The Prosecutor’s Office has charged five St. Petersburg residents with filing false claims and defrauding two car insurance companies after a May 2004 two-car wreck in Pinellas Park, Fla.
Zlatan Ramic, Alija Boskovic, Safet Beganovic, Ferida Beganovic and Izet Beganovic are accused of filing more than $20,000 in claims, according to court documents published in the Tampa Tribune. Investigators found discrepancies in the reports. Some defendants filed for lost wages but were not employed.
According to the documents, the occupants of one of the vehicles said they did not know the occupants of the other, but investigators found some of them were born in the same town in Bosnia and lived within a few blocks of one another in the United States.
Tampa Lawyer, Accomplice Arrested
A Tampa lawyer and a medical center owner have been arrested and charged in an insurance scam. According to the Florida Department of Law Enforcement, Jerry Jaramillo, 34, of Clearwater and 28-year-old Maria Knudsen of Tampa were arrested and charged with insurance fraud and grand theft.
According to authorities, Jaramillo, a lawyer, altered his marriage certificate to show he was legally married to Knudsen, the owner of Tampa Orthopedic Medical Center. The altered marriage certificate was submitted as part of an application for health insurance to include Knudsen and her two children on Jaramillo’s health insurance plan. As a result, the insurance company paid claims of more than $8,000 for Jaramillo, Knudsen and her children.
$100,000 Bogus Global Wind Insurance
Allen E. Weintraub of Miami, Fla., collected more than $100,000 in worthless Global hurricane insurance premiums he sold to at least 45 consumers.
Weintraub was booked into the Miami-Dade County Jail on 45 counts of grand theft and 45 counts of transacting insurance activity without a certificate of authorization, in addition to one count of organizing a scheme to defraud. Bond was set at $510,000.
Weintraub used licensed agents to sell his bogus policies to homeowners and businesses. In one case, the agent canceled legitimate insurance and switched to a Global Insurance policy.
Weintraub’s arrest, at his multi-million dollar home in Golden Beach, follows on the heels of recent action taken against him by the Securities and Exchange Commission, which ordered him to pay more than $1 million in restitution and fines.
Tampa Clinic Owners Patient Brokering
Five Tampa-area clinic owners have been arrested and a warrant issued for the arrest of a sixth owner for “selling” patients, most of whom were accident victims, to diagnostic facilities that billed auto insurers thousands of dollars in claims.
In March, insurance fraud detectives arrested 13 individuals, including three Tampa clinic owners, on similar charges. In this latest investigation, insurance fraud detectives caught clinic owners on undercover audio and videotape taking payments from MRI facility owners for the referral of patients. The investigation revealed some of the clinic owners engaged in patient brokering for several months, collecting thousands of dollars in referral fees.
The investigation revealed that diagnostic companies were paying the fee to get the business and the ability to bill the patients’ auto insurance carriers, under Personal Injury Protection coverage, anywhere from $800 to $1,000 per patient for the MRIs. Florida’s drivers are required by law to carry a minimum of $10,000 in PIP coverage.
$3M False Medicaid Claims Reported
Dr. Aaron M. Hurowitz, the former owner of the Midtown Medical Center in Atlanta, has been indicted by a federal grand jury and charged with 80 counts of health-care fraud, money laundering and five counts of obstructing a federal health-care fraud investigation.
According to the Atlanta Business Chronicle, Hurowitz, an osteopathic doctor, allegedly schemed to defraud the Georgia Medicaid Program from March 1977 until October 2002. The indictment alleges that Medicaid paid Hurowitz $3 million for bogus physician services.
The indictment accuses Hurowitz of billing for services that were not provided; “upcoding,” or submitting claims for services at higher levels of reimbursement than supported by the services that were actually provided; and billing for medically unnecessary services, including numerous drug screens.
The indictment alleges that while Hurowitz was being investigated by the Georgia Department of Community Health and by the State Health Care Fraud Control Unit, he falsified medical records, attempting to conceal his fraudulent billing practices.
Finally, the indictment alleges Hurowitz laundered money by transferring title to his Buckhead residence to his wife to conceal some of the proceeds of the alleged health-care fraud scheme.
According to the Business Chronicle, the indictment seeks the forfeiture of Hurowitz’s residence and the office building where Midtown Medical Center was located, and a judgment equal to the amount of proceeds he obtained as a result of the alleged fraud.
Trucking Co. Owner Charged
The owner of a Lee County, trucking company near Frankfurt, Ky. has been fined $10,000 and ordered to pay over $43,000 in restitution for submitting false information to the company’s workers’ compensation insurance carrier.
Gary W. King, owner of Gary King Trucking at Zoe, pleaded guilty last week to one count of insurance fraud. King admitted giving false information to Kentucky Employers’ Mutual Insurance Company by omitting details about his logging operations when applying for workers’ compensation insurance.
King has paid $43,412 in restitution to KEMI and will be required to pay a $10,000 fine to the Kentucky Office of Insurance’s Fraud Investigation Division at sentencing on Nov. 8.
Temp Workers Supplier Underreported
A Kentucky company that supplies temporary workers for underground coal mines pleaded guilty in Letcher Circuit Court to a felony count of insurance fraud. Boone Mountain Services Inc., of Jackhorn, Ky. was charged with making false and misleading statements to Kentucky Employers Mutual Insurance Co., a workers’ compensation insurance carrier, by underreporting its full payroll. According to court documents, the company knowingly claimed some workers were employed by Oak Mountain Resources Inc. of Virginia.
As part of the court action, the company will pay KEMI $346,330.12, the amount of the insurer’s actual monetary loss. In addition, the agreement includes a $100,000 fine with $25,000 to be paid immediately to the Kentucky Office of Insurance Fraud Investigation Division. The remainder is probated for two years on condition of “good and lawful” behavior.
Boone Mountain Services also is to pay $2,500 to the Letcher County Common-wealth’s Attorney Victim Advocate Fund and all court costs. Boone Mountain Services must submit an acceptable anti-fraud plan to KOI within 90 days.
Tomatoes ‘Iced,’ $9M in Fake Claims Filed
A scheme to defraud a government agency and several private insurance companies of more than $9 million has landed an Asheville, N.C., farmer and his wife in prison. Robert Warren and Vicki Warren, owners of R&V Warren Farms, once one of the largest tomato-growing farms in the eastern U.S., filed fake crop damage reports claiming losses that never happened.
In July 2004, they pleaded guilty to conspiring to defraud the Federal Crop Insurance Corp. and to commit money laundering. Viki Warren pleaded guilty to conspiracy to defraud the FCIC and mail fraud.
Gretchen Shappert, U.S. attorney for the Western District of North Carolina told the Asheville Citizen-Times, in one instance, employees threw ice cubes onto a tomato field, beat the plants with sticks and photographed the results in an attempt to simulate damage from a hail storm to back up an insurance claim.
Judge Lacy Thornburg sentenced Robert Warren to 76 months in prison, while Vicki Warren received 66 months.
Shappert said the couple was ordered to forfeit $7.3 million in assets and pay $9.15 million in restitution.
Agent Kept Funds
Attorney General Henry McMaster announced that Kathy Smith, 51, of Little River, S.C., pleaded guilty Aug. 9 to two counts of Breach of Trust with Fraudulent Intent (over $5,000), a felony violation of §16-13-230 (B)(3) of the Code of Laws, and punishable to 10 years imprisonment (each count), and five counts of Breach of Trust with Fraudulent Intent (between $1,000 and $5,000), a felony violation of §16-13-230 (B)(2) of the Code of Laws, punishable to five years imprisonment (each count).
Smith, a former insurance agent, was doing business as the Smith Insurance Agency, in Loris. From January 2001 to June 2003, Smith is reported to have accepted premiums from various insureds and failed to remit them to the appropriate insurance companies. Most of the insurance policies involved in this case were auto and homeowner’s policies.
Man Faked Identity for TennCare Benefits
The Office of the TennCare Inspector General arrested Ricky Kenneth Lyons of Nashville for assuming the identity of a TennCare enrollee for more than a year and illegally obtaining benefits at local pharmacies and doctor’s offices.
Lyons was charged with a Class E felony, punishable by up to two years in prison. The identity theft charge is a Class D felony, punishable by up to four years in prison.
Workers’ Compensation Fraud
Richard J. Custer Jr. was convicted in Marshall County Circuit Court on a felony charge of making a false statement to the West Virginia Workers’ Compensation Commission for providing false information about dates of employment on an application for a claim. Sentencing is scheduled Oct. 12 in the Marshall County Circuit Court.
According to a statement issued in Charleston, W.V., by Insurance Commis-sioner Jane L. Cline, a November 2004 indictment charged Custer with the offense. Custer pleaded guilty Sept. 8 in Marshall Circuit Court.