Pennsylvania Fraud Stories - Constant...

Pennsylvania Fraud Stories

Message from the Executive Director

M A R C H 2 0 1 7

Inside this issue:

Pennsylvania Insurance Fraud Prevention

Authority

Ralph Burnham

IFPA Executive Director

Many states have taken the route of creating fraud bureaus to combat insurance

fraud. Going in a different direction, Pennsylvania’s legislators, with insurers, con-

sumers and law enforcement created the Insurance Fraud Prevention Authority not

only to combat insurance fraud, but also to prevent insurance fraud.

We provide over $13 million in grants to state and local law enforcement each year

to prosecute insurance fraud; so that the arrests and prosecutions of some, who are

jailed, fined and ordered to pay restitution, will hopefully deter others from com-

mitting the crime. But, unless a law enforcement agency issues a press release on a

case, or the news media picks up on a case, the bulk of cases go unreported and the

general public remains uninformed.

To combat this, in 2016, the IFPA expanded its “real life” storytelling to target the

younger audience segment in regards to insurance fraud. This campaign, “See How They Lie,” produced two

new healthcare and worker’s comp fraud videos to add to our catalogue of high-octane video “movie previews”

that feature “real life, real lies, real foolish” insurance fraud schemes. These were deployed statewide through

paid digital and social media channels throughout the year. In addition we created ten new 60 second radio

commercials based on the same “real life, real lies, real foolish” insurance fraud schemes as our videos.

Philadelphia was designated the priority geographic market. Both broadcast television and radio messages aired

in this region throughout the year. Broadcast television commercials aired from February 8th through March

13th. The IFPA’s new radio ads were aired on the Top Ten radio stations in Winter/Spring from February 15

through March 28th and the Summer/Fall from August 1st through October 2nd. New to 2016 was our radio

partnership with the Philadelphia Phillies and Pittsburgh Pirates. Starting with spring training and continuing

throughout the season, the IFPA aired one of our new 60 second radio commercials during every other Phillies

and Pirates game. In addition, one of our ”See How They Lie” videos was played in the ballparks prior to each

home game. Our partnership with both teams will continue in 2017.

Consumer traffic to the campaign’s “See How They Lie” landing page, YouTube videos, Facebook and the Help

Stop Fraud website had 69,645 viewers, which is an increase of 76% compared to 2015. The strong impact of

the newly energized creative and select market paid broadcast sets the stage for an even more successful effort in

2017.

The Service Industry Advertising Awards recognized the Pennsylvania Insurance Fraud Prevention Authority’s

(IFPA) integrated campaign, “See How They Lie” with Best of Show for outstanding creativity. The same

campaign also won a Gold Award in the Integrated Marketing category. The Service Industry Advertising

Awards began in 2003 to recognize the advertising excellence within the service industry. More than 1,700

entries were received from across the country and a national panel of judges evaluated and rated the entries. The

judges awarded five Best in Show Awards, 136 Gold Awards, 88 Silver Awards and 60 Bronze Awards. A

national panel of industry specialists reviews each piece, judging creativity, marketing execution, message impact,

technology application and innovation of content.

Please visit our website at www.helpstopfraud.org for further information.

Thomas Donahue

Executive Director

Public Relations 3

Know the Risks! 4

Physician’s Employee

Accused of Insurance/

Prescription Fraud

4

One Injury—Two Claims 5

Insurance Dept. Report-

edly Suspends Public

Adjuster’s License

6

Homeowner/Renter

Insurance Fraud

7

Know the Penalties!

8

Mark Your Calendar 14

Who to Call 15

http://www.helpstopfraud.org

Don’t Be a But

The IFPA continued our “Don’t Be a But” (DBAB) campaign on social media through daily memes, animated videos, online interactive content, and

other grassroots marketing. This multi-tiered campaign was implemented to expose the “BUTS” (i.e. lies and excuses) and consequences of false

insurance claims to a younger audience (18-35) via social media, YouTube, live events and more.

Last year, the IFPA entered into a partnership with the Harrisburg Senators AA Baseball team to sponsor strikeouts of opposing players. Whenever a

visiting player struck out, a 10 second ”Don’t Be a But” video was displayed on the scoreboard along with the public address announcer saying “Strike

Out insurance fraud in Pennsylvania, brought to you by the Pennsylvania Insurance Fraud Prevention Authority” The IFPA will once again partner

with the Harrisburg Senators in 2017. New this spring and summer will be our partnership with the Reading Fightin Phils where we will be

sponsoring foul balls similar to the above mentioned strike out sponsorship.

Our grassroots efforts at live events featured onsite digital and online advertising as well as a fully outfitted Weasel mascot that helps draw attention to

Weasy’s customizable “jail cell” booth, offering an assortment of clever promotional products, like “Weasy Simulator Shades,” which blurs truth and

reality, and “Ehrr Fresheners,” which smell like a new car. People of all ages watched our videos and shared pictures on social media in exchange for

promotional items at these live events.

We learned through our live events that kids were attracted to our mascot and videos which led their parents to our booth where they learned about

the consequences of committing insurance fraud.

The campaign continued to promote its fraud awareness message by placing dozens of billboards in high traffic areas in the Harrisburg area along with

digital video boards at the baggage claim area of the Harrisburg airport. This advertising draws attention to the DBAB message and directs viewers to

our website and You Tube sites. Our You Tube site had 49,272 views in 2016 compared to 1,332 in 2015. In addition, our Facebook page had over

22,000 views.

Further information can be found at www.dontbeabut.org

Penn State

In 2016, the IFPA continued its relationship with Penn State Sports Properties to air our new 60 second radio commercials during Penn State

Football games. Due to the success of the team, the IFPA was able to air additional radio commercials during the Big Ten Championship Game and

the Rose Bowl!

Our annual Fraud Awareness Conference is scheduled for April 6th and 7th in Hershey, PA. We are looking forward to another successful conference.

Thank you for your continued efforts in fighting insurance fraud in Pennsylvania.

Executive Director’s Message cont’d

http://www.dontbeabut.org

Public Relations

Be on the look-out for new billboards popping up

throughout Central Pennsylvania!

Weasy’s on Facebook at www.facebook.com/dontbeabut

Visit our website at www.helpstopfraud.org;

https://www.facebook.com/PennIFPA/

and on YouTube!

http://www.facebook.com/dontbeabut

https://www.facebook.com/PennIFPA/

Fraud Stories

The accounts of insurance fraud and insurance-related crimes that follow are drawn from Pennsylvania

law enforcement’s filed criminal complaints, press releases and newsletters. Criminal complaints dock-

eted may be viewed online, using the “OTN” shown in each of the following accounts, through the web

portal of Pennsylvania’s Unified Judicial System. Individuals shown charged with crimes are to be pre-

sumed innocent until they are proven guilty.

Know the Risks, Know the Penalties

Prescription

Fraud

On February 1, 2017, Office of Attorney General special agents arrested 31 year-old Brendlay Rodriguez of

Reading, PA and charged her with Insurance Fraud and Attempted Theft by Deception-False Impression.

According to the Criminal Complaint, it is alleged that Rodriguez filed a vandalism claim with Allstate

Insurance Company for damages that her vehicle sustained before she added comprehensive coverage to

her policy. Allstate did not pay the claim. [OTN: T8868904]

On February 2, 2017, detectives of the Allegheny County Police Department filed a Criminal Complaint

charging 57 year-old Theresa K. Frank of Pittsburgh, PA with five counts of Insurance Fraud, and six counts

each of Forgery, Acquire or Obtain Possession of Controlled Substance and Intentional Possession of Con-

trolled Substance. According to the complaint, Frank worked in a physician’s office and reportedly stole

prescription pads, wrote prescriptions for Oxycodone and forged a physician’s signature and used her

UPMC Health Plan Insurance at several pharmacies to obtain the fraudulent scripts. [OTN: G7665372]

On February 2, 2017, Office of Attorney General special agents arrested 38 year-old Nakia M. Feribee of

Philadelphia, PA and charged her with Insurance Fraud, Attempted Theft by Deception-False Impression

and Criminal Use of Communication Facility. According to the Criminal Complaint, on July 20, 2015,

Feribee submitted a burglary claim to her homeowner insurer, Allstate Insurance. Feribee submitted re-

ceipts to Allstate for three purportedly stolen items which she claimed she had purchased from Luther Ap-

pliance and Furniture Sales. According to the complaint, investigators contacted Luther Appliance and

Furniture Sales and found that the store had no record of the claimed purchases. Allstate denied the claim.

[OTN: T8895574]


charging 36 year-old Clark W. Tomer of Pittsburgh, PA with two counts of Insurance Fraud. According to

the complaint, it is alleged that Tomer applied for an auto insurance policy with GEICO Insurance after he

had been involved in an auto accident. He then reportedly attempted to file a claim and misrepresented the

time of the accident to reflect that the accident occurred after he obtained the policy. [OTN: G7665475]

On February 8, 2017, detectives of the Lehigh County District Attorney’s Office filed a Criminal Complaint

charging 31 year-old Adalgisa M. Jones of Emmaus, PA with two counts of Insurance Fraud. According to

the complaint, it is alleged that Jones applied for an auto insurance policy with Safe Auto Insurance Com-

pany on December 24, 2016 and failed to disclose that she had been involved in an auto accident prior to

her application. The complaint states that Jones subsequently submitted a claim for the accident that oc-

curred before she obtained the Safe Auto policy; however, Safe Auto did not pay the claim. [OTN:

X0781443]

On February 8, 2017, detectives of the Northeast Pennsylvania Insurance Fraud Task Force filed a Criminal

Complaint in Luzerne County charging 19 year-old Henry McCoy of Wilkes-Barre, PA with Insurance

Fraud. According to the complaint, it is alleged that McCoy submitted a claim to Safe Auto Insurance

Company for an auto accident he reported occurred on December 4, 2016. An investigation reportedly

revealed that McCoy was uninsured at the time the accident occurred and that he had contacted Safe Auto

http://ujsportal.pacourts.us/DocketSheets.aspx


to obtain coverage after-the-fact. Furthermore, when McCoy filed the claim, he allegedly misrepresented the

actual time of the accident to reflect it occurred after he obtained a valid policy. [OTN: T8918232]

On February 13, 2017, Office of Attorney General special agents arrested 36 year-old Amy L. Allaman of

Butler, PA and charged her with Insurance Fraud and Attempted Theft by Deception-False Impression. Ac-

cording to the Criminal Complaint, on March 9, 2016, Allaman reported to Safe Auto Insurance that she

had been using her car to deliver newspapers when the vehicle slipped out of gear and coasted into a mobile

home. Safe Auto denied the claim for damages to the residence as it was reportedly determined that Al-

laman’s personal auto policy did not cover the loss because Allaman had been using the vehicle for business

purposes at the time. The complaint states that Allaman subsequently purchased an auto policy from Nation-

wide Insurance and in May 2016, filed a claim with Nationwide for the prior damage to the mobile home.

Reportedly, Allaman reported to Nationwide that the accident took place while she was visiting her cousin;

however, witnesses reportedly verified that the loss occurred in March, not May. [OTN: T8928555]

On February 13, 2017, Office of Attorney General special agents arrested 48 year-old Joseph D. Milcarek of

Pittsburgh, PA and charged him with insurance Fraud and Attempted Theft by Deception. According to the

Criminal Complaint, on June 15, 2015, Milcarek submitted a claim to Sedgwick Insurance for a knee injury

which purportedly occurred on December 15, 2014. Milcarek submitted supporting medical documentation

to the insurer which stated that Milcarek had suffered an injury on December 17, 2014. Milcarek allegedly

insisted to Sedgwick representatives that he had not been injured after December 15th. However, the investiga-

tion revealed that that Chubb Insurance paid $12,000 on a claim filed by Milcarek for injuries he had suf-

fered from a fall which occurred on December 17, 2014 and that Milcarek had submitted the same support-

ing documentation with his Chubb and Sedgwick claims. [OTN: G7675161]

On February 14, 2017, detectives of the Cumberland County District Attorney’s Office filed a Criminal

Complaint charging 44 year-old Robert S. Basom of New Cumberland, PA with two counts of Insurance

Fraud and Attempted Theft by Deception. According to the complaint, on March 20, 2015, Basom pur-

chased a Kia Rio with pre-existing damage from a car dealership. Basom, however, filed a claim with his insur-

er, Farmers Insurance Company, and reported that the damage to the vehicle occurred on March 20, 2015

while it was parked in a Giant parking lot. Basom withdrew the claim with Farmers before adjusters conduct-

ed an assessment of the damages. According to the complaint, Basom applied for and obtained coverage

through Progressive Advanced Insurance Company on June 21, 2016 with an initial deductible of $500 and

on July 11, 2016, lowered his deductible from $500 to $100. Basom submitted a claim with Progressive on

July 29, 2016 for multiple damages he reportedly stated occurred on July 27, 2016. An investigation revealed

that the damage Basom reported to Progressive was allegedly the same damage that was present when Basom

purchased the vehicle. Additionally, Basom reportedly revealed on his Facebook page that he was self-

employed as an Uber driver; however, Basom allegedly had not disclosed to Progressive that the vehicle was

used for commercial use. [OTN: T8938392]

On February 15, 2017, Office of Attorney General special agents arrested 44 year-old Edie A. Sawyer of But-

ler, PA and charged her with Insurance Fraud and Attempted Theft by Deception-False Impression. Accord-

ing to the Criminal Complaint, Sawyer added a 2006 Subaru Forester to her existing Progressive Insurance

vehicle policy on December 16, 2016 and subsequently that same day reported that her Subaru had been

involved in a two vehicle accident shortly after she added the Subaru to her policy. However, the complaint

states that the driver of the second vehicle and the police who responded to the accident confirmed that the

crash occurred before Sawyer added the Subaru to her policy. [OTN: T8943266]

Fraud Stories (Continued)

“...the investigation

revealed that Chubb

Insurance paid

$12,000 on a claim

filed by Milcarek for

injuries he had suffered

from a fall; submitted

the dame supporting

documentation with his

Chubb and Sedgwick

claims.”


On February 17, 2017, detectives of the Delaware County District Attorney’s Criminal Investigation Division

filed a Criminal Complaint charging 24 year-old Cherelle Dillingham of Aston, PA with Insurance Fraud, At-

tempted Theft by Deception-False Impression, Criminal Use of Communication Facility and Unsworn Falsifica-

tion to Authorities. According to the complaint, Dillingham obtained an auto insurance policy with Progressive

Insurance Company to insure her 2013 Chevy Cruz on December 2, 2016. On December 3, 2016, Dillingham

filed a claim with Progressive for damage to the vehicle that occurred in a hit-and-run crash while parked and

unattended. The complaint reflects that Dillingham provided photographs of the damage in support of her

claim in which metadata showed the photos had been taken on December 2, 2016 – prior to Dillingham obtain-

ing the Progressive policy. [OTN: T5336262]

On February 21, 2017, detectives of the Allegheny County Police Department filed a Criminal Complaint charg-

ing 35 year-old Jennifer D. Wessel of Pittsburgh, PA with Insurance Fraud. According to the complaint, Wessel

contacted Progressive Insurance to obtain an auto insurance policy to insure her 2008 Volkswagen and subse-

quently contacted Progressive to report that she had been involved in an accident. Reportedly, a Pittsburgh Po-

lice dispatch report and metadata on cell phone photos revealed that the accident occurred before Wessel ob-

tained the Progressive policy. [OTN: G7682010]

On February 21, 2017, Office of Attorney General special agents arrested 50 year-old John Funari of Philadelph-

ia, PA and charged him with Theft by Deception-False Impression and Failure to Make Required Disposition of

Funds. According to the Criminal Complaint, after a storm caused wind and hail damage to a residential proper-

ty, the property owners retained Funari, a licensed public adjuster, to handle their insurance claim. The parties

entered into an agreement which allowed Funari to receive the claim payment from the insurer, Philadelphia

Contributionship, and entitled Funari to retain 20% of the claim proceeds and required him to remit the re-

mainder to the property owners. On October 1, 2012, Philadelphia Contributionship issued a payment of

$4,864.75 for the claim. According to the complaint, it is alleged that Funari received the insurance check and

cashed it, but failed to send any part of the claim payment to the owners of the damaged property. The property

owners repeatedly tried to contact Funari, but were unable and eventually referred the matter to the Pennsylva-

nia Insurance Department. The complaint states that the Insurance Department was also unable to reach Funari

and subsequently obtained a default judgement against him. The Insurance Department also suspended Funari’s

public adjuster’s license for five years. [OTN: U0662723]

On February 22, 2017, Office of Attorney General special agents arrested 33 year-old Mark H. Watson of Jame-

stown, PA and charged him with Insurance Fraud and Attempted Theft by Deception-False Impression. Accord-

ing to the Criminal Complaint, Watson was driving an uninsured vehicle when he struck another car from be-

hind, injuring the other driver and a pedestrian who had been directing traffic. According to the complaint, it is

alleged that Watson contacted Progressive Insurance from the scene and reinstated his lapsed automobile cover-

age. It is further alleged that Watson subsequently filed an accident claim and stated that the accident occurred

after he had reinstated his policy. The complaint states that Progressive denied payment of the claims, but Na-

tionwide Insurance paid $15,000 on the bodily injury claim filed by its insured driver of the second car. Nation-

wide also paid $16,500 for damages to its insured vehicle. According to the complaint, Watson later admitted

that he did not have insurance at the time of the accident and that he had misrepresented the time of loss to

Progressive in an effort to receive coverage. [OTN: T8963161]


charging 21 year-old Jasmine C. Bey of Pittsburgh, PA with Insurance Fraud. According to the complaint, Bey

applied for and received an auto insurance policy with Donegal Insurance to insure a 2005 Chevy Cobalt. On

the application, Bey listed herself as the only driver of the vehicle and provided the garaging location of the vehi-


Public

Adjuster’s

License

Suspended

After Failing to

Remit Claim

Funds to

Property

Owners

cle was an Arnold, PA address. Reportedly, an investigation revealed that the primary driver of the vehicle

was not Bey but rather her live-in girlfriend and that the vehicle was primarily garaged in Pittsburgh, PA.

Furthermore, according to the complaint, neither Bey nor her girlfriend possessed a valid driver’s license and

Bey’s girlfriend reportedly has an extensive record of moving violations and license suspensions – all of which

would have caused Donegal to not have issued a policy. [OTN: G7682006]

On February 24, 2017, Office of Attorney General special agents arrested 28 year-old Jacob J. Walters of

Meadville, PA and charged him with Insurance Fraud and Attempted Theft by Deception-False Impression.

According to the Criminal Complaint, Walters’ Progressive Insurance coverage on his 2009 BMW was to

expire on November 29, 2016. Walters reportedly obtained coverage for the BMW on November 3, 2016

from Geico Insurance with lower deductibles, which was to take effect after the Progressive policy expired.

The complaint states that on December 2, 2016, Walters filed a claim with Geico for $4,783.09 for damages

to his BMW that resulted from a December 1, 2016 deer strike. According to the complaint, the investiga-

tion revealed that the BMW had been damaged prior to November 29, 2016 and before the Geico policy

went into effect. [OTN: T8974302]

On February 24, 2017, detectives of the Allegheny County Police Department filed two Criminal Com-

plaints charging 25 year-old Damion M. Bonnergreen and 24 year-old Sydnei R. Green, both of Pittsburgh,

PA, with Insurance Fraud, Forgery and Conspiracy. According to the complaints, Bonnergreen’s 2013 Hyun-

dai Sonata was involved in an auto accident. Chubb Insurance, insurer of the other driver who was at-fault

in the accident, had paid over $6,800 for the repair to Bonnergreen’s vehicle; however, when the owner of

Flagship Collision contacted Chubb Insurance to inquire as to when he could expect payment for the repairs

the auto body repair shop had already made, he was reportedly advised that Chubb had already issued pay-

ment to the “owner” of the vehicle. During the investigation, detectives learned that the primary owner of

the Sonata was Bonnergreen’s former stepfather and that Bonnergreen was also listed on the title. However,

the complaint states that Bonnergreen and Green allegedly forged documents to show that Ms. Green’s

mother was the primary owner of the vehicle reportedly in order to receive the claim money for the vehicle’s

repairs. When the claim checks were sent to Ms. Green’s mother, Bonnergreen and Green allegedly spent

the funds and did not issue payment to Flagship Collision for the vehicle’s repairs. [OTN: G7685042,

G7685053]

On February 27, 2017, Office of Attorney General special agents arrested 51 year-old James Schweigert of

Johnstown, PA and charged him with Insurance Fraud and Theft by Deception-False Impression. According

to the Criminal Complaint, on July 30, 2016, Schweigert obtained a renter’s policy from Allstate Insurance.

On that same day, he reportedly contacted Allstate to file a claim for water damage to his property. Schwei-

gert was reportedly advised at that time that his claim would not be covered as his policy did not go into

effect until August 1st. According to the complaint, Schweigert contacted Allstate on August 2nd and reported

that the loss occurred on August 1st, and provided Allstate with a list of damaged items. Allstate paid Schwei-

gert $7,958.35; however, investigators later determined that Schweigert did not own some of the items he

had claimed at the time of loss, including a 65-inch television, a 27-inch computer monitor and a pair of

Bose speakers, as well as DVDs and CDs valued at approximately $2,000. [OTN: T8978196]


charging 25 year-old Marcus V. Robbins of Pittsburgh, PA with two counts of Insurance Fraud. According to

the complaint, it is alleged that Robbins applied for an auto insurance policy with Safe Auto Insurance

Company after he had been involved in an auto accident. He then reportedly attempted to file a claim and


“Allstate paid

Schweigert $7,958.35;

however, investigators

later determined that

Schweigert did ot own

some of the items he had

claimed at the time of

loss....”



misrepresented that the accident occurred shortly after he had obtained the Safe Auto policy. [OTN:

G7689006]

On February 28, 2017, detectives of the Delaware County District Attorney’s Criminal Investigation Division

filed a Criminal Complaint charging 47 year-old George D. Dotsicas of Springfield, PA with Insurance Fraud,

Forgery and Theft by Deception-False Impression. According to the complaint, it is alleged that Dotsicas, who

owns an auto body repair shop, had forged and cashed a check from Nationwide Insurance that was made

out to another individual who had brought his vehicle in for repairs to Dotsicas’ shop. The complaint further

alleges that Dotsicas did not properly repair the vehicle or replace the vehicle parts that were itemized on the

repair estimate he prepared for Nationwide. Nationwide had paid $2,302.09 for the vehicle’s repairs. [OTN:

T8993891]

On February 1, 2017, Jamie Lee Walsh of Mount Pocono, PA pled Guilty to Insurance Fraud and was sen-

tenced to serve 12 months' probation and was ordered to pay a $1,500 civil penalty to the Insurance Fraud

Prevention Trust Fund, $3,336 in restitution and court costs totaling $1,424. On April 27, 2016, detectives of

the Northeastern Pennsylvania Insurance Fraud Task Force filed a Criminal Complaint charging Walsh with

Insurance Fraud and False Reports. According to the complaint, it is alleged that Walsh filed a claim with

Nationwide Insurance Company for some $6,034.59 in damage to her vehicle and was not forthcoming as to

how and where the damage actually occurred. [OTN: T7866725]

On February 1, 2017, Joseph P. Griffin of Philadelphia, PA pled Guilty to Insurance Fraud and Conspiracy

and was sentenced to serve three years' probation and was ordered to perform 100 hours of community ser-

vice and to pay court costs totaling $1,248.75. Also sentenced was Robert Lathrop of Philadelphia, PA. Lath-

rop also pled Guilty to Insurance Fraud and Conspiracy and was sentenced to serve two years’ probation, was

ordered to perform 100 hours of community service and to pay $1,248.75 in court costs. On April 28, 2016,

Office of Attorney General special agents arrested Lathrop, Griffin and 37 year-old Kelly Costanzo. The de-

fendants were each charged with one count of Insurance Fraud, Attempted Theft by Deception-False Impres-

sion and Conspiracy. According to the Criminal Complaints, on August 5, 2014, a truck owned by Griffin

and insured by Allstate Insurance Company was involved in an accident. Costanzo and Griffin filed claims

with Allstate for alleged injuries that they purportedly suffered as a result of the accident. According to the

complaint, Lathrop and the others told Allstate that Lathrop had been driving and that the others had been

riding in the truck when the accident occurred. However, the evidence allegedly revealed that Costanzo was

the driver and the sole occupant of the truck at the time of the accident. According to the complaint, Allstate

denied the bodily injury claims but paid $6,392.28 for the damage to Griffin’s truck. Lathrop, Griffin, and

Costanzo allegedly admitted to investigators that they all had agreed to make false statements to Allstate in

support of their claims. Court records reflect that the case against Costanzo remains active. [OTN: T7869131,

T7868851, T7869050]

On February 1, 2017, from a Negotiated Guilty plea to Insurance Fraud, Theresa Bush of Philadelphia, PA

was sentenced to serve three years' probation and was ordered to perform 40 hours of community service and

to pay a $2,000 civil penalty to the Insurance Fraud Prevention Trust Fund and court costs totaling $1,341.


The Penalties: The following dispositions of cases previously reported on were obtained via

the web portal of Pennsylvania’s Unified Judicial System.

Defendants

Sentenced to

Probation

http://ujsportal.pacourts.us/DocketSheets.aspx



$2,500 Civil

Penalty

Ordered Paid

to Insurance

Fraud

Prevention

Trust Fund

Office of Attorney General special agents arrested Bush in November 2016 and charged her with two counts of

Insurance Fraud, Attempted Theft by Deception, Criminal Use of Communication Facility. According to the

Criminal Complaint, on July 10, 2014, Bush’s uninsured vehicle was involved in an accident. Following the

accident, Bush contacted Safe Auto Insurance to reinstate her policy and subsequently filed a claim for injuries

which she claimed resulted from the accident. An investigation revealed that Bush misstated the time of the

accident when filing the claim in an effort to receive money for her claim. [OTN: U0567405]

On February 1, 2017, a Philadelphia, PA man was granted ARD with two years' probation and was ordered to

pay a $2,500 civil penalty to the Insurance Fraud Prevention Trust Fund and court costs totaling $419. On July

10, 2016, detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested the defendant and

charged him with Insurance Fraud and Forgery. According to the Criminal Complaint, detectives investigating

a 1994 Mercury learned from the car’s PennDOT title history that the defendant had registered the 1994 Mer-

cury with an American Independent Insurance Company financial responsibility identification insurance card.

Reportedly, detectives contacted American Independent and learned that the defendant was never insured by

the company and that the listed policy number corresponded to a policy owned by another customer. [OTN:

U0429866]

On February 1, 2017, Verna V. Vaughn of Pittsburgh, PA pled Guilty to Insurance Fraud and was sentenced to

serve four years' probation and was ordered to pay $6,841.20 in restitution and court costs totaling $3,865.88.


charging Vaughn with Insurance Fraud. According to the complaint, Vaughn applied for and obtained an auto

insurance policy with Donegal Insurance Company on March 13, 2015 to insure her 2004 Ford Mustang. On

April 15, 2015, Vaughn’s Mustang was involved in an accident while allegedly being operated by her son and

was deemed a total loss. Reportedly, Vaughn had not disclosed on the application that her 24 year-old unli-

censed son resided with her or that she allowed him to operate her vehicle. The complaint reflects that Donegal

paid Vaughn $2,290.81 to settle her claim. [OTN: G7363510]

On February 2, 2017, William I. Crawn of Greeley, PA pled Guilty to Insurance Fraud and was sentenced to

serve 12 months' probation and was ordered to pay a $1,000 civil penalty to the Insurance Fraud Prevention

Trust Fund and court costs of $1,275. On May 2, 2016, detectives of the Northeastern Pennsylvania Insurance

Fraud Task Force filed a Criminal Complaint charging Crawn with two counts each of Insurance Fraud and

Attempted Theft by Deception. According to the complaint, it had been alleged that Crawn applied for auto

insurance with Erie Insurance Group and failed to disclose that the vehicle in which he was applying for cover-

age for had been involved in an accident prior to his applying for coverage. The complaint alleges that Crawn

then filed a claim for damage to the vehicle that was sustained from an accident that occurred before Crawn

obtained coverage. [OTN: T7886815]

On February 6, 2017, from a Non-Negotiated Guilty plea to Insurance Fraud, William S. Macko of Can-

onsburg, PA was sentenced to serve 12 months' probation and was ordered to pay $1,760.14 in court costs. On

May 20, 2016, detectives of the Allegheny County Police Department filed two Criminal Complaints charging

Macko with two counts of Insurance Fraud. Also charged was a 63 year-old co-defendant of Pittsburgh, PA with

one count of Insurance Fraud. According to the complaints, on August 19, 2015, Macko’s co-defendant who is

part owner and sales manager of Used Car World, purchased a 2008 Honda Civic. Macko, a part-time employ-

ee of the used car dealership, was driving the vehicle on August 19, 2015 when he became involved in a motor

vehicle accident. At that time, Macko reportedly provided the driver of the other vehicle involved with an Erie

insurance card which identified the vehicle as having been owned by the used car dealership, not Macko. The

complaint reflects that Macko, on August 21, 2015, submitted a claim to his insurer, Donegal Insurance Com-


Accelerated

Rehabilitative

Disposition

pany, and stated at that time that he was in the process of purchasing the vehicle at the time of the accident

and requested that his policy cover the vehicle as if it were his; however, he further stated that since being in-

volved in the accident, he had decided he was not proceeding with the purchase. Reportedly, one week later on

August 28, 2015, Macko’s statement changed when he reported to a Donegal claims representative that he had

in fact purchased the vehicle with cash on August 19, 2015, and he provided a bill of sale showing the same.

According to the complaint, when questioned on October 8, 2015, Macko’s co-defendant also stated that the

sale took place prior to the accident, but was unable to explain why the bill of sale showed a cash transaction

even though Macko had initially stated that he had only been in the process of purchasing but had not actually

paid for the vehicle. Reportedly, on February 22, 2016, Macko in an Examination Under Oath, admitted that

he did not purchase the vehicle and that the information and documentation he provided to Donegal in sup-

port of his claim was fabricated. He further stated that he had collaborated with his co-defendant to file the

claim with Donegal in order to have Donegal pay the claim. Court records reflect that Macko’s co-defendant

was granted ARD with 18 months’ probation and was ordered to perform 200 hours of community service and

to pay $2,728.50 in court costs. [OTN: G7439434, G7439460]

On February 8, 2017, a Wampum, PA woman was granted ARD with two years' probation and was ordered to

perform 50 hours of community service and to pay $2,691 in court costs. On October 4, 2016, Office of Attor-

ney General special agents arrested the defendant and charged her with Insurance Fraud, Attempted Theft by

Deception-False Impression and Tampering with Records. According to the Criminal Complaint, the defend-

ant submitted a wage loss disability claim to American Heritage Life Insurance Company. The complaint

stated that the defendant told the insurer that medical reasons forced her to miss work. The defendant alleged-

ly submitted time sheets to the insurer in support of her claim and received $720 in benefits from American

Heritage. However, a subsequent investigation reportedly revealed that the time sheets in question were altered

to make it appear that the defendant had missed work, when in fact she had not. According to the complaint,

the defendant's employer confirmed that the time sheets did not accurately represent the defendant's work

schedule and that she had been at work when she allegedly claimed to have been absent. [OTN: T8470346]

On February 9, 2017, a Claysburg, PA woman was granted ARD with 12 months' probation and was ordered

to perform 50 hours of community service and to pay court costs of $1,755. On September 15, 2016, Office of

Attorney General special agents arrested the defendant and charged her with Insurance Fraud and Attempted

Theft by Deception-False Impression. According to the Criminal Complaint, in October 2013, the defendant

filed a theft and vandalism claim under her homeowner’s policy with Allstate Insurance. After Allstate paid the

claim, the defendant later filed for withheld depreciation under the replacement cost provision of her policy.

According to the complaint, the defendant provided receipts to Allstate for several items she claimed to have

replaced with purchases from Macy’s, Payless Shoes and Best Buy retail stores. However, Allstate contacted the

stores and found that the defendant placed orders for various items then canceled the orders shortly thereafter.

The defendant reportedly admitted to investigators that she had submitted receipts to the insurer for items

which she had ordered online, then canceled. [OTN: T8401013]

On February 13, 2017, from a Non-Negotiated Guilty plea to two counts of Insurance Fraud and one count of

Attempted Theft by Deception, Ernest Vandervort of Pottsville, PA was sentenced to serve 16 months in an

Intermediate Punishment Program and was ordered to pay $300 in fines and court costs totaling $1,369.50.

On August 1, 2016, from a referral received from Progressive Insurance Company, Office of Attorney General

special agents filed two Criminal Complaints in Northumberland County charging 35 year-old Tiffany Bashore

of Sunbury, PA and Vandervort each with two counts of Insurance Fraud and one count of Attempted Theft

by Deception-False Impression. According to the complaints, it is alleged that Bashore and Vandervort misrep-



resented the dates on two vandalism claims made on their auto insurance policy. On June 5, 2014, Bashore

obtained an auto insurance policy with Progressive to insure her 1997 Jeep Cherokee and listed Vandervort as

an insured driver. On June 16, 2014, Vandervort contacted Progressive requesting assistance in towing the

Jeep as it had been vandalized. Vandervort was advised that the Progressive policy did not include comprehen-

sive/liability or rental coverage and therefore no assistance for a tow was available. Vandervort did not file a

claim at that time. However, according to the complaint, Vandervort contacted Progressive on June 22, 2014

to add comprehensive/collision and rental coverage and had not disclosed that the Jeep had damage prior to

obtaining the additional coverage. Bashore, on June 26, 2014, filed a vandalism claim alleging that someone

had flattened the Jeep’s tires, placed sugar in the gas tank and scratched the side of the vehicle. According to

the complaint, the investigation revealed that the damages to the Jeep occurred before Vandervort had added

the additional coverage. Progressive did not pay the claim. Court records reflect the case against Bashore re-

mains an active investigation. [OTN: T8229723, T8230331]

On February 13, 2017, from a Negotiated Guilty plea to multiple counts of Insurance Fraud and one count of

Conspiracy, Gary Cottrell of Philadelphia, PA was sentenced to serve six years' probation and was ordered to

pay a $5,000 civil penalty to the Insurance Fraud Prevention Trust Fund, $10,000 in restitution and court

costs totaling $4,018.50. Detectives of the Philadelphia District Attorney’s Office charged Cottrell with six

counts each of Insurance Fraud, Theft by Deception and Conspiracy, three counts of Bribery and one count

each of Corrupt Organization and Dealing in Proceed of Unlawful Act. According to the Criminal Com-

plaint, Philadelphia Police Officer Cottrell was one of eleven individuals arrested as the result of a lengthy

investigation of alleged illegal activities at University Collision Centers (UCC) in Philadelphia. It had been

alleged that the firm's owner and employees of UCC inflated the value of motor vehicle physical damage

claims by enhancing and creating damage to vehicles brought into UCC for repairs. UCC employees would

use a forklift, modified to accept a variety of car bumpers, as well as other methods, to create damage to cars.

An attorney had allegedly advised the owner of UCC with respect to fraudulent aspects of the business and

allegedly filed fraudulent bodily injury claims in concert with the firm's owner and certain employees of the

firm. Cottrell, who was a Philadelphia Police officer, reportedly acted as a "wreck chaser" steering accident

victims for a fee to UCC and filed fraudulent claims for damage to his own vehicles. According to the com-

plaint, seven motor vehicle physical damage appraisers employed by insurers had participated by inflating

damage appraisals in exchange for cash payments. [OTN: N7388754]

On February 15, 2017, from a Negotiated Guilty plea to Insurance Fraud, Linda Walthour of Philadelphia,

PA was sentenced to serve two years' probation and was ordered to pay a $250 civil penalty to the Insurance

Fraud Prevention Trust Fund and court costs of $750. On December 8, 2016, detectives of the Philadelphia

District Attorney’s Insurance Fraud Unit arrested Walthour and charged her with Insurance Fraud and For-

gery. According to the Criminal Complaint, during the course of investigating a 1996 Toyota, detectives

learned from the car’s PennDOT title history that Walthour had registered the 1996 Toyota with an Ameri-

can Independent Insurance Company insurance card. Detectives spoke to a representative from American

Independent who advised that Walthour’s policy expired on June 25, 2015 due to non-payment, and further

that the vehicles insured under that policy were a 2001 Buick and a 2004 Pontiac. Her 1996 Toyota was never

insured under that policy. [OTN: U0599351]

On February 15, 2017, from Non-Negotiated Guilty pleas to seven counts each of Insurance Fraud and Con-

spiracy, Stuart Doctorvitz of Pennsauken, NJ was sentenced to serve 14 years' probation and was ordered to

pay $109,900 in restitution, a $5,000 civil penalty to the Insurance Fraud Prevention Trust Fund and court

costs totaling $4,949.50. On January 20, 2016, detectives of the Philadelphia District Attorney’s Insurance


“Cottrell, who was a

Philadelphia Police

officer, reportedly acted

as a “wreck chaser”

steering accident victims

for a fee to UCC and

filed fraudulent claims

for damage to his own

vehicles.”

Fraud Unit arrested Doctorvitz and charged him with Insurance Fraud, Theft by Deception, Attempted Theft

by Deception, Criminal Conspiracy, Unsworn Falsification, False Swearing and False Reports. Detectives in-

vestigated Doctorvitz, a New Jersey attorney, for paying several co-conspirators to recruit individuals to file

fraudulent personal injury lawsuits involving bogus slip-and-fall accidents. [OTN: N9942236]

On February 15, 2017, from a Negotiated Guilty plea to Insurance Fraud, Michael J. Smith of Philadelphia,

PA was sentenced to serve five years' probation and was ordered to pay $5,333 in restitution and court costs

totaling $750. In October 2016, from a referral received from the Southeastern Pennsylvania Transportation

Authority (SEPTA), detectives of the Philadelphia District Attorney’s Office arrested Smith and charged him

with two counts of Insurance Fraud and one count each of Theft by Deception-False Impression and Attempt-

ed Theft by Deception-False Impression. According to the Criminal Complaint, on March 23, 2015, Smith

was passenger on a SEPTA bus when the bus made minor contact with a Ford Escape. Both vehicles had re-

portedly sustained minor damage. In fact, the driver of the Ford Escape never filed a claim on his own behalf.

According to the complaint, USAA paid $9,700 to buff a scratch on the SEPTA bus as well as $8,000 for

Smith’s alleged injuries. The complaint states that Smith had received treatment and incurred bills totaling

$9,828 in addition to a $2,100 medical bill from an MRI and another $764 from a pharmacy for medication.

Detectives obtained video surveillance footage on the bus at the time of the incident which reportedly shows

that no passengers were disturbed when the incident occurred and that Smith had been injured as he had

claimed. [OTN: U0548612]

On February 16, 2017, from a Non-Negotiated Guilty plea to Insurance Fraud and Conspiracy, Rasheed Har-

ris of Philadelphia, PA was sentenced to serve five years' probation and was ordered to pay a $2,000 civil penal-

ty to the Insurance Fraud Prevention Trust Fund, $2,000 in restitution and $749 in court costs. On March

19, 2016, from a referral received from the Pennsylvania Financial Responsibility Assigned Claims Plan

(PFRACP), detectives of the Philadelphia District Attorney’s Insurance Fraud Unit arrested Harris and 20

year-old Malikah Weaver, both of Philadelphia, PA, and charged each with Insurance Fraud, Attempted Theft

by Deception-False Impression, Conspiracy and False Reports. According to the Criminal Complaints, on

November 18, 2014, Harris and Weaver sought treatment at Temple University Hospital for neck, back and

shoulder injuries sustained during an accident they alleged they were involved in while they were passengers in

a PFRACP insured 1999 Buick Century on November 17, 2014. Harris and Weaver then continued to receive

medical treatment at Northwest Medical and Rehabilitation Center on 50 separate occasions between Novem-

ber 2014 and November 2015. Detectives reviewed medical records seized from Northwest Medical and Reha-

bilitation Center and learned that Harris and Weaver reported multiple ailments including back and shoulder

pain. On January 5, 2015, two months after the accident reportedly occurred, Harris and Weaver went to

Philadelphia Police to file an accident report. Harris and Weaver stated that they were passengers in a 1999

Buick when the owner of the vehicle crashed into a pole. However, the investigation revealed that the 1999

Buick Century was impounded with the Philadelphia Parking Authority on the date of the alleged accident.

Detectives interviewed the registered owner of the Buick who stated that she was never involved in an accident

and that the Buick has been impounded with the Philadelphia Parking Authority since October 23, 2014.

According to court records, the case against Weaver remains an active investigation. [OTN: M7909381,

M7913430]

On February 16, 2017, from a Negotiated Guilty plea to Insurance Fraud, Tyheem Inge of Upper Darby, PA

was sentenced to serve two years in an Intermediate Punishment Program followed by three years' probation

and was ordered to pay court costs totaling $3,215.50. On June 21, 2016, from a referral received from USAA

Insurance Company, detectives of the Delaware County District Attorney’s Criminal Investigation Division

“The complaint states

that Smith had

received treatment and

incurred bills totaling

$9,828 in addition to

a $2,100 medical bill

from an MRI and

another $764 from a

pharmacy for

medication.”

Page 9 Know the Risks, Know the Penalties



filed a Criminal Complaint charging Inge with Insurance Fraud, Attempted Theft by Deception-False Impres-

sion and Forgery. According to the complaint, it is alleged that Inge submitted a fraudulent tow receipt from

Sunrise Towing for $145 in support of a claim to USAA Insurance Company. During the course of the inves-

tigation, detectives learned through the tow company’s owner that it was not his tow company’s bill and that

the address and phone number on the bill Inge submitted was incorrect. Further investigation revealed that

Inge had made more than 30 similar tow claims. [OTN: T8080925]

On February 21, 2017, from a Negotiated Guilty plea to Insurance Fraud, Jack Taylor of Belle Vernon, PA

was sentenced to serve seven years' probation and was ordered to pay $400,000 in restitution and court costs

totaling $4,478.80. On January 16, 2014, Office of Attorney General special agents filed a Criminal Com-

plaint in Westmoreland County charging Taylor with one count each of Insurance Fraud and Theft by Decep-

tion-False Impression and two counts of Corrupt Organizations. The complaint reflects that Taylor was in-

volved in a motorcycle accident on September 18, 2010 and following the accident, due to injuries sustained

in the accident, began collecting full disability benefits of Unum Insurance. It was alleged that Taylor, a chiro-

practor, returned to work in January 2011, but continued to claim to Unum that he was unable to work. Tay-

lor had reportedly collected some $45,000 in disability benefits of Unum, to which he was not entitled. [OTN:

T4215676]

On February 24, 2017, from a Negotiated Guilty plea to Insurance Fraud, David G. Miller, III of Hon-

eybrook, PA was sentenced to serve two years' probation and was ordered to pay a $500 civil penalty to the

Insurance Fraud Prevention Trust Fund and court costs of $960. Office of Attorney General special agents

arrested Miller in November 2016 and charged him with Insurance Fraud and Attempted Theft by Deception.

According to the Criminal Complaint, on June 6, 2016, Miller was operating his uninsured vehicle when it

struck a deer and damaged the car. After the accident, Miller allegedly obtained an automobile policy from

Allstate Insurance Company and subsequently filed a claim and misrepresented the time of the accident to

reflect the accident occurred after he obtained the Allstate policy. [OTN: T8626623]


“Taylor had

reportedly collected

some $45,000 in

disability benefits of

Unum, to which he

was not entitled.”

National & State Anti-Fraud Events Offer New Knowledge & New Contacts

*April 6—7, 2017 — PA 2017 Insurance Fraud Conference — Hershey Lodge & Convention

Center, Hershey, PA

*September 10—13, 2017 — IASIU 2017 Seminar — New Orleans Sheraton Hotel, New

Orleans, LA

National & State Anti-Fraud Events Offer New Knowledge & New Contacts

Who to Call

P A I N S U R A N C E F R A U D

P R E V E N T I O N

A U T H O R I T Y

6 Kacey Court, Ste. 101

Mechanicsburg, PA 17055

Insurance Fraud

Allegheny County DA’s Office, (412) 461-2328

Allegheny County PD, (412) 473-1254

Attorney General’s Office, (717) 787-0272

Bucks County DA’s Office, (215)348-6344

Cumberland County DA’s Office, (717) 240-7764

Delaware County DA’s Office, (610) 891-4700

Erie Bureau of Police, (814) 870-1258

Lehigh County DA’s Office, (610) 264-8758

NE Insurance Fraud Task Force, (570) 963-5177

Philadelphia DA’s Office, (215) 686-8723

York County DA’s Office, (717) 771-9600 x 329

Arson

Dauphin County DA’s Office, (717) 255-2770

PA State Police-Fire Marshals, (717) 346-4597

Anti-Fraud Compliance

PA Insurance Department, (717) 705-4199

Phone: 717-691-1828

Fax: 717-697-1013

www.helpstopfraud.org

IFPA Staff

Thomas Donahue, Executive Director, [email protected]

Joan Dockery,

Associate Executive Director, [email protected]

Christine Cassel, Grants Administrator, [email protected]

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