Disability Claims Were Teacher’s ‘Achilles Heel’

CDI investigators arrested a Los Angeles Unified School District teacher, Randolph Zane, on 36 counts of insurance fraud. Zane, 55, was booked on a $320,000 bail felony warrant. The San Bernardino County District Attorney’s Office is prosecuting the case.

An investigation revealed that in December 1993, Zane applied for a disability policy with Colonial Life and Accident Insurance Company. Zane filed a claim in March 1994 for a sinus disorder. In June 1994, Zane applied for another disability policy with Paul Revere Insurance Company and stated he had not been on disability for the last 12 months.

One day after submitting his application with Paul Revere, Zane made a second disability claim with Colonial Life for a back strain. Later that month, in a telephone interview with a Paul Revere representative, Zane allegedly confirmed his application statements and indicated he was not under doctor care, taking medication or undergoing therapy.

In September 1994, Zane made a third claim with Colonial Life for a heel injury. Zane was paid $10,283 for this claim. Investigators allege Zane forged the signatures of his employers on his claim forms. During this time, Zane also made his first Paul Revere claim, for which he received a total of $6,583.

In March 1995, Zane applied for Group Disability Insurance through Capitol American Insurance Company, allegedly lying on his application regarding previous disability insurance and claims. In December 1995, he submitted a claim to all three carriers for a heel injury and was paid a total of $14,955 by those companies.

In March 1996, Zane applied for another disability policy with Allianz Life Insurance, denying prior medical treatment. The following month, Zane made claims to both Paul Revere and Capitol American for bronchitis and lung disease and received $8,916. In July 1997, Zane initiated three concurrent claims for interstitial lung disease and received $142,807.

A claim representative for Paul Revere discovered the existence of the Colonial Life policy through an employer verification check. Investigators said, through 1997, Zane simultaneously saw four different doctors, each verifying ailments to different insurers. When Zane returned to work in January 2000, he failed to notify Allianz, which overpaid Zane approximately $6,600.

Topics Claims