Reports of Convictions From the Coalition Against Insurance Fraud –
may be found here.
* Jorge Moreno wanted to help a friend dump his 2002 Cadillac Escalade for insurance money. But the Reno-area con wasn’t very friendly; it was fatal. His buddy Oscar Zavala-Gallegos couldn’t afford the $620 monthly payments and owed more than the Caddy was worth. So he decided to fake a theft. Zavala-Gallegos
parked the car at a mall, leaving the keys inside. Moreno and Fabian Cedeno took the car and broke out its windows. The pair then drove the car at a high speed, intending to hit a guardrail and damage the Caddy.
Cedeno was driving. He jumped out before the crash and was killed by a head injury. Moreno drove Cedeno to a hospital, claiming Cedeno was beaten in a bar fight. That story didn’t wash, and cell phone records helped expose the con.
Moreno pleaded guilty, and faces up to four years when sentenced in September.
No word on the fate of Zavala-Gallegos.
* The public-spirited handyman wasn’t very handy to a would-be arsonist. Susan Washington wanted to burn down her Ocala, Ga. home to collect $100,000 in insurance money. She told her handyman that tenants had made a mess of the place, and she wanted to torch it. Washington offered him $5,000 to do the deed.
But instead of taking the windfall, he told Ocala police about the plot. “Go and get it done and if you can call me from a pay phone from now on, cuz I’m not going to ring your number after this goes down, because I don’t want them to think that I’m talking to you after it’s been done because that might raise suspicion,” Washington said in a taped conversation with the handyman. She
pleaded guilty yesterday, and faces up to 20 years in federal prison when sentenced.
* Larry Butler filed the same injury claims against several razor manufacturers for the same injury, stealing $9,500 from the companies. The scam cost him 14 years and four months in California state prison, the insurance department said yesterday. The Palmdale man said razors made by Phillips, Proctor & Gamble,
Eveready/Energizer and Panasonic caused him to have ingrown facial hairs that scarred his face. Butler submitted the same photos of the claimed injury plus the same receipt and price quote for skin treatment to all the companies, which are self-insured. Coalition member GlobalOptions SIU investigated on behalf of one of its third-party administrator clients, and referred the case to the California insurance department for further investigation.
* Needing a good high, David Van Dunk Jr. used his father’s prescription plan to scam painkillers oxydodone, Percocet, morphine sulphate and other drugs. The Hewitt, Conn. man claimed the drugs were for his father. Junior bilked Connecticut General Life out of $12,140. Van Dunk received probation Monday, and must go into rehab.
* A strip-mall owner hired a mother-son team to burn down the place for insurance money. Dan Thornton had borrowed nearly $400,000 to launch the Stockton, Calif. mall, but fell behind on payments. He allegedly offered Dina Larson and her 19-year-old son Jacob Smith a cut of the insurance money to torch the place. They did the deed, then Thornton said it was a hate crime by someone who disliked Thornton because he was gay, prosecutors charge. But Smith confessed the next day, implicating his mother. Officials also discovered containers of kerosene at the site. They traced the containers back to a nearby Wal-Mart. Store security cameras showed Larson purchasing Coleman fuel, gloves,
black shirts and hats, nylons and other items. Larson and Smith have pleaded guilty. Each faces at least five years in federal prison when sentenced, but could receive up to 20 years. Thornton still faces charges.
* A pipe burst and damaged Kenneth and Charlene Frye’s house in Orlando. The couple made an insurance claim to re-pipe their home, and Travelers of Florida paid out $8,827.50. Four months later, Charlene said they’d incurred more expenses and handed Travelers a $21,610 proposal from Absolute Affordable by Anthony’s.
Travelers re-inspected their home and found that many items on the proposal weren’t completed. The insurer met with Antonio Fiol, owner of the repair company. He said he’d done work and was paid $4,965. But Fiol denied preparing or signing the larger proposal. Travelers referred the case to the Florida Department of Financial Services. Charlene recently received probation and must repay Travelers $4,275. Kenneth apparently wasn’t implicated.
* Jesus Quiroz told Infinity Insurance that someone stole his 2002 GMC Denali on August 9. Except that Infinity learned the Oxnard, Calif. man’s vehicle had been impounded in Mexico on August 8. Quiroz finally admitted he had financial problems and couldn’t afford the payments, so he abandoned the Denali in Mexico to collect an insurance payout. He received 90 days in county jail in September.
* An agent who also was a prominent volunteer education official stole more than $22,000 in client premiums and used the loot for personal expenses. Al Perry once chaired the North Andover (Mass.) school committee. The head of the Internet Insurance Agency, Perry used the premiums to pay personal gas, phone
and credit card bills. His clients began complaining when they discovered they didn’t have workers comp or other coverage for which they thought they paid.
Perry’s agent-sons turned him in when they discovered the scheme. He received two years of probation, and has begun repaying his clients. The con was triggered by unspecified medical problems Perry said he suffered.
* The largest workers comp fraud case in California history closed a major chapter yesterday when the state workers comp board dismissed $70 million in bogus medical bills allegedly submitted for payment by a giant medical mill called Premier Medical Management Systems. Premier allegedly submitted several thousand bills to comp insurers, paying lawyers kickbacks for referring patients. Premier targeted Hispanic claimants with minor injuries and tried to
ring up thousand of dollars in medical bills for each claim by providing worthless treatment then inflating the bills, officials say. It was a complex “pay to play” cross-referral network involving physicians and lawyers, officials charge. The dismissal this week culminates seven years of investigation and litigation by Travelers Insurance and other carriers. A multi-agency task force launched a criminal probe, and courts threw out Premier’s retaliatory lawsuits.
The September deal was part of a plea bargain that will keep Premier’s operators out of prison, says Al MacKenzie, Los Angeles County Deputy DA. MacKenzie says he still plans to file criminal charges.
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