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Posts Tagged ‘Insurance fraud’

Insurance Company May Have Scammed Thousands

September 10th, 10

Estimates show that as many as 10,000 people nationwide may have been duped by Association of Independent Managers (AIM). Nancy Stowe is one of them, according to WBTV. She was looking for affordable healthcare coverage online and contacted the North Carolina Department of Insurance for a reference before completing a purchase. “They had nothing that made me think this wouldn’t be a good purchase,” Stowe told WBTV. So she went ahead and purchased coverage from AIM, but now she’s out thousands of dollars in unpaid medical bills. “I am going to testify in this cease and desist order being put up against this company by the state of North Carolina,” Stowe told WBTV.

Stowe thought she was getting a good deal– paying hundreds less for coverage for her and her husband. She checked out AIM’s website and membership materials and moved forward with her purchase. Her premium was more than $400 a month, but then Stowe’d doctor told her all of her medical bills were being denied by her insurance company. “It was so frustrating because I owed thousands of dollars, plus all of those monthly premiums my boss had reimbursed me for,” Stowe told WBTV.

WBTV offered some tips to help others from going through what Stowe went through. Their tips include:

  • Always remember that if it sounds too good to be true, it probably is.
  • Deal only with licensed agents and companies.
  • If you have any doubt, call your state’s Department of Insurance, Consumer Services Division.
  • If the agent you are dealing with starts becoming vague or hard to reach, consider canceling.
  • Do NOT sign any blank application or claims forms.
  • NEVER pay premiums in cash.
  • Keep all your records and proof of payments.
  • You can always call your insurance company (the company who has the policy) to confirm your policy exists and is what you think it is.

Some scams to look out for when it comes to insurance include:

  • Companies that try to look and act like licensed insurance companies when they’re not. They offer low rates regardless of your health history, but then claims are either paid slowly or not paid at all. These companies typically operate under different names.
  • Web sites that look like companies you are familiar with, but that are actually stealing your information.
  • Pyramid schemes where insurance companies offer incentives for paying a membership fee or recruiting more members.
Tags: Insurance fraud, North Carolina Department of Insurance, Scammed, insurance scam, healthcare coverage
 

Doctor Accused Of Lying To Medicare Thousands Of Times

August 12th, 10

A mansion, Arizona real estate, luxury cars and investments were all paid for by money authorities say a Chicago cardiologist scammed from Medicare, according to a report by the Associated Press. The suburban doctor practicing in Burr Ridge was sentenced to five years in prison for what authorities say amounted to more than $13 million in Medicare reimbursements for care that was never provided.

Authorities say 50-year-old Sushil Sheth pleaded guilty a year ago to one count of health care fraud, and received his sentence this week. He’ll begin serving a five year prison term in two months. The fraud happened between January 2002 and July 2007. In June 2007, the Associated Press says that federal agents seized more than 600 uncashed checks from insurance companies totaling more than $6.7 million.

The Chicago Tribune reported that Sheth “lied thousands of times to Medicare and other insurers in order to receive millions of dollars he did not earn for patients he never treated,” according to a statement released by the  U.S. attorney’s office. According to the Chicago Tribune, Sheth stole patient information from three unnamed hospitals and used it to bill Medicare and other insurance companies for services he never performed and patients he never treated.

Tags: Healthcare in the United States, medicare, insurance, Insurance fraud, Chicago cardiologist
 

Investigators Catch Auto Insurance Fraud Ring

July 31st, 10

Auto insurance companies paid out more than $1 million in claims for fake car accidents, according to investigators. The extensive scheme included dozens of people and this week the man police say was at the head of the scam was sentenced to four to ten years in state prison in Pennsylvania. Forty-four-year-old Wallace Morris Sr, also known as “Popsicle” and “Pops” also faces federal charges, according to the Philadelphia Inquirer.

Authorities say Morris pleaded guilty to his involvement in 44 fake car accidents in order to collect insurance money. The judge also ordered Morris to repay about $440,000 to 17 different insurance companies that Morris scammed. The insurance companies include AIG, Allstate, Geico, Liberty Mutual, Nationwide, Progressive, and State Farm, according to the Philadelphia Inquirer. While Morris was at the head of the insurance fraud operation, officers say Philadelphia police officers Deshane Riggins and Drexel Reid Jr. were a part of it too. Riggins wrote fake accident reports for Morris, according to reports.

For a period of two years, from 2004 to 2006, Morris lead a fraud ring that included at least 268 relatives, friends and acquaintences. The District Attorney’s Office says Morris orchestrated the submission of 187 fake insurance claims. Officials say each phony accident usually involved two vehicles with three passengers in each car so that six claims were generated. So far, nearly 100 arrests have been made, but more could be on the way.

According KYW, the assistant district attorney says Morris’ friends and relatives would claim they were injured in accidents that never happened. “Mr. Wallace Morris was a co-conspirator in a large insurance fraud scheme totalling in 44 car accidents, 115- arrests, over $1-million loss to 17 insurance companies,” Linda Montag told KYW. The judge in the case also mentioned the irony in the fact that Morris stated his transportation company went out of business because of high insurance costs.

Tags: Insurance fraud, Crimes, fake car accidents, insurance, car accidents
 

Dancer Charged With Insurance Fraud

May 5th, 10

A 43-year-old stripper is charged with insurance fraud after collecting worker’s compensation checks while dancing in a Pennsylvania club. Authorities say Christina Gamble claimed she fell while working in a Red Robin restaurant three years ago. Gamble claimed she hurt her back, making it difficult to stand or change positions. But authorities say Gamble was well enough to work as a stripper at CR Fanny’s Gentleman’s Club and Sports Bar according to the Associated Press. Now she’s facing two counts of insurance fraud.

According to newspaper reports, Highmark Casualty Insurance Co has paid Gamble nearly $23,000 in disability benefits and another $4000 in medical expenses. The company received a tip and started investigating. During the investigation, the company was able to get video of Gamble working as a dancer. She has been charged with two counts of workers compensation insurance fraud, a felony charge.

Here are some statistics on insurance fraud from the Coalition Against Insurance Fraud:

  • Nearly one of four Americans say it’s ok to defraud insurers, says a survey by the consulting firm Accenture Ltd.
  • About one in 10 people agree it’s ok to submit claims for items that aren’t lost or damaged, or for personal injuries that didn’t occur.
  • Two of five people are “not very likely” or “not likely at all” to report someone who ripped of an insurer.
  • Nearly one of 10 Americans would commit insurance fraud if they knew they could get away with it.
Tags: Workers' compensation, didn, Insurance fraud, disability benefits, Coalition Against Insurance Fraud
 

The Right Way To File A Health Insurance Claim

February 14th, 10

After you have taken all the time to get the right , do you know the correct way to go about filing a claim?

Sometimes your medical provider does not take on the burden of filling out the claim form on your behalf so you have to figure out how to do it.

Here are the steps you will want to take to do this successfully and well as some tips to make sure that your claim is successful.

Tags: Health Insurance, health insurance policy, health insurance claim, Insurance fraud, insurance
 

Fraudulent Maryland Auto Insurance Reports On The Rise

November 18th, 09

The Maryland Insurance Administration has a fraud division that is run by Carolyn Henneman. It is her division’s responsibility to process complaints indicating possible cases of all types of insurance fraud. The division recently published a report for the fiscal year just ending 6/30/09 and there was some interesting information in it.

Tags: auto insurance fraud cases, U.S. Securities and Exchange Commission, auto insurance fraud, Insurance fraud, Vehicle insurance
 

Auto Insurance Companies Give Special Discount To Hybrid Drivers

August 9th, 08

The effects of the sluggish economy can be seen almost anywhere in the country if you go to a gas station and look at the prices for fuel. We’re living in a time where people have to be conservative when it comes to driving, because paying at the pump for a full tank is becoming something of a luxury that most people are hard-pressed to afford.

Tags: gas station, Increase Filing, Insurance fraud, recent additions, special vehicles, government officials