Fraud

S. Fla. agent sold ‘bogus’ policies
The license of South Florida insurance agent, Gordon Arthur Esses of Aventura, Fla. has had his license revoked for selling “bogus” policies.
According to Tom Gallagher, Florida CFO, the agent has been banned from writing business in Florida.
“A licensed insurance agent should know whether the product he or she is selling is illegal or properly licensed,” Gallagher said.
Florida’s CFO warned that, “although a majority of agents are not marketing unlicensed plans, unscrupulous agents that areselling bogus coverage or policies will be held accountable.”
Esses represented N.A.P.T., an unlicensed entity that sold bogus health insurance policies to thousands of Floridians and subsequently left many with unpaid claims, according to Gallagher. Claims from unlicensed entities are not eligible to be paid from the state guaranty fund which covers the claims of authorized insurers that become insolvent. The former organizer of N.A.P.T., David A. Weinstein, was sentenced to probation for three years, ordered to pay more than $600,000 in restitution and costs, and banned from participating in banking and insurance industry activities in Florida.

Man accused of defrauding TennCare
A man was indicted in Winchester, Tenn. on charges of allegedly impersonating a doctor and defrauding insurance companies for six years while working in his father’s practice.
Dennis Charles “Chuck” Arellano was indicted May 1 on one count of theft over $60,000, one count of TennCare fraud, and one count of impersonation of a licensed professional, according to a release from the Tennessee Bureau of Investigation.
Arellano graduated from medical school but did not pass examinations to get his license to practice before working at the Huntsville practice belonging to his father, Dr. Bernard Arellano.
Witnesses told TBI and TennCare investigators that the younger Arellano often worked by himself, caring for and diagnosing patients from 1998 to 2004.
The practice closed in 2004 and his father died in 2005.
Investigators found that during the six years Arellano saw patients, the practice collected more than $1 million from TennCare and private insurance companies, the TBI said.

Ga. agents kept premiums
Arrest warrants have been issued for two Gainesville, Ga. insurance agents, both of whom are charged with insurance fraud.
Robert Frank Kubitz, 51, allegedly kept premiums paid to his business, R.F. Kubitz Agency, for coverages including auto liability, workers’ compensation, professional liability and general liability.
Kubitz’ clients reportedly had no coverage because he kept their premiums, totaling approximately $36,000, instead of turning the money over to the contracted insurance companies.
Alan Franklin Carter, 53, also allegedly kept premiums paid by customers who thought they were paying for auto and homeowners coverage. So far, Georgia officals said, 20 witnesses have come forward; their combined losses total approximately $20,000. Carter was also allegedly selling insurance through Carter Insurance Agency without a valid agent’s license.