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OIFP Criminal Case Notes - Insurance Fraud



AUTO INSURANCE FRAUD                                tion targeting Health Care Claims Fraud and          by the law firm of Goldberger, Seligsohn &
                                                    the illegal use of “runners.” The racketeering       Shinrod, PA, as a result of the alleged illegal in-
Criminal Use of Runners                             and conspiracy charges represent the first time      surance fraud scheme. The indictment seeks
State v. Dannie Campbell, et al.                    the Division of Criminal Justice - Office of         proceeds such as investments, bank accounts,
   Sentencing continued in 2005 for defen-          the Insurance Fraud Prosecutor has used New          office equipment, real estate, and other assets
dants implicated in three indictments that          Jersey’s Racketeering Influenced & Corrupt           obtained as proceeds from engaging in theft by
charged Dannie Campbell and ten other defen-        Organization (RICO) statute to prosecute an          deception, Health Care Claims Fraud, Criminal
dants with conspiracy, Health Care Claims           attorney and a law firm for Health Care              Use of Runners, and tax fraud.
Fraud, and attempted theft by deception. The        Claims Fraud, Criminal Use of Runners, and                              The Lawyers
State alleged in the indictments that Dannie        related insurance fraud crimes.
                                                                                                         • Irwin B. Seligsohn, Esq., was charged with
Campbell masterminded fictitious automobile            The 20-count superseding State Grand Jury           racketeering and conspiracy to commit
accidents in 1997 and 1998 that involved other      indictment was returned on November 15,                racketeering. He was also charged with
co-conspirators so that the co-conspirators         2005, charging Seligsohn, his Essex County law         Health Care Claims Fraud, theft by decep-
could treat for injuries purportedly sustained in   firm, five “runners,” and 23 phony accident            tion, Criminal Use of Runners, filing or
the phony accidents and submit Personal Injury      claimants variously with criminal racketeering,        preparing a false or fraudulent New Jersey
Protection (PIP) insurance claims to an insur-      conspiracy to commit racketeering, auto insur-         tax return, and conspiracy to commit the
ance company. The fictitious accidents oc-          ance-related Health Care Claims Fraud, Crimi-          same.
curred in Hillside and Newark.                      nal Use of Runners, theft by deception, and
   Campbell pled guilty to Health Care Claims       tax fraud.
Fraud, and on April 1, 2005, was sentenced
to three years in state prison and ordered to
pay a $3,000 criminal fine. Nathaniel Jones            The indictment alleges that the lawyers and       • The law firm of Goldberger, Seligsohn &
pled guilty to Health Care Claims Fraud and         their law firm engaged in a scheme of paying           Shinrod, PA, was charged with racketeering
was sentenced on June 13, 2005, to two years        “runners” to solicit and obtain automobile ac-         and conspiracy to commit racketeering. It
probation with the condition that he pay a          cident clients for the law firm in order to sub-       was also charged with theft by deception,
$2,500 civil insurance fraud fine. Duane            stantially increase the amount of money ob-            Criminal Use of Runners, Health Care
Smith pled guilty on January 7, 2005, to            tained through insurance claims, lawsuits, and         Claims Fraud, filing or preparing a false or
Health Care Claims Fraud and was sentenced          other legal actions.                                   fraudulent New Jersey tax return, and con-
on April 1, 2005, to three years probation and                                                             spiracy to commit the same.
                                                       The superseding State Grand Jury indict-
ordered to pay a $2,500 civil insurance fraud       ment alleges that between October 30, 1993                The “Runners,” Claimants, and Others
fine. Shaheed Johnson pled guilty to con-           and September 15, 2005, Irwin B. Seligsohn           • Louis Campbell; Edward Campbell, a/k/a
spiracy and was sentenced to three years pro-       and the law firm of Seligsohn, Goldberger &            Edward Campbell, Jr.; Edward Campbell,
bation and ordered to pay a $2,500 civil insur-     Shinrod, PA, 735 Northfield Ave., W. Orange,           Sr., a/k/a Reverend Campbell; Richard Wil-
ance fraud fine.                                    Essex County, conspired with others to pay             liams; and Damon Brown, alleged ”runners,”
   The charges as to the other defendants are       “runners” to solicit other individuals to partici-     were charged with conspiracy to commit
pending trial.                                      pate in staged automobile accidents so that au-        racketeering, racketeering, conspiracy,
   In all cases, Keystone Insurance Company/        tomobile insurance Personal Injury Protection          Health Care Claims Fraud, theft by decep-
AAA Mid-Atlantic Insurance Company re-              (PIP) and other insurance claims could be sub-         tion, and Criminal Use of Runners. Edward
ferred the matters to OIFP.                         mitted to various insurance companies. Addi-           Campbell, Jr., was additionally charged with
                                                    tionally, the indictment alleges that Seligsohn        failure to pay or turn over taxes.
State v. Irwin B. Seligsohn;                        improperly accounted for the payments made
             Louis Campbell; Edward                                                                      • Ralph Campbell, Kasim Nash, Bobbie
                                                    to the “runners” and, as a result, it is charged       Campbell, and Tamesha Campbell, were
Campbell, Jr.; Richard Williams; Damon              that Seligsohn,               and the law firm
Brown; Goldberger, Seligsohn & Shinrod, PA;                                                                charged with conspiracy to commit rack-
                                                    violated various New Jersey tax statutes.
Ralph Campbell; Kasim Nash; Bobbie                                                                         eteering, racketeering, conspiracy, Health
Campbell; Tamisha Campbell; Iesha Harris;               The indictment charges the “runners” with          Care Claims Fraud, and theft by deception.
Edward Campbell, Sr.; Antoine Amos;                 illegally receiving payments for acting as “run-     • Antoine Amons, Chandra Vaughan, Janelle
Chandra Vaughan; Janelle Wilson; Javiena            ners,” violations of State income tax laws,
                                                                                                           Wilson, Javiena McDonald, Pamela Rogers,
McDonald; Pamela Rogers; Lawrence                   and with assisting in the submission of phony          Lawrence Freeman, Alonzo Goldbourne,
Freeman; Alonzo Goldbourne; Sharon                  insurance claims knowing that the accidents            Sharon Blanding, Patrice Woodson,
Blanding; Patrice Woodson; Rhonda Evans;            were staged and that no one was injured. The
                                                                                                           Rhonda Evans, Chris Russell, Phyllis Jack-
Chris Russell; Phyllis Jackson; Tia Pullin;         other defendants named in the State Grand              son, Tia Pullin, Edith Pullin, Eugenia Acey,
Edith Pullin; Eugenia Acey; James Bearfield;        Jury indictment, alleged to be insurance claim-        James Bearfield, Angelique Pickett, and
Angelique Pickett; and Wade Brown                   ants, were charged with Health Care Claims
                                                                                                           Wade Brown were charged with Health
                                                    Fraud for assisting in the submission of the           Care Claims Fraud, conspiracy, and theft by
   OIFP has filed racketeering and conspiracy       phony insurance claims.
charges against two Essex County lawyers,                                                                  deception.
their law firm, and 28 other individuals as             The indictment also seeks the forfeiture of an
                                                                                                           The defendants’ cases are pending trial.
part of an ongoing insurance fraud investiga-       estimated $5 million in financial assets obtained

99
                                                                                                        bation and ordered her to pay a $7,500 civil
                                                                                                        insurance fraud fine.
                                                                                                           A State Grand Jury returned an indictment
                                                                                                        that charged Angel Lobo and Mercy Lobo
                                                                                                        with conspiracy, Health Care Claims Fraud,
                                                                                                        theft by deception, Criminal Use of Runners,
                                                                                                        and falsification of medical records. Angel
                                                                                                        Lobo, a licensed medical service provider, and
Supervising Deputy Attorney General Tina Polites (l.)
                 Administrative Assistants Cynthia Ronan, Susan Cedar, and Pat Miller                   his office manager, Mercy Lobo (no relation),
and Deputy Attorney General Phillip Mogavero (r.) draftthe Annual Report.
                               work on distribution of a Motion for court.                              operated the Pain Management Clinic located
                                                                                                        in Paterson. The State alleged in the indict-
State v. Orlando Rolon and Erika Ramos               impression was created that Ramos, who was         ment that Angel Lobo and Mercy Lobo paid
                                                     an employee of Rolon’s at Brotherhood Reha-        persons to act as “runners” to procure patients
   A State Grand Jury returned an indict-                                                               for the purpose of submitting PIP insurance
ment on December 2, 2005, charging Or-               bilitation, owned, operated, and controlled
                                                     JOL&M Medical Supply so that it would ap-          claims to Parkway Insurance Company and
lando Rolon and Erika Ramos with con-                                                                   AIG Claims Services, Inc. The State also al-
spiracy, Criminal Use of Runners, Health             pear to insurance company claims personnel
                                                     that JOL&M Medical Supply was indepen-             leged that Angel Lobo and Mercy Lobo pre-
Care Claims Fraud, attempted theft by de-                                                               pared false patient records in support of An-
ception, and misconduct by a corporate offi-         dent from Brotherhood Rehabilitation, when
                                                     both corporations were owned, operated, and        gel Lobo’s false billing for health care services.
cial. The indictment also charged Ramos
with uttering a forged document.                     controlled by Rolon.                                  All of the claims that formed the basis of
                                                        The State also alleges that Rolon and others    the Health Care Claims Fraud charges were
   According to the indictment, between De-                                                             for services rendered to undercover OIFP
cember 11, 1998 and February 13, 2002,               acted as “runners” to attract patients by offer-
                                                     ing payments of between $200 to $300 to pa-        State Investigators.
Rolon and Ramos conspired to commit auto
PIP insurance fraud. The State alleged that          tients to treat at Brotherhood Rehabilitation      State v. Lisa Tsilionis, George Tsilionis, Carl
Rolon and Ramos owned, operated, or con-             so that Brotherhood Rehabilitation, JOL&M          Love, Jr., Rajauhn Sharrieff, and Rudolf Hora
trolled several companies including Brother-         Medical Supply, and OR Medical Transport              Rajauhn Sharrieff previously pled guilty to
hood Rehabilitation Associates, P.C., JOL&M          would have a steady stream of patients for         official bribery, theft by deception, conspiracy,
Medical Supply Company, and OR Medical               which automobile insurance PIP carriers and        and misconduct by a corporate official. On
Transport. These companies did business pro-         other insurance carriers could be billed.          March 24, 2005, the court sentenced him to
viding treatment, medical supplies, and trans-          In addition to Criminal Use of Runners,         three years probation conditioned upon serv-
portation to patients, primarily automobile          the State alleges that Rolon and Ramos com-        ing 364 days in county jail. Carl Love, Jr.,
accident patients covered by automobile PIP          mitted Health Care Claims Fraud by submit-         pled guilty on March 21, 2005, to conspiracy
insurance in and around Camden.                      ting false claims to Liberty Mutual and AIG        and possession of a weapon by a convicted
   The State alleges that Rolon used “runners”       Insurance Companies related to medical ser-        felon. The court sentenced him on April 25,
to solicit and pay patients so that Brother-         vices provided by Brotherhood Rehabilitation       2005, to three years probation.
hood Rehabilitation could provide medical            and related companies.                                A State Grand Jury previously returned an
services, including chiropractic, physical              Finally, the State alleges that Rolon and       indictment charging Lisa Tsilionis and her
therapy and other related services, to patients      Ramos committed theft and forgery by creat-        former husband, George Tsilionis, chiroprac-
who were injured in automobile accidents.            ing the impression that Dr. Michael Marek, a       tors and the owners and operators of Allied
The State alleges that some of the patients          chiropractor, made medical decisions with          Trauma and Health Care Center, Inc., with
solicited by the “runners” were sent to              respect to Brotherhood Rehabilitation pa-          conspiracy, Health Care Claims Fraud, theft
JOL&M so that medical supplies, including            tients and signed claims forms submitted to        by deception, money laundering, and miscon-
TENS Units which are used to treat soft tis-         the insurance companies to include Liberty         duct by a corporate official. The indictment
sue injuries of persons injured in auto acci-        Mutual when, in fact, Marek was deceased.          also charged Carl Love, Jr., and Rajauhn
dents, and that OR Medical Transport was             Fraudulent PIP Insurance Claims by                 Sharrieff, operators of medical transportation
used to transport some of the patients to and                                                           companies Essex Shuttle, Inc., and Love Cou-
from Brotherhood Rehabilitation and other
                                                     Doctors, Chiropractors, & Other Health             rier, Inc., with conspiracy, Health Care Claims
locations, all so that Rolon could bill auto in-     Care Providers                                     Fraud, theft by deception, and misconduct by
surance companies more money.                        State v. Angel Lobo and Mercy Lobo                 a corporate official. Another defendant,
   The State further alleges that Rolon, who            Angel Lobo pled guilty to Health Care           Rudolf Hora, was charged with conspiracy.
had no medical or chiropractic license,              Claims Fraud and the court sentenced him on           Love was also separately charged with un-
owned, operated, and controlled Brotherhood          February 14, 2005, to three years in state         lawful possession of a weapon. According to
Rehabilitation but created the appearance            prison and ordered him to pay $1,196 in resti-     the indictment, between July 1996 and March
that a licensed chiropractor actually owned,         tution and a $100,000 civil insurance fraud        1999, Lisa Tsilionis and George Tsilionis alleg-
operated, and controlled Brotherhood Reha-           fine. Mercy Lobo also pled guilty to Health        edly fraudulently billed numerous insurance
bilitation so insurance claims were more likely      Care Claims Fraud and the court sentenced          companies for chiropractic services and
to be paid. The State also alleges that a false      her on February 14, 2005, to 15 months pro-        electro-diagnostic tests known as Somatosen-

                                                                                                                                                     100
OIFP Criminal Case Notes - Insurance Fraud



sory Evoked Potentials (SSEP). The State            trolled dangerous substances (CDS) by fraud.        for separate anaesthetic and steroid injections
also alleged that the Tsilionises, through Allied   The court admitted him into the PTI Program         as part of epidurals when those procedures
Trauma, fraudulently billed approximately 30        on June 24, 2005, conditioned upon paying a         should not have been billed separately and
different insurance carriers over $1.2 million.     $25,000 civil insurance fraud fine and per-         wrongfully separately billed insurance compa-
The insurance carriers paid approximately           forming 50 hours of community service.              nies for use of a contrast agent as part of an
$435,000 in claims.                                 Monique Hernandez pled guilty to attempted          epidural procedure when the procedure
   The indictment stated that between June          theft by deception, and the court admitted          should not have been separately billed, both
1998 and December 1998, Love and                    her into the PTI Program on June 24, 2005,          billing practices known as “unbundling;”
Sharrieff allegedly created a patient transpor-     conditioned upon her performing 50 hours of         wrongfully billed insurance companies for use
tation business called Essex Shuttle to dis-        community service.                                  of medical supplies to include sterile trays
guise illegal patient referral fees (known as          A State Grand Jury returned an indictment        when sterile trays were not used; wrongfully
“‘runners’ fees”) that Lisa and George              that charged Monique Hernandez, Richard             billed insurance companies for a separate “fa-
Tsilionis made to Love, Sharrieff, and Hora as      Herbert, and Melissa Caraballo with con-            cility fee” when the separate fee was not law-
transportation costs. The indictment also           spiracy, Health Care Claims Fraud, and at-          fully charged; wrongfully altered Magnetic
charged that Love and Sharrieff, through            tempted theft by deception. The State also          Resonance Imaging (MRI) reports so that pa-
Essex Shuttle, also fraudulently billed various     charged Herbert in a second indictment with         tients, primarily patients injured in automo-
insurance carriers approximately $5,400 for         attempting to obtain CDS by fraud.                  bile accidents, would appear to have an
transportation services.                                                                                auto-related injury when, in fact, they did
                                                       The State alleged in the first indictment that   not; and wrongfully billed mechanical disk
    The State alleged that Love used his corpo-     between October 1998 and November 1999,             recovery system treatments as surgical proce-
rations to solicit patients for Allied Trauma,      Herbert and his office employees, Caraballo         dures when, in fact, they were not surgical
acting, in essence, as a “runner.” The State al-    and Hernandez, conspired to submit bills for        procedures.
leged that while both of these businesses           diagnostic tests and chiropractic treatments
were purportedly incorporated to transport          that were not rendered to a patient, but to an          The State also alleges that Ottenstein,
automobile accident insurance PIP claimants         undercover OIFP investigator looking into           Woolman, and the medical practices unlaw-
to and from treating medical service provid-        fraudulent automobile insurance PIP claims.         fully misrepresented treatments and services
ers, Love actually used his corporations to so-     The State alleged that fraudulent automobile        to various insurance companies. Among these
licit patients for Allied Trauma so that false      insurance PIP claims totaling $2,219 were sub-      insurance companies were New Jersey Manu-
automobile insurance PIP claims could be            mitted to GSA Insurance Company. Herbert, a         facturers, Aetna, Allamerica, Allstate,
submitted to insurance companies. Most of           licensed chiropractor, owned Rehab Associates       AmeriHealth, Guardian, HealthNet, Horizon
Allied Trauma’s patients were automobile ac-        located in East Orange.                             Blue Cross Blue Shield, Liberty Mutual,
cident insurance claimants who sought treat-                                                            MetLife, New Jersey CURE, The Oxford
                                                       In the second indictment, the State              Plan, Prudential, State Farm, and Zurich.
ment at Allied Trauma under their automobile        charged Herbert with allegedly attempting to
insurance PIP coverage. Essex Shuttle and                                                               The State alleges that perhaps as much as $2
                                                    obtain Tylenol with codeine, Diazepam,              million in fraudulent claims were submitted
Allied Trauma both ceased operations follow-        Lortab, and Acetaminophen with codeine by
ing the commencement of the State’s investi-                                                            to the insurance companies by the defendants
                                                    misrepresentation, fraud, forgery, deception,       through the medical practices.
gation in approximately March 1999.                 or subterfuge.
   Working with OIFP, the Division of                                                                   Fraudulent Automobile “Give Up” and
                                                    State v. Alan E. Ottenstein and Jean Woolman        Theft Claims
Criminal Justice’s Civil Forfeiture Unit froze
Love Courier and Essex Shuttle bank ac-                A State Grand Jury returned an indictment
                                                                                                        State v. Latoya Fisher
counts containing approximately $2,800.             on December 16, 2005, charging Alan E.
The accounts are subject to possible forfei-        Ottenstein and Jean Woolman with con-                  The court admitted Latoya Fisher into the
ture. Additionally, a lien was filed on Love’s      spiracy to commit racketeering, racketeering,       PTI Program on January 7, 2005, conditioned
                                                    attempted theft by deception, and Health            upon her paying $657 in restitution to First
residence located on Northfield Avenue in
West Orange. Love subsequently filed for            Care Claims Fraud. Ottenstein was also              Trenton Indemnity Company, a $5,000 civil
bankruptcy.                                         charged with false swearing. According to the       insurance fraud fine, and performing 70 hours
                                                    indictment, from October 1, 1990 through            of community service. Fisher pled guilty to
  The State also seized and forfeited the           August 31, 2003, Ottenstein, a physician for-       an accusation that charged her with Insurance
Tsilionises’ home in Bergenfield and approxi-       merly licensed in New Jersey, and his former        Fraud. Fisher admitted that she reported to
mately $895,000 in their bank accounts.             associate, Woolman, through medical prac-           the New York City Police Department that
State v. Richard Herbert, Melissa Caraballo,        tices Ottenstein owned, operated, and con-          her 2001 Mitsubishi Montero had been stolen.
and Monique Hernandez                               trolled, as well as a Las Vegas corporation, al-    Fisher also allegedly reported the purported
                                                    legedly fraudulently billed automobile insur-       theft to her insurer, First Trenton Indemnity
   Melissa Caraballo pled guilty to attempted
                                                    ance companies, particularly PIP insurance          Company. Fisher admitted that the car had
theft by deception, and the court admitted
                                                    coverage, through a variety of schemes.             not been stolen, but that she gave the keys to
her into the Pre-trial Intervention (PTI) Pro-
                                                                                                        an unidentified person who took the car so
gram on May 20, 2005, conditioned upon her             The State alleges that Ottenstein wrong-
                                                                                                        that Fisher could make a phony stolen vehicle
performing 50 hours of community service.           fully billed insurance companies for epidural
                                                                                                        theft insurance claim with her insurer and no
Richard Herbert pled guilty to Health Care          injections in connection with pain manage-
                                                                                                        longer make payments on the vehicle.
Claims Fraud and attempting to obtain con-          ment; wrongfully billed insurance companies

101
State v. Raiza Y. De Los Santos                    jail awaiting sentencing on federal drug-re-
   The court admitted Raiza Y. De Los Santos       lated charges, conspired with Mazara to sub-
into the PTI Program on January 14, 2005,          mit a phony auto insurance theft claim. The
conditioned upon her paying a $5,000 civil         State further alleges that Paez took possession
insurance fraud fine and performing 50 hours       of a 1999 Jeep Cherokee with the purpose to
of community service. De Los Santos pled           destroy it so that Mazara could submit an         State v. Monique S. Everett, Javin Ward, James
guilty to an accusation that charged her with      auto theft claim.                                 Westfield, and Robert Wayne Williams
tampering with public records or information.      State v. Steven Garcia                               Monique S. Everett pled guilty to con-
De Los Santos admitted that she falsely re-           The court sentenced Steven Garcia on Feb-      spiracy to commit theft by deception. The
ported to the Jersey City Police Department        ruary 18, 2005, to three years probation and      court admitted her into the PTI Program on
that, while in her possession, someone stole       ordered him to pay a $1,000 criminal fine af-     October 28, 2005, conditioned upon her pay-
her brother’s 1997 Chevrolet Blazer. De Los        ter he pled guilty to attempted theft by decep-   ing $1,018 in restitution to Encompass Insur-
Santos allegedly made the police report to col-    tion. A Union County Grand Jury returned          ance Company and performing 75 hours of
lect insurance money from Selective Insurance      an indictment that charged Garcia with at-        community service. Robert Wayne Williams
Company of America.                                tempted theft by deception, tampering with        pled guilty to conspiracy on October 3, 2005.
State v. Israel Rivera                             public records or information, and false          He is scheduled to be sentenced in 2006.
   The court sentenced Israel Rivera on Janu-      swearing. According to the indictment,               A Passaic County Grand Jury returned an
ary 14, 2005, to five years probation and or-      Garcia allegedly submitted a fraudulent stolen    indictment that charged Monique S. Everett,
dered him to pay $10,399 in restitution and a      vehicle insurance claim to First Trenton In-      Javin Ward, James Westfield, and Robert
$5,000 civil insurance fraud fine. Rivera          demnity Company. Garcia allegedly reported        Wayne Williams with conspiracy and theft by
pled guilty to an accusation that charged him      someone stole his 1999 Ford F-150 pickup          deception. The State also charged Everett
with Insurance Fraud. Rivera admitted that         truck. The truck was subsequently recovered       with tampering with public records or infor-
he falsely reported to the Liberty Mutual In-      in a garage in Lebanon, PA. An investigation      mation. According to the indictment, be-
surance Company that someone stole his             revealed that Garcia had been paying storage      tween November 8, 2001 and January 11,
2001 Honda Civic. Rivera allegedly submit-         to keep the truck in Pennsylvania. First Tren-    2002, Westfield and Everett allegedly “gave
ted an automobile insurance theft claim for        ton, suspecting fraud, denied the claim and       up” a 2000 Mitsubishi Mirage valued at
$10,398. Liberty Mutual paid the claim to          referred the matter to OIFP for investigation.    $10,149 to Williams and Ward. Westfield and
satisfy the car loan, towing, and storage          State v. James Good                               Everett allegedly “gave up” the car to Will-
charges. Liberty Mutual became suspicious             The court sentenced James Good on Janu-        iams so that it could be concealed from law
of the claim and referred the matter to            ary 18, 2005, to one year probation condi-        enforcement and they could submit a false in-
OIFP. OIFP’s investigation revealed that           tioned upon his paying a $5,000 civil insur-      surance claim. Later the car was allegedly re-
Rivera’s car was found burning in Philadel-        ance fraud fine and performing 50 hours of        ported stolen to Encompass Insurance Com-
phia prior to the date he reported to Liberty      community service. He previously pled guilty      pany and the phony auto theft claim was sub-
Mutual he last saw the Honda.                      to falsifying records. According to a State       mitted. Williams was arrested in possession
State v. Esther Mazara and Serapio Paez            Grand Jury indictment charging him with fal-      of the 2000 Mitsubishi Mirage by the
                                                   sifying records, on January 10, 2002, Good        Montville Police Department on November
   Esther Mazara pled guilty to an accusation                                                        25, 2001.
that charged her with Insurance Fraud and          allegedly falsely filed a stolen vehicle claim
arson. Mazara admitted that she falsely re-        with Liberty Mutual Insurance Company, re-           Ward’s and Westfield’s cases are pending
ported to Metropolitan Property and Casualty       porting someone stole his 1989 Subaru.            in court.
Insurance Company (MetLife) that someone           Good allegedly knew that the vehicle had not      State v. Ysirdo Paulino
stole her 1999 Jeep Cherokee. She also ad-         been stolen and that he was not entitled to
                                                   the insurance money. OIFP’s investigation            The court admitted Ysirdo Paulino into the
mitted that she assisted another person, who                                                         PTI Program on January 3, 2005, conditioned
was not identified in the accusation, with set-    revealed that on October 12, 2001, Good’s
                                                   1989 Subaru was involved in an automobile         upon his performing 25 hours of community
ting her vehicle ablaze so she could collect the                                                     service. Paulino pled guilty on the same day
insurance claim money. Mazara’s car was            accident in Newark in which the driver and a
                                                   passenger fled the scene. The State alleged       to attempted theft by deception. A Hudson
found completely burned in Philadelphia prior                                                        County Grand Jury returned an indictment
to the time she reported the car stolen to         that Good submitted the false claim with Lib-
                                                   erty Mutual to cover up for the person driving    that charged Paulino with attempted theft by
MetLife. The court sentenced Mazara on                                                               deception, tampering with public records or
April 1, 2005, to two years probation and or-      the car who left the scene of the accident.
                                                                                                     information, and false swearing. According to
dered her to pay $10,243 in restitution and                                                          the indictment, Paulino allegedly falsely re-
perform 50 hours of community service.                                                               ported to the Jersey City Police Department
   A Hudson County Grand Jury returned an                                                            on March 12, 2003, that his 1999 Ford
indictment that charged Serapio Paez with                                                            Windstar had been stolen. Paulino also alleg-
conspiracy, Insurance Fraud, theft by decep-                                                         edly submitted a fraudulent vehicle theft in-
tion, and tampering with public records or in-                                                       surance claim to Allstate Insurance Company.
formation. The State alleges that Paez, who                                                          OIFP’s investigation revealed that the New-
is currently incarcerated in the Passaic County                                                      ark Police Department towed Paulino’s ve-

                                                                                                                                              102
OIFP Criminal Case Notes - Insurance Fraud



hicle to its impound lot on March 10, 2003.      or could not offer evidence of five or more       public records or information. It was alleged
Allstate suspected Paulino’s claim was fraudu-   acts of insurance fraud within the meaning of     in an indictment that Bances allegedly re-
lent and denied the claim.                       the statute. On September 15, 2005, OIFP          ported to the Elizabeth Police Department
State v. Roberto C. Ferreira                     perfected an appeal of the trial judge’s order    that her 2002 Nissan Altima had been stolen
                                                 dismissing the count to the Appellate Divi-       in order to collect insurance claim money
   The court admitted Roberto C. Ferreira        sion. The case is scheduled for argument in       from Metropolitan Property and Casualty In-
into the PTI Program on July 27, 2005, con-      early 2006.                                       surance Company.
ditioned upon his paying a $5,000 civil insur-
ance fraud fine and performing 50 hours of       State v. George T. Guden, Michael T. Guden,       State v. Larnardo R. Pittman
community service. Ferreira pled guilty to an    John E. Gassert, and Angela Guden                    The court sentenced Larnardo R. Pittman
accusation that charged him with Insurance          A Middlesex County Grand Jury returned         on July 29, 2005, to three years probation.
Fraud. Ferreira admitted that on September       an indictment that charged George T. Guden,       The court also ordered him to pay $19,000 in
8, 2004, he falsely advised the Newark Police    Michael T. Guden, John E. Gassert, and An-        restitution and a $5,000 civil insurance fraud
Department that he discovered his 2000 Land      gela Guden with conspiracy and theft by de-       fine. Pittman pled guilty to theft by decep-
Rover stolen when he left a gym after a work-    ception. The State also charged Angela            tion. A State Grand Jury returned an indict-
out. Ferreira allegedly submitted a phony sto-   Guden with tampering with public records or       ment charging Pittman with theft by decep-
len automobile insurance claim to the Pre-       information and false swearing.                   tion, tampering with public records or infor-
server Group Insurance Company. He alleg-           According to the indictment, between           mation, and false swearing. According to the
edly claimed that the Land Rover contained       January 2002 and March 2002, George T.            indictment, Pittman allegedly falsely reported
approximately $2,300 worth of golf clubs.        Guden and Michael T. Guden allegedly “gave        to the Newark Police Department that his
He filed an insurance claim for $27,000. An      up” Angela Guden’s 1995 Lincoln Mark VIII.        2000 Ford F-350 pickup truck was stolen in
investigation revealed that the New York         The State alleged that Angela Guden reported      Newark. The State also alleged in the indict-
Sanitation Department impounded Ferreira’s       to the Woodbridge Police Department that          ment that Pittman allegedly reported the theft
Land Rover almost two months earlier on          someone stole the Lincoln from the                to Empire Insurance Company, a subsidiary of
July 12, 2004.                                   Woodbridge Shopping Mall. The Lincoln was         Zurich North American Insurance Company.
State v. Randi Fleischman                        later recovered in the possession of John E.      Empire Insurance Company paid Pittman ap-
                                                 Gassert, who is alleged to be an acquaintance     proximately $29,000 based on the fraudulent
   A Middlesex County Grand Jury returned                                                          stolen truck insurance claim.
an indictment on March 22, 2005, that            of the Gudens. An allegedly fraudulent sto-
charged Randi Fleischman with Insurance          len car insurance claim was submitted to Lib-     State v. Janelle Hall
Fraud, attempted theft by deception, tamper-     erty Mutual. Liberty Mutual paid approxi-            The court admitted Janelle Hall into the
ing with public records or information, and      mately $12,330 to Angela Guden for the re-        PTI Program on August 1, 2005, conditioned
false swearing. According to the indictment,     ported theft of her Lincoln.                      upon her paying a $3,000 civil insurance fraud
between November 1, 2003 and February 19,           John E. Gassert previously pled guilty to      fine. Hall pled guilty to an accusation charg-
2004, Fleischman allegedly submitted a phony     conspiracy to commit theft by deception, and      ing her with Insurance Fraud. Hall admitted
auto insurance theft claim to Liberty Mutual     the court sentenced him to three years sus-       that she falsely reported to the Allstate Insur-
Insurance Company. The State alleges that        pended sentence conditioned on his full coop-     ance Company that someone stole her 1999
Fleischman advised Liberty Mutual and the        eration with the State’s investigation. The       Nissan Maxima when it had not been stolen,
Edison Police Department that someone stole      court admitted Michael T. Guden into the          but had been left in New York City. Hall ad-
her 2000 Chrysler Sebring while she was          PTI Program, conditioned upon his paying          mitted that she falsely reported the car stolen
shopping at the Menlo Park Mall on Decem-        $4,185 in restitution to Liberty Mutual Insur-    so she would no longer have to make pay-
ber 5, 2003. An investigation revealed that      ance Company.                                     ments on the vehicle. Allstate, suspecting
the Bureau of Fire Investigations of the New        In a continuing matter, George T. Guden        fraud, denied the claim and reported the mat-
York City Fire Department discovered the car     and Angela Guden pled guilty on February 28,      ter to OIFP for investigation.
burning in Brooklyn on November 27, 2003,        2005, to conspiracy to commit theft by de-        State v. Sandra Rodriguez and
casting doubt on Fleischman’s alleged claim      ception. The court sentenced George T.            Jonathan Rodriguez
that her car had been stolen.                    Guden on April 22, 2005, to 364 days in              A Cumberland County Grand Jury returned
   Fleischman allegedly submitted a phony        county jail as a condition of five years proba-   an indictment on July 20, 2005, that charged
auto insurance theft claim for $12,932. Lib-     tion, and ordered him to pay $4,000 in resti-     Sandra Rodriguez and her nephew, Jonathan
erty Mutual denied the claim and referred to     tution and a $5,000 civil insurance fraud fine.   Rodriguez, with conspiracy, aggravated arson,
the matter to OIFP for investigation.            The court sentenced Angela Guden on the           attempted theft by deception, tampering with
   This indictment is among the first in which   same day to four years probation and ordered      public records or information, arson, and fal-
the new crime of Insurance Fraud, which be-      her to pay $4,000 in restitution and a $5,000     sifying records. According to the indictment,
came effective June 9, 2003, was used to         civil insurance fraud fine.                       between April 12, 2003 and July 5, 2003,
charge a person who submitted a false auto-      State v. Lim Y. Bances                            Sandra Rodriguez and Jonathan Rodriguez al-
mobile theft claim.                                 The court admitted Lim Y. Bances into the      legedly conspired to dispose of a 2002
   The trial judge in Middlesex County dis-      PTI Program on July 20, 2005, conditioned         Chevrolet Cavalier and submit a false automo-
missed the Insurance Fraud count on August       upon her performing 60 hours of community         bile insurance theft claim.
4, 2005, on the grounds that the State did not   service. Bances pled guilty to tampering with
103
   The State alleges that Sandra Rodriguez        Operation “Give and Go”                           State charged an additional ten people with
falsely reported to the Vineland Police De-          OIFP initiated a complex undercover in-        conspiracy, receiving stolen property, tamper-
partment and Rutgers Casualty Insurance           vestigation to address the increasing problem     ing with public records, alteration of motor
Company that someone stole her Chevrolet          of automobile theft and automobile insur-         Vehicle Identification Numbers (VIN), and
Cavalier. The State further alleges that          ance “give ups” in North Jersey. OIFP’s in-       simulating a motor vehicle insurance identifi-
Jonathan Rodriguez took the Chevrolet             vestigation led to 22 criminal indictments        cation card.
Cavalier from Sandra Rodriguez and set it on      against 38 persons on charges that they alleg-       State Investigators recovered 46 cars and
fire in Buena Vista Township so that a claim      edly planned or participated in actual thefts     SUVs from several persons who allegedly ei-
could be sent to Rutgers Casualty. Rutgers        of the vehicles or owner-involved automo-         ther stole the vehicles or acted as “middle-
Casualty denied the automobile theft insur-       bile thefts in order to collect more than         men” and received the “give up” automobiles
ance claim and referred the matter to OIFP        $790,000 in insurance claims.                     from car owners who filed false stolen car
for investigation.                                                                                  reports. Undercover State Investigators also
                                                     Abraham Cepeda pled guilty to an accusa-
   Sandra Rodriguez pled guilty on Novem-         tion that charged him with receiving stolen       received some vehicles directly from the
ber 28, 2005, to arson with purpose to col-       property. Cepeda admitted that between De-        owners. The total market value of all the
lect insurance proceeds. She is scheduled to      cember 9, 2002 and January 10, 2003, he as-       vehicles recovered exceeded $1 million.
be sentenced in early 2006. Jonathan              sisted a co-conspirator, Juan E. Naut, and        More than 32 automobile theft insurance
Rodriguez is a fugitive.                          others to submit phony automobile theft           claims were submitted to 21 insurance com-
State v. Maria Kernizan and Loubert               “give up” insurance claims. Cepeda admitted       panies. Claims for $48,056 were not paid
Barthelemy                                        that he assisted Naut and others by transport-    either because the insurance company be-
                                                  ing purportedly stolen cars, to include three     came suspicious of the claims, or the OIFP
   A Union County Grand Jury returned an                                                            investigation interrupted the claims process.
indictment on November 9, 2005, that              Honda Civics, a 1998 Infiniti QX4, a 2000
                                                  Dodge Stratus, a 2000 Toyota Celica, and a        Most of the cars were turned over to the in-
charged Maria Kernizan and her son,                                                                 surance carriers because they owned the cars
Loubert Barthelemy, with conspiracy, at-          2001 Mitsubishi Montero, to a garage located
                                                  on Tonnele Avenue in Jersey City. The court       after the auto theft claims were paid. The
tempted theft by deception, and Insurance                                                           companies may seek restitution for the
Fraud. According to the indictment,               sentenced Cepeda on December 2, 2005, to
                                                  two years probation and ordered him to pay a      amount of money paid for claims.
Kernizan and Barthelemy allegedly con-
spired to submit a phony automobile theft         $500 criminal fine.                                  In total, phony automobile insurance theft
loss claim to Clarendon National Insurance           An automobile “give up” is the voluntary       claims were submitted to the following 21 in-
Company. The State alleges that Kernizan          transfer of an automobile by the owner to an-     surance carriers: AIG Insurance Company,
submitted an Affidavit of Theft to the            other person who then disposes of the ve-         Allstate Insurance Company, Erie Insurance
Clarendon National Insurance Company              hicle, often for a cash payment, for the pur-     Company, First Trenton Indemnity, Hanover In-
claiming that she last saw her 1993 Toyota        pose of allowing the owner to file a false auto   surance Company, Liberty Mutual Insurance
4-Runner in Elizabeth on December 31,             insurance theft claim with his automobile in-     Company, Manufacturers Insurance Company,
2002. OIFP’s investigation revealed that          surance carrier and collect insurance money       Metropolitan Property and Casualty, Motors In-
Kernizan and Barthelemy allegedly falsely         for the phony theft. The owner may also           surance Company, Ohio Casualty Insurance
reported to the New York Police Depart-           have the car loan or lease paid off by the in-    Company, Penn National Insurance Company,
ment that someone stole the car. Addi-            surance carrier.                                  Progressive Insurance Company, Prudential In-
tional investigation revealed that the New                                                          surance Company, Rutgers Casualty Insurance
                                                     Undercover OIFP State Investigators            Company, Selective Insurance Company, Sompo
York Department of Sanitation tagged the          leased a garage on Tonnele Avenue in Jersey
vehicle as a derelict or abandoned vehicle in                                                       Japan Insurance Company of America, State and
                                                  City and operated it as an auto repair shop.      Country Fire Insurance Company, State Farm
the Bronx on December 25, 2002, casting           The investigators let it be known that any-
doubt on Kernizan’s and Barthelemy’s                                                                Insurance Company, Travelers Insurance Com-
                                                  body could “give up” a financed or leased car     pany, Universal Underwriters Insurance Com-
claims that the vehicle was last seen and         who wanted to get rid of it to avoid further
stolen on or after December 31, 2002.                                                               pany, and USAA Insurance Company.
                                                  car or lease payments, or because the car was
   The Clarendon Insurance Company denied         damaged or needed expensive repairs. After           As part of OIFP’s continuing investiga-
the claim and referred the matter to OIFP for     the owners “gave up” the cars, they reported      tion into automobile theft and automobile
investigation and prosecution.                    them stolen to the police, submitted false in-    “give up” schemes, OIFP obtained additional
                                                  surance auto theft claims, and the insurance      indictments that charged ten people with
State v. Harry J. Torella                                                                           crimes related to phony automobile insur-
                                                  company paid the claims.
  Harry J. Torella pled guilty to an accusation                                                     ance “give up” claims. Two of these addi-
on October 11, 2005, that charged him with           As the result of OIFP’s complex under-         tional indictments charged eight people with
Insurance Fraud. Torella admitted that be-        cover investigation of auto theft and phony       conspiracy, alteration of motor vehicle
tween June 27, 2003 and September 30,             owner-initiated automobile “give up” insur-       trademarks and identification numbers, re-
2003, he knowingly falsely reported that          ance claims, 28 people were charged in 18 in-     ceiving stolen property, theft by deception,
someone stole his 1997 Chrysler Sebring to        dictments with conspiracy, theft by deception,    and tampering with public records or infor-
the Island Heights Police Department and to       receiving stolen property, tampering with         mation. The State alleges in the two indict-
the Prudential Insurance Company. He is           public records and information, and false         ments that, between November 2001 and
scheduled to be sentenced in early 2006.          swearing. In four of the indictments, the         August 2002, three automobiles were alleg-

                                                                                                                                              104
OIFP Criminal Case Notes - Insurance Fraud



edly re-tagged by several of the eight defen-     police report to reflect that he was injured in    involved in an automobile accident. The car
dants. A “re-tagged” car’s VIN has been al-       an automobile accident that purportedly oc-        contained disc jockey sound equipment, alleg-
tered in order to conceal the true identity of    curred on April 8, 2000. He allegedly sought       edly valued at over $15,000, owned by
the car and its owner, and hide the fact that     medical treatment for purported injuries and       Catrambone’s disc jockey business.
it has been “given up” to facilitate filing       caused bills to be submitted to First Trenton      Catrambone admitted that he submitted
fraudulent auto theft insurance claims.           for approximately $15,900.                         phony receipts to support his claim to Pali-
State v. Donna L. Bermudez                           The insurance company that purportedly          sades Insurance Company that the sound
                                                  insured the other driver referred to in the        equipment was lost or damaged. Palisades In-
   The court admitted Donna L. Bermudez                                                              surance Company, suspecting fraud, denied
into the PTI Program on December 14, 2005,        false police accident report, Pacesetter Ad-
                                                  justment Company of Baton Rouge, Louisi-           the claim.
conditioned upon her performing 40 hours of
community service. Bermudez pled guilty to        ana, suspected fraud and contacted First Tren-     State v. Virginia B. Kinion and John Knight
an accusation that charged her with Insurance     ton about the matter. First Trenton referred          A Passaic County Grand Jury returned an
Fraud. Bermudez admitted that between             the matter to OIFP for investigation and           indictment on June 29, 2005, that charged
September 21, 2004 and September 29, 2004,        prosecution.                                       Virginia B. Kinion and her husband, John
she falsely reported to the Little Ferry Police   State v. Heather Dorst                             Knight, with conspiracy, Health Care Claims
Department and the First Trenton Indemnity           The court sentenced Heather Dorst on            Fraud, and attempted theft by deception.
Company that her 2001 Mercedes SLK had            March 4, 2005, to three years probation con-       The State also charged Kinion with theft by
been stolen.                                      ditioned upon her performing 100 hours of          deception, tampering with public records or
                                                                                                     information, and falsifying records. The State
False Automobile-Related Insurance                community service. Dorst pled guilty to
                                                  charges of Insurance Fraud. Dorst admitted         charged Knight separately with falsifying
Claims                                                                                               records and false swearing.
                                                  that on December 25, 2003, an individual al-
State v. O’Neil J. Williams                                                                             According to the indictment, between June
                                                  legedly drove her car in Magnolia, NJ, when it
   The court admitted O’Neil J. Williams          was struck in the rear by another vehicle. The     6, 2002 and December 31, 2002, Kinion and
into the PTI Program on October 5, 2005,          individual, alone in the vehicle and driving       Knight allegedly submitted a false automobile
conditioned upon paying a $125 criminal           with a suspended license, allegedly fled the       insurance policy application and false PIP
fine. Williams pled guilty to an accusation       scene of the accident. Later the same day,         claims to Clarendon National Insurance Com-
that charged him with Insurance Fraud.            Dorst allegedly reported to the Magnolia Po-       pany. The State alleges in the indictment that
Williams admitted that he falsely reported        lice Department that she was driving the car.      Kinion and Knight submitted an automobile
his Honda stolen as part of an insurance          She then allegedly submitted a PIP insurance       insurance policy application that indicated
property damage claim. Williams admitted          claim to her insurance company, Farm Family        they had no automobile insurance and no au-
that he concocted the stolen car story to         Casualty Insurance Company, swearing that          tomobile accidents for the 36 months prior to
avoid admitting an accident with his car in       she was driving the car and that she suffered      the date of the application. The State alleges
which the vehicle suffered damage.                personal injuries as the result of the accident.   that Kinion and Knight had been involved in
State v. Zia Ghahary                              Medical bills for approximately $2,364 were        an automobile accident just hours before they
                                                  submitted for payment.                             submitted the insurance policy application,
   The court admitted Zia Ghahary into the                                                           and that they allegedly attempted to represent
PTI Program on February 14, 2005. Ghahary         State v. Shirish M. Parikh and Bindu S. Parikh
                                                                                                     to the insurance company that the automobile
pled guilty to an accusation that charged him        The court admitted Shirish M. Parikh and        accident occurred after it agreed to provide
with Insurance Fraud. Ghahary admitted that       his wife, Bindu S. Parikh, into the PTI Pro-       automobile insurance. The State alleges that
he submitted a phony automobile insurance         gram on January 10, 2005, conditioned upon         Kinion and Knight caused PIP insurance
property damage claim to The Hartford Insur-      their performing 50 hours of community ser-        claims for $9,917 and $13,231 to be submit-
ance Company. Ghahary allegedly claimed           vice. The State charged Shirish M. Parikh and      ted to Clarendon National for the automobile
that the rear of his vehicle was damaged in a     Bindu S. Parikh with Insurance Fraud in com-       accident. Clarendon denied the claims and re-
automobile accident when the damage was           plaints alleging that they falsely claimed that    ferred the matter to OIFP for investigation.
pre-existing, and he was not entitled to pay-     their Toyota Camry was damaged in a hit-and-
ment for the damage.                              run accident. They then allegedly submitted           Both defendants failed to appear at their
                                                  fraudulent repair bills to New Jersey Manu-        pre-arraignment conference. The court issued
State v. Anthony Dunlock                                                                             a bench warrant for their arrests. OIFP inves-
                                                  facturers Insurance Company, which denied
    The court sentenced Anthony Dunlock on        the claim and referred the case to OIFP for        tigators arrested Kinion on October 26, 2005.
December 16, 2005, to two years probation,        investigation.                                     The charges are pending trial.
conditioned upon serving 364 days in county                                                          State v. Ayana Torres, Geraldo Torres, and
jail, and ordered him to pay $15,900 in resti-    State v. Frank Catrambone
                                                                                                     Jose Rivera
tution. Dunlock pled guilty to an accusation         The court admitted Frank Catrambone into
that charged him with theft by deception.         the PTI Program on May 18, 2005, condi-               A Union County Grand Jury returned an
Dunlock admitted that he used a fictitious        tioned upon his performing 20 hours of com-        indictment on May 6, 2005, that charged
police report to submit an automobile insur-      munity service. Catrambone pled guilty to an       Ayana Torres, Geraldo Torres, and Ayana
ance PIP claim to First Trenton Indemnity         accusation that charged him with Insurance         Torres’ brother, Jose Rivera, with conspiracy
Company. He admitted that he falsified the        Fraud. Catrambone admitted that on Sep-            to commit Health Care Claims Fraud, Health
                                                  tember 12, 2003, a car driven by his son was       Care Claims Fraud, and theft by deception.

105
According to the indictment, between March        also allegedly submitted false limousine trans-   surance with collision coverage. Foremost
10, 2000 and November 28, 2000, Ayana             portation receipts for 41 dates for $2,460,       investigated Senf ’s June 22, 2003, claim and
Torres, Geraldo Torres, and Jose Rivera alleg-    when she only used limousine transportation       referred the matter to OIFP for further inves-
edly conspired to submit false PIP claims to      on 28 dates for $1,680.                           tigation and prosecution.
an insurance carrier.                                                                                  Senf ’s case is currently on appeal.
   The State alleged that Ayana Torres went
                                                                                                    Insurance Claims Involving “Jump Ins”
to a garage in Elizabeth to pick up her car on
March 10, 2000. The police had towed the                                                            State v. David Scott, Nicole Barker, and
car because it did not have a valid inspection                                                      Charles Gladney
sticker, and Rivera, who was allegedly driving                                                         A State Grand Jury previously returned an
the vehicle at the time, did not have a valid                                                       indictment that charged David Scott with
driver’s license. When Ayana Torres started                                                         conspiracy to commit Health Care Claims
the vehicle, it allegedly lurched forward and                                                       Fraud, Health Care Claims Fraud, theft by de-
struck another vehicle. The State alleges that                                                      ception, and falsification of records. Nicole
Rivera and Geraldo Torres were not in the ve-                                                       Barker and Charles Gladney were each
hicle at the time it lurched forward. The                                                           charged in the indictment with conspiracy to
State alleges that although Geraldo Torres and                                                      commit Health Care Claims Fraud. According
Rivera were not in the vehicle when it            State v. Tommy Edwards
                                                                                                    to the indictment, Nicole Barker allegedly had
lurched forward, PIP claims were allegedly           The court sentenced Tommy Edwards on           an automobile accident in Philadelphia be-
submitted to State Farm Insurance Company         August 24, 2005, to two years in state prison.    tween March 17 and May 1, 2002. She then
for them in excess of $1,000. State Farm re-      On the same day, he pled guilty to an accusa-     allegedly conspired with Scott and Gladney to
ferred the matter to OIFP for additional in-      tion that charged him with Insurance Fraud.       make it appear to the police and the insurance
vestigation and prosecution.                      Edwards admitted that in July 2003, he            company that both Barker and Scott were
State v. Kevin O’Connor                           sought the advice of an attorney because he       passengers in the car. Gladney was a tow
                                                  claimed that he had an automobile accident in     truck driver who allegedly supported the false
   The court admitted Kevin O’Connor into         June 2003. Edwards signed a PIP insurance         claim Barker and Scott made about being in-
the PTI Program on November 2, 2005, con-         application indicating that he was struck by a    jured in the automobile accident.
ditioned upon his paying a $5,000 civil insur-    car on June 17, 2003, and he allegedly signed
ance fraud fine. O’Connor pled guilty to an                                                            Scott pled guilty to conspiracy and Health
                                                  an affidavit stating that he had no car insur-
accusation that charged him with attempted                                                          Care Claims Fraud, and the court sentenced
                                                  ance. The documents enabled him to submit
theft by deception. O’Connor admitted that                                                          him to 364 days in county jail as a condition
                                                  an insurance claim for medical bills in excess
he filed a false automobile accident claim                                                          of three years probation. The court sen-
                                                  of $4,200, and perhaps also a legal claim for
with Rutgers Casualty Insurance Company                                                             tenced Barker on January 14, 2005, to three
                                                  non-economic injuries to include pain and
claiming that his 2000 Ford van was involved                                                        years probation after she pled guilty to con-
                                                  suffering. AIG Insurance Company denied the
in an automobile accident on March 4, 2003.                                                         spiracy to commit Health Care Claims Fraud.
                                                  claim and referred the matter to OIFP.
The accident actually took place a month ear-                                                       Insurance Fraud Involving Police Officers
lier when O’Connor had no insurance cover-        State v. Jason Senf
age for his van. Rutgers Casualty, suspecting         The court admitted Jason Senf into the        State v. Philip Major, et al.
fraud, denied the claim and referred the mat-     PTI Program on July 25, 2005, conditioned            The court meted out sentences in 2005 for
ter to OIFP for investigation.                    upon his paying a $5,000 civil insurance fraud    31 of the 39 persons, primarily from Essex
State v. Romonde Lominy Laguerre                  fine and performing 100 hours of community        County, who were charged in four separate
                                                  service. A Mercer County Grand Jury re-           indictments with conspiracy to commit theft
   The court admitted Romonde Lominy              turned an indictment that charged Senf with       by deception and official misconduct relating
Laguerre into the PTI Program on July 20,         Insurance Fraud and attempted theft by de-        to automobile insurance PIP fraud.
2005, conditioned upon her paying a $5,000        ception. According to the indictment, Senf
civil insurance fraud fine. Laguerre pled                                                              The 39 persons named in the indictments
                                                  allegedly submitted an insurance claim to         were allegedly involved in automobile acci-
guilty to attempted theft by deception. A         Foremost Insurance Company for damage to
Somerset County Grand Jury returned an in-                                                          dents in police reports written by former East
                                                  his all-terrain vehicle (ATV). The State al-      Orange Police Officer Philip Major between
dictment that charged Laguerre with at-           leged that Senf claimed he damaged his ATV
tempted theft by deception, uttering forged                                                         June 1995 and October 1999. The indict-
                                                  on June 22, 2003, when he struck a tree.          ments returned by a State Grand Jury alleged
writings, and falsifying records. The State al-   Senf allegedly attempted to make a collision
leged in the indictment that Laguerre submit-                                                       that the automobile accident police reports
                                                  claim for damages to his ATV. The State al-       were used to support fraudulent automobile
ted false automobile insurance claims between     leged that Senf ’s friend actually damaged the
September 15, 2000 and October 17, 2000,                                                            insurance PIP and bodily injury claims.
                                                  ATV earlier on April 18, 2003, when he
to Liberty Mutual Insurance Company follow-       struck a tree with the ATV. At that time,            The following dispositions occurred in 2005:
ing the theft of a recovered 1991 Ford Ex-        however, the ATV was not covered with col-           Jose Frias, Lawrence Hannah, Rafael
plorer. Laguerre allegedly submitted a false      lision insurance by Foremost Insurance Com-       Torres, and Brunilda Blanco were each sen-
automobile repair invoice by altering the in-     pany. The State alleged that after the ATV        tenced on February 4, 2005, to one year pro-
voice amount from $310 to $3,995. Laguerre        was damaged, Senf attempted to obtain in-         bation and ordered to pay a $1,500 civil insur-

                                                                                                                                              106
OIFP Criminal Case Notes - Insurance Fraud



ance fraud fine. The court also ordered           ordered her to pay $2,456 in restitution and a    $2,000 in restitution, and Saint Jean to pay
Blanco to pay $4,766 in restitution and Torres    $1,500 civil insurance fraud fine; Little was     $1,000 in restitution.
to pay $4,690 in restitution.                     sentenced to one year probation and ordered          Cari Blanco and Nieves Carasco failed to
   The court sentenced Cordell Vaxter on          to pay a $1,500 civil insurance fraud fine.       appear at their arraignment and the court is-
March 4, 2005, to one year probation and or-         Juan Frias, Romona Mora Silvero, Linc          sued a bench warrant for their arrests. Both
dered him to pay $3,157 in restitution and a      Palmer, and Felix Frias pled guilty to con-       Blanco and Carasco surrendered on June 13,
$1,500 civil insurance fraud fine.                spiracy to commit official misconduct and         2005, and each pled guilty to conspiracy to
   Bienviendo Sanchez, Kenneth Kennedy,           theft by deception. The court sentenced Juan      commit official misconduct. They are sched-
Barry Hill, Audrey Lopez, Katrina Campbell,       Frias on April 1, 2005, to one year probation     uled to be sentenced in early 2006.
Ronald Kelly, and Ron Bagley pled guilty to       and ordered him to pay a $1,500 civil insur-         Former East Orange Police Officer Philip
conspiracy to commit official misconduct          ance fraud fine. The court sentenced Felix        Major previously pled guilty to conspiracy and
and theft by deception. The court sentenced       Frias on April 1, 2005, to two years probation    two counts of official misconduct. Major
Sanchez, Kennedy, Lopez, and Campbell on          and ordered him to pay $2,330 in restitution      pled guilty to writing 16 false police automo-
February 28, 2005, to one year probation.         and a $1,500 civil insurance fraud fine. The      bile accident reports so that approximately 60
The court ordered Sanchez, Kennedy, Lopez,        court sentenced Silvero to two years proba-       insurance claims could be submitted to insur-
and Campbell to each pay a $1,500 civil in-       tion and ordered her to pay $4,394 in restitu-    ance companies for PIP, property damage, and
surance fraud fine. The court also ordered        tion and a $1,500 civil insurance fraud fine.     non-economic losses arising from bodily inju-
Lopez to pay $5,975 in restitution, Sanchez       The court sentenced Palmer on April 15,           ries purportedly sustained in automobile acci-
to pay $6,537 in restitution, and Campbell to     2005, to one year probation and ordered him       dents. Many of the people posing as alleged
pay $5,709 in restitution. The court sen-         to pay a $1,500 civil insurance fraud fine.       accident victims filed insurance claims for
tenced Kelly, Hill, and Bagley on March 4,           Enercida Noboa pled guilty to conspiracy       personal injuries.
2005, to one year probation and ordered           to commit official misconduct and theft by           At his guilty plea hearing, Major admitted
each to pay a $1,500 civil insurance fraud        deception. The court sentenced her on April       that he was a “runner” who accepted bribe
fine. Additionally, the court ordered Kelly       15, 2005, to three years probation and or-        payments from two chiropractors for the pur-
to pay $2,371 in restitution.                     dered her to pay $5,165 in restitution and a      pose of providing information from police
   Miguel Sanchez and Victor Medina pled          $1,500 civil insurance fraud fine.                accident reports to the chiropractors who
guilty to conspiracy to commit official mis-        Darrick Farmer and Mark Boyette pled            used the information to recruit patients to
conduct and theft by deception. The court         guilty to conspiracy to commit official mis-      submit insurance claims. A “runner” is a per-
sentenced Sanchez on March 4, 2005, to one        conduct and theft by deception. The court         son who for money recruits persons for li-
year probation and ordered him to pay $8,340      sentenced Boyette on April 15, 2005, to one       censed medical professionals or lawyers so
in restitution and a $1,500 civil insurance       year probation and ordered him to pay a           they can submit insurance claims. Further-
fraud fine. Medina failed to appear at his sen-   $1,500 civil insurance fraud fine. On the         more, Major admitted he had a financial inter-
tencing on March 4, 2005; the court issued a      same day, the court sentenced Farmer to three     est in Metro Medical Services, a medical facil-
bench warrant for his arrest.                     years probation and ordered him to pay            ity that specialized in treating persons for in-
   Richard Morales pled guilty to conspiracy      $10,770 in restitution and a $1,500 civil in-     surance claims, and also admitted that he at-
to commit official misconduct and theft by        surance fraud fine.                               tempted to bribe another police officer for
deception. The court sentenced him on                Jose Noboa pled guilty to conspiracy to        additional police accident report information
March 11, 2005, to one year probation with        commit official misconduct and theft by de-       in order to recruit patients to submit insur-
credit for 17 days time served. As a condition    ception. The court sentenced him on May 6,        ance claims.
of probation, the court ordered him to pay a      2005, to two years probation and ordered him        Major is scheduled to be sentenced in
$1,500 civil insurance fraud fine.                to pay $2,710 in restitution and a $1,500 civil   early 2006.
   Investigators from OIFP arrested fugitive      insurance fraud fine.                             State v. Jeffrey Nemes
defendant, Ronald West, on January 26, 2005,         Janice Smart pled guilty to conspiracy to         As part of a continuing investigation into a
pursuant to a bench warrant. West pled guilty     commit official misconduct and theft by de-       series of arson fires in Mercer County and
to conspiracy to commit official misconduct       ception, and on June 3, 2005, the court sen-      elsewhere, OIFP previously returned three
and theft by deception. The court sentenced       tenced her to six months probation and or-        indictments that charged Jeffrey Nemes, a
him on April 15, 2005, to one year probation      dered her to pay a $1,500 civil insurance         former Hamilton Township police officer,
and ordered him to pay a $1,500 civil insur-      fraud fine.                                       with charges in one indictment relating to
ance fraud fine.                                     Davon Charisma, Jerry St. Louis, Guy           bribes allegedly offered to local fire district
   Ana Baretto, Selena Brown, and Barbara         Longechamp, and James Saint Jean pled             fire chiefs, in a second indictment with bribes
Little pled guilty to conspiracy to commit of-    guilty to conspiracy to commit official mis-      allegedly offered to the Executive Vice Presi-
ficial misconduct and theft by deception. On      conduct and theft by deception. The court         dent of the East Windsor Police Athletic
April 1, 2005, the court sentenced Baretto to     sentenced them on July 15, 2005, to one year      League (PAL), and in a third indictment with
two years probation and ordered her to pay        probation and ordered each to pay a $1,500        the alleged theft of insurance claims money in
$7,946 in restitution and a $1,500 civil insur-   civil insurance fraud fine. The court also or-    connection with a construction and home re-
ance fraud fine. On the same day, the court       dered Charisma and St. Louis each to pay          pair business known as Nemes Enterprises,
sentenced Brown to two years probation and        $2,500 in restitution, Longechamp to pay          Inc., that was owned and operated by Nemes.

107
   With respect to the third indictment, the       Receiving Stolen Property                          partment who arrested Siurek on other
Appellate Division of the New Jersey Supe-                                                            charges. At the time of the arrest, Siurek
                                                   “Operation VIN Swap”
rior Court reversed Nemes’ conviction for                                                             possessed a bag containing automobile keys
                                                   State v. Antonio Rodriguez-Baez
theft by failure to make proper disposition of                                                        and automobile VIN plates. VIN plates are
property on May 19, 2005. The Appellate                The court sentenced Antonio Rodriguez-         commonly used to identify automobiles.
Court returned the case to the trial court for a   Baez on September 16, 2005, to four years in       Sometimes people who steal or “give up” an
new trial. The jury had found Nemes guilty         state prison and ordered him to pay $19,838        automobile will change the VIN plates on the
of theft by failure to make proper disposition     in restitution to State Farm Insurance Com-        automobile to conceal its identity (re-tag) and
of property. Nemes, while employed as a            pany, $39,172 in restitution to AAA Mid-At-        to hide the fact that it has been reported as a
Hamilton Township police officer, allegedly        lantic Insurance Company, and $64,677 to           stolen automobile.
took insurance claim money in the approxi-         Motors Insurance Company. Rodriguez-Baez
                                                                                                      State v. Anthony Josephs
mate amount of $130,000 from both com-             pled guilty to being a leader of an automobile
mercial and residential property owners            theft trafficking network. The network alleg-         Anthony Josephs pled guilty to receiving
through Nemes Enterprises, Inc., but he alleg-     edly bought and sold stolen and re-tagged cars     stolen property, and the court sentenced him
edly failed to complete repairs to the proper-     at several garages located in Jersey City and      on October 17, 2005, to five years in state
ties. The court sentenced Nemes to seven           North Bergen. Re-tagging of automobiles is         prison. Josephs admitted that between De-
years state prison and ordered him to pay a        done by altering the VIN to conceal the iden-      cember 2002 and January 2004, he knowingly
total of $130,833 in restitution and he ap-        tities of the cars and facilitate fraudulent in-   possessed a stolen 2004 Cadillac Escalade, and
pealed. The conviction was reversed.               surance claims.                                    between August 2003 and October 2003, he
                                                                                                      knowingly possessed a stolen 2000 Porsche
   The trial on the charges that Nemes offered     “Operation Car Swap”
                                                                                                      Boxster. Josephs also admitted that he alleg-
bribes to fire chiefs in and around Hamilton       State v. Terron Session
                                                                                                      edly participated in stealing other cars from
Township, began on August 24, 2005. During            After he pled guilty to receiving stolen        automobile dealerships. Josephs and others
the trial, the State alleged that Nemes offered    property, the court sentenced Terron Session       would allegedly appear at dealerships, test
a bribe on April 22, 1998, to the fire chief of    on January 21, 2005, to five years probation       drive expensive cars, and switch the real igni-
the Rusling Hose Fire Company. A second            with 364 days in county jail as a condition of     tion keys to the cars with fake keys so they
bribe was alleged to have occurred during a        probation. The court also ordered him to per-      could return and use the real ignition key to
conspiracy in which Nemes and Marc Rossi,          form 200 hours of community service and pay        steal the cars. The defendant allegedly stole
the former owner of Rossi Adjustment Ser-          a $500 criminal fine. An Essex County Grand        cars from dealerships located in Oakhurst and
vices, a public insurance claims adjusting busi-   Jury returned an indictment that charged Ses-      Lawrence.
ness, agreed to offer a bribe to the fire chief    sion with receiving stolen property. Accord-
of the Enterprise Fire Company in Hamilton                                                            State v. Giovanni Muscia
                                                   ing to the indictment, Session allegedly was in
Township. During the trial, the State alleged      possession of a stolen 1992 Lexus SC300, a            A Passaic County Grand Jury returned an
that bribes were offered to the fire chiefs so     2002 Cadillac DeVille, and a 2000 Honda            indictment on September 21, 2005, that
that they would allow fires to burn longer in      VTR motorcycle from a Port Authority stor-         charged Giovanni Muscia with conspiracy and
order to cause additional damage. The State        age facility.                                      theft by deception. According to the indict-
alleged that Nemes owned and operated a                                                               ment, Muscia owned and operated Rocky’s
                                                   State v. Jaroslaw Siurek
construction and home repair business during                                                          Auto Body formerly located on Bloomfield
the period of time the alleged bribes were            The court sentenced Jaroslaw Siurek on          Avenue in Paterson. Muscia allegedly re-
paid and was seeking additional construction       October 7, 2005, to three years probation.         ceived, stripped, and stored parts from auto-
work for his business. The trial ended in a        Siurek pled guilty to an accusation that           mobiles that had been reported stolen, includ-
mistrial on September 13, 2005, and is pend-       charged him with receiving stolen property.        ing a 1994 Mercedes Benz.
ing retrial.                                       Siurek admitted that on October 30, 2003, he
                                                   knowingly possessed a stolen Porsche Boxster       Staged and Fictitious Accidents
  Likewise, the indictment alleging that
                                                   automobile. OIFP’s investigation revealed          State v. Erik Bula
Nemes allegedly offered bribes to the Vice
                                                   that the Boxster was part of an alleged auto-         The court sentenced Erik Bula on March
President of the East Windsor PAL is
                                                   mobile insurance “give up” fraud. An auto-         11, 2005, to two years probation and ordered
pending trial.
                                                   mobile insurance “give up” occurs when the         him to pay $5,438 in restitution and a $5,000
State v. Jeffrey Nemes and John Fiore              owner of an automobile “gives up” his car to       civil insurance fraud fine. Bula pled guilty to
   A State Grand Jury previously returned an       another person so that the car can be hidden,      an accusation that charged him with Health
indictment that charged Jeffrey Nemes and          chopped into parts, or re-tagged in order to       Care Claims Fraud and theft by deception.
John Fiore with conspiracy and bribery in of-      permit the original owner to make a phony          Bula admitted that he staged an automobile
ficial and political matters. Fiore, the Execu-    automobile insurance theft claim. In this          accident in Union City that involved two cars
tive Vice President of the East Windsor Po-        case, an automobile theft claim was allegedly      and five other people. As the result of the
lice Athletic League (PAL) and a former East       submitted to Chubb Insurance Company.              staged accident, Bula and the people purport-
Windsor police detective, was also charged         Chubb paid a total of $73,943 to settle the        edly involved in the accident received treat-
with misapplication of entrusted property          theft claim.                                       ment for injuries they alleged were sustained
and official misconduct. Marc Rossi was               OIFP began the investigation of Siurek          in the accident. They also allegedly sought
named as an unindicted co-conspirator in this      following a report by the Linden Police De-        bodily injury settlements from Liberty Mutual
case. This case is pending trial.
                                                                                                                                                108
OIFP Criminal Case Notes - Insurance Fraud



Insurance Company. Bula admitted that as         Hill, Vanessa Miller, Louis McKenzie, Emilio       The court admitted Vanessa Miller into the
the result of the staged accident, Liberty Mu-   Mayes, Raphael McCray, and Kevin Douglas         PTI Program on October 24, 2005.
tual paid approximately $5,437 to him or on      State v. Tamika Sutton, Shonique Carney,           Alnisca Franklin pled guilty on December
his behalf. In total, Liberty Mutual paid ap-    Sheri Brown, Sareesah Houston a/k/a              15, 2005, to attempted theft by deception.
proximately $28,500 in PIP benefits and          Jareeseah Houston, Ona Jones, Robert             She is scheduled to be sentenced in 2006.
bodily injury settlements as the result the      Henderson, and Ali Sawab a/k/a Abdul Sawab
staged car accident.                                                                                Charges as to the remaining defendants are
                                                    The court sentenced defendants in 2005        pending trial.
State v. Gladys Roman, Manuel Hernandez,         who were previously named in four State
Yaneris Diaz, Hernando Nhar, and Claudia                                                          State v. Iris Salkauski, et al.
                                                 Grand Jury indictments variously charging
Quiroz Mazo                                      conspiracy, Health Care Claims Fraud, and           The court handed down a sentence on Sep-
   In connection with the Bula investigation,    attempted theft by deception. The defen-         tember 23, 2005, for another defendant
a Passaic County Grand Jury returned an in-      dants allegedly conspired with Eric Boyer,       caught in a staged accident ring that involved
dictment in 2004 that charged Gladys Roman,      the alleged mastermind of three staged acci-     48 defendants. The court sentenced David
Manuel Hernandez, Yaneris Diaz, Hernando         dents between October 1998 and October           Agosto to four years probation conditioned
Nhar, and Claudia Quiroz Mazo with con-          1999 which resulted in the submission of         upon serving 180 days in county jail through
spiracy. Diaz, Quiroz Mazo, and Nhar were        multiple phony PIP insurance claims to sev-      the SLAP program. The court also ordered
also charged with theft by deception. Mazo       eral insurance companies. Over $204,378 in       him to perform 100 hours of community ser-
allegedly drove a car that struck Roman’s car    fraudulent claims were submitted to insur-       vice and to pay a $1,500 civil insurance fraud
on October 13, 1998. Nhar and Bula were          ance companies.                                  fine. Agosto pled guilty to conspiracy.
passengers in Mazo’s car. Hernandez and Diaz        Kevin Douglas and Shinaka Hill pled              A State Grand Jury returned ten separate
were passengers in Roman’s car. The State        guilty to attempted theft by deception. The      indictments against 48 people. The defen-
alleged in the indictment that the defendants    court sentenced Shinaka Hill on January 28,      dants were charged with conspiracy, theft by
staged the accident in order to submit ficti-    2005, to five years probation. On the same       deception, and attempted theft by deception
tious PIP claims and bodily injury claims to     day, the court sentenced Douglas to three        for their participation in a staged accident
Liberty Mutual Insurance Company and             years probation with credit for 84 days          ring. The State alleged that the 48 defendants
ELCO Administrative Service. Claims were         served in county jail, and ordered him to per-   planned or participated in at least ten staged
paid in the following amounts:                   form 75 hours of community service and to        automobile accidents over a two-and-a-half-
  Gladys Roman - $2,619 (PIP);                   pay $3,009 in restitution.                       year period, most frequently in the City of
                                                                                                  Camden and Pennsauken Township. At least
  Manuel Hernandez - $6,323 (PIP);                  Emilio Mayes was arrested in California on    one staged accident involved undercover law
  Yaneris Diaz - $3,571 (PIP), $1,200 (bodily    or about January 3, 2005, pursuant to a fugi-    enforcement officers posing as participants in
  injury);                                       tive bench warrant. He waived extradition        the illegal scheme. Allstate Insurance Com-
                                                 and was transported to New Jersey. Mayes         pany received PIP claims totaling $567,940
  Claudia Quiroz Mazo - $967 (PIP), $7,000       pled guilty to attempted theft by deception,
  (bodily injury);                                                                                from the staged accident scheme.
                                                 and the court sentenced him on May 20,
  Hernando Nhar - $572 (PIP), $3,275             2005, to three years probation with credit for      OIFP’s investigation revealed that the de-
  (bodily injury);                               serving 52 days in county jail and ordered him   fendants allegedly staged the fake automobile
                                                 to pay $1,935 in restitution and to perform      accidents by purposely crashing cars into one
   Erik Bula - $712 (PIP), $4,725                                                                 another or into fixed objects. The defendants
                                                 100 hours of community service.
   (bodily injury).                                                                               allegedly reported the motor vehicle accidents
   Roman, Diaz, Hernandez, and Nhar pled           Sakinah Hill was also arrested pursuant to a   to area police departments, principally the
guilty to conspiracy to commit Health Care       fugitive bench warrant. She pled guilty to at-   Camden and Pennsauken Police Departments.
                                                 tempted theft by deception, and the court ad-    The “victims” then allegedly sought and ob-
Claims Fraud and theft by deception. The
court sentenced them on June 24, 2005, to        mitted her into the PTI Program on June 6,       tained treatment for the reported injuries sus-
two years probation and ordered each to pay a    2005, conditioned upon her performing 50         tained as a result of the staged accidents. Ul-
                                                 hours of community service.                      timately, defendants allegedly filed fraudulent
$2,500 civil insurance fraud fine, and to pay
restitution as follows: Roman, $2,619; Diaz,        Tamika Sutton failed to appear at her ar-     PIP claims with Allstate Insurance Company
$4,771; Hernandez, $6,323; and Nhar,             raignment and was arrested on a bench war-       for payment or reimbursement of medical ex-
$3,848. Quiroz Mazo pled guilty to theft by      rant on June 2, 2005. Sutton pled guilty to      penses and “pain and suffering” costs.
deception, and the court sentenced her on        attempted theft by deception, and the court         The principal indictment identified Iris
July 22, 2005, to two years probation and or-    sentenced her on October 17, 2005, to two        Salkauski as the alleged leader of the con-
dered her to pay $7,967 in restitution and a     years probation with credit for 65 days served   spiracy and the coordinator of each of the
$2,500 civil insurance fraud fine.               in county jail. The court also ordered Sutton    ten staged accidents. Salkauski allegedly or-
State v. Eric Boyer, et al.                      to perform 50 hours of community service         chestrated the staged accidents, recruited the
                                                 and to pay $445 in restitution.                  participants or “victims” for each of the
State v. Shaquan McClaurin, Kirk McNeill,
Alnicsa Franklin, Otis Christopher, Rodney          Sareesah Houston pled guilty to attempted     staged accidents, paid the “victims” for their
Mayes, and Raynelle Hamilton                     theft by deception. The court sentenced her      participation in the staged accidents, and di-
                                                 on November 16, 2005, to two years proba-        rected the “injured victims” to obtain medical
State v. Tamika Sutton, Sakinah Hill, Shinaka    tion with credit for nine days jail time.
109
care and legal services. Salkauski ultimately     informant to create and transfer a fictitious    motor vehicle insurance identification card,
pled guilty to conspiracy. The court sentenced    New Jersey motor vehicle driver’s license.       and sale of simulated documents. Six other
her to five years state prison and ordered her    Hojas-Bravo pled guilty to official misconduct   defendants were charged in separate indict-
to pay a $235,000 civil insurance fraud fine.     and the court sentenced him to 30 months         ments as follows:
State of New York v. Alexander Karsheboym,        probation conditioned upon his serving 180       • Jose Vivanco with simulating a motor ve-
Sergey Chizov, Ella Chisov, and Vlad Meisher      days in county jail.                               hicle insurance identification card and sale
   OIFP assisted the Westchester County New       State v. Santa Vasquez                             of a simulated document;
York District Attorney’s Office on October           The court admitted Santa Vasquez into the     • Pedro Roca Garcia with simulating a motor
17, 2005 and October 18, 2005, with the ar-       PTI Program on July 19, 2005, conditioned          vehicle insurance identification card and
rests of Alexander Karsheboym, Sergey             upon her performing 60 hours of community          sale of a simulated document;
Chisov, Ella Chisov, and Vlad Meisher. The        service. OIFP filed an accusation that           • Julio Aviles with conspiracy, simulating a
four, in addition to other defendants, were       charged her with simulating a motor vehicle        motor vehicle insurance identification card,
charged by the Westchester County New York        insurance identification card. Vasquez alleg-      and sale of a simulated document;
District Attorney’s Office variously with en-     edly presented a counterfeit New Jersey In-
terprise corruption, money laundering, and        demnity Insurance Company motor vehicle          • Geovani Geson Villeda-Fajardo with
other related charges. It is alleged that the     insurance identification card to an inspector      simulating a motor vehicle insurance iden-
four defendants assisted in a staged accident/    at the Rahway MVC inspection facility.             tification card and sale of a simulated
automobile PIP insurance fraud in which                                                              document;
                                                  State v. Taleatha L. Thomas
claims were submitted to numerous insurance                                                        • Joe J. Velez with simulating a motor vehicle
companies, including GEICO, Nationwide In-           The court admitted Taleatha L. Thomas           insurance identification card; and
surance Company, Liberty Mutual Insurance         into the PTI Program on March 17, 2005.
                                                  Thomas pled guilty to simulating a motor ve-     • Cristian Y. Batres with simulating a motor
Company, Allstate Insurance Company, State                                                           vehicle insurance identification card.
Farm Insurance Company, Lyon Insurance            hicle insurance identification card. A Mercer
Company, Royal Alliance Insurance Company,        County Grand Jury returned an indictment             The State alleges in the indictments that
and Progressive Insurance Company arising         that charged Thomas with simulating a motor      between May 25, 2001 and July 19, 2002,
from alleged staged accidents in and around       vehicle insurance identification card. Accord-   Sara Corcuera created and sold counterfeit
the New York area.                                ing to the indictment, Thomas allegedly pre-     motor vehicle insurance identification cards,
                                                  sented a counterfeit Liberty Mutual Insurance    New Jersey State drivers’ licenses, as well as
   Attorneys and investigators from OIFP          Company motor vehicle insurance identifica-      other phony documents. The State also alleges
assisted with the arrests and extraditions        tion card to a motor vehicle inspector while     that in at least one instance, Corcuera sold fic-
of the defendants to New York State to            having her 1997 Geo Prism inspected at the       titious documents to an undercover OIFP in-
answer the above referenced charges. These        Lawrenceville MVC inspection facility.           vestigator. Corcuera pled guilty to conspiracy,
cases are pending disposition in New York
                                                  State v. Wesley M. Jordan                        simulating a motor vehicle insurance identifi-
criminal court.                                                                                    cation card, and sale of simulated documents.
Uninsured Motorists (Fictitious Insur-                The court admitted Wesley M. Jordan          The court sentenced her on September 9,
ance Identification Cards and Motor               into the PTI Program on January 14, 2005,        2005, to five years probation and ordered her
                                                  conditioned upon his performing 50 hours         to perform 150 hours of community service.
Vehicle Documents)                                of community service. Jordan pled guilty to
State v. Jorge Fonseca and Joe Abel Hojas-Bravo   an accusation that charged him with exhibit-        Joe J. Velez pled guilty on July 7, 2005, to
                                                  ing and/or displaying a simulated motor ve-      simulating a motor vehicle insurance identi-
   The court sentenced Jorge Fonseca on                                                            fication card. The court sentenced him on
January 5, 2005, to three years probation and     hicle insurance identification card to a law
                                                  enforcement officer. Jordan, a former            the same day to time served in county jail
ordered him to pay a $1,000 criminal fine fol-                                                     (47 days) and ordered him to pay a $250
lowing his guilty plea to conspiracy. Fonseca’s   Cumberland County corrections officer, ad-
                                                  mitted that he presented a fictitious New        criminal fine.
charges stem from a Motor Vehicle Commis-
sion-related investigation into the sale of       Jersey Skylands automobile insurance identi-        Julio Aviles pled guilty to simulating a mo-
fraudulent motor vehicle documents.               fication card to an inspector while having his   tor vehicle insurance identification card. The
                                                  car inspected at the Millville MVC inspection    court sentenced him on October 28, 2005, to
   According to the first indictment, be-         facility. He later presented the same ficti-     two years probation conditioned upon his
tween June 28, 2002 and July 9, 2002,             tious card to a State Trooper.                   performing 50 hours of community service.
Fonseca allegedly conspired with an em-
ployee of the Irvington Motor Vehicle Com-        State v. Sara Corcuera, Jose Vivanco,               The remaining defendants’ cases are
mission (MVC) facility to make fictitious         Pedro Roca Garcia, Julio Aviles, Geovani         pending trial.
drivers’ licenses, driving permits, and auto-     Geson Villeda-Fajardo, Joe J. Velez, and
                                                                                                   State v. Hernando David
mobile titles. The MVC employee was a             Cristian Y. Batres
                                                                                                      A Passaic County Grand Jury returned an
confidential OIFP informant.                         A State Grand Jury returned seven indict-     indictment on March 28, 2005, that charged
  The State alleged in the second indictment      ments on February 28, 2005, against several
                                                                                                   Hernando David with conspiracy and tamper-
that on July 9, 2002, Hojas-Bravo, in his ca-     defendants allegedly involved with creating      ing with public records or information. The
pacity as an employee of the Rahway MVC           false documents. One indictment charged          State alleges in the indictment that David
office, conspired with a confidential OIFP        Sara Corcuera with conspiracy, simulating a
                                                                                                   used numerous aliases and conspired with two
                                                                                                                                               110
OIFP Criminal Case Notes - Insurance Fraud



other persons to obtain a driver’s license using      State v. Darnell C. Kimbrough                       Plainfield MVC Inspection Station. He is
a fictitious name.                                       The court sentenced Darnell C. Kimbrough         scheduled to be sentenced in 2006.
State v. Shanda Renee Coleman                         on December 2, 2005, to three years proba-          State v. Monique Singleton
   The State admitted Shanda Renee Coleman            tion and ordered him to perform 100 hours              The court admitted Monique Singleton into
into the PTI Program on April 4, 2005, con-           of community service. Kimbrough pled                the PTI Program on December 14, 2005, con-
ditioned upon her performing 50 hours of              guilty to simulating a motor vehicle insurance      ditioned upon her performing 60 hours of
community service. She pled guilty on the             identification card. A Somerset County              community service. Singleton pled guilty on
same day to simulating a motor vehicle insur-         Grand Jury returned an indictment that              the same day to simulating a motor vehicle
ance identification card. A Monmouth                  charged Kimbrough with simulating a motor           insurance identification card. A Union
County Grand Jury returned an indictment              vehicle insurance identification card and forg-     County Grand Jury returned an indictment
that charged Coleman with simulating a mo-            ery. According to the indictment, on Septem-        that charged Singleton with simulating a mo-
tor vehicle insurance identification card. Ac-        ber 27, 2004, Kimbrough allegedly presented         tor vehicle insurance identification card. Ac-
cording to the indictment, Coleman allegedly          a phony National Consumer Insurance Com-            cording to the indictment Singleton allegedly
presented a phony motor vehicle insurance             pany automobile insurance identification card       presented a counterfeit Prudential Insurance
identification card to a New Jersey State             to a State Trooper. At the time, National           Company motor vehicle insurance identifica-
Trooper during a traffic stop in Howell.              Consumer Insurance Company had not been             tion card to an inspector at the Plainfield
                                                      doing business for six years. Kimbrough alleg-      MVC Inspection Station.
State v. Lunic Adisson                                edly presented the phony card to retrieve his
   The court sentenced Lunic Adisson on               vehicle from the Somerville State Police im-        Motor Vehicle Commission Initiative
April 18, 2005, to four years probation, or-          pound. The State also alleged that in support                         “FIX-MVC”
dered her to pay a $2,500 civil insurance fraud       of his claim that his vehicle was insured,
                                                                                                             In 2005, OIFP continued to make strides
fine, and to perform 50 hours of community            Kimbrough allegedly presented the trooper
                                                                                                          in the disposition of defendants prosecuted as
service. Adisson pled guilty to simulating a          with a phony National Consumer Insurance
                                                                                                          part of “FIX-MVC.” “FIX-MVC” is OIFP’s
motor vehicle insurance identification card.          Company letter stating that a policy existed
                                                                                                          continuing investigation into official miscon-
   An Essex County Grand Jury returned an in-         for Kimbrough and his vehicle.
                                                                                                          duct and fraud at the State Motor Vehicle
dictment that charged Adisson with simulating a       State v. Jeffrey Ferrer and Nelson Ferrer           Commission (MVC), as well as the procure-
motor vehicle insurance identification card. Ac-        The court admitted Jeffrey Ferrer into the        ment of fictitious identification to include
cording to the indictment, Adisson allegedly pre-     PTI Program on June 23, 2005. The court             drivers’ licenses, commercial drivers’ licenses,
sented the fictitious insurance identification card   sentenced Nelson Ferrer on July 1, 2005, to         and other MVC-related documents. As OIFP
to an Irvington police officer to regain posses-      one year probation.                                 has learned through successful prosecutions,
sion of her impounded car.                                                                                many people file false insurance claims utiliz-
                                                          Jeffrey Ferrer and his father, Nelson Ferrer,
State v. Kamillah Ali and Julia Ali                                                                       ing several different false identities. Phony
                                                      pled guilty to separate accusations that
                                                                                                          drivers’ licenses and other false identification
   Kamillah Ali pled guilty to sale of a simu-        charged them with simulating a motor vehicle
                                                                                                          facilitate this illegal conduct.
lated document and simulating a motor ve-             insurance identification card. Jeffrey Ferrer
hicle insurance identification card. The court        admitted that on June 24, 2004, he assisted in      “FIX-MVC - 1”
sentenced her on September 12, 2005, to               obtaining and selling a phony Countryway In-        State v. Rita Okolo, Josefina Martinez,
three years probation, conditioned upon pay-          surance Company automobile insurance iden-          and Fermin Capellan
ing $1,200 in restitution. Kamillah’s mother,         tification card. An undercover OIFP investi-           A State Grand Jury returned an indictment
Julia Ali, pled guilty to a disorderly persons        gator approached Jeffrey Ferrer seeking to buy      that charged Rita Okolo, an MVC employee,
offense of creating a nuisance and was or-            a phony auto insurance identification card.         with multiple counts of conspiracy, official
dered to pay court fines.                             Jeffrey Ferrer allegedly indicated that he          misconduct, sale of a simulated document,
   A State Grand Jury returned an indictment          would be able to obtain the card from Nelson        and bribery in official matters. A second in-
that charged Kamillah Ali with simulating a           Ferrer. The undercover investigator paid            dictment charged Josefina Martinez and
                                                      $400 for the card. Jeffrey Ferrer allegedly re-     Fermin Capellan each with conspiracy and
motor vehicle insurance identification card,
conspiracy, and sale of simulated documents.          tained $175 and gave the balance of the             bribery in official matters.
The Grand Jury also charged Julia Ali with            money to his father.
                                                                                                             According to the second indictment, be-
sale of a simulated document. According to            State v. Andres Zapata-Quisqueya                    tween February 2003 and May 2003, Okolo
the indictment, Kamillah Ali and Julia Ali al-           Andres Zapata-Quisqueya pled guilty on De-       allegedly accepted a bribe from Capellan to
legedly sold fictitious motor vehicle-related         cember 14, 2005, to simulating a motor vehicle      provide him with a fictitious commercial
documents including drivers’ licenses, auto-          insurance identification card. A Union County       driver’s license in the name of Josefina
mobile titles, a temporary registration tag, a        Grand Jury returned an indictment charging          Martinez. The State alleged in the indictment
fictitious insurance identification card, a           Zapata-Quisqueya with simulating a motor ve-        that Martinez was issued a commercial
phony birth certificate, and a phony Social Se-       hicle insurance identification card. According      driver’s license without taking the commercial
curity card. The State alleged that the docu-         to the indictment, Zapata-Quisqueya allegedly       driver’s license exam. The State alleged that
ments were sold to an OIFP undercover in-             presented a counterfeit New Jersey Manufac-         Okolo permitted another individual, an OIFP
vestigator as part of an investigation into the       turers Insurance Company motor vehicle insur-       undercover investigator, to take the commer-
source of fictitious documents.                       ance identification card to an inspector at the     cial driver’s license exam for Martinez.

111
   Capellan pled guilty on April 25, 2005, to      Morelli, Luis Lagos, and Betty E. Doering,       County Grand Jury indictment charging him
conspiracy; Martinez pled guilty on May 24,        the defendants were charged in a State           with simulating a motor vehicle insurance
2005, to conspiracy to commit official mis-        Grand Jury indictment with conspiracy and        identification card for a 1988 Ford Taurus.
conduct; and Okolo pled guilty to official         tampering with public records. The State         According to the indictment, Ragin allegedly
misconduct on October 26, 2005. Sentencing         alleged that Morelli, Lagos, and Doering pro-    presented a fictitious Allstate insurance iden-
is scheduled for early 2006.                       vided an undercover OIFP investigator with       tification card to an inspector at the Cherry
“FIX-MVC - 2”                                      a fictitious birth certificate, paycheck stub,   Hill MVC Inspection Station.
State v. Tiffany Swinney                           and Union County identification card in or-      State v. Jose E. Alvarez
                                                   der to facilitate obtaining a fictitious New
   Tiffany Swinney pled guilty to tampering        Jersey driver’s license. Along with Vallego,        A Camden County Grand Jury returned an
with public records or information, and on         the defendants allegedly sold various ficti-     indictment on October 6, 2005, that charged
May 27, 2005, the court sentenced her to           tious MVC documents.                             Jose E. Alvarez with simulating a motor ve-
three years probation and ordered her to per-                                                       hicle insurance identification card. According
form 200 hours of community service. Swin-           Doering, Morelli, and Lagos pled guilty to     to the indictment, Alvarez allegedly presented
ney was previously charged by a State Grand        conspiracy. On January 7, 2005, the court        a fictitious State Farm motor vehicle insur-
Jury with tampering with public records or         sentenced Doering to two years probation,        ance identification card to a Collingswood pa-
information and sale of a simulated docu-          Morelli to 30 months probation and ordered       trolman during a traffic stop.
ment. Swinney, who was an employee of the          her to pay $2,310 in restitution, and Lagos to
Wayne MVC office located on Route 23, was          three years probation and ordered him to pay     State v. Michael Jeune
stopped by a Wayne police officer for a motor      $2,310 in restitution. Vallego pled guilty to       Michael Jeune pled guilty on June 2,
vehicle violation. According to the indict-        conspiracy to commit a sale of a simulated       2005, to sale of simulated documents. A
ment, Swinney allegedly presented a fictitious     document, and on May 20, 2005, the court         State Grand Jury returned an indictment
driver’s license to the police officer. The in-    sentenced her to two years probation.            charging him with sale of simulated docu-
vestigation revealed that the State had sus-       State v. Ghmaso Nyasanu Johnson, Delandras       ments. According to the indictment, be-
pended Swinney’s driver’s license.                                                                  tween January 1, 2001 and March 23, 2001,
                                                   Markeith Williams, and Gentree Vanblake
“Fix-MVC - 6”                                                                                       Jeune allegedly purchased counterfeit U.S.
                                                      A Union County Grand Jury returned an         Department of Defense DD214 Discharge
State v. Esterlina Marin
                                                   indictment that charged Ghmaso Nyasanu           forms from a co-conspirator. The State also
   Esterlina Marin pled guilty on December         Johnson, Delandras Markeith Williams, and        alleged that Jeune used the DD214 Dis-
16, 2005, to an accusation charging her with       Gentree Vanblake with conspiracy and brib-
official misconduct. Marin, a clerk at the                                                          charge forms to obtain drivers’ licenses that
                                                   ery. Johnson and Williams, both employees        were sold on the street for between $300
Lodi branch of the MVC, admitted that she          of the Plainfield MVC Inspection Station,
assisted in obtaining four drivers’ licenses for                                                    and $1,500. OIFP investigators arrested
                                                   were also charged with official misconduct.      Jeune on March 23, 2001, for possessing the
individuals by falsifying official MVC docu-
ments. Specifically, she admitted that she al-        According to the indictment, between          phony government documents. He is
legedly reviewed the birth certificates of four    January 20, 2004 and February 13, 2004,          scheduled for sentencing in 2006.
applicants when she had not reviewed birth         Johnson and Williams allegedly issued an au-     State v. Larry Murphy and Charlotte Murphy
certificates for those applicants. Marin is        tomobile inspection sticker that falsely indi-
                                                   cated that an automobile passed inspection.         Larry Murphy and Charlotte Murphy were
scheduled to be sentenced in 2006.
                                                   The indictment further sets forth that           arrested by OIFP investigators on September
“Fix-MVC - 13”                                     Vanblake, the owner of the automobile that       29, 2005, and charged with simulating a mo-
State v. Stacey Chestnut                                                                            tor vehicle insurance identification card. The
                                                   failed inspection, allegedly bribed Johnson
   On December 5, 2005, Stacey Chestnut pled       and Williams for $40 to issue a motor vehicle    State alleges that the Murphys were producing
guilty to official misconduct. A State Grand       inspection sticker that falsely indicated that   fictitious insurance identification cards. In-
Jury returned an indictment charging her with      the car passed. The MVC fired Johnson            surance identification cards are used to pro-
official misconduct. According to the indict-      and Williams.                                    vide evidence that persons have the required
ment, Chestnut, in her capacity as an employee                                                      automobile insurance. Fake insurance identi-
of the Wayne MVC facility located on Route            Johnson and Williams pled guilty to con-      fication cards are sold on the street for prices
23, allegedly created two fictitious motor ve-     spiracy on August 3, 2005, and on the same       ranging from $200 to $500. They are dis-
hicle forms for two people who were not            day, the court admitted them into the PTI        played to police officers and MVC officials so
named in the indictment. The State alleges         Program conditioned upon their performing        that it appears that the person showing a fake
that Chestnut created and processed an applica-    60 hours of community service. The court ad-     insurance identification card has the appropri-
tion for a duplicate non-photo driver’s license    mitted Vanblake into the PTI Program on Au-      ate automobile insurance.
and an application for a driver’s examination      gust 10, 2005, conditioned upon performing
                                                   60 hours of community service.                   State v. Wilberta Johnson
permit for a commercial driver’s license (CDL).
She is scheduled to be sentenced in 2006.          State v. Darren Ragin                              Wilberta Johnson pled guilty on Novem-
“Fix-MVC - 16”                                                                                      ber 28, 2005, to presenting a false insurance
                                                      The court sentenced Darren Ragin on July      card. A State Grand Jury returned an indict-
State v. Karina Noelia Vallego, Monica Morelli,    22, 2005, to three years probation and or-
Luis Lagos, and Betty E. Doering                                                                    ment charging her with simulating a motor
                                                   dered him to perform 75 hours of community       vehicle insurance identification card and
 After OIFP investigators arrested Karina          service. Ragin pled guilty to a Camden
Noelia Vallego, Vallego’s mother Monica
                                                                                                                                               112
OIFP Criminal Case Notes - Insurance Fraud



manufacturing a false insurance card. Ac-          cycles valued at approximately $153,557, and        September 12, 2005, to nine months in
cording to the indictment, Johnson allegedly       12 separate instances of fencing stolen motor-      state prison after he pled guilty to an accu-
exhibited a phony Clarendon Insurance Com-         cycles valued at approximately $83,857.             sation that charged him with receiving sto-
pany auto insurance identification card when         The investigation is continuing and further       len property.
having her 2002 Kia inspected at the               charges are anticipated.                               Randolph Brolo, Rodney Butler, and Kevi
Plainfield MVC Inspection Station. Suspect-                                                            Williamson pled guilty to accusations on Oc-
ing the card was fraudulent, MVC personnel             Previously, as part of the investigation, the
                                                   Bensalem, PA, Police Department arrested            tober 31, 2005, that charged them with re-
contacted OIFP. Johnson is scheduled to be                                                             ceiving stolen property. The court sentenced
sentenced in early 2006.                           Torray Murphy and Gregory Haygood on June
                                                   16, 2004, and charged them with attempted           Williamson on December 23, 2005, to one
State v. Natasha V. Crisp                          theft of an automobile. The defendants were         year probation and ordered him to pay $2,159
   A Union County Grand Jury returned an           placed in the Bucks County Correctional Fa-         in restitution. Brolo and Butler are scheduled
indictment on November 9, 2005, that               cility. OIFP and the New Jersey State Police        to be sentenced early in 2006.
charged Natasha V. Crisp with simulating a         arrested Murphy on July 8, 2004, at the Bucks         Torray Murphy pled guilty to an accusation
motor vehicle insurance identification card.       County Correctional Facility and charged him        on November 14, 2005, that charged him
According to the indictment, Crisp allegedly       with eluding a police officer. Murphy was al-       with eluding; he was sentenced on the same
exhibited a phony Prudential Insurance Com-        legedly in the process of stealing a motorcycle     day to five years in state prison.
pany auto insurance identification card when       on May 14, 2004, when he was spotted and              The other cases are pending.
she was having her 1997 Dodge Intrepid in-         fled the police in his van. He abandoned the
spected at the Plainfield MVC Inspection Sta-      van and continued to flee on foot. OIFP’s           State v. Arthur Chzubek, Edward Obszanski,
tion. MVC personnel suspected the card was         subsequent investigation identified Murphy as       Waldemar Kondzielewski, Dariusz
fraudulent and referred the matter to OIFP.        the individual who allegedly fled on foot from      Grabowski, Krzysztof Grabowski, Dominik
                                                   the van. As a result, OIFP made the July 8,         Tabor, Patrick M. Gutorski, and Marcin D.
Vehicle Theft                                                                                          Kisz (Operation Key Code Express)
                                                   2004, arrest of Murphy.
Operation Ninja                                                                                           OIFP Investigators arrested six people on
                                                      The arrest resulted from an undercover in-
State v. Torray A. Murphy, Kyle J. Bunn, Jamar     vestigation in New Jersey of stolen motor-          November 1 and 2, 2005, and charged them
L. Doggett, Ronald R. Crosland, Gregory            cycles, and an automobile in Pennsylvania.          as follows:
Haygood, Rodney Butler, John White, Janine         OIFP, the New Jersey State Police, and other        • Arthur Chzubek with conspiracy to com-
Barnes, Alan Barbosa, Arthur Outram, John          law enforcement agencies are continuing the            mit receiving stolen property, receiving
Kennedy, Jaesen Hensely, Rodney West, Floyd        investigation. Based on the investigation, the         stolen property, leader of auto trafficking
Robertson, Anthony Angelone, Cory Carthan,         following dispositions occurred in 2005:               network, and conspiracy to commit Insur-
Kevi Williamson, Quentin Durden, Michael                                                                  ance Fraud;
                                                      Anthony Angelone pled guilty to an accusa-
Green, Anton Hall, Aaron Auten, Randy Brolo,
                                                   tion that charged him with receiving stolen         • Edward Obszanski with receiving stolen
David Schall, Jason Reed, and Jason Hobbs
                                                   property, and the court sentenced him on Sep-         property, conspiracy to commit receiving
   OIFP and State Police conducted a joint         tember 16, 2005, to two years probation and           stolen property, certain alterations of mo-
investigation of a conspiracy to steal motor-      ordered him to pay $2,159 in restitution.             tor vehicle trademarks and identification
cycles, change the Vehicle Identification                                                                numbers, and conspiracy to commit Insur-
                                                      Floyd Robertson pled guilty on June 27,
Numbers (VIN) of each motorcycle to con-                                                                 ance Fraud;
                                                   2005, to a disorderly persons charge of fenc-
ceal the true identity and ownership of the
                                                   ing; the court sentenced him on the same day        • Dariusz Grabowski with conspiracy to re-
motorcycles in a process known as “stamp-
                                                   to one year probation conditioned upon his            ceive stolen property, receiving stolen prop-
ing,” and to otherwise obtain false title docu-
                                                   continued cooperation with the State’s inves-         erty, conspiracy to commit certain alter-
ments and registrations for the stolen vehicles.
                                                   tigation into this matter.                            ations of motor vehicle trademarks and
   As the result of the joint investigation, 23                                                          identification numbers, certain alterations
                                                      Quentin Durden pled guilty to an accusa-
persons were arrested on May 4, 2005, for                                                                of motor vehicle trademarks and identifi-
                                                   tion that charged him with receiving stolen
their roles in a motorcycle theft ring that op-                                                          cation numbers, and leader of auto traf-
                                                   property, and on July 19, 2005, the court ad-
erated in Mercer and Burlington Counties.                                                                ficking network;
                                                   mitted him into the PTI Program conditioned
The defendants were variously charged with
                                                   upon his paying $3,300 in restitution.              • Waldemar Kondzielewski with receiving
racketeering, conspiracy, Insurance Fraud, re-
ceiving stolen property, and fencing.                 Aaron Auten pled guilty to an accusation           stolen property, conspiracy to commit re-
                                                   that charged him with receiving stolen prop-          ceiving stolen property, conspiracy to com-
   Among the 23 persons arrested were Kyle                                                               mit certain alterations of motor vehicle
                                                   erty, and the court admitted him into the PTI
Bunn, Ronald Crosland, Gregory Haygood,                                                                  trademarks and identification numbers, and
                                                   Program on August 11, 2005, conditioned
Jamar Doggett, and John White, who were                                                                  certain alterations of motor vehicle trade-
                                                   upon his paying $2,169 in restitution.
each charged with theft by unlawful taking,                                                              marks and identification numbers;
receiving stolen property, and fencing. The           Anton Hall pled guilty to an accusation
State alleges that the defendants conspired to     that charged him with receiving stolen prop-        • Krzysztof Grabowski with conspiracy to
steal 16 motorcycles in Burlington County          erty, and the court sentenced him on October          commit receiving stolen property, receiving
valued at approximately $97,225, with 23           28, 2005, to one year probation.                      stolen property, and leader of auto traffick-
separate instances of receiving stolen motor-                                                            ing network;
                                                      The court sentenced John Kennedy on

113
• Patrick M. Gutorksi with conspiracy to           erty for her role in a scam in which automo-       including First Trenton Indemnity Company,
   commit receiving stolen property, receiving     biles were stolen and their VINs altered so        New Jersey Manufacturers Insurance Com-
   stolen property, and leader of auto traffick-   that law enforcement could not trace the sto-      pany, and State Farm Insurance Company.
   ing network.                                    len vehicles to their legitimate owners.           The insurance companies allegedly paid
   It is alleged that these defendants stole          OIFP’s investigation revealed that automo-      Potacco approximately $48,022. Potacco
cars, purchased similar salvaged or wrecked        bile insurance theft claims were filed for these   is scheduled to be sentenced in 2006.
cars in order to obtain the VINs, and re-          stolen cars with several insurance companies       State v. Lev Natovich, Boris Natovich, and
placed the original VINs in the stolen cars        including New Jersey Manufacturers Insur-          Joseph Matriss
with the VINs from the salvaged cars to con-       ance Company, AIG Insurance Company,                  A State Grand Jury returned a superseding
ceal the identity of the stolen cars. It is fur-   Allstate Insurance Company, and the Peerless       indictment on January 10, 2005, that charged
ther alleged some of the stolen cars were          Insurance Company.                                 Lev Natovich with tampering with witnesses
sold on online auctions.                           State v. Steven E. Williams                        and informants. The new charge added by the
State v. Mariusz Mroczka and                          The court sentenced Steven E. Williams          superseding indictment alleges that between
Kristina Kowalczyk                                 on May 11, 2005, to three years probation          November 17, 2003 and November 19, 2003,
    Mariusz Mroczka pled guilty to an accusa-      and ordered him to pay $3,555 in restitution       Lev Natovich approached an individual and
tion that charged him with receiving stolen        and a $500 criminal fine. Williams pled            requested that he change or alter his antici-
property, and the court sentenced him on May       guilty to an accusation that charged him with      pated testimony with respect to the charges
13, 2005, to four years in state prison and or-    theft by unlawful taking. Williams admitted        alleged in the original indictment.
dered him to pay $46,114 in restitution.           he stole a 2004 Cadillac Escalade from a              A State Grand Jury previously charged
   Mroczka admitted that between September         dealership in Florham Park. Williams admit-        Lev Natovich with Health Care Claims
26 and October 2, 2003, he accepted stolen         ted that he went to the dealership to shop         Fraud, conspiracy to commit Health Care
cars from another person. Specifically,            for a new Cadillac. When the salesman              Claims Fraud, conspiracy to commit theft by
Mroczka admitted that he took possession of        showed him a new Cadillac, Williams alleg-         deception, unlawful practice of dentistry,
a 2001 Lexus IS 300, a 2001 Lexus GS 430, a        edly switched a blank key with the valet key       theft by deception, and conspiracy to com-
2003 Lexus SC 430, and a Volkswagen Jetta.         for the new Cadillac. Williams admitted that       mit unlawful practice of dentistry. Also
In total, the four cars were valued in excess      he went back to the dealership the same day        named in the original indictment was Boris
of $170,000. Mroczka allegedly took posses-        and utilized the valet key to steal the            Natovich, Lev Natovich’s father, who is the
sion of the stolen cars so that they could be      Cadillac Escalade. Later, Williams allegedly       owner of United Dental Center. Boris
re-tagged and resold. “Re-tagging” a vehicle       re-tagged the stolen Cadillac by changing the      Natovich was charged with one count of
means that the VIN is removed from the car         VIN in order to conceal its identity from law      conspiracy to commit unlawful practice of
and a different VIN is placed on the car so        enforcement. The stolen Cadillac was valued        dentistry. The final defendant named in the
that it can be hidden from law enforcement         at over $61,000.                                   original indictment was Joseph P. Matriss,
and appear to be not stolen.                                                                          who is a dentist licensed to practice dentistry
                                                   HEALTH AND DISABILITY FRAUD                        in New Jersey and who performed dental
   The alleged stolen cars were found on                                                              services at United Dental Center. Matriss
Mroczka’s property in Linden when OIFP in-         Fraudulent Health and Disability Claims
                                                                                                      was charged with Health Care Claims Fraud,
vestigators executed a search warrant as part      by Doctors, Chiropractors, and Other
                                                                                                      conspiracy to commit Health Care Claims
of an investigation into automobile thefts,        Health Care Providers                              Fraud, conspiracy to commit theft by decep-
automobile re-tagging, and insurance fraud.        State v. Philip Potacco                            tion, and theft by deception.
Investigators allegedly found various parts
from other automobiles, mechanics’ tools, and         Philip Potacco pled guilty on December 12,         The State alleged in the original indictment
other evidence consistent with vehicle re-tag-     2005, to theft by deception. A State Grand         that, between September 1999 and March
ging during the search.                            Jury returned an indictment that charged           2002, Boris Natovich and Matriss assisted Lev
                                                   Potacco with Health Care Claims Fraud and          Natovich and another person who was previ-
   Kristina Kowalczyk pled guilty to an accu-      attempted theft by deception. According to         ously charged, Vadim Lioubomoudrov, to pro-
sation that charged her with receiving stolen      the indictment, Potacco allegedly continued        vide dental treatment to United Dental Cen-
property, and the court admitted her into the      to practice chiropractic medicine for approxi-     ter patients, including children. Allegedly,
PTI Program on September 28, 2005, condi-          mately four years in Little Falls Township,        neither Lev Natovich nor Lioubomoudrov
tioned upon her performing 60 hours of com-        Passaic County, and South Orange, Essex            were licensed in New Jersey to practice den-
munity service. Kowalczyk admitted that be-        County, even though his license had been sus-      tistry. It is believed that Lioubomoudrov held
tween September 26, 2003 and October 2,            pended by the Board of Chiropractic Examin-        a Russian license to practice dentistry. The
2003, she knowingly possessed parts from a         ers on several occasions.                          State also alleged that United Dental Center
stolen 2001 Lexus IS 300. The owner of the                                                            submitted fraudulent bills for dental services
2001 Lexus reported the vehicle stolen on             Despite not having a valid license to prac-
                                                   tice chiropractic medicine, Potacco allegedly      to a labor union and to Delta Dental Insur-
May 15, 2003, to the Clifton Police Depart-                                                           ance patients for dental treatments performed
ment. New Jersey Manufacturers Insurance           billed automobile insurance companies for
                                                   treating automobile accident patients under        by unlicensed dentists. The State alleged that
Company paid $26,225 to settle the automo-                                                            the fraudulent bills were submitted to the in-
bile theft insurance claim. Kowalczyk pled         their PIP insurance. Potacco allegedly billed
                                                   approximately $98,175 to multiple companies        surance carriers reflecting Matriss, who was
guilty to the charge of receiving stolen prop-

                                                                                                                                                   114
OIFP Criminal Case Notes - Insurance Fraud



licensed, as the treating dentist even though      never provided to patients. In total, the State       State v. Ettore C. Carchia
he had not treated some of the patients.           alleged that LeClerc Adisson and Lunic                     Ettore C. Carchia pled guilty to an accusa-
   Joseph Matriss pled guilty to an accusation     Adisson fraudulently billed insurance carriers        tion charging him with Health Care Claims
that charged him with falsifying or tampering      approximately $48,273, of which the                   Fraud, and the court sentenced him on October
with records. The court sentenced him on           Adissons were paid approximately $26,028.             7, 2005, to three years probation. It also or-
September 6, 2005, to one year probation and           Lunic Adisson was also named in a previous        dered him to surrender his chiropractic license.
ordered him to pay $2,219 in restitution to        unrelated indictment that charged her with            Carchia admitted that between January 1,1999
Delta Dental, $9,781 in restitution to the la-     possession of a fictitious insurance identifica-      and October 20, 2000, he committed Health
bor union, and a $550 criminal fine. The           tion card. The State alleged in the indictment        Care Claims Fraud by submitting PIP insurance
court admitted Boris Natovich into the PTI         that she presented the fictitious insurance iden-     claims to Allstate Insurance Company and Selec-
Program on September 6, 2005, conditioned          tification card to an Irvington police officer to     tive Insurance Company. The claims were false
upon his paying $5,213 in restitution. Lev         regain possession of her impounded car.               because they represented bills for chiropractic
Natovich pled guilty to Health Care Claims         State v. Eugene Ruta and Andrew Farro                 services not rendered, and chiropractic services
Fraud, and the court sentenced him on Octo-                                                              that could not have been rendered given the
ber 7, 2005, to five years probation condi-            A State Grand Jury returned an indictment         time patients spent in the chiropractor’s office.
tioned upon his spending at least six months       on May 12, 2005, charging Eugene Ruta and
                                                   Andrew Farro with conspiracy, Health Care                Carchia was charged for his role in an insur-
in a drug rehabilitation center, and ordered                                                             ance fraud and official corruption conspiracy
him to pay $12,000 in restitution.                 Claims Fraud, and Criminal Use of Runners.
                                                   Ruta was a licensed chiropractor formerly em-         that allegedly involved Camden Police Lieu-
Fraudulent Billing by Health Care                  ployed at Valley Total Health Center in Orange,       tenant Jerome Bollettieri, who was in charge
Providers                                          Essex County. Farro was also formerly em-             of the Camden Police Department Records
                                                   ployed as an office manager at Valley Total           Room; retired Camden police officer, Thomas
State v. LeClerc Adisson and Lunic Adisson
                                                   Health Center. According to the indictment,           DiPatri; a person who acted as a “runner,”
   LeClerc Adisson and Lunic Adisson pled          Farro allegedly agreed to pay a “runner” who          Charles Warrington; and a now deceased man
guilty to theft by deception, Health Care          was cooperating with OIFP $500 for every pa-          who owned, operated, or controlled a chiro-
Claims Fraud, and Criminal Use of Runners.                                                               practic clinic known as American Spinal Care,
                                                   tient the “runner” could bring to Valley Total
The charges were contained in an accusation        Health Center. The indictment further alleges         Inc., located in Collingswood.
and a State Grand Jury indictment. The court       that insurance claims were submitted to an in-           The court sentenced Thomas DiPatri to
sentenced LeClerc Adisson on April 19, 2005,
                                                   surance company for patients solicited for Valley     three years in state prison pursuant to guilty
to 364 days in county jail as a condition of       Total Health Center in addition to claims for         verdicts returned for the crimes of conspiracy,
five years probation, and ordered him to pay       chiropractic services that were never rendered to     bribery, official misconduct, and Criminal Use
approximately $26,000 in restitution to nine
                                                   patients. The patients the “runner” allegedly so-     of Runners.
insurance companies and a $5,000 civil insur-      licited, and another person to whom Farro alleg-
ance fraud fine. LeClerc Adisson also surren-                                                               Jerome Bollettieri filed an appeal to the
                                                   edly paid money as a “runner,” were all under-        State Supreme Court seeking dismissal of the
dered his medical license. The court sen-
                                                   cover OIFP investigators. Additionally, an un-        indictment. The Supreme Court recently dis-
tenced Lunic Adission to four years proba-         dercover Newark police officer posed as a pa-
tion, ordered her to pay a $2,500 civil insur-                                                           missed his appeal and returned the case to
                                                   tient. The State alleged in the indictment that       Camden County Superior Court for trial.
ance fraud fine, and to perform 50 hours of
                                                   the defendants paid approximately $2,000 to
community service.                                 persons who posed as “runner.”                           The court sentenced Charles Warrington to
    A State Grand Jury returned an indictment                                                            three years in state prison.
                                                      The State alleged in the indictment that
against LeClerc Adisson and his niece Lunic                                                              State v. Mark Radowitz
                                                   Ruta committed Health Care Claims Fraud by
Adisson, charging them with Health Care            permitting his office manager, Farro, to sub-            A State Grand Jury returned an indictment
Claims Fraud, theft by deception, misconduct       mit claims to insurance companies for services        on July 15, 2005, charging Mark Radowitz
by a corporate official, and falsifying records.
                                                   not rendered totaling approximately $5,945.           with Health Care Claims Fraud, theft by de-
According to the indictment, between April         The State also alleged that Ruta knew that            ception, and falsifying records. According to
1997 and December 2000, LeClerc Adisson            Farro used a “runner” to solicit patients for         the indictment, between July 2, 1999 and
concealed that he owned and had a “benefi-
                                                   Valley Total Health Center.                           September 5, 2000, Radowitz allegedly billed
cial interest” in two corporations, Dantor
                                                      As part of the undercover investigation, in        both Allstate Insurance Company and the
Medical Supply and Clara Medical Services.
                                                   addition to sending investigators and police of-      California State Workers Compensation Insur-
The State further alleged that, with the assis-
                                                   ficers to Valley Total Health Center, investiga-      ance Fund for multiple chiropractic services
tance of his niece, LeClerc Adisson submitted
                                                   tors executed a search warrant to seize records       allegedly provided to two patients. OIFP’s
bills to various insurance companies for medi-
                                                   and other evidence to support the charges. In         investigation revealed that the chiropractic
cal supplies and related services knowing the
                                                   total, bills for approximately $12,499 were al-       services billed to Allstate and the California
insurance companies would not pay the bills
                                                   legedly submitted to Parkway Insurance for            State Workers Compensation Insurance Fund
if they had known he owned Dantor Medical
                                                   “runner” solicited patients. Parkway paid ap-         were not rendered even though Radowitz
Supply and Clara Medical Services. The State
                                                   proximately $5,945 to Valley Total Health Cen-        billed for them. The State alleges that
alleged that some of the bills were fraudulent
                                                   ter for insurance claims submitted.                   Radowitz billed on approximately 179 dates
because they were inflated or for equipment
                                                                                                         for approximately $16,000 in chiropractic
                                                     The case against Ruta and Farro is pending trial.   treatments never rendered to two patients.
115
State v. Paul Anodide                                 A State Grand Jury returned an indictment           A State Grand Jury previously returned an
    Paul Anodide pled guilty on November 14,       charging Clark with theft by deception and          indictment charging Acquaire with two
2005, to theft by deception. A State Grand         Health Care Claims Fraud. Clark was presi-          counts of Health Care Claims Fraud, two
Jury returned an indictment charging Anodide       dent of Home Health Care Center, Inc.               counts of attempted theft by deception, and
with Health Care Claims Fraud, theft by de-        (HHC), located in Hoboken, and director of          two counts of theft by deception. According
ception, and falsifying records. According to      the now defunct Medical Care Management,            to the indictment, Acquaire allegedly rendered
the indictment, Anodide, a licensed dentist        Inc., d/b/a Mile Square Medical Group, for-         services as an electrologist, a person who re-
with an office in Trenton, allegedly submitted     merly located in Weehawken. HHC is a busi-          moves unwanted hair. The State alleged that
bills to three insurance carriers regarding ap-    ness that delivers prescription medications         Acquaire, using the business name “High
proximately 28 patients with more than 75          from pharmacies to patients’ homes and is not       Mountain Medical Center,” submitted fraudu-
allegedly fraudulent dental insurance claims.      licensed to dispense or otherwise sell prescrip-    lent claims totaling $908,843 to United
The claims totaled approximately $85,914 and       tion medication. Mile Square Medical Group          Health Group Insurance Company and Aetna
the carriers paid approximately $62,846 on         was a medical facility staffed by various physi-    Insurance Company. The State alleged the
the claims. The allegedly fraudulent claims        cians. Clark, himself, was neither a medical        claims were fraudulent because Acquaire
included claims for root canals, crowns, and       service provider nor a licensed pharmacist.         billed for hair removal by means of electroly-
fillings. All of the services were billed to the      According to the indictment, between De-         sis as though it was a reimbursable medical
carriers but allegedly were not rendered to the    cember 1, 1996 and September 11, 1998,              surgical procedure known as a debridement,
patients. The State also alleged that Anodide      Clark allegedly misrepresented to Horizon           which can only be performed by or under the
submitted claims for Sunday dental services        Blue Cross Blue Shield, which served as a           supervision of a properly licensed medical
when the dental office was closed. According       third party claims administrator for the New        provider. The State alleged that Acquaire was
to the indictment, Anodide also allegedly sub-     Jersey State Health Benefits Program, that          not a licensed medical service provider, was
mitted claims for crowns and root canals that      HHC was licensed to supply, dispense, and sell      not qualified to perform medical or surgical
were performed twice on the same tooth.            the prescription medications that were deliv-       procedures, and would not have been autho-
Anodide allegedly submitted fraudulent claims      ered to patients of Mile Square Medical             rized to bill the insurance companies for
to insurance carriers including Prudential         Group. The State alleged that HHC grossly           such procedures.
Health Care of New Jersey, Aetna US                inflated the cost over the usual and customary      State v. Carol Severe
Healthcare, and Delta Dental Insurance Com-        price of the medicine for many prescriptions           The court sentenced Carol Severe on June
pany. Prudential was the third party claims        on claims it submitted to the State Health          10, 2005, to one year probation, ordered her
administrator for the New Jersey State Health      Benefits Program. The State also alleged that       to pay $13,947 in restitution and a $5,000
Dental Plan that provides dental services to       Clark submitted fraudulent health care reim-        civil insurance fraud fine, and to perform 80
State employees. Prudential processed den-         bursement claims to Horizon Blue Cross Blue         hours of community service. Severe pled
tal insurance claims that were paid with           Shield and the State Health Benefits Program        guilty to an accusation charging her with
State money.                                       for prescription medications that were neither      Health Care Claims Fraud and uttering a
  Anodide is scheduled to be sentenced in 2006.    dispensed nor delivered to patients.                forged document. Severe admitted that be-
False Health Care Claims                              The State proved that Clark submitted            tween January 5, 2000 and May 4, 2004, she
                                                   nearly 400 fraudulent insurance claims for          obtained approximately $13,947 from Hori-
State v. Reginald Smithson                         various medications. Approximately 330              zon Blue Cross Blue Shield by submitting
   The court issued a bench warrant on August      claims were submitted for medications that          false health insurance claims. An investiga-
5, 2005, when Reginald Smithson failed to ap-      were never dispensed and never delivered to         tion revealed that Severe allegedly submitted
pear at his arraignment. An Essex County           the patients. The total amount of fraudulent        42 false claims for psychologist services on
Grand Jury returned an indictment on June 9,       billings allegedly submitted by Clark to Hori-      192 dates. Severe allegedly submitted the
2005, charging Smithson with theft by decep-       zon Blue Cross Blue Shield and the State            false claims to Horizon Blue Cross Blue
tion, Insurance Fraud, and forgery. According      Health Benefits Program was in excess of            Shield by signing the psychologist’s name to
to the indictment, Smithson allegedly submit-      $365,000, of which Horizon paid more than           the claim forms.
ted a phony receipt to State Farm Insurance        $343,000. The fraudulent prescription               State v. Barry Cohen
Company showing he paid a hospital $1,001          scheme allegedly involved at least eight differ-
                                                   ent patients. The State Health Benefits Pro-           Barry Cohen pled guilty to Health Care
for medical treatment related to injuries sus-
                                                   gram is funded by tax dollars.                      Claims Fraud, and the court sentenced him on
tained in an automobile accident. The State
                                                                                                       June 24, 2005, to three years probation and
alleges Smithson altered the receipt and the       State v. Florence Acquaire                          ordered him to pay $328,000 in restitution
hospital treated him for an unrelated illness.
                                                      The court sentenced Florence Acquaire on         and a $105,000 civil insurance fraud fine. A
State v. James Clark                               September 30, 2005, to seven years in state         State Grand Jury returned an indictment
   Following a 15-day jury trial, a jury found     prison and ordered her to pay $65,046 in restitu-   charging Cohen with Health Care Claims
James Clark guilty of theft by deception and       tion to Aetna Insurance Company and $4,428 in       Fraud, theft by deception, and misconduct by
Health Care Claims Fraud. The court sen-           restitution to United Health Care. Following a      a corporate official. Cohen, a Certified Public
tenced Clark on April 1, 2005, to nine years in    ten-day bench trial, Acquaire was convicted of      Accountant, operated a family-owned corpo-
state prison and ordered him to pay a $5,000       Health Care Claims Fraud, theft by deception,       ration known as Headways, Inc. The corpo-
criminal fine.                                     and attempted theft by deception.                   ration provided health care services to pa-

                                                                                                                                                 116
OIFP Criminal Case Notes - Insurance Fraud



tients who had suffered brain injuries. Ac-        State v. Anthony Williams                              The State also alleged that Rhody submit-
cording to the indictment, Cohen allegedly            A State Grand Jury returned an indictment       ted false records about his disability, occupa-
caused Headways to submit more than                on October 4, 2005, charging Anthony Will-         tion, income, and was held in contempt of
$350,000 in fraudulent health insurance            iams with Health Care Claims Fraud and theft       court in connection with a divorce action
claims to several insurance companies and          by deception. According to the indictment,         filed in Monmouth County Superior Court.
self-funded health benefits plans. Among the       between April 21, 2002 and April 28, 2005,           Rhody was formerly employed as an attor-
insurance companies and health benefits plans      Williams allegedly submitted a false New Jer-      ney by the Ocean-Monmouth Counties Legal
that allegedly received the false claims were      sey Transit automobile collision and personal      Services Office.
Allstate Insurance Company, Horizon Blue           injury claim to New Jersey Transit. The State
Cross Blue Shield of New Jersey, State Farm                                                           State v. Jasmine Gomez
                                                   alleges that Williams falsely claimed he was a
Insurance Company, Proformance Mutual In-          passenger in a minivan that sustained rela-           The court admitted Jasmine Gomez into
surance Company, the New Jersey Automobile         tively minor damage when a New Jersey Tran-        the PTI Program on February 7, 2005, condi-
Full Insurance Underwriting Association, and       sit bus struck the side-view mirror of the         tioned upon her paying $5,100 in restitution.
Key Benefit Administrators, a third party          minivan. The State also alleges that Williams      A State Grand Jury returned an indictment
claims administration company that adminis-        claimed to be a passenger in the minivan even      charging Gomez with theft by deception and
tered health insurance for the Teamsters           though the police investigation and OIFP’s         uttering a forged document. According to the
Union Local 560 Benefit Fund. The State al-        investigation revealed that he was not a pas-      indictment, Gomez allegedly wrongfully col-
leged in the indictment the claims were for        senger in the minivan. The State further al-       lected approximately $5,100 in disability in-
services that were not rendered by Cohen.          leges that Williams retained the services of an    surance claims from Trustmark Insurance
State v. Olivette Henderson                        attorney and allegedly consulted with at least     Company. The State alleged that Gomez
                                                   two physicians with respect to purported in-       started receiving disability insurance claims
   Olivette Henderson pled guilty on No-                                                              money from Trustmark after a November
vember 15, 2005, to Health Care Claims             juries. Williams failed to appear at his ar-
                                                   raignment on November 18, 2005. The court          2001 automobile accident. The State further
Fraud and theft of identity. A State Grand                                                            alleged Gomez forged physician statements to
Jury returned an indictment charging               issued a bench warrant for his arrest.
                                                                                                      falsely indicate she was still injured and un-
Henderson with Health Care Claims Fraud            State v. Vera Maynard                              able to return to work in order to continue
and attempted theft by deception. Accord-             The court admitted Vera Maynard into the        receiving disability insurance payments.
ing to the indictment, between December            PTI Program on October 26, 2005, condi-
11, 2000 and March 12, 2001, Henderson                                                                State v. Douglas E. “David” Fittinger
                                                   tioned upon her paying $6,066 in restitution
allegedly utilized the insurance identification    and a $1,500 civil insurance fraud fine. An           The court sentenced Douglas E. “David”
information of another person to obtain            accusation was filed charging Maynard with         Fittinger on June 24, 2005, to five years pro-
medical services. The medical services alleg-      theft by deception. According to the accusa-       bation, ordered him to pay $14,882 in restitu-
edly included foot surgery and related medi-       tion, Maynard allegedly submitted fraudulent       tion and a $5,000 civil insurance fraud fine,
cal bills for approximately $44,745. The bills     receipts to Horizon Blue Cross Blue Shield for     and to perform 325 hours of community ser-
were submitted to the CIGNA Property and           reimbursement of medical bills for treatments      vice. Fittinger pled guilty to an accusation
Casualty Insurance Company and CIGNA               never rendered to patients. The State alleges      charging him with theft by deception.
paid approximately $7,550.                         that Maynard was paid $6,066 by Horizon            Fittinger admitted that between February 1,
  Henderson is scheduled for sentencing in 2006.   Blue Cross Blue Shield based on the fraudu-        2003 and June 10, 2003, he wrongfully ob-
                                                   lent receipts.                                     tained workers’ compensation payments from
State v. Kita McNeil                                                                                  his employer which is self-insured for work-
   The court admitted Kita McNeil into the         Fraudulent Disability Claims                       ers’ compensation insurance. The company
PTI Program on October 20, 2005, condi-            State v. John Rhody                                administers its own workers’ compensation
tioned upon her paying $3,247 in restitution.                                                         insurance plan and makes workers’ compensa-
                                                      John Rhody pled guilty on December 19,
A State Grand Jury returned an indictment                                                             tion payments. Fittinger admitted that he
                                                   2005, to falsification of records. He is sched-
charging McNeil with theft by unlawful tak-                                                           falsely claimed total disability in order to steal
                                                   uled to be sentenced in 2006. A State Grand
ing. According to the indictment, between                                                             workers’ compensation insurance money. An
                                                   Jury returned an indictment charging Rhody
February 25, 2002 and June 18, 2002, McNeil                                                           investigation revealed that Fittinger was alleg-
                                                   with theft by deception, falsifying or tamper-
allegedly stole money from Oxford Health                                                              edly dancing at a night club, training as a
                                                   ing with records, and contempt of court. Ac-
Plans. The State alleged that after McNeil left                                                       firefighter, working on a boat, and engaging in
                                                   cording to the indictment, between May 31,
the employment of a New York medical prac-                                                            other conduct inconsistent with his claim of
                                                   2001 and July 31, 2002, Rhody allegedly col-
tice, she allegedly received and cashed checks                                                        total disability. In total, Fittinger received ap-
                                                   lected disability insurance benefits from the
from Oxford Health Plans that were gener-                                                             proximately $14,882 in workers’ compensa-
                                                   Standard Insurance Company by submitting a
ated from false health care insurance claims.                                                         tion benefits from his employer.
                                                   disability claim. The State further alleged that
The State alleged that the treatments were                                                            State v. John Manto
                                                   the evidence demonstrates that Rhody was
not rendered and that the claims were fraudu-
                                                   actually working by buying and selling post-         The court admitted John Manto into the
lent. The State alleged that McNeil stole ap-
                                                   cards on Ebay, and on other occasions and          PTI Program on June 21, 2005, conditioned
proximately $3,875 from Oxford Health
                                                   places, while he was allegedly disabled and        upon paying $20,366 in restitution and a
Plans as the result of these false claims.
                                                   collecting disability insurance.                   $5,000 civil insurance fraud fine. Manto was

117
charged with theft by deception. Between         America Life Insurance that he was not per-        as part of the State Prescription Drug Plan.
August 22, 2002 and June 5, 2003, Manto al-      forming gainful work for a business entity.        The fraud against the state and county health
legedly collected temporary workers’ compen-     As a result of his plea, Serbin will repay Re-     and prescription benefits plans allegedly con-
sation benefits by misrepresenting he was un-    assure America Life Insurance the $170,774         tinued until approximately July 1, 2000, when
able to return to work. Manto had been em-       he received in disability payments.                Maldonado deleted Perez from all insurance
ployed at a car repair business located in       State v. Lisa Kuhn                                 coverage on the grounds that they had sepa-
Manasquan. He allegedly claimed that he was                                                         rated. Later, in September 2001, Maldonado
injured while working and began to collect          The court admitted Lisa Kuhn to the PTI         allegedly indicated that he was widowed.
temporary workers’ compensation benefits.        Program on December 5, 2005. Kuhn admit-
                                                 ted that she collected disability after becom-        The State alleges that Lionel Maldonado
He collected approximately $20,066 in tem-                                                          and Marisol Perez were never legally married,
porary workers’ compensation benefits from       ing pregnant. She also admitted that when
                                                 her temporary disability insurance claim ex-       and as a result, Marisol Perez was not entitled
the workers’ compensation carrier, New Jer-                                                         to any insurance coverage as the wife of
sey Manufacturers Insurance Company.             pired, she submitted fraudulent disability
                                                 claim forms to the Department of Labor on          Lionel Maldonado. During the time Lionel
   New Jersey Manufacturers terminated           four occasions to extend her legitimate dis-       Maldonado allegedly represented that Marisol
Manto’s temporary workers’ compensation          ability claim. The forms were fraudulent be-       Perez was his wife, the State Health Benefits
benefits and referred the case to OIFP for in-   cause she forged the name of her attending         Plan was administered variously by Blue Cross
vestigation and prosecution. OIFP’s investi-     physician.                                         Blue Shield of New Jersey, Aetna
gation revealed that during the period of time                                                      USHealthcare, Protective Dental Care
Manto claimed to be injured and not working,     State v. Michelle Cannin                           (OraCare), and the New Jersey Division of
he was allegedly working for a construction         A State Grand Jury returned an indictment       Pensions and Benefits. The companies paid
business owned by his brother.                   on December 14, 2005, charging Michelle            approximately $41,899 for health care and
State v. Michael Scherb                          Cannin with Insurance Fraud, theft by decep-       prescription coverage as the result of Lionel
                                                 tion, forgery, and unsworn falsification. Ac-      Maldonado’s alleged representation that
   The court sentenced Michael Scherb on         cording to the indictment, Cannin submitted        Marisol Perez was his wife.
September 9, 2005, to three years probation,     fraudulent insurance disability claim forms to
ordered him to pay $11,760 in restitution to                                                           Maldonado’s and Perez’s trials are sched-
                                                 the New Jersey Department of Labor. The            uled for early 2006.
Guard Insurance Group and a $3,000 civil in-     State alleges those forms indicated a physician
surance fraud fine. Scherb pled guilty to an     certified that Cannin was unable to work, was      State v. Bernard Gelman
accusation charging him with theft by decep-     disabled, and therefore entitled to collect dis-      Bernard Gelman pled guilty on December
tion and falsifying records. Scherb admitted     ability insurance payments. The State further      16, 2005, to an accusation charging him with
that between April 18, 2003 and January 27,      alleges that Cannin forged records in the name     theft by deception. Gelman admitted that he
2004, he committed theft of workers’ com-        of the physician to support her disability         caused the Director of Risk and Insurance
pensation benefits. Scherb admitted that he      claim. In total, it is alleged that Cannin com-    Management of an administrative services
advised the Guard Insurance Group, which         mitted Insurance Fraud by stealing approxi-        provider to change the date that his son left
provided workers’ compensation insurance,        mately $3,000 in disability claim benefits.        employment with the company. At the time
that he was injured and unable to work. As a                                                        of the fraud, Bernard Gelman was a senior
result, he collected approximately $11,760       Health Insurance Underwriting/
                                                                                                    executive with the corporation. Bernard
in workers’ compensation insurance ben-          Application Fraud                                  Gelman allegedly intentionally instructed the
efits. Scherb also admitted that during the      State v. Lionel Maldonado and Marisol Perez        company’s employees to alter the date of his
relevant time, he was able to work and was                                                          son’s resignation from the company so that he
employed by a tree trimming service. The            A State Grand Jury returned an indictment
                                                 on June 6, 2005, charging Lionel Maldonado         could obtain disability insurance coverage un-
Guard Insurance Group became suspicious                                                             der a new policy that went into effect after
of the claim and referred the matter to          and Marisol Perez with theft by deception
                                                 and falsifying records. According to the in-       his departure. Approximately $80,087 was
OIFP for investigation.                                                                             obtained from Prudential Insurance Company
                                                 dictment, Maldonado was employed by the
State v. Richard Serbin                          Camden County Department of Health in              as the result of Bernard Gelman’s fraud. He
   The court admitted Richard Serbin into        March 1990. During this time he allegedly          is scheduled to be sentenced in 2006.
the PTI Program on December 16, 2005,            falsified a “group enrollment application” list-   Life Insurance Fraud
conditioned upon his paying $170,744 in res-     ing “Marisol Maldonado” as his wife. As a de-
                                                                                                    State v. Michelle Kush
titution and a $50,000 civil insurance fraud     pendant wife, “Marisol Maldonado” would
fine. Serbin pled guilty to an accusation        have been entitled to health care benefits be-       The court sentenced Michelle Kush on June
charging him with falsifying records. Serbin     cause of Lionel Maldonado’s employment             24, 2005, to two years probation conditioned
was licensed as both a pharmacist and an at-     with Camden County.                                upon paying $5,184 in restitution. Kush pled
torney-at-law in New Jersey. Serbin admit-                                                          guilty to an accusation charging her with theft
                                                    Additionally, the State alleged that the
ted that a claim statement he submitted in                                                          by deception. Kush admitted she fraudulently
                                                 fraud continued when Maldonado was ap-
support of a disability claim to Reassure                                                           used her mother’s name to collect her father’s
                                                 pointed as a Camden County Probation Of-
America Life Insurance Company contained                                                            death benefits. Kush’s mother was the legal
                                                 ficer. The State alleged that Lionel
a false statement. He admitted the claim                                                            beneficiary of her father’s death benefits until
                                                 Maldonado identified Marisol Perez as his
statement falsely reported to Reassure                                                              the time of her death. Kush admitted that
                                                 wife when he enrolled her in family coverage

                                                                                                                                               118
OIFP Criminal Case Notes - Insurance Fraud



pursuant to a Power of Attorney, she alleg-        placed the newspaper on his front porch. In       erty damage claim to Germantown Insurance
edly endorsed and cashed the checks from           depositions and interrogatories submitted by      Company/The Philadelphia Contributionship
CIGNA Insurance Company payable to her             Scott as part of his lawsuit, he allegedly        Insurance Company for a damaged skylight.
deceased mother. The checks totaled $7,921.        falsely represented that he was injured picking   Sims had already been reimbursed by the in-
State v. Regina Woods                              up the newspaper.                                 surance company for the damage.
   The court sentenced Regina Woods on June           Although the Honorable Ronald Lee              State v. Richard Farber
10, 2005, to nine months in county jail to run     Reisner, J.S.C., of Monmouth County dis-             On November 17, 2005, Richard Farber
concurrent with a nine-month jail sentence         missed the lawsuit, the Asbury Park Press         pled guilty to an accusation charging him with
she was serving for other unrelated charges.       spent in excess of $10,000 defending Scott’s      theft by deception. Farber admitted that be-
Woods pled guilty to an accusation charging        fraudulent claim.                                 tween October 23, 2003 and November 5,
her with forgery. Woods admitted that she          Miscellaneous Medical-Related Fraud               2003, he submitted a false homeowners insur-
sent a forged and phony City of Plainfield                                                           ance claim to Philadelphia Contributionship
                                                   State v. Julianne O’Brien
marriage certificate to Life Investors Insur-                                                        Insurance Company alleging that a burglar
ance Company reflecting that she had been             The court sentenced Julianne O’Brien on        stole his plasma television, digital camera,
married to an individual who is now de-            April 1, 2005, to 18 months probation and         camcorder, notebook computer, and scanner.
ceased. She told the court that she did so in      ordered her to pay $369 in restitution.           Farber supported his claim with receipts
order to obtain the benefits of a hospital in-     O’Brien pled guilty to an accusation charging     showing purchases of the items, but Farber
come insurance policy that provided certain        her with obtaining controlled dangerous sub-      returned the items to the store for a refund.
benefits to a surviving spouse. Woods and the      stances. O’Brien admitted that while working      He is scheduled to be sentenced in early 2006.
decedent were never legally married. Life In-      for a dentist, she stole a pad of prescription
                                                                                                     State v. Linda Hayes
vestors Insurance Company of America               blanks to write prescriptions for Vicodin and
learned of the phony marriage certificate and      Vicoprofen. O’Brien admitted that she ob-            The court sentenced Linda Hayes on March
referred the case to OIFP for investigation        tained the controlled dangerous prescription      18, 2005, to three years probation and or-
and prosecution.                                   drugs Vicodin or Vicoprofen by filling the        dered her to pay a $5,000 civil insurance fraud
                                                   forged prescriptions at pharmacies located in     fine. Hayes pled guilty to falsifying records.
State v. Julieta Mangulabnan                                                                         Hayes admitted that she falsified certain re-
                                                   Barnegat. O’Brien’s health insurance com-
   The court admitted Julieta Mangulabnan          pany, Horizon Blue Cross Blue Shield, paid        ceipts to support a homeowners insurance
into the PTI Program on October 5, 2005.           approximately $368 for the drugs O’Brien ob-      claim she submitted to USAA Casualty Insur-
The State charged Mangulabnan by way of an         tained from the pharmacies using the forged       ance Company. Hayes allegedly submitted re-
accusation with attempted theft by deception.      prescriptions.                                    ceipts to USAA Insurance Company claiming
According to the accusation, Mangulabnan                                                             that certain property was stolen in a burglary.
                                                   State v. Gerald McGuigan
allegedly forged a fraudulent affidavit and                                                          Hayes admitted that she inflated some re-
medical certificate to Fidelity Security Life          OIFP investigators arrested Gerald            ceipts, and in other cases, the receipts were
Insurance Company in order to collect insur-       McGuigan on July 19, 2005, and charged him        entirely fictitious.
ance benefits for the death of her husband.        with Health Care Claims Fraud, theft by de-
                                                                                                        Additionally, Hayes allegedly submitted a
The Mangulabnans’ homeowners insurance             ception, obtaining controlled dangerous sub-
                                                                                                     fraudulent Evesham Township Police Depart-
policy issued by Fidelity contained benefits       stances by fraud, and forgery. The State al-
                                                                                                     ment Statement of Loss to USAA Insurance
for accidental death. Her husband died of          leges that McGuigan obtained fraudulent pre-
                                                                                                     Company, as well as a burglary report or theft
natural causes. Julieta allegedly submitted        scriptions for Oxycontin, a controlled danger-
                                                                                                     itemized statement of loss. USAA, suspect-
false documentation to Fidelity in support of      ous substance used primarily for treating
                                                                                                     ing fraud, questioned Hayes and referred the
her claim that he died of injuries suffered in a   chronic pain. The prescriptions were allegedly
                                                                                                     matter to OIFP for additional investigation
fall. Fidelity denied the claim and referred       filled at a local pharmacy and issued to him in
                                                                                                     and prosecution.
the matter to OIFP for investigation.              the name of his brother. Insurance claims
                                                   were then sent to his brother’s prescription      State v. David Feiner
Phony “Slip and Fall” Claims                       plan, Caremark, Inc., for payment. The inves-        The court admitted David Feiner into the
State v. Robert P. Scott                           tigation is continuing into more than $11,000     PTI Program on June 22, 2005, conditioned
   The court sentenced Robert P. Scott on          alleged fraudulent prescription claims submit-    upon his paying a $2,500 civil insurance fraud
July 22, 2005, to three years probation and        ted to insurance carriers.                        fine. Feiner was forced to find alternate
ordered him to pay $10,056 in restitution.                                                           housing following a flood in his home. He
Scott pled guilty to an accusation charging
                                                   PROPERTY AND                                      stayed at a hotel and his bills were paid by
him with perjury and falsifying records. Scott     CASUALTY FRAUD                                    High Point Insurance Company. Feiner alleg-
admitted that he filed a false “slip and fall”     False Homeowners Insurance Claims                 edly submitted a phony $438 hotel receipt for
law suit against the Asbury Park Press. In the                                                       a night he never stayed in the hotel.
lawsuit, Scott asserted that he allegedly          State v. Crystal Sims
                                                                                                     State v. Michael Oteri
slipped and fell as he attempted to retrieve a        The court admitted Crystal Sims into the
copy of the Asbury Park Press from his front       PTI Program on March 28, 2005, conditioned           A Camden County Grand Jury returned an
porch. He claimed the Asbury Park Press            upon her performing 75 hours of community         indictment on September 26, 2005, charging
newspaper delivery person “negligently”            service. Sims pled guilty to Insurance Fraud      Michael Oteri with forgery by uttering. Ac-
                                                   and admitted that she submitted a false prop-     cording to the indictment, Oteri allegedly pro-

119
vided a phony sales receipt to support his         State v. James Eifler                              leged that Siligato also submitted a $206,900
claim that certain items were stolen from his         James Eifler pled guilty on October 31,         claim to Farmers Mutual Insurance Company
home, including fishing rods and other prop-       2005, to Insurance Fraud and forgery. A State      for the contents of the building.
erty related to boating. The indictment fur-       Grand Jury returned an indictment charging            OIFP investigators arrested Gary Dixon on
ther alleges that the receipts he submitted        Eifler with Insurance Fraud, attempted theft       May 25, 2005, and charged him with perjury.
were phony.                                        by deception, and forgery. According to the        Prior to the date Siligato’s trial was originally
State v. Rita Farmer                               indictment, in November 2003, Eifler alleg-        scheduled to begin, Siligato offered Dixon’s
   Rita Farmer pled guilty on November 29,         edly submitted a claim for approximately           testimony in his defense. An OIFP investiga-
2005, to an accusation charging her with forg-     $6,017 to State Farm Insurance Company.            tion determined that Siligato allegedly threat-
ery. Farmer admitted that she submitted            Eifler alleged that someone stole certain          ened Dixon and his family to offer perjured
phony receipts to Hanover Insurance Com-           plumbing tools from a shed on his property.        testimony to exculpate him with respect to
pany to support her homeowners insurance           State Farm settled Eifler’s claim for approxi-     the building and contents insurance claims.
claim of water damage to her home. She is          mately $3,830. In February 2004, Eifler alleg-        Siligato also offered the testimony of Fran-
scheduled to be sentenced in 2006.                 edly submitted additional claim information        cisco Diaz. OIFP investigators arrested Diaz
                                                   to State Farm Insurance Company seeking an         on June 9, 2005, and he was also charged
State v. JoAnn Gallagher                           additional $6,000. In support of the second        with perjury. The State alleged that Siligato
   JoAnn Gallagher pled guilty on December         claim, Eifler allegedly submitted false receipts   coerced Diaz for perjured testimony.
13, 2005, to an accusation charging her with       reflecting the purchase of some of the
attempted theft by deception. Gallagher ad-        plumbing tools he sought reimbursement for            As part of the continuing investigation
mitted that she falsified a homeowners insur-      from State Farm Insurance Company. He is           and prosecution of Siligato, an arrest war-
ance claim with Allstate Insurance Company         scheduled to be sentenced in early 2006.           rant for terroristic threats was issued on July
by claiming that water damage in her base-                                                            21, 2005, for Michael Howell. The State al-
                                                   State v. Al Bernat and Lindsey Bernat              leges that Howell threatened the son of a
ment was caused by a broken washing ma-
chine hose. The damage was actually caused            The court admitted Al Bernat and Lindsey        cooperating witness who is expected to tes-
by heavy rain and poor drainage which was          Bernat into the PTI Program on April 25,           tify at Siligato’s trial.
not covered under her homeowners policy.           2005, conditioned upon their paying $3,489            A State Grand Jury returned an additional
She will be sentenced in 2006.                     in restitution and each performing 25 hours        indictment on August 29, 2005, charging
                                                   of community service. A Burlington County          Siligato with witness tampering.
Fraudulent Stolen/Damaged                          Grand Jury returned an indictment charging
Property Claims                                    Al Bernat and his wife, Lindsey Bernat, with       State v. Dave Bhavesh
State v. Jack DiCristofalo                         theft by deception. According to the indict-          The court admitted Dave Bhavesh into the
                                                   ment, the couple allegedly submitted a bur-        PTI Program on July 25, 2005, conditioned
   The court admitted Jack DiCristofalo into       glary insurance claim to an insurance company      upon his performing 50 hours of community
the PTI Program on February 16, 2005. The          indicating the theft of automobile repair          service. Bhavesh pled guilty to an accusation
State charged DiCristofalo with attempted          equipment including a scanner and a KV             charging him with attempted theft by decep-
theft by deception. DiCristofalo owned a se-       module that is used to diagnose engine             tion. Bhavesh, the owner and operator of
curity monitoring company known as IDS Se-         trouble. The State alleged that the equipment      The Gift Shop, allegedly submitted a property
curity. DiCristofalo admitted that he submit-      was not stolen, but was concealed by Bernat.       damage insurance claim to Selective Insurance
ted inflated and false invoices to Merchants       Bernat owned and operated A & F Auto Re-           Company when inventory at his shop sus-
Insurance Group for an insurance claim for         pair. The Ohio Casualty Insurance Company          tained water damage from a broken pipe.
repairs to his company’s computers, which          paid $12,516 for the Bernats’ burglary claim.      Bhavesh admitted that he submitted altered
had purportedly been damaged by lightning.         A portion of the claim money covered loss of       and fraudulent receipts to Selective to sup-
State v. David Guyton                              the scanner and the KV module.                     port his $17,000 property damage claim. Se-
   A State Grand Jury returned an indict-          State v. Samuel Siligato                           lective, suspecting fraud, denied the claim and
ment on July 20, 2005, charging David                                                                 referred the matter to OIFP for investigation.
                                                   State v. Gary Dixon
Guyton with attempted theft by deception.                                                             State v. Leona Darby
According to the indictment, between Octo-         State v. Francisco Diaz
                                                                                                         The court admitted Leona Darby into the
ber 13, 1999 and August 15, 2001, Guyton           State v. Michael Howell                            PTI Program on December 1, 2005, condi-
allegedly falsified receipts in order to inflate      A State Grand Jury charged Samuel Siligato      tioned upon paying a $3,500 civil insurance
a property insurance claim. Guyton allegedly       with theft by deception, attempted theft by        fraud fine. The State filed an accusation
submitted the approximate $7,004 claim to
                                                   deception, and conspiracy. According to the        charging her with Insurance Fraud. Darby al-
the New Jersey Insurance Underwriting As-          indictment, Siligato allegedly conspired to        legedly submitted a phony claim to Allstate
sociation for the loss of four gas ranges and      submit false insurance claims in connection        Insurance Company for the loss of her en-
four refrigerators that resulted from a fire at
                                                   with a suspicious arson fire at a commercial       gagement ring. An OIFP investigation re-
an apartment building located at 22                building he owned in Hammonton. First              vealed that Darby had previously submitted a
Goodwin Avenue in Newark. The State al-            Trenton Insurance Company paid a $15,000           claim and was paid $4,250 by New Jersey
leges Guyton falsified a number of records in
                                                   insurance claim for the building’s contents and    Manufacturers Insurance Company for the
support of the claim.                              $165,000 for the building itself. The State al-    loss of the same engagement ring.

                                                                                                                                                  120
OIFP Criminal Case Notes - Insurance Fraud



State v. Spiros Martini                           A Burlington County Grand Jury returned an         the phony Certificate of Insurance to the
   A State Grand Jury returned an indict-         indictment charging him with forgery. Ac-          management and mortgage holder of an
ment on October 19, 2005, charging Spiros         cording to the indictment, Hamilton operated       apartment building located in West Orange.
Martini with attempted theft by deception         a business known as TreeFellers, Inc. He al-       State v. William Scanlan
and forgery. According to the indictment,         legedly presented a phony Penn Mutual/
                                                  Harleysville Insurance Company insurance en-          The court admitted William Scanlan into the
between September 11, 2002 and April 30,                                                             PTI Program on September 22, 2005. A State
2003, Martini allegedly falsified certain         dorsement declaration page to a customer on
                                                  whose property he was removing a tree.             Grand Jury returned an indictment charging
documents in connection with a commercial                                                            Scanlan with forgery. The State alleged that
business fire loss insurance claim in order to    State v. Scott Rosanio                             William Scanlan, a contractor doing business as
inflate the claim submitted to Franklin Mu-           The court admitted Scott Rosanio into the      William C. Scanlan, Jr., and Son, issued a
tual Insurance Company.                           PTI Program on May 9, 2005, conditioned            phony Zurich Insurance Company Certificate
   Martini owned commercial property con-         upon his performing 50 hours of community          of Liability Insurance. The State alleged that
taining a computer business and a rubber busi-    service. Rosanio was terminated from the           Scanlan issued the phony Certificate of Insur-
ness in South Amboy. After property was           program on November 14, 2005. He pled              ance to a construction company to become a
damaged by fire, and during the course of ad-     guilty on the same day to forgery and will be      subcontractor for the company. The State also
justing a commercial fire damage claim, the       sentenced in early 2006.                           alleged that the phony Certificate of Insurance
State alleges that Martini falsified an amend-        An Ocean County Grand Jury returned an         represented that William C. Scanlan, Jr., and
ment to a lease indicating that he was due to     indictment charging Rosanio with forgery.          Son were insured by Zurich Insurance Com-
be reimbursed property taxes from tenants at      According to the indictment, Rosanio was a         pany for auto and general liability, but not for
the commercial site. The State also alleges       home repair contractor doing business as Cre-      workers’ compensation and excess liability.
that Martini falsified these documents in or-     ative Construction. He allegedly forged a Cer-     State v. Todd Cifrodelli
der to wrongfully inflate the total amount of     tificate of Liability Insurance. The Certificate
the insurance claim sought from Franklin Mu-                                                            The court admitted Todd Cifrodelli into the
                                                  of Insurance purported that Mercer Mutual          PTI Program on September 7, 2005, condi-
tual Insurance Company.                           Insurance Company insured Rosanio’s con-           tioned upon his performing 60 hours of com-
State v. Soena Sahni                              tracting business for liability. OIFP’s investi-   munity service. An accusation was filed
   Soena Sahni pled guilty on December 12,        gation revealed that Rosanio forged the Cer-       charging Cifrodelli, who operated Chief Con-
2005, to an accusation charging her with          tificate of Insurance.                             tracting, with forgery. Cifrodelli allegedly
Insurance Fraud. Sahni admitted that be-          State v. Wayne Kellum                              submitted a phony Travelers Insurance Com-
tween March 13, 2004 and August 31,                  The court admitted Wayne Kellum into the        pany Certificate of Insurance to a construc-
2004, she submitted altered and fraudulent        PTI Program on February 7, 2005, following         tion company for subcontracting work.
receipts to The Hartford Insurance Com-           his guilty plea to forgery. A State Grand Jury     State v. William Van’t Veer
pany to support her claim that rented com-        returned an indictment charging Kellum with
puter equipment was stolen from her place                                                                A Somerset County Grand Jury returned an
                                                  forgery. According to the indictment, Kellum       indictment on May 19, 2005, charging Will-
of business during a burglary. She is sched-      owned and operated WK Trucking, a subcon-
uled to be sentenced in 2006.                                                                        iam Van’t Veer with forgery. Van’t Veer, a
                                                  tractor. Kellum allegedly presented a fraudu-      construction contractor, allegedly submitted a
Phony Certificates of Insurance                   lent Certificate of Insurance to a general con-    phony Ohio Casualty Insurance Company Cer-
                                                  tractor. Frequently, subcontractors have to        tificate of Insurance to obtain work at a
State v. Robert Huber
                                                  prove they have the appropriate insurance          bank. Van’t Veer failed to appear at his ar-
   Robert Huber pled guilty to forgery, and       when working for general contractors. The          raignment on August 5, 2005. The court is-
on March 4, 2005, the court sentenced him         State alleged that the fraudulent Certificate      sued a bench warrant for his arrest.
to two years probation. A Hunterdon County        of Insurance falsely indicated WK Trucking
Grand Jury returned an indictment charging        had general liability and automobile insurance     State v. Rueben Stewart
Huber with forgery. According to the indict-      from Selective Insurance Company.                      Ruben Stewart pled guilty on March 31,
ment, on or about July 28, 2003, Huber al-                                                           2005, to forgery. An Atlantic County Grand
                                                  State v. Nicholas Barbella
legedly committed forgery by providing a                                                             Jury returned an indictment charging Stewart
phony Certificate of Insurance in connection         Nicholas Barbella pled guilty to forgery, and   with forgery. According to the indictment,
with the lease of rental property. Landlords      on May 6, 2005, the court sentenced him to         Stewart allegedly issued an altered Certificate
sometimes require persons to offer proof of       two years probation conditioned upon his           of Insurance to an environmental manage-
insurance before they rent property. The          paying a $5,000 criminal fine and performing       ment company in New York. An insurance
State alleged that Huber forged a Certificate     75 hours of community service. An Essex            agency in Toms River properly issued the Cer-
of Insurance that allegedly indicated insur-      County Grand Jury returned an indictment           tificate of Insurance, but Stewart allegedly
ance was provided to Huber by Selective In-       charging Barbella with forgery. According to       altered it to show that he had insurance cov-
surance Company.                                  the indictment, Barbella, a roofing contractor     erage provided by Ohio Casualty Insurance
                                                  who did business as Dr. Frank-n-Stein, Inc.,       Company, which was no longer represented by
State v. Matthew Hamilton
                                                  allegedly issued a phony Cumberland Mutual         the insurance agency. The court issued a bench
   The court sentenced Matthew Hamilton on        Fire Insurance Company Certificate of Insur-       warrant for Stewart’s arrest on May 13, 2005,
April 25, 2005, to one year probation follow-     ance. The State alleged that Barbella issued       when he failed to appear for sentencing.
ing his guilty plea to forgery on the same day.
121
State v. Anthony J. Phillips, Jr.                 ery. Belisonzi, owner of a catering business     State v. Lola Ruth Byrd
   A State Grand Jury returned an indictment      known as the Mason Jar, admitted that he           The court sentenced Lola Ruth Byrd on
on October 19, 2005, charging Anthony J.          provided a phony Eastern Insurors, LLC,          September 2, 2005, to three years probation
Phillips, Jr., with forgery. According to the     Certificate of Insurance to a business for       conditioned upon her serving 220 days in
indictment, Phillips, a contractor and the        which he was contracted to provide catering      county jail. The court also ordered her to pay
owner of ACP General Contracting, had con-        services. Belisonzi is scheduled to be sen-      $2,500 restitution and to sign a $19,374
tracted to do work for a maintenance services     tenced in 2006.                                  Consent Judgment. Byrd pled guilty to theft
company. The State alleged that Phillips sub-     State v. Philip Boccadoro                        by deception.
mitted a phony Barclay Group Certificate of          The court admitted Philip Boccadoro into         A State Grand Jury returned an indictment
Liability Insurance to the company. The court     the PTI Program on December 19, 2005, con-       charging Byrd with theft by deception. Ac-
issued a bench warrant for Phillips’ arrest af-   ditioned upon his performing 50 hours of         cording to the indictment, Byrd allegedly used
ter he failed to appear for his arraignment on    community service. Boccadoro pled guilty on      her position at State Farm Insurance to gener-
December 5, 2005.                                 the same day to an accusation charging him       ate ten State Farm Insurance drafts payable to
State v. Thomas Schnepp                           with forgery. Boccadoro, the owner of PMB        another individual. The State alleged that
   The court admitted Thomas Schnepp into         Asphalt Construction, Inc., allegedly provided   Byrd used closed insurance claims files and
the PTI Program on September 15, 2005. An         a phony Hartford Certificate of Insurance on     generated insurance claims checks as if the
accusation was filed charging Schnepp with        two occasions to businesses for which            individual had sustained property losses and
forgery. The State alleged that Schnepp issued    Boccadoro contracted to do paving work.          was entitled to insurance claim money. The
a phony Certificate of Liability Insurance on     State v. Joseph Fleres                           individual had no connection to any of the
behalf of Lincoln General Insurance Com-                                                           old property loss files that Byrd allegedly used
                                                     A Bergen County Grand Jury returned an        to create the fictitious claims checks. State
pany to a company.                                indictment on December 7, 2005, charging         Farm became aware of the fraud when Byrd
State v. Dariusz (Darek) Krzak                    Joseph Fleres with forgery. According to the     allegedly attempted to cash the fraudulent
   The court admitted Dariusz Krzak into the      indictment, Fleres, the owner of Fleres Con-     claims checks. It then conducted an internal
PTI Program on December 6, 2005, condi-           struction, allegedly provided a forged           investigation, contacted OIFP, and fully co-
tioned upon his performing 50 hours of com-       Scottsdale Insurance Co. Certificate of Insur-   operated with the criminal investigation.
munity service. A Mercer County Grand Jury        ance to a business for which Fleres was con-
                                                  tracted to do construction work.                 State v. Umberto Mazzone
returned an indictment charging Krzak with
forgery. According to the indictment, Krzak,                                                          The court admitted Umberto Mazzone
while doing subcontracting work for a roofing
                                                  INSURANCE PROFESSIONAL                           into the PTI Program on May 13, 2005, con-
contractor, allegedly presented a phony Selec-    FRAUD                                            ditioned upon his paying $7,252 in restitu-
tive Insurance Company Certificate of Work-                                                        tion to Preserver Group. Mazzone pled
                                                  Insurance Carrier Employee Fraud                 guilty to an accusation charging him with
ers’ Compensation Insurance to the company.
                                                  State v. Linda Clements-Wright                   theft by deception. Mazzone, a claims ad-
State v. Art Gallagher                                                                             juster for Preserver Group, Inc., admitted
                                                     The court sentenced Linda Clements-
   Art Gallagher pled guilty to an accusation     Wright on March 4, 2005, to seven years in       that he stole two Preserver Group insurance
on October 7, 2005, charging him with             state prison, and ordered her to pay a $40,000   claims checks totaling $7,252, by wrongfully
forgery. Gallagher allegedly provided a           criminal fine and restitution in the amount      endorsing them and depositing them into his
phony Atlantic Insurance Services Certifi-        of $74,999.                                      personal bank account. The checks were
cate of Insurance to a contractor for whom                                                         made payable to two legitimate Preserver
he was doing sub-contracting work.                   Following a three-week trial, a jury con-     Group insurance claimants.
Gallagher is the owner and operator of            victed Clements-Wright of conspiracy, theft
                                                  by unlawful taking, and money laundering. A      State v. Bruce Baez and Eddie Perez
Tower Building Contractors. He is sched-
uled to be sentenced in 2006.                     State Grand Jury charged Clements-Wright, an        Bruce Baez pled guilty to theft by decep-
                                                  Allstate Insurance Company Insurance Claims      tion. Baez failed to appear at his sentencing,
State v. Michael Fernandez                        Process Specialist, with conspiracy, theft by    and on August 14, 2005, he was arrested on a
   Michael Fernandez pled guilty on Decem-        unlawful taking, and money laundering.           bench warrant. The court sentenced him on
ber 12, 2005, to an accusation charging him       Clements-Wright worked out of Mount Lau-         September 16, 2005, to four years state prison
with forgery. Fernandez, the owner/operator       rel and Moorestown. According to the indict-     and ordered him to pay $435 in restitution.
of Michael’s Carpentry & Construction, ad-        ment, Clements-Wright issued approximately       Eddie Perez pled guilty to conspiracy to com-
mitted that he provided a phony York-Jersey       150 Allstate insurance claim checks totaling     mit theft by deception. The court sentenced
Underwriters, Inc., Certificate of Insurance      approximately $614,344 to 11 persons with        him on June 17, 2005, to two years probation
to a person at whose home Fernandez was           whom she was acquainted, but who were not        and ordered him to pay $870 in restitution.
contracted to do work. Fernandez is sched-        entitled to the insurance claim money. It was       A State Grand Jury returned an indict-
uled to be sentenced in 2006.                     alleged that Clements-Wright conspired with      ment charging Baez and Perez with con-
                                                  her acquaintances to cash the checks, keep 10    spiracy and theft by deception. The State
State v. Robert Belisonzi
                                                  percent of the proceeds, and return the bal-     also charged Baez with uttering a forged
  An accusation was filed on December 7,          ance of the proceeds to her.                     document. According to the indictment,
2005, charging Robert Belisonzi with forg-

                                                                                                                                              122
OIFP Criminal Case Notes - Insurance Fraud



Perez and Baez allegedly conspired to steal      ance at a much lower rate. The State further      tution: $3,746,524 to Wasaw Insurance;
six disability checks issued by New Jersey       alleges that Brown accepted approximately         $6,320,056 to AIG Insurance Company; $15.8
Manufacturers Insurance Company to an in-        $3,600 in insurance premium money and is-         million to Virginia Surety; $4.9 million to XL
dividual who died in March 2000. The dece-       sued fraudulent Chubb Insurance Company           Insurance Company; and $48,069,678 to
dent had been receiving insurance disability     and First Trenton Indemnity Company docu-         Kemper Insurance Company. The court also
checks pursuant to a workers’ compensation       ments, including policy binders. The State        permanently revoked Gruppuso’s insurance
insurance policy from New Jersey Manufac-        also alleges that Brown stole the premium         agent’s license.
turers Insurance Company. New Jersey             money and left the insurance customers               Gruppuso pled guilty to an accusation
Manufacturers, unaware that the individual       without valid automobile insurance. Brown         charging him with theft by failure to make re-
had died, continued to send checks to his        was allegedly neither licensed nor authorized     quired disposition of property received.
Millville home. The State alleged the defen-     to sell insurance or accept premiums as a li-     OIFP investigators arrested Gruppuso, a li-
dants forged and cashed the disability checks.   censed insurance agent.                           censed insurance agent, and charged him with
State v. Sharonda Ross, Ivery Ross, and          Persons Licensed by Department of                 three counts of theft by failure to make re-
Michelle Patterson                               Banking and Insurance: Insurance                  quired disposition of insurance premiums ob-
   A State Grand Jury returned an indictment     Agents, Real Estate Agents                        tained from various insurance customers. The
charging Sharonda Ross, her husband Ivery                                                          State alleged that Gruppuso wrongfully en-
                                                 State v. Robert Stone                             gaged in insurance premium financing transac-
Ross, and Ross’s sister-in-law, Michelle
Patterson, with conspiracy and theft by de-         The court sentenced Robert Stone on Feb-       tions and that he embezzled insurance premi-
ception. Ivery Ross was also charged with        ruary 10, 2005, to two years probation with       ums entrusted to him by insureds.
theft of identity. According to the indict-      the condition that he pay $21,702 in restitu-     State v. Melvin Smith
ment, between October 8, 2002 and April 16,      tion and perform 80 hours of community
                                                 service. Stone pled guilty to a State Grand          An Essex County Grand Jury returned an
2003, Sharonda Ross, who was employed as a                                                         indictment on July 27, 2005, charging Melvin
Treasury Operations Associate for Prudential     Jury indictment charging him with failure to
                                                 make required disposition of property re-         Smith with theft by failure to make required
Insurance Company, allegedly conspired with                                                        disposition. According to the indictment,
Ivery Ross and Michelle Patterson to steal       ceived. Stone, a licensed insurance agent,
                                                 was the owner/operator of Stone Insurance         Smith, a licensed insurance agent, allegedly
nearly $50,000 from Prudential. The State                                                          failed to remit a $2,759 insurance premium
alleged that Sharonda Ross diverted insurance    Company. According to the indictment,
                                                 Stone allegedly stole approximately $22,585.      check payable to North American Company
company checks to Ivery Ross and Michelle                                                          for Life and Health Insurance on behalf of an
Patterson by using the identification codes of   The State alleged that Stone obtained pre-
                                                 mium money from insurance customers or            insurance purchaser. The State also alleges
other Prudential employees to issue the                                                            that Smith deposited the check into his own
checks. The State alleged that the conspiracy    from the Standard Funding Corporation
                                                 (SFC), a company that was in the business         personal bank account. Smith failed to ap-
netted the defendants approximately $49,889,                                                       pear at his pre-arraignment on August 22,
and a total of approximately 18 checks were      of lending insurance premium money to per-
                                                 sons who needed to borrow money to buy            2005, and the court issued a bench warrant
wrongfully diverted in this manner.                                                                for his arrest.
                                                 insurance policies. The State further alleged
   Sharonda Ross pled guilty to theft by de-     that Stone stole the money and used it for        State v. Joseph Birnie and Michael Delisi
ception, and the court admitted her into the     his own benefit.
PTI Program on October 17, 2005, condi-                                                                Joseph Birnie pled guilty to theft by failure
tioned upon her paying $22,259 in restitu-       State v. Erica Nanne                              to make required disposition of property re-
tion to Prudential Insurance Company. Ivery         The court admitted Erica Nanne into the        ceived. The court sentenced him on Decem-
Ross also pled guilty to theft by deception      PTI Program on April 22, 2005, conditioned        ber 16, 2005, to three years probation, condi-
and theft of identity. The court sentenced       upon her paying $4,863 in restitution and per-    tioned upon his serving 270 days in county
him on December 2, 2005, to three years          forming 50 hours of community service. A          jail, and ordered him to pay $145,870 in resti-
probation and ordered him to pay $22,258 in      Somerset County Grand Jury charged Nanne          tution. Michael Delisi also pled guilty to theft
restitution to Prudential Insurance Company.     with theft by failure to make required disposi-   by failure to make required disposition of
Patterson failed to appear at her arraignment    tion. According to the indictment, Nanne al-      property received. The court sentenced him
on July 27, 2005. The court issued a bench       legedly stole approximately $4,863 in insur-      on December 16, 2005, to one year probation
warrant for her arrest.                          ance premiums from insurance customers who        and ordered him to pay $10,000 in restitution,
                                                 had given her the money to purchase insur-        and to surrender his public adjuster’s license.
State v. Lisa Brown
                                                 ance. The State alleges that Nanne used the          A State Grand Jury returned an indict-
   A Union County Grand Jury returned an         money for her personal benefit. The Mondaro       ment charging Birnie and Delisi with con-
indictment on November 2, 2005, charging         Agency in Hillsborough employed Nanne as a        spiracy and theft by failure to make required
Lisa Brown with theft by deception. Ac-          licensed insurance agent.                         disposition of property received. The State
cording to the indictment, between Novem-                                                          also charged Birnie with a separate count of
ber 12, 2001 and February 20, 2002, Brown,       State v. Vito Gruppuso
                                                                                                   theft by failure to make required disposition
who was employed as a claims service repre-        The court sentenced Vito Gruppuso on            of property received. According to the in-
sentative by Fleet Insurance Services in         September 23, 2005, to ten years state prison,    dictment, Birnie allegedly received residential
Cranford, allegedly stole insurance premium      ordered him to pay a $225,000 criminal fine,      insurance property damage claim money
money from three insurance customers with        and ordered him to pay the following in resti-    from insureds who suffered either fire losses
the promise that she could obtain auto insur-
123
or who were building modular homes. He            securities dealer selling investments for a com-   ties owned, operated, and controlled by
allegedly stole the money and used it for his     pany known as American Skandia. Prudential         Nardone. The State alleged that Nardone and
own purposes. The State alleged that Birnie       Insurance Company later purchased American         Januik created three fictitious employees.
did very little or no work for the insureds,      Skandia. The State alleged that Chamberlain        Nardone and Januik allegedly issued at least
but he retained all the insurance claim and       stole $300,000 from a 78-year-old victim by        144 corporate checks exceeding $400,000 to
other money. The State alleged in a separate      forging documents related to three annuity         the fictitious employees. According to the in-
count of the indictment that Birnie con-          accounts in connection with the American           dictment, Nardone then allegedly instructed
spired with co-defendant Delisi, a licensed       Skandia/Prudential company. The Prudential         an employee to endorse and cash the checks at
public insurance adjuster who did business as     Insurance Company reported the matter to           an unlicensed check cashing business in
Anton Adjustment, Inc., and a building con-       OIFP for further investigation. At OIFP’s re-      Irvington. The employee allegedly returned
tractor. The State alleged in the indictment      quest, Florida’s Marion County Sheriff ’s De-      the cash to Nardone. Additionally, the State
that Birnie and Delisi obtained insurance         partment assisted in the arrest of Michael         alleged that Nardone and Januik utilized cor-
claim money from an insured for restoration       Chamberlain. OIFP extradited Chamberlain           porate accounts to pay for more than
of a home damaged by fire. They allegedly         from Florida to New Jersey in 2004.                $180,000 in personal expenses without re-
stole over $185,000 from the insureds and                                                            porting the funds as income.
used the money for their own purposes.            MISCELLANEOUS INSURANCE                               The investigation identified the location of
State v. Rodger Strandskov                        FRAUD                                              Nardone’s chiropractic office as 150 Main St.,
    On October 7, 2005, Rodger Strandskov         Insurance-Related Tax Cases                        Orange, Essex County. Nardone’s related
pled guilty to an accusation charging him                                                            businesses are identified as: Professional
                                                  State v. Richard Nardone and Donna M. Januik       Medical Technologies, Inc. (PMT), located in
with theft by failure to make required dispo-
sition of property received. Strandskov,             The court sentenced Richard Nardone on          Mountainside, Union County; Camino Reha-
who was the president of Eastern Insurance        June 17, 2005, to 30 months probation and          bilitation, Inc., located in Springfield, Union
Agency which operated in Kendall Park, ad-        ordered him to pay restitution in an amount        County; Hermosa Medical Services, Inc., lo-
mitted that he committed theft in two dif-        to be determined by the court. Nardone             cated in Mountainside; Advanced Diagnostic,
ferent ways.                                      pled guilty to filing false and fraudulent New     Inc., located in Roselle Park, Union County;
                                                  Jersey Income Tax returns, failure to pay          and Medical Diagnostic, Inc., located in
   Strandskov admitted that he did not remit      New Jersey Gross Income Tax with intent to         Mountainside. The State alleged that Januik
premium finance money to insurance compa-         evade, and misconduct by a corporate offi-         also operated a billing and collection agency
nies to pay for insurance policies sold through   cial. The court sentenced Donna M. Januik          known as ZNS Billing.
his agency. The premium finance money was         on the same date to 30 months probation.
provided by AMGRO Premium Financing.                                                                    During the course of the investigation,
                                                  Januik pled guilty to filing false and fraudu-     OIFP and Division of Taxation investiga-
Insurance premium financing occurs when an        lent New Jersey Income Tax returns, and
insurance customer, in this case commercial                                                          tors seized financial books and records re-
                                                  failure to pay New Jersey Gross Income Tax         lating to the case. Shortly thereafter, the
trucking companies, borrow money from a           with intent to evade.
lender to purchase the required commercial                                                           chiropractic practice and the related busi-
trucking insurance. Strandskov admitted              A State Grand Jury returned an 18-count         nesses ceased operations.
that, in some cases, he stole borrowed insur-     indictment charging Richard Nardone and his        State v. Paul LoPapa
ance premium financing money and used it for      sister, Donna M. Januik. Nardone, a New
                                                  Jersey licensed chiropractor, was charged with        The court sentenced Paul LoPapa on No-
his own purposes. Additionally, Strandskov                                                           vember 17, 2005, to five years probation
admitted that he did not return borrowed in-      conspiracy, filing false and fraudulent New
                                                  Jersey Income Tax returns, filing false and        with credit for 507 days served in the county
surance premium financing money for certain                                                          jail. Consent Judgments were entered in fa-
insurance policies that terminated earlier than   fraudulent New Jersey Corporate Tax returns,
                                                  failure to pay New Jersey Gross Income Tax         vor of the following: $3.35 million to FSB
the anticipated end date of the insurance cov-                                                       Mortgage of Little Rock, AR; $9,248 to
erage for approximately 14 insurance custom-      with intent to evade, and misconduct by a
                                                  corporate official. Januik was charged with        Alphonse Stoia; $20,000 to David Dubrow;
ers. Strandskov admitted that he stole ap-                                                           $35,000 to XOZ Entertainment, S.A./Tyco
proximately $474,289 from or due to               conspiracy, filing false and fraudulent New
                                                  Jersey Income Tax returns, filing false and        Capital Ltd; and $20,000 to Patrick Pereira.
AMGRO Premium Financing.                                                                             LoPapa pled guilty to an indictment and a
                                                  fraudulent New Jersey Corporate Tax returns,
   Strandskov is scheduled to be sentenced in     and failure to pay New Jersey Gross Income         separate accusation charging him with theft
early 2006.                                       Tax with intent to evade.                          by deception, attempted theft by deception,
State v. Michael Chamberlain                                                                         falsifying records, and forgery.
                                                     According to the State Grand Jury indict-
   Michael Chamberlain pled guilty on De-         ment, between January 1, 1998 and May 31,             LoPapa admitted that between November
cember 5, 2005, to theft by unlawful taking.      1999, Nardone and Januik, in order to avoid        1, 1995 and February 1, 1996, through his
He is scheduled to be sentenced in 2006.          paying New Jersey corporate business and in-       real estate partnership known as Castle Rock
                                                  come taxes, allegedly transferred and with-        Real Estate, he purchased residential real es-
   A State Grand Jury returned an indictment                                                         tate located in Saddle River, Bergen County.
                                                  drew large sums of money from Nardone’s
charging Chamberlain with theft by unlawful                                                          A mansion and a guest house are located on
                                                  chiropractic business and from related medical
taking, forgery, and misapplication of en-                                                           the property. LoPapa allegedly funded the
                                                  treatment, diagnostic, or rehabilitation facili-
trusted property. Chamberlain was a licensed                                                         purchase of the real estate by representing

                                                                                                                                               124
OIFP Criminal Case Notes - Insurance Fraud



that a fictitious person was willing to buy        ery, falsifying records, and false swearing for    duct, Phillips was charged with and pled
the real estate from LoPapa for $4.9 million.      allegedly notarizing the signature of the ficti-   guilty to acting as a real property title agent
LoPapa admitted that he created the false          tious individual on a deed in connection with      and misappropriating approximately $98,468,
impression that the fictitious person gave         the Saddle River real estate fraud. The court      which was earmarked to retire a mortgage.
LoPapa $1 million cash and a promissory            sentenced him to three years probation on          State v. Monserrat Rodriguez
note for $3.9 million to buy the Saddle River      October 1, 1999, and it ordered him to pay
property. LoPapa allegedly used the ficti-         $30,000 in criminal fines.                           Monserrat Rodriguez pled guilty to an ac-
tious person’s worthless promissory note and                                                          cusation on November 17, 2005, charging
                                                   Miscellaneous OIFP Investigations                  her with issuing bad checks. Rodriguez ad-
the purported $1 million cash to induce a
mortgage lender to agree to advance the            State v. E. Nkem Odinkemere                        mitted that between April 26, 2005 and
funds needed to purchase the property.                                                                May 14, 2005, she allegedly wrote approxi-
                                                      A State Grand Jury returned an indictment
LoPapa also admitted that he later trans-                                                             mately 39 checks totaling $7,803. The
                                                   on August 8, 2005, charging E. Nkem
ferred the worthless promissory note to the                                                           checks were allegedly drawn on a bank ac-
                                                   Odinkemere with misapplication of entrusted
mortgage lender for $3.35 million to finance                                                          count of High Point Insurance Company.
                                                   property. The State alleges that on September
and to acquire the Saddle River property.                                                             Rodriguez allegedly knew the bank would
                                                   1, 2000 and thereafter, Odinkemere, a li-
The mortgage lender in turn, sold the worth-                                                          not honor the checks. She is scheduled to
                                                   censed New Jersey attorney, misapplied
less note through the banking system to FSB                                                           be sentenced in 2006.
                                                   money received from a client in connection
Mortgage of Little Rock, AR. Immediately           with a real estate transaction, and he used the
after the bogus transaction, LoPapa allegedly      money for his own benefit. His case is pend-
transferred the property to his company,           ing trial in 2006.
Castle Rock Real Estate, Inc.
                                                   Miscellaneous Theft/Attempted Theft
   LoPapa also admitted that between April
17, 1996 and January 7, 1997, he falsely in-       State v. Mercedes Lastra
flated a homeowners contents insurance claim          OIFP investigators arrested Mercedes
in the amount of $33,400. LoPapa allegedly         Lastra on March 11, 2005, and charged her
submitted the inflated claim to the Great          with theft by unlawful taking. Lastra was a
Northern Insurance Company alleging that           licensed bail bond agent who was charged
water from a leaky roof damaged valuable           with theft of approximately $60,000 from
artwork located at the Saddle River home.          her employer, a bail bond company. The
The artwork allegedly never existed.               owner of the company reported to the Eliza-
   LoPapa also allegedly falsified a receipt for   beth Police Department that Lastra allegedly
a fictitious Certificate of Deposit that was       stole bail bonds from a company safe and
purportedly given to Castle Rock Real Estate,      posted the bail bonds on behalf of various
Inc., in order to deceive an attorney about the    persons who were charged with criminal of-
financial position of Castle Rock Real Estate,     fenses. In return for posting the bail bonds
Inc. Similarly, LoPapa admitted that he            for the persons charged with criminal of-
forged two letters and two affidavits purport-     fenses, Lastra allegedly received money, and
edly issued by an attorney in order to deceive     instead of turning the money over to the bail
the credit agency about LoPapa’s and Castle        bond company, she kept the money for her
Rock Real Estate’s financial conditions.           own purposes. The State alleges that between
                                                   September 24, 2004 and January 26, 2005,
   Finally, LoPapa pled guilty to a separate ac-   Lastra posted 15 stolen bail bonds and re-
cusation and admitted that between April 20,       tained the money for the bail bonds.
2000 and August 2, 2000, he stole mortgage
loan application fees in the total approximate        OIFP is continuing the investigation into
amount of $85,000 from four victims.               this matter.
LoPapa admitted that he falsely represented        Jay Phillips, Inc./John A. Phillips
he was a real estate investor and mortgage           The court sentenced John A. Phillips on
broker representing the Citadel Group of           December 21, 2005, in United States District
Companies in order to induce persons looking       Court to three years in prison followed by five
for real estate loans to pay over to him mort-     years probation. It also ordered him to pay
gage application fees. LoPapa allegedly stole      $4,278,055 in restitution.
mortgage application fees, and provided no
mortgage loan money for all four victims.             Following an investigation by OIFP, and in
                                                   coordination with the United States
  OIFP previously filed other criminal             Attorney’s Office, the United States Attor-
charges in connection with this investigation.     neys previously filed a Federal Information
Attorney Salvatore DeLello was charged on          charging John A. Phillips with conduct related
August 10, 1999, with criminal bribery, forg-      to wire fraud. Among other fraudulent con-

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