was scheduled. He remains free on bail while awaiting a June trial in federal court in Reno.

In the federal case, he is charged with multiple counts of bank fraud and aggravated identity theft for using his father's identity to obtain a $100,000 commercial bank loan.

Court records show that in October 2005, Deatherage filed for Chapter 11 bankruptcy and, months earlier, received about $200,000 from insurance claims for his business, Winchester Music, which he later named Western Music Sales and High Sierra Music Co., 148 Plumb Lane.

The Nevada attorney general's staff said restitution was set at $150,000. Court documents show victims claimed Deatherage stole about $280,000.

Deatherage pleaded guilty to fraudulently reporting to the Hartford Insurance Co. that someone in May 2006 had burglarized his storage facility in Sparks and stole a 50-inch plasma screen television, a computer laptop and musical instruments valued at nearly $100,000. He then created false invoices and receipts for the stolen property.

Months before he made the claim, the insurance company paid him more than $73,000 after he said someone burglarized his

store.

At the time, he reported the storage unit burglary, he had defaulted on commercial bank loans, was going through bankruptcy and the bank had seized many instruments that had been collateral for his loans, records show.

Other claims made against Deatherage in a criminal complaint included creating fake inventory, hiding inventory, paying maintenance workers to not make repairs on his store, creating phony receipts for merchandise he didn't have and generating false payroll records to show a higher loss to the insurance company.

http://www.rgj.com/

Fighting Fraud Crime Is A Priority - FBI

The Federal Bureau of Investigation pursued 529 financial crime cases in its most recent fiscal year, including 209 insurance fraud cases.

During it fiscal year 2007, the 209 insurance fraud cases investigated by the FBI resulted in 39 indictments and 47 convictions. The FBI says it realized $27.2 million in restitutions and $427,000 in fines from its insurance investigations.

The FBI said it expects the number of cases and subsequent arrest and conviction statistics to rise in the near future as more fraud is uncovered in the wake of Hurricane Katrina.

The insurance fraud cases are included in the FBI's Financial Crimes Report to the Public, Fiscal Year 2007. The report discusses corporate fraud, securities and commodities fraud, health care fraud, mortgage fraud, insurance fraud, mass marketing fraud, and asset forfeiture/money laundering.

"Financial crimes affect the economic security of millions of Americans, and the FBI is dedicated to working with our partners in industry and law enforcement to combat these offenses,"; said Assistant Director Kenneth W. Kaiser, FBI Criminal Investigative Division.

Some key findings presented in the report include:

As of the end of FY 2007, 529 corporate fraud cases were being pursued by the FBI, several of which involve losses to public investors that individually exceed $1 billion.

FBI securities and commodities fraud cases increased from 937 in 2006 to 1,217 in FY 2007, and resulted in $24 million in recoveries, $1.7 billion in restitution orders, and $202.7 million in fines.

The 2,493 health care fraud cases investigated by the FBI resulted in 839 indictments and 635 convictions of health care fraud criminals.

The 1,204 pending mortgage fraud cases in FY 2007 resulted in 321 indictments, 206 convictions, $595.9 million in restitution orders, and $21.8 million in recoveries.

The FBI investigated 548 money laundering cases in FY 2007, resulting in 141 indictments, 112 convictions, $66.9 million in restitution orders, $2.2 million in recoveries, and $11.4 million in fines.

Insurance Fraud
The report said the FBI considers insurance fraud an investigative priority, due in large part to the insurance industry's significant status in the U.S. economy.

The Coalition Against Insurance Fraud (CAIF) estimates that the cost of fraud in the industry is as high as $80 billion each year. This cost is passed on to consumers in the form of higher premiums. The National Insurance Crime Bureau (NICB) calculates insurance fraud raises the yearly cost of premiums by $300 for the average household.

The FBI goes after what it sees as the most prevalent schemes and the top echelon criminals defrauding the insurance industry, working with the National Association of Insurance Commissioners, NICB, CAIF, as well as state fraud bureaus, state insurance regulators, and other federal agencies. Currently, the FBI reports it is focusing a majority of its resources relating to insurance fraud on the following schemes:

Arson Fraud Related to Mortgage Industry Credit Crisis - Whether unable or unwilling to meet their mortgage obligations, it is believed that some number of distressed homeowners, property flippers, and/or other real estate investors have resorted to committing arson to avoid real estate foreclosure. The insurance policy holders for these properties are then able to extract otherwise unattainable proceeds/profits through the filing of false insurance claims. The FBI said that this illicit activity is being prioritized due to market forecasts calling for increasing numbers of real estate foreclosures.

Hurricane Katrina Insurance Fraud - In late August 2005, Hurricane Katrina caused approximately $100 billion in damages along the Gulf Coast. According to the CAIF, Katrina generated approximately 1.6 million insurance claims totaling $34.4 billion in insured losses. The destruction caused by the storm has resulted in a marked increase in insurance fraud in the area, according to the FBI report. Of the more than $80 billion in government funds appropriated for reconstruction efforts in the region, it is estimated insurance fraud accounts for between $4 and $6 billion. The FBI created the Insurance Fraud Task Force (IFTF) to investigate the spike in insurance fraud related to Katrina.

Insurance-Related Corporate Fraud - Although corporate fraud is not unique to any particular industry, there has been a recent trend involving insurance companies caught in the web of these schemes. The temptations for fraud within the corporate industry can be greater during periods of financial downturns. Insurance companies hold customer premiums which are forbidden from operational use by the company. However, when funding is needed, unscrupulous executives invade the premium accounts in order to pay corporate expenses. This leads to financial statement fraud because the company is required to "cover its tracks" to conceal the improper utilization of customer premium funds.

Premium Diversion/Unauthorized Entities - The most common type of fraud involves insurance agents and brokers diverting policyholder premiums for their own benefit. Additionally, there is a growing number of unauthorized and unregistered entities engaged in the sale of insurance-related products. As the insurance industry becomes open to foreign players, regulation becomes more difficult. Additionally, exponentially rising insurance costs in certain areas (i.e., terrorism insurance, directors'/officers' insurance, and corporations), increases the possibility for this type of fraud, according to the FBI report.

Workers Compensation Fraud - The Professional Employer Organization (PEO) industry operates chiefly to provide workers compensation insurance coverage to small businesses by pooling businesses together to obtain reasonable rates. Workers compensation insurance accounts for as much as 46 percent of a small business owners' general operating expenses, said the FBI report. Due to this, small business owners have an incentive to shop workers compensation insurance on a regular basis. This has made it ripe for entities that purport to provide workers compensation insurance to enter the marketplace, offer reduced premium rates, and misappropriate funds without providing insurance, the FBI says. The focus of these investigations is on allegations that numerous entities within the PEO industry are selling unauthorized and non-admitted workers compensation coverage to businesses across the U.S. This insurance fraud scheme has left injured and deceased victims without workers compensation coverage to pay their medical bills.

Viatical Settlement Fraud - A viatical settlement is a discounted, pre-death sale of an existing life insurance policy on the life of a person known to have a terminal condition. Viatical settlement fraud occurs when misrepresentations are made on the insurance policy applications, in effect, hiding the fact that the party applying for a policy has already been diagnosed with a terminal condition. On the investor end, the fraud occurs when misrepresentations are made to the investors by the viatical companies about life expectancies of insured parties and guaranteed high rates of return.

The FBI cites a case involving Mutual Benefits Corp. (MBC), a viatical settlement company, as among its most significant recent cases. More than 30,000 investors worldwide were defrauded of approximately $1 billion by the principals of MBC, who misrepresented the investment and failed to disclose prior regulatory actions. In October 2006, Peter Lombardi, former MBC president, pled guilty to securities fraud and received a 20-year sentence. In 2007, six additional subjects were charged as part of the scheme, and five have been convicted. Sentences for the additional subjects range between one and 10 years. The SEC and IRS are assisting with this investigation.

www.fbi.gov

Fight Insurance Fraud: Agents Role

Insurance agents can play a big role in helping states to fight insurance fraud. And with insurance fraud costing California alone $15 billion each year, or $500 per resident, the cost of which is eventually passed onto consumers, they should provide assistance.

In fact, because they are on the front lines of insurance transactions, agents might see and hear things before the insurance company, claims department or insurance investigator even hears about a problem, according to Howard Goldblatt, director of government affairs for the Coalition Against Insurance Fraud. "They are the grassroots. They are in the streets, in the neighborhoods."

As a result, an agent may see things in a neighborhood that would raise questions with an anti-fraud department. "They may know of someone that they've insured who is having economic problems, and all of a sudden there's a claim filed by that person," Goldblatt said.

When that happens, there are steps an insurance agent can take to help with a Department of Insurance investigation, said Fraud Bureau Chief Cindy Schmell of the Iowa Division of Insurance and Anti-Fraud Division Director Ted Clark of the Kansas Department of Insurance.

"Insurance agents can help us immensely with our insurance fraud investigations if they document information," Schmell said. "For instance, if someone comes to an agent wanting to purchase insurance, they can verify the identity of that person. If they uncover something that indicates the person maybe isn't who he says he is, [the agent] can document that and provide that to [the insurance department] when we come to interview them in our investigation."

Clark agreed, noting that agents should obtain positive identification from the person proposing to be insured. He also recommended agents actually inspect vehicles prior to insuring them, to determine upfront whether there is pre-existing damage or problems with a car.

"Agents can certainly assist us in fraud investigations," Clark said. "In many fashions, they are the gatekeepers of information of the insured. Second, there are things [insurance agents] acquire as far as identification, pre-existing condition of vehicles and such, before they are insured."

Then, it's important for agents also to report any kind of false information they receive from someone trying to purchase insurance to their state insurance fraud bureaus, Schmell recommended. "And then, of course, agents can cooperate with the authorities when we proceed with our investigations."

Analyzing Employees
Beyond scrutinizing customers, Clark and Schmell said insurance agencies should scrutinize their own employees when hiring, as well. Based on a survey of 2.6 million job applicants, 44 percent lied about their work experience, 23 percent fabricated credentials or licenses and 41 percent lied about their education. And "past behavior is the best predictor of future behavior," Schmell said.

When you consider that occupational fraud and abuse costs organizations about $600 billion annually, or roughly 6 percent of gross revenues, according to the Association of Certified Fraud Examiners, and the fact that insurance agents have access to a wealth of customers' personal information, it's important to examine a potential employee's track record.

"Agencies should screen their employees prior to employment because there are many issues that can be addressed by pre-screening employees," Clark said. "One would be to make certain that the information that the agency has is not subject to identity theft. Other things would be [to make certain] that the agency is less likely to have an employee that might themselves perpetuate some sort of internal theft or participate in some sort of insurance fraud scheme."

Oftentimes, companies will do background checks on senior management, but not examine other personnel such as janitors or office assistants, Schmell said. She noted it is important to evaluate all employees, looking at such areas as their criminal history, civil litigation history, collections/credit history, employment history, address history, claims history, mental illness or addition, education and professional licensure.

Outside vendors can assist with researching a person's background, Clark and Schmell said. Checking the person out on cyberspace, such as on Google, YouTube, and social networking sites like Facebook and MySpace also can provide insight on a person's background. Nevertheless, they noted "there is no suitable substitute" for an in-person interview where employers can watch for meta-messages and ask the candidate what else they will find. "You'd be surprised what potential job applicants tell you," Schmell said.

While researching a potential employee's background might seem like an invasion of privacy, remember that insurance agencies are entrusted with a lot of personal information, both for the insureds and insurance companies they represent, Schmell said. The law also is on the agency-employer's side. "There is a federal law that says someone who's been convicted of a felony for a breach of trust crime cannot participate in the business of insurance — unless they are provided a waiver by that state's insurance commissioner," Schmell concluded.

Clark, Goldblatt and Schmell were speakers at the National Association of Insurance Commissioners Insurance Fraud Seminar held in March 2009 in San Diego.
http://www.insurancejournal.com/

Insurance Fraud Waiting For Storm Victims

An insurance scam has hit Mena tornado victims, says a report from the Arkansas Insurance Department.

Insurance adjusters requesting payment from the insured for their services are not permitted in the state, says Arkansas Insurance Commissioner Jay Bradford.

“The department has received reports that public adjusters have approached citizens in Mena following the storm,” Bradford said.

Only adjusters whose salaries are paid by the insurance company are allowed, he said.

http://www.texarkanagazette.com/

$6.3 Million workers compensation insurance fraud

Andrew Kim (aka Sung Young Kim) and Chan Hee Yang (aka Chan Hee Ko), both of Northridge, Calif., were arrested by the state Department of Insurance on multiple counts of insurance premium fraud and conspiracy connected to Bell Building Maintenance Co. - a janitorial business based in Sherman Oaks, Calif. The alleged fraud amounts to more than $6.3 million dollars, the DOI reported.

According to CDI investigators, Bell Building Maintenance Co., through Chan and Kim, purposefully misrepresented the number of employees working for the janitorial company in an effort to reduce the proper rate of workers' compensation insurance premium. The criminal investigation was launched in September of 2006 based upon a referral from State Fund.

According to payroll reports allegedly submitted to State Fund by Kim, from 2000 to 2005, the only employees of the company consisted of Kim and his wife. As a result, the company was only required to pay the minimum amount of premium to receive a workers' compensation insurance policy during this period. However, the investigation revealed that, in reality, Bell Building Maintenance was a much larger operation that employed hundreds of janitors servicing numerous private companies and public entities in Los Angeles, Ventura, Orange, San Bernardino and Riverside counties. Chan, who is not Kim's wife, was later identified as the company's corporate president during this time period.

A State Fund audit of documents seized by CDI personnel in October of 2006 determined that Bell Building Maintenance Company intentionally underpaid premiums from 1998 through 2006 in the amount of $4,466,936.52. A subsequent audit conducted by the California Employment Development Department revealed that Chan failed to accurately report employee wages and/or wage payments from April 2001 through December 2006. This, allegedly, resulted in her underpaying her payroll, unemployment insurance, and state disability insurance taxes in the amount of $1,889,580.15.

Kim has been formally charged with one count of criminal conspiracy; ten counts of presentation of false/fraudulent writing to public entity; one count of misrepresentation to obtain a lower rate with State Fund; and, one count of misrepresentation to obtain a lower rate with a carrier other than State Fund - all felonies. His bail has been set at $3.28 million.

Chan has been formally charged with one count of criminal conspiracy; ten counts of presentation of false/fraudulent writing to public entity; one count of misrepresentation to obtain a lower rate with State Fund; one count of misrepresentation to obtain a lower rate with a carrier other than State Fund; one count of failure to pay tax; one count of false tax return; one count of failure to make contributions; and, one count of failure to make contributions to the Disability Fund - all felonies. Her bail has been set at $3.3 million.

The case is being prosecuted by the Los Angeles County District Attorney's Office. The California State Compensation Fund and Employment Development Department (EDD) assisted in the investigation.

http://www.claimsjournal.com/

R3 Million Policies Murder Case

The Wyebank businessman who allegedly faked his own death for financial gain is due to appear in the Pinetown Magistrate's Court on Wednesday.

Sundraganes "Rajen" Chetty, 44, presently on bail, and his cousin Dayalan Reddy, 29, are accused of faking Chetty's death to claim from a R3 million insurance policy.

Chetty was released on R50 000 bail while Reddy was released on bail of R5 000.

Both have been charged with murder and defeating the ends of justice.

Chetty and Reddy have been on bail since October 2008 but under strict conditions imposed by the court.

Magistrate Verushka Jamuna ordered that the two men hand over their travel documents and instructed them to not interfere with state witnesses and report regularly to the police station.

However, Jamuna found that both men were not flight risks. Chetty stands accused of faking his own death, which was allegedly done by burning a body in his Nissan bakkie, to cash in on his life insurance policies. The body found in Chetty's vehicle was that of 60-year-old Bharath Lutchman of Merebank.

After allegedly burning the body in the car, Reddy was sent to the mortuary to identify the charred remains and identified them as those of Chetty, because of a ring.

However, the alleged plot was uncovered after the investigating officer, Insp Ramesh Ramdeen, and the pathologist were not satisfied with how Reddy had identified the body, because they said the ring was not clearly visible.

At the bail application in October, Ramdeen said Chetty had hatched the plan to cash in on life insurance policies that had been updated to double their value two weeks before the incident occurred.

http://www.dailynews.co.za/

Law Enforcement Officer offered a Insurance Fraud training

Law enforcement officers are welcome to take advantage of this free Friday-only training opportunity.

Once again, the Texas Association of Special Investigation Units (TASIU) is proud to offer 4 hours of FREE TCLEOSE-approved training in insurance fraud awareness and investigation to law enforcement officers during the TASIU 2009 Gulf Coast Insurance Fraud Seminar at the South Shore Resort & Conference Center on Clear Lake in League City, TX. The free 4-hour class will be taught by agents of the National Insurance Crime Bureau on Friday morning, May 1, 2009

Law enforcement officers are welcome to take advantage of this free Friday-only training opportunity or they may attend the full day and a half seminar beginning on Thursday, April 30, 2009 at a special law enforcement price. The full seminar will include a variety of antifraud topics focused on insurance fraud and will also cover overlap into other criminal activities, i.e. organized fraud and gang activity, legal aspects, fire, arson and now more than ever, how the economy has produced motivation and an environment ripe for fraud. For full seminar attendees, the keynote luncheon speaker on Thursday will be Harris County District Attorney, Judge Pat Lykos.

Seating for this free law enforcement training opportunity is limited so if interested, please RSVP at www.tasiu.org.

TASIU is a non-profit organization and local chapter of the International Association of Special Investigation Units. Our membership is comprised of insurance fraud investigators employed by insurance companies, self-insured corporations, the National Insurance Crime Bureau, the Texas Department of Insurance, and local, state and federal law enforcement, along with claim professionals involved in or supporting insurance fraud investigations.

http://www.tasiu.org/
http://www.familybadge.org

Car Stolen Fraud Increased

An expensive crime is on the rise in New Hampshire and across the nation -- and if you pay for auto insurance, it's costing you.

Insurance companies are reporting an increase in auto insurance fraud.

Some people who can't afford their vehicle anymore are claiming it was stolen in order to collect insurance money.

Police said Rock Rimmon Park in Manchester is a hot spot to dump or burn cars that were reported stolen.

Some states are reporting a rise in fraudulent stolen boat claims, as people are sinking their boats to cash in on insurance.

Prosecutors said insurance fraud can be a felony punishable by up to 15 years in prison.

http://www.wmur.com/

Auto Mechanic pleaded not guilty for Insurance Fraud

A Town of Tonawanda auto mechanic faces charges for allegedly turning over his pickup truck to another mechanic for dismantling so he could collect an insurance claim, the state Insurance Department reported.

Todd Coughlin, 27, of Glendale Drive, was charged with insurance fraud, grand larceny, conspiracy and falsely reporting an incident.

Coughlin allegedly asked Derrick Lucas, 32, of Dupont Avenue, Town of Tonawanda, to dispose of his 2004 Chevrolet Silverado so he could get out of making loan payments on the vehicle and file a $32,500 insurance claim.

Lucas, who is accused of dismantling the pickup truck and selling parts, was arrested in December. He was charged with criminal possession of stolen property and unlawful possession of a vehicle identification number.

Each man faces up to seven years in prison if convicted.

http://www.buffalonews.com/home/index.html

Funeral fraud red handed

LOS ANGELES - Two women accused of staging funerals for fictitious people in an insurance fraud scheme pleaded not guilty to wire and mail fraud charges on Monday.

Faye Shilling of Hawthorne, and Jean Crump were arrested on Wednesday.

Investigators claim the two allegedly planned to collect almost $1 million from insurance and lending companies by buying policies for people who did not exist. The women would then hold funeral services for them.

After the funerals, the women allegedly filed phony documents with the county claiming the remains had been cremated and scattered at sea.

The insurance policies were worth between $50,000 and $450,000. Prosecutors claim the two collected on some policies as large as $250,000.

Crump is also accused of offering a doctor $50,000 to create records for a phony death certificate.

Shilling and Crump are free on $10,000 bail. If convicted, they face up to 100 years in federal prison.

http://abclocal.go.com/kabc/index

Rochester Fraud Insurance Triumph

New York - A Rochester woman who reported her SUV stolen hours after she abandoned the vehicle while it was being observed by police in a shoplifting investigation was arrested Friday for insurance fraud, the New York State Insurance Department reported.

Rochester police arrested Tiffany Parnell, 29, of Garson Avenue, Rochester, for filing a fraudulent insurance claim with Progressive Insurance Company for the purported loss of her 1998 Chevrolet Blazer.

William Fedrau, an investigator with the Insurance Department's Frauds Bureau, said Parnell was arrested as part of an investigation begun Aug. 28 after she and an unnamed companion were identified as shoplifters by merchants at the Waterloo Outlet Mall in Seneca County. Parnell abandoned her vehicle in the mall's parking lot after police were called by the merchants.

Several hours later, Parnell telephoned police to report that her vehicle had been stolen. She also filed an insurance claim. State police subsequently advised her that they had recovered her vehicle and asked her to come to the state police station at Waterloo. She was arrested for criminal possession of stolen property in connection with shoplifting when she arrived at the station the next day.

Rochester police and state police assisted in the investigation. Parnell's companion was not charged in connection with the insurance fraud allegation. The shoplifting charge against Parnell is still pending. The insurance claim was never paid.

Parnell could be sentenced to up to three years in prison if she is convicted. She was released pending a hearing in Monroe County Court. The case is being prosecuted by Assistant District Attorney William Gargan.

http://www.ins.state.ny.us/

$37000 insurance fraud

A Bay Shore man and two accomplices have been arrested and charged with defrauding a Minnesota insurance company of $37,000 in commissions, police said Friday.

Peter Ezagui, 25, of Monroe Avenue, was charged with second-degree insurance fraud and second-degree grand larceny, detectives said.

Two accomplices Kevin Huhn, 26, of Shelly Place, East Meadow, and James Connolly, 29, of Bayview Avenue, Bayville, were both charged with third-degree grand larceny and falsifying business records.

Police said Hugh and Connolly purchased a total of $1.7 million in insurance through Ezagui, who posed as an insurance agent with the Allianz insurance company of Minneapolis from January 2006 to September 2008.



All their checks for the insurance contracts bounced, detectives said, but not before Ezagui collected his $37,000 in commission for the sales.



http://www.newsday.com/

A year jail for former police

A former Los Angeles police officer was sentenced Tuesday to a year in jail upon pleading guilty to insurance fraud and filing a false police report, in which he claimed he was shot outside his home.

Los Angeles Superior Court Judge Norm Shapiro ordered Anthony Razo, 49, to surrender Thursday at the East Los Angeles sheriff's station to begin serving the jail term.

Razo also was sentenced to three years probation and ordered to pay $5,400 in restitution to the LAPD's Hollenbeck Division, which held a fundraiser to help pay his medical bills.

Razo admitted that he falsely reported his car stolen on Jan. 4 and made fraudulent claims against his auto and homeowners' insurance policies for the car and its contents, according to the District Attorney's Office.

Razo also fabricated his claim that two men assaulted him in his driveway on Jan. 31 and used his gun to shoot him, admitting that he shot himself, prosecutors said.

Razo was relieved of duty in March and has since resigned.



http://www.contracostatimes.com/

Taiwan cracked down insurance fraud

Taipei, April 9 (CNA) Dozens of medical institutions and professionals in southern Taiwan were found of defrauding more than NT$70 million (US$2.09 million) from the National Health Insurance program in over 100,000 cases in an investigation conducted during the first three months of this year, a spokesman for the Tainan Public Prosecutors Office said Thursday.

Although almost all the cases occurred in Tainan and Kaohsiung cities, the spokesman said, they represent only "the tip of the iceberg" in the widespread problem of fraud against the insurance system by medical institutions in the country.

Those accused of being involved in the insurance fraud cases include the Department of Health (DOH) -governed Tainan Hospital Hsinhua Branch, 10 private clinics, five pharmaceutical stores and about 70 nursing homes, as well as two clinic owners, 19 medical doctors, seven pharmacists, and four medical service brokers, according to the spokesman.

The Tainan District Court granted a prosecutors' request to detain 12 suspects. Fourteen others have been released on bail, the spokesman added.

During raids of the medical institutions, investigators removed a batch of patient records and questioned 22 people, including nine physicians at the DOH Tainan Hospital, the first time a public hospital was suspected to have been involved in fraud, according to the spokesman.

The nine medical professionals, including three active executives and six former physicians at the hospital, were suspected of colluding with scores of local nursing homes to defraud the national health care program of NT$30 million between 2006 and 2008 by issuing a large number of chronic illness prescription refill slips, according to spokesman.

The nine doctors have been released on NT$800,000-NT$1 million bail after admitting to committing fraud, the spokesman said. They had claimed they were under pressure to reach their business targets set by the hospital to avoid being fired, the spokesman added.

However, the hospital issued a statement Thursday denying that it had pressed doctors to meet revenue objectives, adding that some of the accused were contracted doctors and were unlikely to be under work performance pressure.

Using fake prescriptions is a common fraud practice against the national health insurance system, the spokesman added.

Taiwan News

Insurance fraud case for Missisippi doctor

The insurance fraud management found a news about A Jackson doctor has been arrested following an insurance fraud investigation, announced Attorney General Jim Hood today at Jackson,Mississippi.

Dr. Larry Cruel (age 44) was arrested this morning by investigators with the Attorney General's Office, Insurance Integrity Unit, on one count of insurance fraud and one count of wire fraud. Dr. Cruel is accused of submitting false claims to Blue Cross Blue Shield.

Dr. Cruel, who is a podiatrist at Advanced Foot Care located at 4510 Office Park Drive Jackson, MS, faces up to three years and a fine of $5,000 or the value of the fraud, whichever is greater, for the insurance fraud charge and up to five years and a fine of $10,000 for the wire fraud charge.

Dr. Cruel was taken to the Rankin County Jail. Judge Kent McDaniels, Rankin County Circuit Court, set his bond at $30,000. A court date has not yet been set and an insurance fraud investigation is still going. As with all cases, the defendant is presumed innocent until proven guilty in a court of law.

http://www.workerscompensation.com/compnewsnetwork/