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Fraud and Abuse
October 8, 2003 -- New Jersey Attorney General Peter Harvey announced that a former Camden City Police Sergeant was sentenced for insurance fraud and related charges following a guilty verdict on Aug. 7, after a six-day trial before Camden County Superior Court Judge John McNeill, III. - full story
August 5, 2003 -- New Jersey Attorney General Peter Harvey announced that an Essex County chiropractic physician and seven other Essex County residents have been charged by the Division of Criminal Justice - Office of Insurance Fraud Prosecutor with staging numerous phony automobile accidents in order to submit fraudulent insurance claims totaling more than $50,000. - full story
October 16, 2003 -- A scheme using medical clinics to defraud insurance companies under New York's no-fault law is punishable under a federal anti-medical fraud statute, the 2nd U.S. Circuit Court of Appeals has ruled. - full story
October 6, 2003 -- Continuing efforts to put an end to reported spiraling auto insurance premiums by combating fraud, Florida's Chief Financial Officer Tom Gallagher recently joined Miami-Dade State Attorney Katherine Fernandez-Rundle in announcing that a prosecutor will soon be hired to specifically prosecute auto insurance fraud cases. The prosecutor will be hired within 90 days and will be based in Miami, where more than 510 arrests have been made since 1999. - full story
October 1, 2003 -- The Alliance of American Insurers has issued an announcement noting that the State of New Jersey has assumed a leadership role in efforts to fight insurance fraud, following a "change in attitude and increased efforts, backed by strong legislation." - full story
If your company is admitted to do insurance business in California you must recognize that the Department of Insurance has made almost every employee part of your integral anti-fraud personnel. It defines the term as follows: -
HOUSTON -- Dr. Chijioke Victor Okoro, 50, was sentenced Tuesday to 151 months in federal prison, without parole, for health care fraud. In addition to the maximum prison term United States District Judge Lynn N. Hughes also ordered Okoro to pay restitution in the amount of $525,000 to the Medicare program and private insurers, and fined him $6.25 million. -
September 17, 2003 -- Insurance Commissioner Robert Wooley says at least two Louisiana victims have been claimed by a quasi-health insurance telemarketing scam that has been spreading across the United States and Canada. Confirmation of two victims in central Louisiana prompted the Fraud Units of the Department of Insurance and the State Police to investigate the matter, Wooley said. -
September 15, 2003 -- New Jersey Attorney General Peter Harvey announced that a Passaic County M.D. has pleaded guilty to various insurance fraud crimes, including paying "runners" to bring in patients, submitting phony health care insurance claims and billing for medical services that were never rendered to patients. -
September 12, 2003 -- The Florida Office of Insurance Regulation is reportedly moving ahead with developing guidelines designed to tighten personal injury protection (PIP) rules in the state, as required by legislation passed in the last session. -
September 9, 2003 -- New Jersey Attorney General Peter Harvey announced that an Essex County man has been sentenced in Superior Court for his reported role in an organized scheme to illegally obtain official police accident reports in order to collect more than $36,000 in fraudulent insurance payouts. -
ORANGE COUNTY - A Los Angeles man pleaded no contest to two felony counts of insurance fraud after CDI Fraud investigators determined that he misrepresented injuries allegedly sustained in his workplace. Tommie Lee Robinson, 55, claimed he injured himself while moving materials in his position as a Quality Control Inspector at Cherokee International, a manufacturing company in Irvine, CA. Robinson was sentenced on September 17 in Orange County Superior Court to 90 days in jail and ordered to pay $11,562 in restitution, $200 in fines, and serve three years formal probation. - full story
The Ohio Bureau of Workers' Compensation has issued its annual Special Investigations Department report for fiscal year 2003, identifying a record $102 million in savings, with the referral of 306 subjects for criminal prosecution for a record 166 indictments and a record 148 convictions. -
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