The Associated Press contributed to this article. An eleventh defendant, Alexander Gulkarov, was arrested in Miami, Florida, and is scheduled to appear before a U.S. Magistrate Judge in the Southern District of Florida later today. If you have information that may lead to their arrest, please contact your local law enforcement agency or the Washington state Office of the Insurance Commissioner's Criminal Investigations Unit (CIU). Approximately 1.6 million insurance claims were filed, totaling $34.4 billion in insured losses. Marshals Service, and United States Attorneys Offices for the Middle and Southern Districts of Florida. Giving back to the community through a variety of venues & initiatives. Agents arrested: Six cases of fraud by insurance agents in 2021 By Heather A. Turner | June 28, 2021 at 12:00 AM A $86,000 crime A former Kansas agent was sentenced in March to 24 months of. Creating or using forged prescriptions is a crime, and prescription fraud comes at an enormous cost to physicians, hospitals, insurers, and taxpayers. Federal authorities cited the case of a Japanese woman, known only as F.K. in court papers, as one example of the alleged romance scams that began through what she assumed was an international social network for digital pen pals. Get instant access to members-only products and hundreds of discounts, a FREE second membership, and a subscription toAARP The Magazine. These two sweeps have now resulted in eleven arrests. Forty-eight (48) states now have specific criminal laws for insurance crime. The Division of Criminal Justice is led by Executive Deputy Attorney General Margaret Garnett. Charged in the indictment are JAMES MILLS, also known as Jamie Montes, 47, of Oak Lawn, Ill., JOSEPH BROWN, 50, of Chandler, Ariz., JULEY ELY, 47, of Oak Lawn, Ill., GINGER ELY, 26, of Oak Lawn, Ill., SYLVIA EVANS, 48, of Kissimmee, Fla., HOLLY STERGO, also known as Holly Stego, 29, of Missouri City, Texas, JESSICA VACA, 51, of Deerfield Beach, Fla., ANGELA BECHO, 30, of Fort Lauderdale, Fla., FRANK COSTELLO, 44, of Hoffman Estates, Ill., JOE ROUGA, 29, of Oak Lawn, Ill., MARY BACCO, 53, of Bridgeview, Ill., STEVE MONTEGA, also known as Fonzie Cerano, 44, of Orland Park, Ill., NIKO RISTICK, 23, of Orland Park, Ill., TONY RISTICK, also known as Anthony Walker, 52, of Orlando, Fla., RACHEL MONTEGA, also known as Samantha Walker, 48, of Orlando, Fla., ROBERT CRAIG, also known as Jake, 37, of Lakeland, Fla., STEVE VEGA, also known as Cabby, 45, of Fort Lauderdale, Fla., SOPHIE BECHO, 46, of Fort Lauderdale, Fla., MARK BLANCA, 30, of Burbank Ill., DIANA LUMAS, 30, of Burbank, Ill., RICKY BLANCA, also known as Fonz Ristick, 48, of Orland Park, Ill., DAVID JENSEN, also known as Tony, 52, of Lakeland, Fla., and JOE JOHN, 66, of Arlington Heights, Ill. According to Texas law . Beware of trucks which conveniently arrive to help. Brian Correia, 34, of Bay Ridge, Brooklyn, who let his insurance coverage lapse while he was away on a trip, and returned from his trip on January 17, 2016 to discover that his vehicle had been vandalized. If you suspect that you may be the victim of insurance fraud, your New York private detectives are here for you! Health care fraud is not a victimless crime. Examining the risks and rewards of ChatGPT for the insurance industry, Budget-friendly cybersecurity tips for organizations with limited resources, 7 Ways to avoid falling victim to a PayPal scam, WalletHub: 10 least expensive cars to insure in 2023. He surrendered himself to State Police on August 3 and was booked into EBR Parish Prison on two counts of forgery of a certificate of insurance. Albemarle Building The defendants submitted fraudulent applications to obtain life insurance policies in the names of various individuals and then induced the carriers to pay death benefits by knowingly misrepresenting the identity of a different deceased person as the insured, according to an indictment unsealed today in U.S. District Court in Chicago. Report fraud to your state authority. We Value Your Privacy Download the latest white paper from LexisNexis Risk Solutions on the customer claims experience for insights into these questions and more. Fraud News Weekly Your trusted every-Friday recap of all things insurance fraud: the newest cases, trends and legislation. If there is no satisfactory explanation for the delay, contact the Department of Financial Services at (800) 342-3736. At least 1 in 10 small business owners worry that their employees will fake work-related injuries. New York and New Jersey no-fault insurance laws require a drivers automobile insurance company to pay automobile insurance claims automatically for certain types of motor vehicle accidents, provided that the claim is legitimate, and is below a particular monetary threshold (the No-Fault Laws). All Rights Reserved. The government is represented by Assistant U.S. Police say Toussaint filed several fraudulent . That means Insurance Fraud costs the average U.S. family between $400 and $700 per. Terry Garcia, however, was a fiction in an elaborate scam that left F.K. Mr. Williams noted that the investigation is ongoing. Sentencing Guidelines. More and more commonly, people are running to post their opinions, daily lifesynopsis's and their locations at anygiven time,on the internet. In carrying out their massive scheme, among other methods, they allegedly bribed 911 operators, hospital employees, and others for confidential motor vehicle accident victim information. All insurance companies have a Special Investigation Unit (SIU) or trained special fraud investigators. Homepage - InsuranceFraud.org Your car is your castle on four wheels. The Pierre Indictment separately charges five additional individuals (the Pierre Conspirators) with participating in a second criminal scheme to exploit the No-Fault Laws. The public can help reduce fraud and minimize its impact by learning how to recognize fraud, by avoiding becoming a victim of fraud, and by reporting suspected fraud to the DFS. A .gov website belongs to an official government organization in the United States. Read your policy carefully before you sign. As alleged, the leaders of the Gulkarov Conspirators are non-physicians, including ALEXANDER GULKAROV, a/k/a Little Alex, ROMAN ISRAILOV, a/k/a Roman Matatov, PETER KHAIMOV, a/k/a Peter Khaim, and ANTHONY DIPIETRO. Find the fraud facts across all lines of insurance. Jevon Holder, 34, of the 500 block of N. 52nd St., Philadelphia, is charged with one felony count of insurance fraud, a separate misdemeanor count of insurance fraud and one count each of theft by deception, criminal use of a communication facility and forgery. He was booked into the EBR Parish Prison. Makes arrests. on charges of filing or maintaining false public records and insurance fraud. Braving the elements: Manage rising peril risk with science. When viewed alone, each transaction appears to be legitimateonly after the cumulative effect is considered does fraud emerge. The SIU works closely with the local law enforcement community, including the National Insurance Crime Bureau, Federal Bureau of Investigation (FBI) and Criminal Investigation/ Fraud Divisions within the regulatory agency (like theNorth Carolina Department of Insurance). These are the best 2023 model family cars across nine categories, according to U.S. News & World Report. BATON ROUGE - After a relatively slow decline in crawfish prices over the past month, the market is finally hitting peak springtime form. Billions of dollars are lost annually, and we urge citizens to be aware of these sophisticated financial schemes to protect themselves or their businesses from becoming unsuspecting victims. The FBI arrested 14 people across the United States (11 in the Los Angeles region) who were named in a 252-count federal grand jury indictment that alleges 80 defendants used online fraud schemes to try to defraud victims out of at least $46 million. CHICAGO A federal grand jury in Chicago has charged 23 defendants with participating in a fraud scheme through which they allegedly swindled ten life insurance carriers out of at least $26 million in fraudulent benefits. If you do not receive it, question your insurer, agent or broker. Capt. Carriers are laser-focused on customer satisfaction, and each claims experience yields a different result. The indictment charges the 23 defendants with multiple counts of wire and mail fraud. Fraudsterscan face multiple felony charges, restitution and jail time. According to the criminal summons, Black told AFLAC that he could no longer work when he was still employed and working., Andrew Davis, 32, of Whitakers, was charged with four counts of insurance fraud and four counts of obtaining property by false pretense, all felonies. New York law also prohibits fraud involving senior life settlements. Whether its FNOL processes, the ease of digital interactions or the time it takes to settle the claim, where is the industry delivering for customers? I commend the FBI Chicago Field Office and the Arlington Heights Police Department for their diligent work in uncovering this complex scheme and seeking to hold the defendants accountable for their personal and economic harms., We will not allow deceitfulness to prevail for selfish financial gain, said FBI SAC Buie. ROLANDO CHUMACEIRO, a/k/a Chuma, and MARCELO QUIROGA are licensed medical practitioners who incorporated medical practices as part of the scheme, prescribed unnecessary and excessive medical treatments, and overbilled insurance companies under the No-Fault Laws. Download this white paper to help answer those questions by applying structured, relevant data to help determine where you stand in relation to your strategic goals. The scheme allegedly including business email compromise (BEC) frauds, romance scams and scams targeting older adults. For Lamar baseball wins series against Southeastern with 7-1 win on Saturday. Insurance policy holders across New York State are victimized to the tune of more than half a million dollars a day. The indictment seeks forfeiture from the defendants of at least $26 million in alleged ill-gotten gains, as well as nine luxury automobiles, eight Rolex watches, and properties in the Chicago suburbs of Orland Park, Bridgeview, and Burbank. Where is it falling short? This is a dangerous game in which the penalties include federal criminal charges., Westchester County District Attorney Miriam E. Rocah said: This case is a perfect example of federal, state and local law enforcement working in partnership to investigate and take down two criminal organizations that allegedly defrauded insurance companies and exploited vulnerable individuals by subjecting them to unnecessary, harmful,and sometimes painful,medical treatments for the sake of greed and profit. What Is Insurance Fraud: A Legal Definition. Unlimited access to PropertyCasualty360.com - your roadmap to thriving in a disrupted environment, Access to other award-winning ALM websites including BenefitsPRO.com, ThinkAdvisor.com and Law.com. According to Crawfish Tracker: Signs of life (and price drops). NEW YORK Attorney General Eric T. Schneiderman announced the arrests of five individuals for an auto insurance scheme in which they allegedly purchased or increased automobile insurance policy coverage after their vehicles were already damaged, and then misrepresented the dates of loss in claims submitted to their insurance carriers. An official website of the United States government. Assistant United States Attorneys Mathew Andrews and Louis A. Pellegrino are in charge of the prosecution. Please enable Javascript in your browser and try U.S. Attorney's Office, Northern District of Illinois, Law Enforcement Coordinating Committee (LECC), 23 Defendants Charged With Participating in $26 Million Life Insurance Fraud Scheme, Wives of Convicted Drug Traffickers Plead Guilty to Laundering Drug Proceeds, Former Payroll Manager for Chicago Museum Admits to Misappropriating More Than $2 Million, Former Executives of Outcome Health Convicted in $1B Corporate Fraud Scheme. Please do not confuse the crime of insurance fraud with a dispute that you may have with an insurance company, for example, delays in customer payment, monetary disputes, policy cancellations and nonrenewals. Take time to decide what's right for you. After their car was damaged, each defendant allegedly either purchased car insurance, increased the amount of their insurance coverage, or reduced their deductible after the fact, and then filed false claims with their insurance company stating that the incidents occurred after the enhanced policies were in effect. AARP Membership $12 for your first year when you sign up for Automatic Renewal. Smith was charged with insurance fraud, a felony. The HKTF was designed to deter, investigate, and prosecute disaster-related federal crimes. Brittney Meredith-Miller | We look forward to our continued partnership in combatting insurance fraud for all New Yorkers.. The Insurance Frauds Bureau (IFB) was established by an act of the Legislature in 1981 as a law enforcement agency within the New York State Department of Insurance. By using this website you consent to our use of cookies. The FBI investigates these crimes in partnership with: We need your help to identify, investigate, and prosecute this crime. to detect and recognize fraud. False or exaggerated claims by policyholders. Alston Jones, 54, of Canarsie, Brooklyn, who allegedly was involved in a car accident on January 31, 2016, added collision coverage on February 3, 2016, then filed a claim on March 30, 2016, falsely stating that the accident had occurred sometime during the night of March 29 to March 30, 2016. If you have received medical or dental treatment that is covered by a health care provider, you will receive an "Explanation of Benefits" statement listing the services for which benefits have been paid. An official website of the United States government. As alleged, as part of the scheme, ARONOV logged into NYPD computers during off-hours and searched for confidential motor vehicle accident reports on the NYPDs servers. We will continue to work with ourlawenforcement partnerstohold accountable those who manipulate the insurance system on which so many people depend, especially when the alleged perpetrators are professionalswho allegedlyviolated theoathsthey tookto serve and protect., State Police Superintendent Kevin P. Bruen said: These indictments are the result of years of investigative work and could not have succeeded without the collaboration between federal, state and local law enforcement. Health care fraud can be committed by medical providers, patients, and others who intentionally deceive the health care system to receive unlawful benefits or payments. Even a legitimate accident may lead to fraud if "towing bandits" haul your damaged vehicle to a crooked body shop for shoddy, inflated repairs. The Pierre Conspirators further defrauded automobile insurance companies by billing insurance companies for unnecessary, harmful, and excessive medical treatments, falsifying clinical injuries in reports, and lying under oath to insurance company representatives. The fraud scheme charged in the indictment began in 2013 and continued until last month.
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