Big Apple Selects Top 10 ‘Rotten Apples’

April 5, 2004

The New York Insurance Departments announced its “Top 10” list of worst cases of insurance fraud in the state for 2003:

MURDER—A Brooklyn man was accused of staging an accident that resulted in the death of a Queens grandmother. He was charged with murder in the second degree, manslaughter in the second degree, criminally negligent homicide and conspiracy to commit insurance fraud.

WTC FRAUD—A Broome County man turned himself in on charges of defrauding Combined Life Insurance Company of $20,000. The defendant filed a death benefit claim stating that his daughter died in the World Trade center attack on Sept. 11. However she was alive and living outside New York.

GOTCHA—In the first phase of an undercover investigation known as “Operation Gateway,” 51 people, including one doctor, were arrested for their role in a no-fault insurance fraud ring that defrauded insurers of tens of millions of dollars. The scheme involved using “runners” who were paid to recruit people to pose as auto accident victims. They were then steered to medical facilities that were part of the scheme where unscrupulous individuals billed insurance companies for unnecessary treatment and lawyers filed bogus lawsuits.

23-COUNT INDICTMENT—A Long Island body shop, its owner and its manager were indicted on 23 counts of insurance fraud. According to the indictment, the defendants engaged in activity where they systematically enhanced the damages to vehicles or failed to do the repair work for which they were paid.

NO-FAULT FRAUD—Nineteen members of two insurance fraud rings operating in Queens and Nassau Counties were arrested on various fraud charges. Those arrested included three personal injury attorneys, two former New York City police officers, two insurance brokers, several middlemen, and the operators of various medical clinics. The group ran a personal injury scheme that involved steering auto accident victims to corrupt medical facilities and billing for medical treatments that were unnecessary or never performed.

SWEEPING UP—Eighteen Suffolk County residents were arrested for defrauding the workers’ compensation system of $550,000. Most of the defendants were gainfully employed while fraudulently collecting benefit checks. Among those arrested were two teachers, the owner/operator of a limousine service and a chiropractor.

BUSTED—The ringleader and four participants in a Queens-based fraud scheme were arrested for their involvement in the theft of luxury vehicles. Some vehicles were stolen off the street or “given up” by their owners to collect the insurance settlements. Cars involved included a Mercedes Benz, a BMW, a Montero and a Hummer.

A GOOD DAY’S WORK—A two-year joint investigation culminated in arrest of 16 people, including one former and four active New York City police officers, charged with the theft of $750,000 from seven insurance companies. The scheme involved the submission of fraudulent auto accident reports in order to receive compensation from the insurers.

TEAMWORK—The Department’s Frauds Bureau teamed up with other state and local authorities in a roundup of nine individuals suspected of workers’ compensation fraud. They were part of a larger sweep over a three-week period in November, which resulted in 15 fraud arrests in cases representing more than $1.1 million.

MEDICAL INDICTMENTS—A 263-count indictment was filed against four psychotherapists for their involvement in a no-fault fraud ring. A licensed psychologist and three psychotherapists in his employ at medical clinics throughout New York City and Long Island were charged with fraudulently billing for counseling services they claimed were provided to hundreds of auto accident victims. They’re charged with submitting falsified no-fault claims totaling approximately $88,000.

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Insurance Journal Magazine April 5, 2004
April 5, 2004
Insurance Journal Magazine

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