Philadelphia Healthcare Business & Owner Charged With Workers' Compensation Fraud Bucks County Woman Sentenced in Fraudulent Auto Claim by ps94506



                                                                                                                   March 2011

                        Philadelphia Healthcare Business & Owner
                       Charged With Workers’ Compensation Fraud
                           On February 23, 2011, Sean Williams and his business, CAS Home Healthcare,
                       Inc., were arrested in Philadelphia County.

                        According to the Criminal Complaint, Sean Williams owns and operates, CAS Home
                    Healthcare, a Philadelphia business that provides staffing for people looking for
                    nurses’ aides, certified nurse assistants, and other healthcare related personnel.
                    Williams was allegedly responsible for obtaining and maintaining insurance for CAS.
                    According to the Complaint, during five different time periods spanning from a period
                    in 2005, through a period late in 2010, CAS Home Healthcare failed to maintain the
                    required workers’ compensation coverage for their employees. Williams allegedly
knew of his obligation to do so. In 2008, a work related injury occurred during a time period the business
allegedly did not have insurance. As a result of the injury, the State Uninsured Employer Guarantee Fund
paid out in excess of $100,000.

  Sean Williams and CAS Home Healthcare, Inc., have been charged with 706 counts of Failure to Carry
Worker’s Compensation Insurance (F3).

       Bucks County Woman Sentenced in Fraudulent Auto Claim

                          Bernadette Jones pled guilty to one count of Insurance Fraud (F3) in Bucks

                           Bernadette Jones’ vehicle was rear-ended by another car. Jones was not in the car
                       at the time of the accident. Nevertheless, Jones falsely told the other driver’s insurer,
                       the Infinity Insurance Company, and her own insurer, the Progressive Insurance
                       Company, that she was in the vehicle at the time of the accident. Jones also claimed
                       that she was injured as a result of the accident.

                   On February 16, 2011, Bernadette Jones was sentenced to serve 3 years probation,
ordered to perform 100 hours of community service and to pay restitution and all court costs.

                                          INSURANCE FRAUD SECTION NEWSLETTER

                                                                            the Criminal Complaint, Jones reported to the
                                                                            Philadelphia Police Department that her 2001
                                                                            Buick    Century,    insured   through     the
                                                                            Progressive Insurance Company, was
   On February 22, 2011, Rhonda Shoffner was                               stolen.   Jones further made a claim with
    arrested in Montgomery County. According to                             Progressive reporting the car stolen.      The
    the Criminal Complaint, Shoffner, Carnell                               vehicle was recovered burned later that same
    Cooper and Anthony Dingle, Jr., filed                                   day in New Jersey and deemed a total loss.
    insurance claims with the Progressive                                   According to the Complaint, Jones lent her car
    Insurance Company and the Capitol                                       to a friend who allegedly traded it for drugs.
    Insurance Company for injuries they allegedly                           The Complaint further alleged that Jones had
    sustained as a result of a motor vehicle                                known that her friend traded the car for drugs
    accident on May 30, 2009. Shoffner, Cooper                              prior to the theft report being made. Rakia
    and Dingle allegedly claimed that Shoffner                              Jones has been charged with two counts of
    was driving the vehicle and that Cooper and                             Insurance Fraud (F3), one count of Criminal
    Dingle were passengers when they were                                   Attempt/Theft by Deception (F3) and False
    struck by another vehicle driven by Menso                               Reports to Law Enforcement (M2).
    Munkanta.     Shoffner was insured by the
    Capitol Insurance Company and Menso                                    On February 25, 2011, Yusef Sabri was
    Munkanta was insured by the Progressive                                 arrested in Lehigh County. According to the
    Insurance Company. However, the Complaint                               Criminal Complaint, in 2007 and 2008, Sabri
    stated that Cooper and Dingle were not in                               submitted three claims to the Liberty Mutual
    Shoffner’s vehicle at the time of the accident                          Insurance Company, reporting that in each
    and that Shoffner was not injured. Rhonda                               of the three separate accidents, his car’s rear
    Shoffner has been charged with four counts of                           bumper and tailgate had been damaged.
    Insurance Fraud (F3), two counts of Criminal                            Liberty Mutual paid Sabri after each claim.
    Attempt/Theft by Deception (F3), two counts                             The Complaint further stated Sabri submitted
    of Criminal Conspiracy (F3) and one count of                            another claim in 2009 to the Esurance
    False Reports to Law Enforcement Authorities                            Insurance Company, again reporting the
    (M3). On February 23, 2011, Carnell Cooper                              same damages in yet another accident. As a
    was picked up on a fugitive warrant awaiting                            result of this claim, Esurance obtained a
    extradition from New Jersey and a warrant                               repair estimate of $4,694.37 but did not pay
    has been issued for Anthony Dingle, Jr.                                 any amount on the claim. Photographs of
                                                                            Sabri’s car taken in connection with each of
   On February 25, 2011, Corey Middleton was                               the four claims allegedly show that all of the
    arrested in Philadelphia County. According to                           claimed damage was identical. Yusef Sabri
    the Criminal Complaint, Middleton reported to                           has been charged with two counts of
    both the Philadelphia Police and his insurer,                           Insurance Fraud (F3), one count of Criminal
    the Bristol West Insurance Company, that                                Attempt/Theft by Deception (F3) and one
    his car was stolen after he parked it in                                count of Theft by Deception (M1).
    Philadelphia on February 29, 2008. Bristol
    West paid Middleton $15,500 in settlement of                           On February 18, 2011, Yetundo Teyibo was
    his claim. However, the Complaint stated                                arrested in Montgomery County. According to
    that Middleton’s car was not stolen and that                            the Criminal Complaint, Teyibo was interning
    he paid someone to get rid of it for him.                               with   the   Liberty   Mutual    Insurance
    Corey Middleton has been charged with one                               Company in 2009. On December 27, 2009,
    count of Theft by Deception (F3), one count                             Teyibo returned to her apartment in
    of Insurance Fraud (F3), one count of                                   Philadelphia and discovered it had been
    Criminal Conspiracy (F3) and one count of                               burglarized. According to the Complaint, at
    False Reports to Law Enforcement Authorities                            the time of the burglary, Teyibo’s renter’s
    (M3).                                                                   insurance policy had been cancelled for non-
                                                                            payment.     Teyibo subsequently contacted
   On February 25, 2011, Rakia Jones was                                   Liberty Mutual, applied for a new renter’s
    arrested in Montgomery County. According to                             policy increasing her policy limits and
                                           INSURANCE FRAUD SECTION NEWSLETTER

    lowering her deductible. Teyibo subsequently                            Criminal Attempt/Theft by Deception (M1).
    contacted Liberty Mutual the following day
    and made a claim alleging she discovered the                           On February 28, 2011, Michelle Mustin was
    loss on December 28, 2009, after the new                                arrested in Cumberland County. According to
    policy became effective. Yetundo Teyibo has                             the Criminal Complaint, Mustin, a Delta
    been charged with two counts of Insurance                               Dental insurance employee, submitted a
    Fraud (F3 & M1).                                                        claim for dental services which her daughter
                                                                            purportedly     received.      However,    the
   On February 28, 2011, Kevin Deberry was                                 investigation allegedly revealed that the
    arrested in Fayette County. According to the                            services were not rendered and that the
    Criminal Complaint, in January 2009, Deberry                            dentist listed on the claim form was no longer
    was injured when he slipped on ice while                                employed by the purported provider on the
    working as a janitor for Service Master.                                date in question. The Complaint stated the
    Deberry      began      collecting    workers’                          dentist was out of the country on vacation at
    compensation benefits from the Mutual                                   the time. Michelle Mustin has been charged
    Benefit Insurance Company.            Deberry                           with one count of Insurance Fraud (F3) and
    allegedly submitted forms stating that he had                           one count of Criminal Attempt/Theft by
    not been employed at any time while                                     Deception (M1).
    collecting workers’ compensation benefits.
    The Complaint further stated that in January                           On February 28, 2011, Deborah Grysiak was
    2010, Deberry testified at a workers’                                   arrested in Allegheny County. According to
    compensation hearing that he did not work,                              the Criminal Complaint, Grysiak impersonated
    nor receive pay, since leaving Service Master.                          a     physician   assistant    to    phone-in
    However, Deberry allegedly worked and                                   approximately a dozen prescriptions for
    collected wages from a landscaping business                             Vicodin (Hydrocodone) over a one year
    in 2009 and from Papa Johns Pizza in 2010.                              period. The Complaint further stated that the
    Kevin Deberry has been charged with two                                 cost of the medicine was billed to the UPMC
    counts of Workers’ Compensation Fraud (F3),                             Health Care Insurance. Deborah Grysiak
    one count of Theft by Deception (F3) and one                            has been charged with one count of Drug Act
    count of Perjury (F3).                                                  Violations (F) and one count of Insurance
                                                                            Fraud (F3).
   On February 27, 2011, Jason and Holly Boring
    were arrested in Cumberland County.
    According to the Criminal Complaint, Jason,
    an excluded driver on Holly’s auto policy, was
    driving her Saturn when he backed into a car
    driven by Seth McConaughey in the parking                              Okechukwu Isienyi and Antione Etienne pled
    lot of an apartment complex. According to                               guilty to one count of Insurance Fraud (F3)
    McConaughey, Jason was the only person in                               and one count of False Application for Title or
    the vehicle at the time. McConaughey also                               Registration (M1) in Dauphin County. Isienyi
    stated that Jason identified himself and                                and Etienne, residents of New York, seeking
    provided him with the vehicle’s Progressive                             less expensive auto insurance, obtained
    Insurance    information.       McConaughey                             coverage from the American Independent
    subsequently    filed  a   claim    with    the                         Insurance Company (AIIC) by falsely
    Progressive Insurance Company.            In a                          representing that they lived in Pennsylvania.
    recorded statement, Jason allegedly told                                AIIC does not write auto insurance in New
    Progressive that his wife, Holly was driving                            York.     Similarly, Isienyi and Etienne also
    the vehicle at the time of the accident.                                obtained title and registration for their car(s)
    Additionally, Holly allegedly confirmed to                              from PennDOT and Etienne further obtained a
    Progressive that she had been the driver.                               Pennsylvania driver’s license by falsely
    Jason and Holly Boring have been charged                                representing Pennsylvania residency.         On
    with two counts of Insurance Fraud (F3), one                            February 14, 2011, Okechukwu Isienyi was
    count of Criminal Conspiracy (M1) and                                   sentenced to serve 3 years probation and
                                                                            ordered to pay a fine of $1,000 and all court
                                           INSURANCE FRAUD SECTION NEWSLETTER

    costs.    Antione Etienne was sentenced to                                         TRAINING VIDEOS
    serve 1 year probation and ordered to pay a
    fine of $500 and all court costs.
                                                                            The Pennsylvania Office of Attorney General is
                                                                            committed to taking the fight against
   Chad Cahill pled guilty to one count of
                                                                            Insurance Fraud to the next level. A series of
    Insurance Fraud (M1) in Westmoreland
                                                                            training videos intended to help uncover and
    County.     Cahill, a passenger in his own
                                                                            fight fraud have been developed to assist in
    vehicle, opened his door striking another
                                                                            this endeavor. The eighth video in this series,
    vehicle that was pulling into the space beside
                                                                            which was just released, focuses on the
    his vehicle.     Cahill refused to provide his
                                                                            important concept: Documents are key.
    insurance information; however, out of
    Cahill’s presence, the driver of his vehicle
                                                                            The basis of a successful prosecution is
    provided an insurance card to the driver of
                                                                            evidence – so asking the right questions and
    the other vehicle, unaware that the policy had
                                                                            making       sure     to    obtain    follow-up
    expired.      Following the accident, Cahill
                                                                            documentation can be pivotal to making a
    obtained liability coverage for his vehicle from
                                                                            case. When an individual tells you a piece of
    the Safe Auto Insurance Company and
                                                                            information, be sure to ask for records or
    failed to disclose that he had previously been
                                                                            documents that can support that claim. If an
    in an accident. Cahill subsequently reported
                                                                            individual is lying, he or she may try to avoid
    the accident, providing false information as to
                                                                            providing documents.         Do not let them
    the time it occurred. On February 9, 2011,
                                                                            distract you; be persistent.
    Chad Cahill was sentenced to serve 1 ½ years
    probation and ordered to pay restitution and
                                                                            It is important for you to collect as much
    all court costs.
                                                                            information as possible because oftentimes,
                                                                            once law enforcement becomes involved in a
   Elizabeth Dally pled guilty to one count of
                                                                            case, individuals become less willing to
    Tampering with Records or Identification (M1)
                                                                            cooperate. That is precisely why we need
    in Allegheny County.       Dally fraudulently
                                                                            your help before you even send us the case.
    created     insurance   cards    listing  the
                                                                            A successful prosecution requires a team
    Nationwide Insurance Company as the
                                                                            effort and it is crucial for you to obtain as
    carrier for her automobile after her coverage
                                                                            much evidence as possible before referring
    lapsed. Dally’s son was involved in a motor
                                                                            the case over to us.
    vehicle accident and provided the fraudulent
    cards to the other drivers. The other drivers
                                                                            The key here is not only asking the right
    subsequently filed a claim with Nationwide,
                                                                            questions, but obtaining the follow-up
    but their claims were denied after it was
                                                                            documentation as well.
    revealed that the policy information provided
    belonged to a non-associated party.        On
    February 8, 2011, Elizabeth Dally was
                                                                            Lock them in;
    sentenced to serve 1 year probation and to
    pay all court costs.
                                                                            . . . . . . Get it right;

                                                                            . . . . . . . . . Avoid confusion;
              (ARD) DISPOSITIONS
                                                                            . . . . . . . . . . . . . Help build the case.
    During the month of February, five additional
    defendants           received       Accelerated
    Rehabilitative Disposition (ARD). Defendants                            If you would like to be placed on our mailing
    receiving ARD are typically sentenced to                                list to receive these training videos through
    serve 2 years probation and ordered to                                  email distribution, please send us a request
    perform 50 hours of community service, pay                              with the appropriate email address. At this
    full restitution and all ARD and court costs.                           time, distribution of the training videos is
                                                                            provided through email ONLY.
                                           INSURANCE FRAUD SECTION NEWSLETTER

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