Insurance Claims Investigation News

August 11, 2005, 5:39 AM

GRAND RAPIDS, Mich. (AP) — Eleven Lear Corp. workers have been found guilty of unemployment insurance fraud for collecting more than $100,000 in benefits that they were not entitled to, the Michigan Unemployment Insurance Agency said Wednesday.

Twenty-nine other workers face administrative action from the agency for illegally collecting $70,000, The Detroit News reported in a Thursday story.

All 40 workers worked in the Grand Rapids area and collected unemployment benefits while working full time, agency director Sharon Bommarito said in a prepared statement.

The 11 employees prosecuted were found guilty of improperly collecting $5,000 or more each, in amounts ranging from $5,405 to $16,523. They must repay the benefits, perform community service and pay fines and court costs.

The 29 other cases involved amounts ranging from $181 to $4,433. Those workers also will be required to repay the money and could face administrative fines.

The fraud started after Lear began periodic layoffs in January and July 2002 and some workers filed for unemployment benefits. Bommarito said those charged claimed benefits even after they were back to work.

Southfield-based Lear is a top supplier of automotive interiors.

August 11, 2005, 5:39 AM

GRAND RAPIDS, Mich. (AP) — Eleven Lear Corp. workers have been found guilty of unemployment insurance fraud for collecting more than $100,000 in benefits that they were not entitled to, the Michigan Unemployment Insurance Agency said Wednesday.

Twenty-nine other workers face administrative action from the agency for illegally collecting $70,000, The Detroit News reported in a Thursday story.

All 40 workers worked in the Grand Rapids area and collected unemployment benefits while working full time, agency director Sharon Bommarito said in a prepared statement.

The 11 employees prosecuted were found guilty of improperly collecting $5,000 or more each, in amounts ranging from $5,405 to $16,523. They must repay the benefits, perform community service and pay fines and court costs.

The 29 other cases involved amounts ranging from $181 to $4,433. Those workers also will be required to repay the money and could face administrative fines.

The fraud started after Lear began periodic layoffs in January and July 2002 and some workers filed for unemployment benefits. Bommarito said those charged claimed benefits even after they were back to work.

Southfield-based Lear is a top supplier of automotive interiors.

August 10, 2005

Frankie Louis Alston and Darin Antonio Mason have been indicted in connection with an alleged auto insurance fraud ring in Siler City, N.C. that filed at least 480 bogus auto crash claims in Chatham and Randolph counties since 1992. Insurance companies paid out an estimated $2 million on the claims.
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Investigators said Alston, a Chatham County resident, the primary architect of the fraud ring, was indicted on two counts of being a habitual felon, three counts of obtaining property by false pretenses and four counts of conspiracy to obtain property by false pretenses.

Mason, a Greensboro resident, was indicted on three counts of obtaining property by false pretenses and four counts of conspiracy to obtain property by false pretenses.

A grand jury handed down 45 indictments in the case in April, and several defendants have already pleaded guilty and been sentenced to prison

Insurance companies are applauding New York Gov. George Pataki for signing legislation that they say will assist them in their efforts to fight insurance fraud.

Pataki signed A.8376, the physician decertification bill, which decertifies physicians from receiving payment under the no-fault system when the physician engages in deceptive billing or fraudulent practices.

\”This is a great victory for insurers, consumers and patients,\” said Kristina Baldwin, regional manager and counsel for the Property Casualty Insurers Association of America. \”Passage of this bill will help rid the no-fault system of medical mills and unscrupulous medical providers.\”

In recent years, New York\’s no-fault fraud problem has exploded into a $1billion per year issue, according to industry reports. Experts say there is an organized crime element to New York\’s fraud problem with staged accidents, fake injuries and treatment at medical mills, which churn out fake bills and submit them to insurance companies. Ultimately, policyholders pay for this fraudulent activity in the form of higher insurance premiums.

\”While recent regulatory activity, as well as a crackdown on fraud by insurance companies, have recently helped to significantly reduce no-fault fraud in New York, it is still a significant problem that costs New York insurance consumers millions of dollars per year,\” added Baldwin.

She said the enw law would help \”close the doors on medical mills that will further reduce N.Y.\’s no-fault problem.\”

PCI is composed of more than 1,000 member companies that write $173 billion in annual premium, 39.4 percent of the nation\’s property/casualty insurance.

WTOP

RICHMOND, Va. – If you live in Virginia, chances are you have been a victim or know someone who has been a victim of insurance fraud. Nearly half of Virginians fit into one of those two categories, according to a study by Virginia State Police.

The telephone survey was conducted among 400 residents in all regions of the state during a two-week period.

Almost one-half of the respondents said they were likely to report insurance fraud, as compared to one-third of the respondents in a 2000 survey.

Although they are more likely to report it, one in five was not sure how.

The findings are part of a statewide study done by the state police\’s Insurance Fraud Program on attitudes regarding insurance fraud and its implications.

The survey has a margin of error of plus or minus 4.9-percent

Insurance Journal Reports

Eight individuals have been apprehended in West Palm Beach, Fla. for attempting to claim more than $120,000 in auto insurance theft benefits; but, there was one hitch, they attempted to \”ditch\” the vehicles by selling them to undercover officers.

According to Tom Gallagher, Florida\’s CFO, the Department of Financial Services\’ Division of Insurance Fraud worked with a Palm Beach County Multi-Agency Auto-Theft Task Force in making the arrests.

Ditching, also referred to as an owner give-up, occurs when the owner is unhappy with the vehicle or can no longer keep up with payments and either pays someone to get rid of the car, as these suspects are accused of doing, or gets rid of it by dumping or burning the vehicle.

NSURANCE FRAUD
Tuesday, July 26, 2005

An insurance scheme that targeted truck drivers ends with the arrest of a Florida woman. Rosa Bajdor is accused of selling phony insurance certificates, ranging in price from 5 hundred to 15 hundred dollars. The certificates bore the name of Canal Insurance, one of the nation`s largest insurers for truck drivers. That company is now investigating 21 claims worth more than half a million dollars.