Pennsylvania Fraud Stories - Pennsylvania Insurance Fraud

Pennsylvania Fraud Stories
JULY 2016
Pennsylvania
Insurance Fraud Prevention
Authority
Inside this issue:
Message from the Executive Director
Many states have taken the route of creating fraud bureaus to combat insurance
fraud. Going in a different direction, Pennsylvania’s legislators, with insurers,
2
consumers and law enforcement as interested parties, in late 1994 created the
Pennsylvania Insurance Fraud Prevention Authority (IFPA) to bring law enforce-
Know the Risks!
3
ment’s attention to the problem of insurance fraud. As is evident in our authorizing statute, our name and our work, we’re all about the “Prevention” of insurance
Attorney General Arrest
3
Public Relations
fraud.
43 in July Sweep
Workers’ Compensation
4
5
delphia Insurance
Fraud Detectives Re-
Ralph Burnham
Thomas
Donahue
Executive
Director
IFPA
Executive
Director
ed and the general public remains uninformed. In 2013-2014, there was an 18 month dark period where the
IFPA did not air any television or radio ads. As a result, our consumer research revealed that fewer people were
aware of what insurance fraud is along with the costs and consequences of committing fraud. Our current
sults in Arrest
New Jersey Woman
year to prosecute insurance fraud; so that the arrests and prosecutions of some,
who are jailed, fined and ordered to pay restitution, will hopefully deter others
from committing the crime. But, unless a law enforcement agency issues a press release on a case, or the news media picks up on a case, the bulk of cases go unreport-
Fraud
NICB Referral to Phila-
We provide nearly $13 million in grants to state and local law enforcement each
6
Allegedly Files Fraudu-
public awareness campaign is focused on educating insurance consumers about insurance fraud, but more
importantly the consequences and costs of committing insurance fraud.
Last fall, we launched our award winning “See How They Lie” campaign in which we used real life insurance
fraud stories to tell consumers about the consequences of insurance fraud. We are currently running radio ads
lent Claim for $11,085
in Personal Items Sto-
during Philadelphia Phillies and Pittsburgh Pirates games and plan on doing the same in 2017. Our Don’t Be
a But campaign continues to gain traction with teenagers and young adults. This summer we are sponsoring
len from Hotel Room
Know the Penalties!
7
Mark Your Calendar!
12
Who to Call
13
strikeouts at the Harrisburg Senators games with our “Strikeout Insurance Fraud” scoreboard display.
Social media has become an important part of our public awareness campaign. Millennials obtain their news
and information through social media and mostly through their mobile devices. Both of our campaign strategies are focused on creating content that can be shared through social media. For the first time in IFPA history, visitors to our websites using mobile devices have now surpassed desktop visitors.
Digital Advertising is also a major part of our fraud awareness campaign. Digital Advertising is purchased
based on behavioral and demographic targeting of those most likely to commit insurance fraud. Once a person clicks on one of our ads, they are redirected to the IFPA website or our “See How They Lie” landing page.
As you can see, we have a multi-faceted approach to our insurance fraud awareness campaign. We also have
some type of advertising running throughout the year instead of just a few weeks in the spring and fall. Hopefully, this keeps the message of “know the risks, know the penalties” fresh in the minds of people throughout
the year.
Thank you for all that you do in combating insurance fraud in Pennsylvania.
Enjoy the rest of your summer!
Page 2
Public Relations
Visit our website at www.helpstopfraud.org;
Be on the look-out for new billboards popping up
throughout Central Pennsylvania!
Weasy’s on Facebook at www.facebook.com/dontbeabut
Facebook at www.facebook.com/PennIFPA;
Rumor has it that Weasy’s been seen hanging out at Penn
State football games, and there are pictures to prove it!
and on YouTube!
Know the Risks, Know the Penalties
Page 3
Fraud Stories
The accounts of insurance fraud and insurance-related crimes that follow are drawn from Pennsylvania
law enforcement’s filed criminal complaints, press releases and newsletters. Criminal complaints docketed may be viewed online, using the “OTN” shown in each of the following accounts, through the web
portal of Pennsylvania’s Unified Judicial System. Individuals shown charged with crimes are to be presumed innocent until they are proven guilty.
The Pennsylvania Attorney General’s Office Insurance Fraud Section netted 43 arrests during a June Insurance Fraud sweep. Click here for a summary of the arrests.
Here are some of the highlights:
On June 16, 2016, Office of Attorney General special agents arrested 55 year-old Eric Pugh of Philadelphia,
PA and charged him with one count of Insurance Fraud, one count of Theft by Deception, one count of Forgery and one count of Criminal Attempt-Theft by Deception. According to the Criminal Complaint, Pugh
held an accidental injury insurance policy through AFLAC. Between October 25, 2012 and August 8, 2013,
Pugh allegedly submitted six claims to AFLAC which purportedly concerned an injury to Pugh’s back. According to the complaint, Pugh submitted several forms with each claim, which were purportedly filled out and
signed by a doctor reporting that he had repeatedly treated Pugh for his injuries. However, according to the
complaint, the doctor had died prior to all but the earliest of the identified treatment dates, and he had
stopped treating patients prior to that. The complaint stated that AFLAC paid a total of $3,360 on Pugh’s first
five claims, but refused to pay the sixth. Pugh allegedly admitted to investigators that he submitted the claim
forms knowing that the doctor had died. [OTN: U0401144]
On June 21, 2016, Office of Attorney General special agents arrested 39 year-old Lakeisha D. Ford of Pittsburgh, PA and 69 year-old Theodore Webb of Norfolk, VA and charged each with one count of Insurance
Fraud, one count of Criminal Attempt-Theft by Deception and one count of Criminal Conspiracy. According
to the Criminal Complaint, on April 23, 2015, Ford was driving her vehicle when it became involved in a
collision. The complaint stated that the vehicle’s Agency Insurance policy listed Ford as an excluded driver.
On April 24, 2015, Ford allegedly filed a claim with Agency Insurance and stated that her uncle, Theodore
Webb, had been driving her vehicle at the time of the accident. According to the complaint, Webb backed up
Ford’s version of the events in a recorded statement he provided to the insurer. However, the driver of the
other vehicle allegedly identified Ford as the operator and claimed that Webb was not in Ford’s vehicle when
the crash occurred. [OTN: G7469626, G7469641]
On June 6, 2016, Office of Attorney General special agents arrested 51 year-old Mark G. Demblowski of Carnegie, PA and charged him with one count of Insurance Fraud and one count of Criminal Attempt-Theft by
Deception. According to the Criminal Complaint, on April 25, 2015, Demblowski filed a claim with Allstate
Insurance, in which he allegedly stated that approximately $7,000 worth of items were stolen from his 2000
Chevrolet Blazer while the vehicle was parked in Pittsburgh. According to the complaint, the stolen items included a laptop computer, a tablet, video games and a 60-inch television. However, an investigation allegedly
revealed that the laptop and tablet had been returned to a retail store approximately three months before the
date of Demblowski’s insurance claim. Further, Demblowski allegedly admitted to investigators that the video
games and the television had not been stolen. [OTN: G7456610]
On June 23, 2016, Office of Attorney General special agents arrested 86 year-old Lewis Smith of Wallingford,
PA and charged him with one count of Insurance Fraud, one count of Criminal Use of a Communication
Facility and one count of Criminal Attempt-Theft by Deception. According to the Criminal Complaint, on
PA Office of
Attorney General
Makes 43
Arrests in July
Page 4
Know the Risks, Know the Penalties
Fraud Stories (Continued)
February 18, 2013, Smith filed a claim with Allstate Insurance Company, stating that his 1990 Cadillac Deville
was damaged by a hit-and-run vehicle. However, the complaint further stated that investigators subsequently
determined that the Cadillac was damaged when Smith drove it over an embankment. According to the complaint, Smith told the tow truck operator that his brakes had failed and his car had shut off, causing Smith to
drive over the embankment. The tow truck driver allegedly told the insurer that Smith said nothing about another vehicle having been involved in the accident. Smith allegedly admitted to the investigator that he had
driven the Cadillac over a barrier and down the embankment. [OTN: T8091296]
On June 1, 2016, detectives of the York County District Attorney’s Office filed a Criminal Complaint charging
34 year-old Emily C. Witmer of York, PA with Insurance Fraud. According to the complaint, it is alleged that
Witmer, during the application process in applying for an auto insurance policy with Donegal Mutual Insurance Company in June 2015, failed to disclose that her Toyota Tundra had been driven by anyone other than
her and that the vehicle was actually being driven and used by someone else for a construction business. The
complaint states that the Tundra was involved in a crash while being driven by another individual in October
Video
Surveillance
Footage
Reveals
Workers’ Comp
Claim is a
Fraud
2015. The defendant later admitted to investigators that she had not been forthcoming with relevant information when applying for her policy with Donegal. [OTN: T8059726]
On June 3, 2016, detectives of the Lehigh County District Attorney’s Office filed a Criminal Complaint charging 26 year-old Yu Han of Bethlehem, PA with Insurance Fraud. According to the complaint, on March 12,
2016, Han purchased a Progressive Auto Insurance policy to insure his 2016 Volkswagen GTI. His deductibles
were $1,000 for collision and $500 for comprehensive. On March 16, 2016, Han reported to Progressive that he
had hit a curb and damaged the right side and rim of his car but did not file a claim at that time. On March 22,
2016, he contacted Progressive again and reported that there was a scratch on the front of his car and inquired
as to whether or not he would have to pay his deductible. Reportedly, when he was told his deductible would
apply, he again did not file a claim. The complaint reflects that Han lowered his deductibles on March 23, 2016,
and subsequently on March 25, 2016 filed a claim stating that he had scratched the right and left front bumpers
of his vehicle. Progressive investigators obtained photos of Han’s vehicle taken on March 22, 2016 and reportedly found that the damage was the same as in the photos taken by Progressive in support of Han’s claim on
March 25, 2016. According to the complaint, Han later admitted that the damage was the same and that it had
occurred approximately one week prior to changing his deductibles and filing the claim with Progressive. [OTN:
T8016676]
On June 6, 2016, detectives of the Allegheny County Police Department filed a Criminal Complaint charging
38 year-old Daniel R. Morris of Monaca, PA with Workers’ Compensation Fraud. According to the complaint,
on June 2, 2014, Morris reportedly made a workers’ compensation claim to UPMC Health Plan alleging that
on June 2, 2014, he sustained a left shoulder contusion, low back sprain and neck sprain when he fell at a restaurant while delivering supplies. However, video surveillance footage showed that Morris had not fallen or
been injured as he had claimed. [OTN: G7456724]
On June 6, 2016, detectives of the Bucks County District Attorney’s Office filed a Criminal Complaint charging
39 year-old Melissa Cruz of Philadelphia, PA with seven counts each of Insurance Fraud, Forgery and Identity
Theft and three counts of Receiving Stolen Property. According to the complaint, it had been alleged that Cruz
had used three stolen prescription pad sheets from Mercer Bucks Cardiology to forge and fill seven unauthorized prescriptions under the name of a doctor there, who later reportedly confirmed that Cruz was never under
his medical care nor had he prescribed or authorized any of the seven prescriptions to her. According to the
Know the Risks, Know the Penalties
Page 5
Fraud Stories (Continued)
complaint, Cruz reportedly presented the unauthorized scripts to CVS and utilized her Health Partners Plan
insurance to pay a total of $1,307.02. [OTN: T8023035]
On June 9, 2016, from a referral received from the National Insurance Crime Bureau, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 29 year-old Zakia A. Jackson of Philadelphia, PA and
charged her with Insurance Fraud, Attempted Theft by Deception-False Impression and False Reports. According to the Criminal Complaint, on March 22, 2016, Jackson reported her 2007 Volkswagen Jetta stolen to both
the Philadelphia Police Department and State Farm Insurance Company. Detectives obtained the Philadelphia
Police Department Theft Report which stated that Jackson’s 2007 Volkswagen Jetta had been stolen from the
front of her home. Detectives then reviewed the State Farm claim file which showed that Jackson had reported
her car stolen on March 22, 2016 and received a check for $2,636. The investigation revealed that Jackson’s
vehicle was not in her possession on March 22, 2016 but at One Stop Auto Body. Jackson’s State Farm claim
history showed that on November 25, 2015, Jackson had been involved in an accident, and her car was later
towed to One Stop Auto Body. Detectives interviewed the owner of this repair shop who stated that the shop
had been in possession of Jackson’s vehicle since November 25, 2015. The owner provided detectives with tow
slips that corroborated this statement. The owner of One Stop Auto Body also reported that Jackson had at one
point called and asked them to no longer repair her vehicle. The owner recounted that he told Jackson the repairs had already been started, and therefore he would need payment. Several altercations occurred between
Jackson and the owner of One Stop Auto Body in January of 2016. Detectives obtained Philadelphia Police
Department Incident Reports which described disturbances at One Stop Auto Body which occurred when Jackson wanted to retrieve objects from her vehicle but the owner would not allow her to do so until she paid for her
repairs. Jackson then later reported the vehicle stolen to State Farm Insurance Company in March 2016. The
investigation suggested that Jackson received a State Farm claim check after her accident in November 2015 and
allegedly spent the proceeds. Jackson then asked the owner of One Stop Auto Body to stop the repairs once she
no longer had the money to pay him. When the owner demanded payment, and barred Jackson from retrieving
possessions from her car, she reported the vehicle stolen to State Farm in March 2016. [OTN: U0391952]
On June 10, 2016, from a referral received from Allstate Insurance Company, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a Criminal Complaint charging 23 year-old Damon
A. Grippo of Wyalusing, PA with Insurance Fraud and Attempted Theft by Deception. According to the
complaint, on August 26, 2015, a claim was initiated against Grippo’s grandmother’s Allstate Insurance
policy regarding Grippo and a 2007 Jeep Liberty he rented. On August 28, 2015, Grippo provided a
recorded statement to Allstate claiming that he had hit a fawn while operating the Jeep. However, upon
inspection by a representative of Casualty Consultants, Inc., it was determined that the damage to the
Jeep was not consistent with having hit a deer. On May 23, 2016, according to the complaint, Grippo
admitted that he had not hit a deer but rather had swerved off the road and into a ditch. The complaint
states that had Grippo actually struck a deer, it would have resulted in a comprehensive claim subject to
a $50 deductible. Had Grippo been forthcoming as to how the damages to the Jeep occurred, it would
have resulted in an at-fault collision claim subject to a $500 deductible and chargeable loss against his
grandmother’s Allstate policy. [OTN: T8045542]
On June 13, 2016, from a referral received from Nationwide Insurance Company, detectives of the
Northeast Pennsylvania Insurance Fraud Task Force filed a Criminal Complaint charging 41 year-old
Darlene Sawyer of Luzerne, PA with Insurance Fraud and two counts of Theft by Deception. According
to the complaint, it is alleged that Sawyer provided Nationwide that her primary address and garaging location of
her vehicles was that of Luzerne, PA when in fact she resided in Philadelphia, PA and garaged her vehicles in
NICB Referral
to
Philadelphia
Insurance
Detectives
Results in
Arrest
Know the Risks, Know the Penalties
Page 6
Fraud Stories (Continued)
Philadelphia. The complaint states that by not disclosing she resided in Philadelphia, she had paid $3,049.96
less in premiums. [OTN: T8049580]
On June 16, 2016, from a referral received from the Philadelphia Police Department Major Crimes Unit, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 23 year-old Cierra Hall of Philadelphia, PA and charged her with Insurance Fraud, Theft by Deception-False Impression, False Reports and Unsworn
Falsification. According to the Criminal Complaint, on August 23, 2015, Hall reported to the Philadelphia
Police Department that two men approached her and stole her 2015 Nissan Altima. Hall then filed an insurance
claim with USAA Insurance Company and told the company her vehicle had been stolen. In connection with
Hall’s claim, USAA paid a claim check of $19,985. Reportedly, the investigation revealed that at the time of the
alleged theft, Hall was unemployed and could no longer afford to pay her car loan. Hall therefore agreed to stage
“Jordan attempted
to defraud Federal
Insurance
Company of
$11,085 for items
that allegedly went
missing from her
room.”
a theft with her friend in an attempt to have the insurance company pay off her car loan without damaging her
credit. [OTN: U0401111]
On June 28, 2016, from a citizen referral, detectives of the Philadelphia District Attorney’s Insurance Fraud
Unit arrested 47 year-old Tanya Fields of Philadelphia, PA and charged her with Insurance Fraud and Forgery.
According to the Criminal Complaint, detectives learned from the PennDOT title history of Fields’ 1994 Mercury that Fields had originally purchased the vehicle in December 2013 and had allegedly registered the vehicle
with an Omni Insurance financial responsibility identification card. Detectives reportedly contacted an Omni
Insurance representative and found that Fields’ policy number was not valid. [OTN: U0415564]
On June 30, 2016, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested 46 year-old
Kim Jordon of Linwood, NJ and charged her with Insurance Fraud, Attempted Theft by Deception and False
Reports. According to the Criminal Complaint, on July 13, 2014, Jordan returned to the room where she was
staying at a Hilton Hotel in Philadelphia and discovered that her room key would not work. Jordan went downstairs to speak to the manager on duty and learned that the hotel had mistakenly put another guest in Jordan’s
room. Hotel security then moved the guest to another room on the floor so that Jordan and her family could get
back into the room which originally belonged to them. Two days after the incident, Jordan reported to hotel
security that some of her personal belongings were missing, including 20 bathing suits valued at $970. Jordan
was asked to make a list of the missing items and to file a police report. On July 22, 2014, Jordan submitted a
list detailing the allegedly stolen items and filed a report with the Philadelphia Police. Jordan wrote that her
clothing, cell phone, jewelry, sunglasses, perfume, suit cases, makeup and electronics were all allegedly missing as
a result of this incident. Insurance Fraud Unit detectives interviewed Hilton Hotel employees who worked on
the night of the alleged theft as part of their investigation. These employees stated that the man who had been
mistakenly placed in Jordan’s room only had a small bag with him, and when notified of the mistake, he and his
companion left the room immediately. These employees also stated that Jordan had not immediately reported
any of her items missing on the night she discovered that another guest had been in her room. Furthermore,
when Jordan was later asked to provide receipts for these items she stated she was unable to do so. Detectives
also interviewed the man who had been mistakenly put in Jordan’s room and he stated that he had only brought
a small bag of his own to the hotel, and never saw any personal items or suitcases when he entered the room
that belonged to Jordan. Jordan attempted to defraud Federal Insurance Company of $11,085 for items that
allegedly went missing from her room. Jordan contradicted her own account of the night of the supposed theft
on several occasions and was unable to provide receipts for any of the items she alleged had been stolen. [OTN:
U0418235]
Know the Risks, Know the Penalties
Page 7
Fraud Stories (Continued)
On June 1, 2016, an East Stroudsburg, PA man was granted ARD with three months' probation and was ordered to pay $796.50 in court costs. On February 4, 2016, from a referral received from Donegal Insurance
Group, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a Criminal Complaint in
The Penalties:
The following dispositions of cases previously reported on were obtained via
the web portal of Pennsylvania’s Unified Judicial System.
Monroe County charging the defendant with Insurance Fraud. According to the complaint, the defendant's
auto insurance policy with Donegal was canceled on April 17, 2015 due to non-payment. On May 4, 2015, he
contacted Donegal to reinstate his policy and during his application for the reinstatement of his policy, reported that there had not been any losses, damage or accidents during the time his policy was canceled. Subsequently on May 6, 2015, the defendant contacted Donegal to file an accident claim for a crash he reported had
occurred on May 5, 2015; however, a Pennsylvania State Police Accident Report showed that the accident
occurred on April 29, 2015 at 6:00 PM, during the time in which the defendant’s auto insurance policy was
canceled. [OTN: T7558283]
On June 1, 2016, Jennifer Ann Burns of West Chester, PA pled Guilty to Forgery and Theft by Deception-
“The fraud was
revealed when Burns’
mother-in-law
False Impression and was sentenced to serve three years' probation and was ordered to pay $800 in fines,
$150.31 in restitution and $302 in court costs. On February 8, 2016, Office of Attorney General special agents
contacted Cigna
filed a Criminal Complaint charging Burns with four counts each of Insurance Fraud, Acquire or Obtain Possession of Controlled Substance, Criminal Use of Communication Facility, Forgery, Attempted Theft by De-
Insurance Company
ception-False Impression and Prohibited Acts. According to the complaint, it is alleged that Burns used the
identity of her mother-in-law to obtain prescription drugs. The fraud was revealed when Burns’ mother-in-law
contacted Cigna Insurance Company to report that an unknown person had stolen her identity in order to
obtain four Vicodin prescriptions. Burns reportedly admitted while being interviewed by special agents that
she had a drug problem and that she had used her mother’s-in law information to phone in and obtain the
prescriptions. [OTN: T7566591]
On June 6, 2016, from a Negotiated Guilty plea to Insurance Fraud and Conspiracy, Derrick T. Stephens of
Philadelphia, PA was sentenced to serve three years' probation and was ordered to pay $500 in restitution and
court costs of $1,649.50. In November 2015, from a referral received from the National Insurance Crime Bureau (NICB) regarding Repwest Insurance Company, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested Stephens along with three other individuals. Stephens was charged with Criminal
Attempt Theft by Deception-False Impression, Conspiracy and False Reports. According to the Criminal Complaint, it had been alleged that Stephens participated in filing a fraudulent claim alleging that he had been
involved in an accident between a Repwest insured UHaul truck and a USAA insured Nissan Quest. Insurance fraud detectives retrieved a Philadelphia Police Report that is completed by complainants after an accident which indicated that one of Stephens’ co-defendants had crashed a UHaul rental vehicle into a 2004
Nissan Quest occupied by Stephens’ three co-defendants. Each occupant of the Quest retained an attorney to
represent them in a personal injury lawsuit stemming from the alleged accident and also sought physical therapy. However, all four defendants later admitted to a Repwest adjuster that the accident had been staged for the
purpose of filing fraudulent claims. Court records reflect that the cases against the other defendants remain
active investigations. [OTN: N9870582, N9864713, N9866371, N9867992]
to report that an
unknown person had
stolen her identity in
order to obtain four
Vicodin
prescriptions.”
Page 8
Know the Risks, Know the Penalties
Fraud Stories (Continued)
On June 7, 2016, a Philadelphia, PA man was granted ARD with two years' probation and was ordered to
pay $2,500 in restitution and court costs of $419. On February 3, 2016, Office of Attorney General special
agents filed a Criminal Complaint charging the defendant with Insurance Fraud and Attempted Theft by
Deception-False Impression. According to the complaint, the defendant reported to his insurer, Utica First
Insurance Company, that the awning of his pizza shop was damaged by Hurricane Sandy on October, 29,
2012, and sought over $4,000 in benefits to replace it. Utica assigned an independent adjuster to inspect the
awning, and according to the complaint, the adjuster reported to Utica that the damage he saw had been
present when he had inspected the pizza shop in both June of 2012 and September of 2012 in connection to
several other claims. In fact, the damage to the awning was visible in photographs that the adjuster took during earlier inspections. The complaint states that under the defendant's policy with Utica, the damage to the
awning would have been covered by an extraordinary event such as a hurricane, but not by ordinary wear and
tear or ordinary weather conditions. Utica denied the defendant's claim. [OTN: N9957043]
On June 7, 2016, Mary Ann Knechtel of Butler, PA pled Guilty to Acquire or Obtain Possession of Controlled Substance and Forgery and was sentenced to serve 12 months' probation and was ordered to pay
$1,197.65 in restitution and court costs of $838.50. On February 22, 2016, Office of Attorney General spe-
Accelerated
cial agents filed a Criminal Complaint in Butler County charging Knechtel with two counts each of Insurance Fraud, Acquire or Obtain Possession of Controlled Substance and Forgery. According to the complaint,
between August 2012 and April 2014, while employed as a Certified Nurse Practitioner at UPMC Montefiore Hospital in the Anesthesia Department, Knechtel began calling in unauthorized prescriptions for
Rehabilitative
Schedule II Vicodin/Hydrocodone pills for herself and under her husband’s name to various pharmacies in
Butler County. Knechtel obtained the prescriptions by utilizing the DEA registration numbers of physicians
Disposition
physicians from the pain clinic confirm that they did not prescribe nor authorize the prescriptions for
Knechtel. Knechtel also worked as a temp nurse in the Fall of 2012 for three months at a Butler County
at a UPMC pain clinic where she was, at one time, a patient of the clinic. Knechtel had suffered severe neck
pain for several years due to previous surgeries and used all of the Vicodin/Hydrocodone for herself. The
medical office while a nurse from the office was on maternity leave. While employed at the office, Knechtel
called in prescriptions for Vicodin pills by using the practice physician as a prescriber without his authorization. Knechtel paid for the fraudulent prescriptions with her insurance coverage with Highmark PEBTF, in
which she was covered under her husband who is a retired Commonwealth of Pennsylvania employee. The
complaint states that Highmark paid $1,097.65 for the prescriptions. [OTN: T7617842]
On June 8, 2016, a Philadelphia, PA woman was granted ARD with six months' probation and was ordered
to pay $500 in restitution and court costs of $569. On March 17, 2016, from a referral received from Geico
Insurance Company, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested the
defendant and charged her with Insurance Fraud and Attempted Theft by Deception. According to the
Criminal Complaint, the defendant's father was driving her 2010 Honda Civic and was involved in an accident on September 16, 2015, and that the defendant's auto policy with Geico was lapsed at the time. The
defendant, on September 17, 2015, contacted Geico to obtain an insurance policy and subsequently contacted Geico again to file a claim for her father's accident and allegedly misrepresented to Geico representatives
that the accident occurred on September 18 after she obtained her policy. [OTN: M7908036]
On June 8, 2016, from a Negotiated Guilty pleas to Insurance Fraud, Thomas M. Turner of Pittsburgh, PA
was sentenced to serve 18 months' probation and was ordered to pay $2,147.62 in court costs. On March 18,
2016, the Allegheny County District Attorney’s Office received a case for prosecution regarding Turner.
Turner had been charged in July 2015 with two counts of Insurance Fraud and one count of False Reports.
Know the Risks, Know the Penalties
Page 9
Fraud Stories (Continued)
According to the Criminal Complaint, on July 20, 2015 at 5:10 AM, a Baldwin police officer responded to a
report of a vehicle theft. Turner had reported that his rental car, a 2014 Hyundai Sonata had been stolen from
his driveway overnight. The following morning, Baldwin Police Department received a call from an Erie Insurance investigator who had located the vehicle, and when an officer and investigator confronted Turner about
the vehicle, the complaint states that Turner admitted to them that he had crashed the vehicle and left it where
it had been found. [OTN: G7174580]
On June 10, 2016, from a Negotiated Guilty plea to Insurance Fraud, Jason Michael Blanski of Reading, PA
pled Guilty to Insurance Fraud and was sentenced to serve 18 months' probation and was ordered to pay
$2,031.05 in court costs. On February 12, 2016, Office of Attorney General special agents filed a Criminal
Complaint in Lehigh County charging Blanski with Insurance Fraud and Attempted Theft by Deception-False
Impression. According to the complaint, on July 11, 2015 at 9:55 AM, Blanski purchased a Progressive Insurance Company auto insurance policy to insure his 2011 Hyundai Accent, and subsequently on July 12, 2015,
filed an accident claim to Progressive stating that he had been involved in a two-vehicle accident on July 11,
2015 at 1:00 PM. Blanski’s vehicle was towed to Saucon Collision where an estimate to repair Blanski’s vehicle
totaled $2,293. Saucon Collision provided Progressive with an invoice which showed they had been dispatched
to tow Blanski’s vehicle on July 1, 2015, which contradicted Blanski’s claim that the accident occurred on July
11, 2015. Further investigation revealed that the accident had actually occurred on July 1, 2015 at 7:20 AM
before Blanski had obtained his Progressive auto insurance policy, and it is alleged that Blanski misrepresented
the date and time of the accident in an attempt to have Progressive pay his claim.
On June 13, 2016, from a Negotiated Guilty plea to Insurance Fraud, Chrisandra Denna Trapp of Philadelphia, PA was sentenced to serve two years' probation and was ordered to pay $972.48 in court costs. On November 12, 2015, Office of Attorney General special agents filed a Criminal Complaint in Bucks County charging
Trapp with two counts of Insurance Fraud and one count of Criminal Attempt Theft by Deception-False Impression. According to the complaint, Trapp purchased a GEICO Insurance auto insurance policy on September 13, 2013 at 9:15 PM to insure her 2007 Pontiac Grand Prix. Subsequently on September 13, 2013 at 10:43
PM, Trapp contacted GEICO again to report that she had been involved in an accident with a 2011 Ford Focus, insured with Nationwide Insurance, while operating her Grand Prix with her fiancé as a passenger at 9:45
PM that same evening. GEICO reportedly obtained a Philadelphia Police Accident Report that stated the accident occurred on September 13th at 7:45 PM, which was prior to Trapp obtaining her GEICO auto insurance
policy. The investigation revealed that, in addition to Trapp allegedly misrepresenting to GEICO the actual
time of the crash, she had also fraudulently claimed that her fiancé was in the vehicle at the time of the crash
when in fact, she was the only occupant in her vehicle at the time. Neither GEICO nor Nationwide paid any
part of Trapp’s claim. [OTN: T7245066]
On June 23, 2016, from a Negotiated Guilty plea to Unlicensed Broker/Agent Activity, Theft by DeceptionFalse Impression and Forgery, David M. Smith of Lancaster, PA was sentenced to serve five years' probation
and was ordered to pay $3,300 in court costs. On February 11, 2016, Office of Attorney General special agents
filed a Criminal Complaint charging Smith with Insurance Fraud and two counts each of Theft by DeceptionFalse Impression and Forgery. According to the complaint, it is alleged that Smith, a licensed insurance producer, misappropriated some $31,741 in premium payments from March 2009 through October 2010 to make
it appear that Lanco Lawncare’s owner and employees had valid workers’ compensation coverage when in fact
they did not. Further alleged is that Smith purported to obtain life insurance policies for three employees of
Waste Oil Recyclers. Each employee signed policies for coverage through Genworth Life Insurance and Waste
Oil Recyclers paid the premium payments totaling $7,114.98 directly to Smith on behalf of its three employees
Defendants
Sentenced to
Probation
Know the Risks, Know the Penalties
Page 10
Fraud Stories (Continued)
for policies that allegedly did not exist. According to the complaint, Smith had also forged signatures on a Broker of Record form for Waste Oil Recyclers. During a December 2015 interview with special agents, Smith reportedly admitted that he had accepted payments from the owner of Lanco Lawncare and employees of Waste
Oil and then cashed the checks for his own personal use without obtaining the insurance policies, and further
admitted to forging the Broker of Records form signature for Waste Oil and creating falsified workers’ compensation documents so that Lanco Lawncare’s owner and employees believed they had workers’ compensation
coverage. [OTN: T7583892]
On June 24, 2016, an Allison Park, PA woman was granted ARD with 18 months' probation and was ordered
to perform 200 hours of community service and to pay a $300 civil penalty to the Insurance Fraud Prevention
admitted that he had
Trust Fund and $2,596.50 in court costs. On January 19, 2016, from a referral received from Geico Insurance
Company, detectives of the Allegheny County Police Department filed a Criminal Complaint charging the
defendant with Insurance Fraud. According to the complaint, the defendant reported to Geico that her 2011
Dodge Caliber had been stolen. The vehicle was recovered on June 8, 2015 and, according to detectives, was in
accepted payments
generally good condition other than a point of minor impact to the right front bumper and the radio antenna
was broken at the base of the fender. The defendant subsequently contacted Geico to advise that she’d picked
from the owner of
her vehicle up on June 10, 2015 and claimed that there were dents and scratches on the vehicle, the back seat
was cut, the radio did not work and the windshield wiper control/turn signal control was broken. Photographs
Lanco Lawncare and
of the vehicle taken at the time it was recovered were compared to photographs taken after the defendant took
back possession of the vehicle and reportedly showed that the damages Forrester claimed to Geico’s appraiser
“….Smith reportedly
employees of Waste
Oil and then cashed
the checks for his own
had not occurred until after the defendant obtained possession of the vehicle. According to the complaint, the
estimated net cost of repairs minus the defendant's $1,000 deductible was $5,795.45; however, Geico did not
pay the claim. [OTN: G7330794]
On June 24, 2016, an Allentown, PA man was granted ARD with 30 months' probation and was ordered to pay
$1,241 in court costs. On April 27, 2016, detectives of the Lehigh County District Attorney's Office filed a
Criminal Complaint charging the defendant with two counts of Insurance Fraud. According to the complaint,
personal use without
it was alleged that the defendant filed a claim with Safe Auto Insurance for damages to his Cadillac DTS allegedly during a time when the vehicle was uninsured. It had been alleged that the defendant contacted Safe Auto
and obtained an auto insurance policy after the fire had already occurred, and in filing the subsequent claim,
obtaining the
stated that the fire occurred after he obtained the Safe Auto policy. Safe Auto did not pay the defendant's claim.
[OTN: T7867366]
insurance policies…”
On June 29, 2016, a Norristown, PA man was granted ARD with two years' probation and was ordered to pay
$500 in restitution and court costs of $1,019. On April 20, 2016, detectives of the Philadelphia District Attorney's Insurance Fraud Unit arrested the defendant and charged him with Insurance Fraud and Conspiracy.
According to the Criminal Complaint, on October 16, 2015, the defendant was involved in an accident at the
intersection of Henry Avenue and Midvale Avenue in Philadelphia. The defendant called Esurance Insurance
Company to report the accident and learned that his insurance policy had been canceled. The driver of the
other vehicle involved in the accident then instructed the defendant to reinstate his policy and they would report to their insurance companies that the accident happened a day later. The defendant obtained a new policy
with Esurance Insurance Company and then later told the company that the accident occurred on October 17,
2015. Detectives retrieved the defendant's cell phone records which showed that he did call Esurance from his
cell phone on October 16, 2015. The records also indicate that the defendant and the other driver exchanged
calls on October 17, 2015. [OTN: U0325091]
Know the Risks, Know the Penalties
Page 11
Fraud Stories (Continued)
On June 29, 2016, Brian Allen Wenhold of Sellersville, PA pled Guilty to Insurance Fraud and was sentenced
to serve two years' probation and was ordered to pay $1,543.63 in court costs. On February 24, 2016, detectives
of the Bucks County District Attorney’s Office filed a Criminal Complaint charging Wenhold with Insurance
Fraud. According to the complaint, on December 14, 2015, Wenhold obtained an Erie Insurance policy to
insure his 2001 Ford Focus. On December 25, 2015, Wenhold filed a fire claim reporting that after parking
the vehicle in his driveway, a neighbor had alerted him that his car was on fire. During the course of the investigation, it was revealed that Wenhold had an extensive arrest record that included bad checks, failure to register
with state police, terroristic threats, indecent assault, corruption of minors and theft – all of which he failed to
disclose when applying for his auto policy with Erie. The complaint states that Erie rescinded Wenhold’s policy
as he had not been forthcoming as to his prior arrest records. [OTN: T7632704]
On June 30, 2016, a New Port Richey, FL man was granted ARD with six months' probation and was ordered
to pay court costs of $1,191. On December 7, 2015, detectives of the Erie City Police Department filed a Criminal Complaint charging the defendant with Insurance Fraud, Theft by Deception-False Impression, Receiving
Stolen Property, False Swearing, False Reports to Law Enforcement and Unsworn Falsification. On August 31,
2015, the defendant reported to Erie Police that his Nissan Titan pickup truck was stolen around June 5, 2015
while parked in his condo parking lot, and subsequently filed a claim with his insurer, Erie Insurance Company. According to the complaint, the defendant stated he’d been in Mongolia since May 2015 and that his wife
had discovered the truck missing in June; however, he alleged that the police would not take the report from
his wife as the defendant was the only listed owner on the title of the truck. According to the complaint, on
November 27, 2015, the defendant’s “stolen” truck was recovered. Reportedly, the investigation revealed that
the defendant privately sold the truck for $17,900 to the individual operating the vehicle when it was stopped
before reporting it stolen. The complaint reflects that Erie had paid the defendant $18,250.28 for the theft
claim. [OTN: T7338284]
On June 30, 2016, an Edensburg, PA woman was granted ARD with 23 months' probation and was ordered to
pay $2,273.99 in court costs. On February 23, 2016, from a referral received from Progressive Insurance Company, Office of Attorney General special agents filed a Criminal Complaint in Cambria County charging the
defendant with Insurance Fraud and Attempted Theft by Deception-False Impression. According to the complaint, in June 10, 2015, the defendant obtained a full comprehensive and collision policy from Progressive
Insurance Company for her automobile. On June 11, 2015, the defendant submitted a claim with Progressive
stating that she had been involved in an accident at a local high school parking lot. Video surveillance footage
from the school parking lot showed that the accident had actually occurred prior to the defendant obtaining
her new coverage from Progressive. Progressive denied the defendant's claim. [OTN: T7624142]
“The complaint
states that Erie
rescinded Wenhold’s
policy as he had not
been forthcoming as
to his prior arrest
records.”
Page 12
National & State Anti-Fraud Events Offer New Knowledge & New Contacts
*September 11—14, 2016 — IASIU Conference — Red Rock Resort, Nevada
*October 17—19, 2016 — Annual NJSIA Seminar — Harrah’s, Atlantic City, NJ
*April 6—7, 2017 — PA 2017 Insurance Fraud Conference — Hershey Lodge & Convention
Center, Hershey, PA
Page 13
Who to Call
Insurance Fraud
Allegheny County DA’s Office, (412) 461-2328
Allegheny County PD, (412) 473-1254
Attorney General’s Office, (717) 787-0272
Bucks County DA’s Office, (215)348-6344
PA INSURANCE FRAUD
PREVENTION
AUTHORITY
6 Kacey Court, Ste. 101
Mechanicsburg, PA 17055
Phone: 717-691-1828
Fax: 717-697-1013
Cumberland County DA’s Office, (717) 240-7764
Delaware County DA’s Office, (610) 891-4700
Erie Bureau of Police, (814) 870-1258
Lehigh County DA’s Office, (610) 264-8758
NE Insurance Fraud Task Force, (570) 963-5177
Philadelphia DA’s Office, (215) 686-8723
York County DA’s Office, (717) 771-9600 x 329
www.helpstopfraud.org
Arson
Dauphin County DA’s Office, (717) 255-2770
PA State Police-Fire Marshals, (717) 346-4597
Anti-Fraud Compliance
PA Insurance Department, (717) 705-4199
IFPA Staff
Thomas Donahue,
Executive Director, [email protected]
Joan Dockery,
Associate Executive Director, [email protected]
Christine Cassel,
Grants Administrator, [email protected]