Archive for the ‘Insurance Fraud Arrest’ Category

Father and Daughter Charged with Fraud

June 26, 2014

June 16, 2014: – A Philadelphia father and daughter are now facing fraud charges. 48 year old Ronald Walker and his 26 year old daughter Chynise Walker have been charged with Theft by Deception, Insurance Fraud, Criminal Conspiracy, and False Reports.

The Philadelphia District Attorney’s Office Insurance Fraud Unit (IFU) detectives began to investigate Ronald and Chynise Walker after receiving a fraud referral from the Philadelphia Police Major Crimes Auto Squad. On February 28, 2012, a Major Crimes Auto Squad Officer was executing a search warrant inside a garage on West Queen Lane in Philadelphia when he recovered a 2003 Lincoln which had been previously reported stolen by Chynise Walker to the Philadelphia Police. The Lincoln registered as currently belonging to State Farm Insurance Company and so the officer referred the case to the Insurance Fraud Unit detectives for further investigation.

Detectives retrieved the Philadelphia Police Vehicle Theft Report which had been filed by Chynise Walker on May 23, 2010 and indicated that Walker still had the keys to her vehicle in her possession at the time the theft was reported. Detectives then obtained Walker’s State Farm Insurance file which contained a copy of a recorded interview in which Walker again stated that she had turned in the key and remotes to her vehicle only after she reported the theft to the Philadelphia Police and State Farm. However, examination of the 2003 Lincoln revealed that the car could only be operated by a programmed transponder key which Walker still had in her possession at the time of the alleged theft. Furthermore, detectives also discovered that the garage where the Lincoln had been recovered has been leased by Walker’s father, Ronald Walker, for the last six years.

Based on the investigation, both Ronald and Chynise Walker were arrested for allegedly conspiring to file a fraudulent theft claim for the 2003 Lincoln. State Farm Insurance Company issued payment in over fourteen thousand dollars in connection to this claim. Both targets were charged with Theft by Deception, Insurance Fraud, Criminal Conspiracy and False Reports. They are next scheduled to appear for a status hearing in Philadelphia Municipal Court on June 20, 2014.

Detective Robert Stansfield and ADA Dawn Farrell of the Insurance Fraud Unit are specially assigned to this case.

MAN ARRESTED FOR SELLING PHONES HE PREVIOUSLY REPORTED STOLEN

June 26, 2014

June 12, 2014: 47 year old Bardell Wanley is now facing Theft by Deception and Insurance Fraud charges. The Philadelphia District Attorney’s Office Insurance Fraud Unit detectives began to investigate Bardell Wanley after receiving a citizen referral from a complainant who had purchased a Samsung Galaxy and an iPhone5 from Wanley for a sum of one hundred and thirty dollars. Detectives retrieved Wanley’s cell phone records which revealed that Wanley had reported these phones stolen to Assurant Insurance Company on December 30, 2013. The investigation revealed that Wanley had to pay a one hundred and seventy dollar deductible which he later attempted to extort from the complainant who also eventually lost use of the phones because they had been reported stolen. Wanley was arrested for Insurance Fraud and Theft by Deception on June 12, 2014. He is next scheduled for a status listing in Philadelphia Municipal Court on June 17, 2014.

ADA Dawn Farrell and Detective Andrew Snyder of the DA’s Insurance Fraud Unit are specially assigned to this case.

Philadelphia Woman Charged with Filing Workers Comp Claim While Working for Another Company

June 26, 2014

June 11, 2014: The Philadelphia District Attorneys Office has charged 49 year old Donna Shaw with Theft by Deception, Insurance Fraud and Worker’s Compensation Insurance Fraud.

The Philadelphia District Attorney’s Office Insurance Fraud Unit detectives began to investigate Donna Shaw after receiving a referral from the PMA companies who pay worker’s compensation benefits as a third party administrator for the School District of Philadelphia. On November 30, 2004, Shaw allegedly hurt her back moving a box of hamburgers while working as a food service manager for the School District of Philadelphia and has since been receiving Temporary Total Disability benefits from PMA. However, the investigation revealed that in spite of submitting forms where she indicated that she was not self-employed nor had she undergone any change in condition, Shaw began to work at a dog care facility called East Paws. Surveillance footage revealed that Shaw would walk dogs, clean up after dogs and carry supplies while working at the facility. Detectives interviewed the owner of East Paws who confirmed that Shaw had worked at the location for two and a half years prior to the closing of the site. Based on surveillance footage and interviews, detectives determined that Shaw had misrepresented the fact that she was employed while receiving benefits and had she disclosed this information then PMA would have ceased or reduced her compensation. Shaw was arrested for Theft by Deception, Insurance Fraud and Worker’s Compensation Insurance Fraud on June 11, 2014. She is next scheduled to appear in Philadelphia Municipal Court on June 16, 2014 for a status listing.

Detective Andrew Snyder and ADA Vicki Markovitz of the Insurance Fraud Unit are specially assigned to this case.

Fraud Arrest for “Fake” Slip and Fall outside Dunkin Donuts

June 9, 2014

May 20, 2014: 55 year old Anthony Pagano has been charged with Insurance Fraud, Attempted Theft by Deception, Perjury and Unsworn Falsifying by the Philadelphia District Attorney’s Office.

The Philadelphia District Attorney’s Office Insurance Fraud Unit (IFU) detectives began to investigate Anthony Pagano after receiving a referral from Harleysville Insurance Group. Pagano retained counsel to represent him in a personal injury lawsuit resulting from an alleged slip and fall inside of a Dunkin Donuts located on 7300 Rising Sun Avenue. Pagano’s counsel asked for a settlement of fifteen thousand dollars for pain and suffering in addition to payment of over ten thousand dollars in medical bills. Counsel submitted medical records from Flourtown Pain Evaluation and Treatment Center which indicated that Pagano had hurt his knee and hit his back and head when he fell backwards inside of the store. Despite the fact that video surveillance footage shows that Pagano never fell while inside of the Dunkin Donuts, Pagano repeated these same allegations in a sworn deposition with the insurance company.

Pagano is next scheduled for a status listing on July 7, 2014 in Philadelphia Municipal Court. IFU Detective Gilbert Brook and ADA Michael Kershaw are specially assigned to this case.

Philadelphia Woman Charged with Fraudulent Death Claim Benefits

May 7, 2014

April 28, 2014: The Philadelphia District Attorney’s Office Insurance Fraud Unit (IFC) has charged 47 year old Donna Sheehan with Theft by Deception and Insurance Fraud.

IFU detectives began to investigate Donna Sheehan after receiving a citizen insurance fraud referral. A woman called to inform the Philadelphia District Attorney’s Office that Donna Sheehan had fraudulently made herself the sole beneficiary on decedent Francis Carr’s Dearborn National Life Insurance Company policy. Detectives contacted the Delaware State Police, who first received a referral on this case, and were informed that they had an arrest warrant for Sheehan for providing fraudulent information to the Delaware Register of Wills. Detectives then spoke to the benefits manager at Carr’s former location of employment who stated that she had been contacted by Sheehan. The defendant alleged that she was the sole living heir of Carr and related that she wanted to file a death claim for his benefits. The benefits manager related that she told Sheehan that she would have to provide a death certificate for Francis Carr and file a claim form. Sheehan then proceeded to submit the completed claim form along with a notarized Beneficiary Information and Certification Form which stated that she was Carr’s only surviving heir. The benefits manager then unknowingly provided this false information to Dearborn Life Insurance Company. The insurance company provided detectives with the claim file, which included a copy of a check made out to Sheehan in the amount of twenty thousand dollars. PNC bank records indicated that Sheehan signed and deposited the check into her account.

As a result of the investigation, Sheehan was arrested for Insurance Fraud and Theft by Deception on April 28, 2014. She is next scheduled to appear in Philadelphia Municipal Court on May 6, 2014 for a status listing.

ADA Debra Naish and Detective Andrew Snyder of IFU are specially assigned to this case.

Philadelphia Woman Charged with Insurance Fraud

May 7, 2014

April 24, 2014: 36 year old Shahidah Kendall is now facing Criminal Conspiracy, Insurance Fraud, Theft by Unlawful Taking, and False Reports charges

Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit began to investigate Shahidah Kendall after receiving a referral from the Philadelphia Police Major Crimes Auto Squad. An officer from the Major Crimes Auto Squad was notified by the owner of Clearfield Recycling that an Infiniti stripped of its VIN number had been dropped off at the facility on February 14, 2014. When police checked the status of the vehicle three days later, it registered as having been reported stolen.

After receiving the referral from Major Crimes, IFU detectives retrieved the Philadelphia Police Department Vehicle Theft Report which listed that a 2005 Infiniti had been reported stolen from 2312 S. 8th Street in Philadelphia on February 15, 2014. The report was made by the owner of the vehicle, Shahidah Kendall. Detectives interviewed the owner of Clearfield Recycling who stated that the Infiniti was a shell when it was dropped off at the facility and he notified the police when he noticed that there was a VIN listed on the tow slip that he had not previously checked. Detectives then obtained Kendall’s State Farm claim file which indicated that she had reported the 2005 Infiniti stolen on February 17, 2014. Kendall was arrested for Criminal Conspiracy, Insurance Fraud, Theft by Unlawful Taking and False Reports on April 24, 2014. She is next scheduled for a status listing on June 16, 2014.

60 Year Old Woman Charged with “Fake” Slip and Fall

May 7, 2014

April 10, 2014: The Philadelphia District Attorney’s Office Insurance Fraud Unit (IFU) has charged 60 year old Fay Williams with Attempted Theft by Deception, Insurance Fraud and Perjury.

IFU detectives began to investigate Fay Williams after receiving an insurance fraud referral from Save A Lot Risk Management. On July 3, 2011, Williams slipped slightly on the end of a rug as she entered a Save A Lot supermarket located at 5601 Vine Street in Philadelphia. Williams later retained counsel to represent her in a personal injury claim against Save A Lot. Counsel alleged that Williams tripped and fell as a result of an improperly placed carpet in the entryway and that she consequently suffered injuries to her neck, back and shoulder. Williams then sought medical and chiropractic treatment for injuries to her right elbow, shoulder and knee which allegedly occurred after Williams slipped and fell on a wet pavement. Williams received treatment on forty-nine separate occasions between August and December of 2011 and acquired medical bills in excess of ten thousand dollars. Save A Lot denied payment for any of these expenses.

Surveillance footage from the Save A Lot supermarket revealed that Williams slipped slightly as she entered the store. Williams then grabbed a railing and braced herself, thus preventing a fall. At no point did Williams ever fall or make contact with the floor of the supermarket. In spite of this footage, Williams furthered her fraudulent claim by testifying under oath at an arbitration hearing that she had tripped on a bulge in a rug at the Save A Lot and fell, striking the floor and railing.

Based on interviews, medical records and surveillance footage, Williams was arrested on April 8, 2014 for Attempted Theft by Deception, Insurance Fraud and Perjury. She is next scheduled to appear in Philadelphia Municipal Court for a status listing on April 14, 2014.

Detective Donald Murtha and ADA John Doyle of IFU are specially assigned to this case.

40 Year Old Philadelphia Man Charged With Insurance Fraud

May 7, 2014

April 8, 2014: 40 year old Omar Wali-Yuddin is now facing Insurance Fraud, Theft by Unlawful Taking, Criminal Conspiracy, False Reports charges.

The Philadelphia District Attorney’s Office Insurance Fraud Unit (IFU) detectives began to investigate Omar Wali-Yuddin after receiving a referral from the Philadelphia Police Major Crimes Auto Squad. Officers from the Major Crimes Auto Squad were reviewing a list of vehicles that had been dropped off at Clearfield Recycling when one of the vehicles registered as having been reported stolen on August 9, 2012. Clearfield Recycling records, however, indicated that the Buick had been sold to the facility on the previous day.

During the course of their investigation, detectives retrieved the Philadelphia Police stolen vehicle report for the 2007 Buick Lucerne which Omar Wali-Yuddin allegedly reported stolen from the 2200 block of Fernon Street during the early hours of August 9, 2012. Detectives then interviewed the owner of the tow shop which towed Wali-Yuddin’s vehicle to Clearfield Recycling. The owner stated that on August 8, 2012, he had received a call from an acquaintance who asked him to tow a vehicle which was cut in half to Clearfield Recycling. Detectives then reviewed the recycling facility sales receipt which stated that the Buick had been sold on August 8, 2012. The acquaintance who sold Wali-Yuddin’s vehicle to the tow truck owner denied any knowledge of the incident; however, cell phone records indicate that the acquaintance and Wali-Yuddin spoke to each other four times on the date of the sale.

Detectives contacted representatives from Nationwide Insurance Company who confirmed that Wali-Yuddin had made a claim for the theft of his vehicle on August 8, 2012. Nationwide representatives stated that they issued a settlement check in excess of sixteen thousand dollars to Wali-Yuddin for this alleged loss. Wali-Yuddin was arrested for Theft by Unlawful Taking, Insurance Fraud, Criminal Conspiracy and False Reports on April 8, 2014. He is next scheduled to appear in Philadelphia Municipal Court for a status listing on April 14, 2014.

ADA Dawn Farrell and Detective Robert Stansfield of IFU are specially assigned to this case.

Philadelphia Man Charged with using Fake Insurance Card

May 7, 2014

April 2, 2014: The Philadelphia District Attorney’s Office Insurance Fraud Unit (IFU) has charged 20 year old Joseph Matos with Insurance Fraud and Forgery for using a false insurance card.

IFU detectives began to investigate Joseph Matos after receiving a referral from the Philadelphia Police Auto Pound. The referral indicated that on January 6, 2014, Matos attempted to retrieve his 2005 Ford from the Philadelphia Police Auto Pound with a fraudulent American Independent financial responsibility identification card. The officer contacted American Independent Insurance Company who conveyed that the listed policy number was not valid. Matos later retrieved the car with a legitimate Progressive Insurance Company financial responsibility identification card. Pursuant to the investigation, detectives then retrieved the title history for 2005 Ford which showed that Matos had registered the vehicle on November 6, 2012 with the same allegedly fraudulent financial responsibility identification card. Detectives then contacted investigators at American Independent who once again stated that the listed policy number did not belong to Matos nor did they insure Matos.

Matos was arrested on April 2, 2014 for Insurance Fraud and Forgery. He is next scheduled to appear in Philadelphia Municipal Court on May 5, 2014 for a status listing.

Detective Robert Stansfield and ADA Debra Naish of IFU are specially assigned to this case.

ADA John Doyle Honored with PA Fraud Fighter Award

May 2, 2014

May 2, 2014: The Pennsylvania Insurance Fraud Prevention Authority (IFPA) and the Pennsylvania Chapters of the International Association of Special Investigation Units (IASIU) honored Assistant District Attorney John Doyle of the Philadelphia District Attorney’s Office with a 2014 Fraud Fighter Award during the recent PA Insurance Fraud Conference in Hershey.

The award, presented by IFPA executive director Ralph Burnham before over 500 conference attendees, was given in recognition of Doyle’s expertise and skills in securing the criminal convictions of Center City dentist Dr. Owen J. Rogal and his daughter Kim Rogal of The Pain Center.

The heart of the alleged criminal scheme was the Rogals’ billing to numerous insurers of an $800 “radio frequency surgery” pain relief procedure done on joint, nerve and muscle tissue areas – as a much more highly invasive and risky $4,800 radio frequency surgery procedure performed by a neurosurgeon in a hospital setting on a patient’s brain. Dr. Rogal was alleged to have performed and directed medical doctors in performing the procedures at The Pain Center, while office manager Kim Rogal billed insurers.

In May 2013, Doyle successfully prosecuted the Rogals, who had been accused of bilking insurers of some $1 million through $5 million in fraudulent medical billing from 2002 through 2011. Doyle’s skillful presentation of witness testimony and documentary evidence to a jury overcame defense arguments that the alleged false billings were merely a dispute between the Rogals and insurers regarding interpretation of complex medical codes and terminology.

With jury deliberations lasting less than two hours, the Rogals were found guilty of all charges, including corrupt organizations, criminal conspiracy, and multiple counts of insurance fraud, theft by deception, and attempted theft by deception. In their November 2013 sentencing, Dr. Rogal was ordered to immediately begin serving one to seven years imprisonment, while Kim Rogal was placed under house arrest for up to 23 months and ordered to serve probation for five years and perform 200 hours of community service. Each were sentenced to pay restitution of $372,845.88, $55,000 in fines and court costs.

“Insurance fraud is a crime that we all pay for, through needlessly high insurance premiums,” said Burnham. “We are honored to present Fraud Fighter Awards to those whose hard work and dedication help safeguard the Commonwealth’s insurance consumers against higher costs. It is through the work of skilled criminal prosecutors, such as Assistant District Attorney Doyle, that all who would cheat and steal by engaging in insurance fraud may learn to avoid carrying out their criminal schemes in the Commonwealth of Pennsylvania.”

A prosecutor with the Philadelphia District Attorney’s Office for more than 28 years, Doyle has worked in the homicide unit for more than 18 years, exclusively prosecuting murder and vehicular homicide cases, and handling over 150 jury trials before joining the District Attorney’s Insurance Fraud Unit in 2012. Doyle is a graduate of LaSalle University and obtained his law degree at Gonzaga University.

Also recognized with presentations of 2014 Fraud Fighter Award were: Larry Patterson, a detective with the Delaware County District Attorney’s Criminal Investigation Division, for successful resolution of multiple insurance fraud cases referred for investigation by IASIU members; and two former IFPA board members, John Henry of Motorists Insurance Group and Edward Litchko of Independence Blue Cross, for their years of service in guiding the IFPA’s funding of statewide insurance fraud prosecution and public fraud awareness education programs.

The IFPA was created in 1994 by the Pennsylvania General Assembly. Act 166, Pennsylvania’s Insurance Fraud Prevention Act, arms law enforcement with the resources necessary to fight insurance fraud in the Commonwealth. IASIU, founded 1984, is a non-profit organization dedicated to advancing the efforts of law enforcement and insurance industry fraud investigation professionals in combating insurance fraud. For more information about IFPA and IASIU visit http://www.helpstopfraud.org and http://www.iasiu.org.


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