Archive for the ‘Insurance Fraud Arrest’ Category

WOMAN CHARGED WITH FILING A FRAUDULENTCLAIM AGAINST FARMERS INSURANCE COMPANY

July 10, 2017

Defendants:

  • Traine Smith
  • Age: 47
  • OTN: U0818985

Charges:

  • Insurance Fraud 18 Pa C.S. § 4117 – F3
  • Attempted Theft by Deception 18 Pa C.S. § 3922 – F3

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Traine Smith on June 11, 2017 after receiving an insurance fraud referral from Farmers Insurance Company. Ms. Smith picked up her vehicle from the Philadelphia Police Impound Lot on June 11, 2014. She also purchased insurance for her vehicle on that same date. She then filed an insurance claim on June 12, 2014, stating that her vehicle was vandalized while parked in her driveway. Ms. Smith gave a statement to a representative of Farmers Insurance clearly stating that her vehicle was vandalized on the morning of June 12, 2014. She stated that her vehicle did not have any damage when she picked it up from the lot.

Ms. Smith’s vehicle was impounded on May 31, 2013 by the Philadelphia Police Department, pursuant to a narcotics investigation. A Philadelphia Police Department “Impound Lot Vehicle Inventory Control Sheet” states that the vehicle upon delivery to the impound lot had several dents and scratches all over the vehicle. There was also significant damage to the right and left quarter panel, as well as the hood and front window. The police officer who prepared the control sheet was interviewed by detectives from the Insurance Fraud Unit, and confirmed the information written in the records of the Philadelphia Police Impound Lot.

Detectives from the Insurance Fraud Unit also reviewed the case file from Farmers Insurance Company. Their documents revealed that Ms. Smith called Flatts Roadside Assistance Service Company to help jumpstart her vehicle on the day she picked it up from the impound lot. The mechanic that was dispatched by the company stated in an interview with an investigator from Farmers Insurance Company that he noticed significant damage, such as a crack in the windshield, and several scratched and dents on the left and right sides of the vehicle. Furthermore, Ms. Smith in recorded statements to the investigator states that she called OT Tire Company to help her with a flat tire and called Flatts Roadside Assistance Service Company to help jumpstart her vehicle. Unfortunately her vehicle would not start and had to be towed to her home.

Ms. Smith provided Farmers Insurance with a “Proof of Loss, Automobile Physical Damage Claim” form, where she listed the damages to her vehicle as “ rocks dented hood, mirror broken, oil in seat of car, wiring damage, flat tire, paint scratched on all doors, and passenger side fender cracked.” Ms. Smith was interviewed by detectives of the Insurance Fraud Unit on March 20, 2017. She stated again that the damage to her vehicle was due to the vandalism and that when she picked up her vehicle from the impound lot there weren’t any damages.

On April 21, 2017, the mechanic who was dispatched to the impound lot was interviewed. He stated that when he arrived he notices visible damage to Ms. Smith’s vehicle. He also recalled that she wanted him to document the damages so that she can submit the information to her insurance company. He stated that he never filled out any document to sustain her assertions.

After a review of the evidence Ms. Shane was arrested on June 11, 2017, on the above stated charges. She is next listed to appear in Philadelphia Municipal Court on July 21, 2017 for her arraignment.

###

Advertisements

MAN CHARGED FOR REGISTERING A VEHICLE WITH A FRAUDULENT STATE FARM INSURANCE FINANCIAL RESPONSIBILITY CARD

July 10, 2017

Defendant:

  • Christian Van Robertson
  • Age: 25
  • OTN: U0837270

Charges:

  • Forgery 18 Pa C.S. § 4101 – F3
  • Insurance Fraud 18 Pa C.S. § 4117 – F3

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Christian Van Robertson after they received a referral from the Philadelphia Police Department.

On August 17, 2016, Christian Van Robertson was pulled over by two police officers while driving. Mr. Van Robertson provided the two police officers with his license and with his financial responsibility card from State Farm Insurance Company. The police officers called the insurance company which stated that the financial responsibility card provided was fraudulent.

Detectives from the Insurance Fraud Unit conducted a vehicle registration check which revealed that Mr. Van Robertson registered his vehicle with the fraudulent financial responsibility card at Hernandez Auto Tags on May 27, 2016. Further detectives also reached out to State Farm Insurance Company, which provided them with statement that they never issued any insurance cards to the defendant.

Christian Van Robertson was arrested on June 21st, 2017. He is next scheduled to appear for his a status listing in Philadelphia Municipal Court on July 32, 2017

###

WOMAN FILES 23 FRAUDULENT CLAIMS WITH AFLAC INSURANCE COMPANY AND TRAVELERS INSURANCE COMPANY

July 10, 2017

Defendants:

  • Bonita Ashley
  • Age: 60
  • OTN: U0834363

Charges:

  • Forgery 18 Pa C.S. § 4101 – F3 (14 counts)
  • Insurance Fraud 18 Pa C.S. § 4117 – F3 (13 counts)
  •  Attempted Theft by Deception 18 Pa C.S. § 3922 – F3 (1 count)
  • Theft by Deception 18 Pa C.S. § 3922 – F3 (1 count)

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Bonita Ashley after receiving an insurance fraud referral from AFLAC Insurance Company (AFLAC). Over the two year period between 2014 and 2016, Ashley Bonita filed 22 false insurance claims for benefits with AFLAC. She was subsequently paid $10,605.000 in benefits, and attempted to file a claim against Travelers Insurance Company for an alleged broken tooth.

Detectives from the Insurance Fraud Unit performed search warrants for Ms. Ashley’s medical records from various hospitals where Ms. Ashley stated that she was admitted. On many occasions, the records that Ms. Ashley submitted to AFLAC had forged dates, and stated that she was treated for ailments that she never received any treatment. Many of the records submitted were doctored from her previous medical history.

For example, Ms. Ashley submitted a claim to AFLAC stating that she was treated and had spinal surgery performed at Thomas Jefferson University Hospital on March 3, 2015. Her actual medical records stated that she was treated for a posterior lumbar decompression on August 27, 2012 at that hospital.

Other claims submitted contained the same false information. On June 12, 2015, Ms. Ashley submitted a claim which stated that she was treated for a fracture in her right ankle. The surgical report that she submitted, stated that the surgery lasted 105 minutes. Her actual medical records from the Hospital of the University of Pennsylvania revealed that she never had such surgery. Also, the doctor whom Ms. Ashley stated performed the surgery has a strict specialty in surgery of the shoulder. She submitted two other claims on November 2. 2015 and November 3, 2015 claiming that she fell and needed a hip replacement. On these two claims. Ms. Ashley did not identify where she received treatment, however she provided a telephone number to Penn Medicine and Rehabilitation Center. None of the records from that hospital suggest that Ms. Ashley received treatment for hip related injuries or had a hip replacement surgery.

She submitted two other claims on June 10, 2015 and on June 30, 2015 to AFLAC. On the claim submitted on June 10, 2015, Ms. Ashley claimed that she fell down a flight of stairs but did not require any ambulance transportation. She stated that she was treated for a fracture in her right leg and ankle at Chestnut Hill Hospital. On her claim from June 30, 2015, Ms. Ashley stated that she was treated at the Chestnut Hill Hospital emergency department after she fell down a flight of stairs because she was upset at the passing of her mother. Her medical records revealed that she was treated on June 9, 2015, at Chestnut Hill Hospital for joint pain and not a fracture. She was never treated at Chestnut Hill Hospital on June 30, 2015.

On June 29, 2016 and on July 15, 2016, Ms. Ashley submitted two claims claiming that as a result of an automobile accident she suffered from paralysis in her right calf and left knee. She stated that she received treatment at Progressive Injury Care and at the Hospital of University of Pennsylvania. A review of the medical records received from both providers revealed that Ms. Ashley falsified the dates that she received treatment and the type of treatment. Ms. Ashley was treated at Progressive Injury Care on March 21, 2016 and definitely not in June as she claimed in the records that she submitted. Further, Ms. Ashley was treated on June 20, 2016 at the Hospital of the University of Pennsylvania, however her ailment was a kidney cyst and not a paralysis of her calf. AFLAC did not pay any benefits on this claim. When Ms. Ashley was informed that her claim was denied, she threatened to report AFLAC to the media and kept on insisting that she was a paraplegic and therefore eligible for the benefits in her policy for that ailment.

Lastly, a review of Ms. Ashley’s previous insurance claims revealed that she attempted to file a similar fraudulent claim against Travelers Insurance for a broken tooth at a T.G.I Friday restaurant. Ms. Ashley claimed that in December 19, 2014 she was having lunch with her co-workers. While eating her lunch, Ms. Ashley bit down on an uncooked grain of rice which caused her tooth to split in half. She stated that she went to her dentist on the same day, and that by December 31, 2014 she had her tooth extracted. On January 6, 2015 she was informed that her claim was denied. Again, when informed of this Ms. Ashley called Travelers Insurance Company and threatened to call the media and inform them that the restaurant serves uncooked food.

On January 23, 2015, the manager of the T.G.I. Friday restaurant received a call from one of Ms. Ashley’s coworkers. Ms. Ashley was and is currently employed at the Juvenile Justice Center as a case manager for at-risk youth. The coworker asked to remain anonymous, stated that she was having a holiday lunch with Ms. Ashley. In a recorded statement, her coworker stated, that Ms. Ashley’s tooth was chipped previously but that she planned to go into the restaurant and claim that it was their food that damaged her tooth. On May 22, 2017, detectives from the Insurance Fraud Unit interviewed her co-worker and confirmed the version of events that she gave to representatives of Travelers Insurance and the restaurant.

On June 5, 2017, Ms. Ashley was also interviewed by detectives from the Insurance Fraud Unit. She begrudgingly admitted to committing fraud and to falsifying her medical records while stating “as broke as I am, I may have altered the information on the forms”. Nevertheless to this day, Ms. Ashley sustains that she broke her tooth due to uncooked rice.

Overall Ms. Ashley provided drastically altered copies of her medical records from Thomas Jefferson Hospital, Chestnut Hill Hospital, Mercy Fitzgerald Hospital, and Hospital of the University of Pennsylvania Hospital to AFLAC. Further she provided falsified dental records to Travelers Insurance Company to sustain her fractured tooth claim. Before her arrest date, Ms. Bonita was given several chances to surrender. Ms. Bonita on a couple instances would call and state that she cannot comply with her arrest warrant because she was hospitalized. Ashley Bonita finally did surrender and was arrested on June 20, 2017, on the above stated charges.

Bonita Ashley is next scheduled to appear in courtroom 406, for a Status of Counsel Hearing on July 21, 2017 in Philadelphia Municipal Court.

###

MAN CHARGED FOR REGISTERING A VEHICLE WITH A FRAUDULENT TRAVELERS INSURANCE FINANCIAL RESPONSIBILITY CARD

June 14, 2017

Defendant:

  • Harold Mobley

Charges:

  • Forgery 18 Pa C.S. § 4101 – F3
  • Insurance Fraud 18 Pa C.S. § 4117 – F3
  • Tampering with Records 18 Pa C.S. § 4104 – M1

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Harold Mobley after receiving an insurance fraud referral from Travelers Insurance Company. Mr. Mobley was involved in a motor vehicle accident on April 24, 2017. After attempting to flee the scene of the accident, he was apprehended by the driver of the other vehicle, who followed him after the accident for several blocks. Mr. Mobley provided the other driver with his fraudulent Travelers Insurance financial responsibility card.

The other driver attempted to file a claim with Travelers Insurance for the damages to her vehicle, however was informed by representatives from the insurance company that Mr. Mobley did not have a policy with them. Detectives from the Insurance Fraud Unit reviewed the title history for Mr. Mobley’s vehicle and found that he registered his vehicle with the fraudulent financial responsibility card that he provided to the other driver. Further, detectives interviewed the driver of the other vehicle and a tag agent from Martin Tag Agency where Mr. Mobley submitted his registration information. They both identified Mr. Mobley and stated that he provided them with the information on the fake financial responsibility card.

Harold Mobley was arrested on June 5th, 2017. He is next scheduled to appear for his arraignment in Philadelphia Municipal Court on June 26, 2017.

###

AUTO BODY SHOP OWNER ARRESTED AFTER CHARGING CUSTOMER FOR FICTICIOUS REPAIRS TO VEHICLE

May 19, 2017

Defendant

  • Eugene Kenny

Charges:

  • Theft by Deception 18 Pa C.S. § 3922 – F3 (1 count)
  • Insurance Fraud 18 Pa C.S. § 4117 –F3 (1 count)
  • Forgery 18 Pa C.S. § 4101 – F2 (1 count)

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Eugene Kenny on the above charges after receiving a referral from Progressive Insurance. The insured’s daughter was involved in an auto accident on January 16, 2016. The vehicle was towed to Kenny’s Auto Body for repairs following the accident and Progressive Insurance agreed to pay $ 8,463.40 to repair the vehicle. They issued a check to the insured for the cost of repair.

After six weeks of performing repairs on the vehicle, the above defendant contacted the insured and informed him that the vehicle was ready to be picked up. After picking up the vehicle, the insured noticed that the repairs were not made, and that many of the damaged parts of the vehicle were not replaced with new ones.

The insured contacted Progressive and informed them of the problems. Progressive appraised the vehicle and found that none of the parts were replaced and that it would cost them an additional $6,250.73 to have the vehicle properly repaired. The insured also reported to Progressive that he never endorsed the check from Progressive for the repairs, and that the above defendant forged his signature.

Detectives from the Insurance Fraud Unit interviewed the owner of Rosenberg’s Check Cashing, where the defendant cashed the check from Progressive. The owner identified Mr. Kenny and told the detectives that the check from Progressive bounced and that the defendant owes him the balance on the check.

Kenny Rogers was interviewed by detectives from the Insurance Fraud Unit on April 19, 2016. He admitted to cashing the check from Progressive Insurance and to charging for repairs that he did not actually perform on the insured’s vehicle.

Kenny Rogers was arrested on May 2, 2017 on the above stated charges. He is next listed to appear in Philadelphia Municipal Court on May 22, 2017 for his arraignment.

###

MOTHER AND DAUGHTER FILE FRAUDULENT INSURANCE CLAIM WITH PROGRESSIVE

November 17, 2016

Defendants:

  • Marie Peralte, age 51
  • Micheline Peralte, age 26

Charges:

  • Insurance Fraud 18 Pa C.S. § 4117 – F3
  • Theft by Deception 18 Pa C.S. § 3922 – F3
  • Criminal Conspiracy 18 Pa C.S. § 903 – F3

Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit investigated Marie and Micheline Peralte after receiving a referral from Progressive Insurance. On October 26, 2012, Micheline Peralte, daughter of Marie Peralte, was involved in an auto accident at the intersection of Adams Ave. and Whitaker Ave. Marie Peralte filed a claim with Progressive Insurance, where she reported that she was the driver and that her daughter was the passenger, and she further claimed that she sustained injuries from this incident. After this, the Peraltes hired an attorney to represent them against Progressive Insurance.

On November 19, 2012, a Progressive Insurance investigator interviewed the driver of the vehicle that hit the Peraltes. According to her, the driver of the other vehicle was a young African American female, and there were no passengers in the vehicle. Further, after the incident, family members of Micheline Peralte came to the scene. An ambulance was called, and the driver noticed that an older African American female was taken to the hospital by the ambulance. On April 16, 2016 the Insurance Fraud Unit opened an investigation into this matter after a referral from Progressive Insurance was received. During the course of this investigation, Insurance Fraud detectives obtained records from the hospital where Marie Peralte was taken to by the ambulance, and their attorney. The detectives find that both Marie and Micheline Peralte admit to their attorney and to hospital staff that it was Micheline who was the driver of the vehicle.

Marie Peralte and Micheline Peralte were arrested on November 14, 2016, and charged with Theft by Deception, Insurance Fraud, and Criminal Conspiracy. They are next scheduled to appear in Philadelphia Municipal Court for a status hearing on November 21, 2016.

MEN FILE FRAUDULENT PERSONAL INJURY CLAIM WITH STATE FARM INSURANCE COMPANY

November 10, 2016

Commonwealth v Anthony Harrison and Jesse Hughes

Charges:

  • Insurance Fraud 18 Pa C.S. § 4117 – F3
  • Attempted Theft by Deception 18 Pa C.S. § 3922 – F3
  • Criminal Conspiracy 18 Pa C.S. § 903 – F3
  • Unsworn Falsifying 18 Pa C.S. § 4904 – M2
  • False Swearing 18 Pa C.S. § 4903 – M2
  • False Reports 18 Pa C.S. § 4906 – M3

Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Anthony Harrison and Jesse Hughes after receiving a referral from a private citizen. On October 2, 2013, a State Farm insured driver allegedly hit Anthony Harrison and Jesse Hughes while they were working on Conshohocken Avenue in Philadelphia. Both Harrison and Hughes filed a Philadelphia Police Report and retained private counsel. Harrison’s civil action compliant stated that he injured his back, left knee, left arm and neck. Hughes’ City of Philadelphia Accident, Injury and Illness Report stated that he was struck twice by the vehicle. Harrison sought medical treatment at Spring Chiropractic and both testified in an oral examination that they had been injured in this accident.

However, witness testimony later proved that only Hughes was injured in this accident. Both Harrison and Hughes gave statements that Harrison had also been struck by the State Farm insured driver in order that Harrison could file a fraudulent personal injury claim. Harrison was arrested on October 26, 2016 and Hughes was arrested on November 1, 2016. Both were charged with Criminal Conspiracy, Attempted Theft by Deception, Insurance Fraud, False Swear, Unsworn Falsifying and False Reports. They are next listed for a status hearing in Philadelphia Municipal Court on November 14, 2016.

###

WOMAN FILES FRAUDULENT PERSONAL INJURY CLAIM WITH GALLAGHER BASSETT INSURANCE COMPANY

October 11, 2016

Defendant:

Fantina Burgess

 

Charges:

Insurance Fraud 18 Pa C.S. § 4117 – F3

Attempted Theft by Deception 18 Pa C.S. § 3922 – F3

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit began investigating Fantina Burgess after receiving a referral from the Gallagher Bassett Insurance Company. Bassett is the liability carrier for the Shop Rite located at 2800 Fox Street in Philadelphia. On

July 5, 2016, Burgess filed a claim that she had slipped on spilled soda while shopping and twisted her ankle. Burgess hired counsel to represent her. However, video surveillance footage from the store showed Burgess intentionally staging the fall. It showed her walking up the aisle with a group of people. She leaves the aisle, turns back to look at the floor and then bends her legs and sits down. Burgess remained on the floor until customers and store employees notice her.

Based on surveillance footage and detective interviews, Burgess was arrested for Insurance Fraud and Attempted Theft by Deception. She is next scheduled to appear in Philadelphia Municipal Court on October 14, 2016, for a status listing.

MAN FILES FRUAUDULENT PERSONAL INJURY CLAIMS WITH NATIONWIDE AND ACCESS INSURANCE COMPANIES

October 3, 2016

Charges:

Attempted Theft by Deception 18 Pa C.S. § 3922 – F3 (2 counts)

Insurance Fraud 18 Pa C.S. § 4117 – F3 (2 counts)

 

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Hondo Jackson after receiving a referral from Nationwide Insurance Company. On February 22, 2015, a Nationwide insured driver struck an unoccupied 2002 Chevrolet Impala. The impact then caused the Impala to strike a 2010 Nissan Maxima, which was also parked and unoccupied. Hondo Jackson later filed a claim with Nationwide Insurance Company alleging that he had been a passenger in the parked 2010 Nissan Maxima which belonged to his girlfriend. Jackson stated in his claim that he injured his neck and back as a result of this accident. Jackson then hired an attorney to represent him in this fraudulent claim.

Insurance Fraud Unit detectives retrieved the Philadelphia Police Department Non-Reportable Accident form which stated that the driver of a 2013 Chevrolet Impala struck a 2002 Chevrolet Impala and a 2010 Nissan Maxima, both of which were parked and unoccupied. Despite the fact that Jackson was not present in the vehicle, he sought medical treatment at the office of Dr. John Bowden for his alleged injuries. Detectives retrieved Jackson’s medical records which stated that he sought treatment for head, chest, neck and back injuries on multiple occasions between February and May 2015. Nationwide was billed thirty three hundred and seven dollars for Jackson’s treatment; however, the company denied his claim.

Detectives also learned that Hondo Jackson filed a personal injury claim with Access Insurance Company, under a policy that belonged to his mother, for injuries he sustained while he was seated in a parked car struck by a motor vehicle. Jackson stated that he sought treatment at Chestnut Hill Hospital, and later with Dr. John Bowden. Jackson also sought treatment at Freedom Medical Supply and Open MRI Center of Bala Cynwyd. Access was billed forty-one hundred dollars for Jackson’s medical treatment at this facility; however, they, too, denied his claim.

Finally, detectives interviewed the police officers who responded to the original accident scene. They both stated that the two cars struck by the Nationwide insured were parked and unoccupied at the time of the accident. Hondo Jackson was therefore arrested for attempting to defraud two insurance companies for injuries which were fabricated. Jackson was charged with two counts of Attempted Theft by Deception and two counts of Insurance Fraud on September 26, 2016. He is next scheduled to appear for a status listing in Philadelphia Municipal Court on October 7, 2016.

WOMAN FILES FRAUDULENT PERSONAL INJURY CLAIM AGAINST SEPTA

October 3, 2016

Charges:

Attempted Theft by Deception 18 Pa C.S. § 3922 – F3

Insurance Fraud 18 Pa C.S. § 4117 – F3

Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit arrested Lekita McDuffie after receiving a referral from SEPTA. McDuffie claimed that she had been injured while riding on the Route 47 bus on July 30, 2013. McDuffie claimed that the bus operator closed a door on her arm. On July 31, 2013, McDuffie called the SEPTA claims hotline and reported that she had boarded the Route 47 bus at the intersection of 5th Street and Somerville Avenue when the bus operator shut the door on her left arm. McDuffie stated that she went to Moss Rehab to obtain treatment for her injures. McDuffie later hired an attorney to represent her in a personal injury claim.

Insurance Fraud Unit detectives retrieved McDuffie’s medical records from Einstein Medical Center Elkins Park and Wyoming Chiropractic Center. The records indicated that McDuffie sought treatment at Einstein Medical Center Elkins Park on July 30, 2016 for alleged injuries to her arm. The Einstein Medical Center records indicate that personnel found that McDuffie was not suffering from swelling, tingling, numbness or neck pain. Furthermore, an x-ray performed on McDuffie’s arm showed that she had no fractures or dislocations. McDuffie’s medical records from Wyoming Chiropractic Center indicated that McDuffie’s arm had been caught in a SEPTA bus door and that she had been thrown back and forth and injured her neck and back. McDuffie sought treatment at Wyoming Chiropractic on thirty-eight different occasions between August 2013 and April 2014. The total amount of McDuffie’s medical bills reached eleven thousand eight hundred dollars.

Detectives retrieved surveillance footage from the Route 47 bus which showed that the bus door never closed on McDuffie’s arm. Furthermore, the footage shows that McDuffie used her left arm while on the bus, and after the alleged injury occurred. McDuffie never appeared to be disturbed during her time on the bus. She also never spoke to the operator while boarding the bus, nor did she seek assistance from any other passenger. McDuffie was arrested on September 21, 2016 for Attempted Theft by Deception and Insurance Fraud. She is next scheduled to appear in Philadelphia Municipal Court for a status listing on October 25, 2016.