Insurance Claims Investigation News

Tuesday, April 24, 2007
THE SAGINAW NEWS

MIDLAND — A Midland County chiropractor is facing fraud charges.

Court authorities on Friday arraigned Frederick Knochel on six counts of insurance fraud, said State Police Trooper Dave Rivard of the Bay City Post.

Post detectives and investigators for Blue Cross Blue Shield of Michigan conducted a six-month investigation into allegations the chiropractor submitted false insurance claims to the health insurance company, Rivard said.

Knochel\’s office is at 2525 Washington in Midland.

Rivard said investigators continue to look for \”anyone who has ever been a patient of Knochel and noticed a discrepancy in their explanation of benefits.\”

Patients with suspicions should call the post at (989) 684-2234

The head of North Dakota\’s workers compensation agency and the agency\’s top investigator should be suspended from their jobs.

That\’s the opinion of Governor John Hoeven after today\’s news that the head of what\’s called the Workforce Safety and Insurance agency and its top fraud investigator have been charged with felonies.

Director Sandy Blunt and investigator Romi Leingang were to focus of an audit which found improper activities.

Governor Hoeven says until a full investigation has been completed, the two should not be fired.

Brad Feldman has more on today\’s developments…

Sandy Blunt is the executive director of Workforce Safety and Insurance. Now, he is listed as the defendant on three criminal complaints. Blunt is charged with two counts of misapplication of entrusted property. The first count, a Class B felony, accuses Blunt of spending WSI money on things outside of the agencies interest.

(Richard Riha, Burleigh County State\’s Attorney) \”An example would be you know gift certificates to restaurants.\”

The second count, a class C felony, deals with bonuses given to WSI employees.

(Riha) \”There is a statutory limit on bonuses for employees and our allegation there is that was improperly done.\”

In addition, Blunt and co-worker Romi Leingang are charged with conspiracy to commit disclosure of confidential information.

(Riha) \”It essentially involves drivers license photos that were released to people that shouldn\’t have been and that is confidential information.\”

The attorney representing Romi Leingang, Tim Purdon, says they are disappointed with the states attorneys office.

(Tim Purdon, Leingang\’s Attorney) \”Romi in this case is basically just an employee who is basically following orders from her superiors and I think when the facts come out the decision will be that she actually violated no laws.\”

No matter the involvement, the case is now in the courts hands. The legal process will play out and determine who, if anyone is guilty of the charges. Brad Feldman, KX News

If convicted of the charges, Blunt faces up to 20 years in prison and a fine of 20-thousand dollars.

Leingang faces a maximum of five years in prison and a 5-thousand dollar fine.

SAGINAW — A judge ruled Thursday that there is enough evidence for a former mayor charged with arson and insurance fraud in the burning of her 1986 Mercedes-Benz to stand trial in the case.

Wilmer Jones Ham, who serves on the City Council and as mayor pro tem, was bound over for trial in Saginaw County Circuit Court. The date for her next court appearance wasn\’t immediately set.

Wilmer Jones Ham is the mother of ex-Detroit Pistons player Darvin Ham. She has pleaded not guilty.

Wilmer Jones Ham is accused of setting the car on fire March 9, 2006, and trying to make a false insurance claim.

She remains free on a $15,000 personal bond.

California\’s insurance fraud bureau leads the nation in criminal convictions with more than a third of all convictions generated by those state agencies across the U.S., according to a study released Thursday.

The Coalition Against Insurance Fraud said the study is a barometer of the nation\’s annual progress against insurance fraud, which mounts up to $80 million annually.

The results were compiled from official figures reported by the 47 state fraud bureaus, and showed California\’s fraud bureau unit logged 1,546 criminal convictions in 2005. Second was Florida with 493 convictions.

California leads the nation with 27,687 case leads the fraud unit received in 2005, the study said, slightly ahead of New York, which received nearly 26,000 leads. Leads come from a variety of sources such as insurance companies, local law enforcement, calls to the fraud hotline, and leads the fraud unit\’s own investigators uncover.

California ranks second in cases it presented for potential criminal prosecution. Its 754 cases stand slightly behind Florida with 773 for 2005.

California\’s fraud bureau brings more resources to the fraud fight than any other state, the study said. The unit\’s top-ranked $36.8 million budget in 2006 was well ahead of New Jersey\’s, which came in next with $29.7 million.

The Coalition Against Insurance Fraud is a nonprofit alliance of consumer groups, insurers and government agencies combating all forms of insurance fraud.

San Jose Business Journal