Fraud Roundup
2 North Carolina Residents Accused of Insurance Fraud in Multiple Counties
North Carolina Insurance Commissioner Wayne Goodwin announced the arrests of Pamela Christine Liles, 31, and Travis Paul Randolph, 30, of Siloam.
Department of Insurance criminal investigators accuse Liles of insurance fraud in three counties, and Randolph of insurance fraud in two counties, as a result of an investigation into three separate insurance claims filed between 2009 and 2014.
Liles was charged in Surry County with insurance fraud and obtaining property by false pretense. Investigators allege Liles provided false statements to North Carolina Farm Bureau Mutual Insurance Co., claiming her vehicle and items in her vehicle were stolen on Sept. 28, 2009. Liles was compensated $15,343 in claims funds.
Liles and Randolph were charged in Forsyth County with insurance fraud, obtaining property by false pretense and conspiracy. Investigators allege Liles and Randolph provided false statements to Nationwide Mutual Insurance Co., claiming larceny following a breaking and entering at their home on Oct. 15, 2011. Liles and Randolph were compensated $35,512 in claims funds.
Liles and Randolph were also charged in Lee County with insurance fraud, attempting to obtain property by false pretense and conspiracy. Investigators allege Liles and Randolph provided false statements to Nationwide Mutual Insurance Co., claiming property loss in a fire on July 5, 2014.
11 Georgia Residents Charged With Allegedly Staging Car Accidents
Investigators from Georgia Insurance Commissioner Ralph Hudgens’ Fraud division, with assistance from Bibb County Sherriff David Davis and his deputies, arrested six Macon residents on charges of insurance fraud on Aug. 24. Five more Bibb County residents have outstanding warrants.
The arrests stem from three separate investigations referred to the Department by the National Insurance Crime Bureau. Fraud agents from the Department charged the 11 individuals with allegedly staging car accidents.
The first investigation involved Haaruwn Prince, 25, Zanquanishia Floyd, 20, Demario Anton James, 23, and Sammy Lee Briggs, Jr., 52. The four offenders allegedly attempted to collect over $30,000 in claim payments from their insurers after Prince allegedly hit Floyd’s vehicle, which contained two minors, with his.
Each individual was charged with one count each of insurance fraud. Prince, Floyd, and James were each charged with one count of false report of a crime and two counts of cruelty to children, which is a felony. Floyd was charged with one count of theft by deception, also a felony.
The second investigation involved Sammie Lee Starks, 69, Linniece Victoria Starks, 19, Tamika Dashon Hogan, 20, and Jonathan Gutierrez, 22.
Sammie Starks allegedly attempted to obtain $30,000 claim payments after Hogan struck Sammie Stark’s vehicle, which Linniece Stark was driving at the time.
Each individual was charged with one count of insurance fraud and one count of theft by deception. Linniece Starks and Hogan were each charged with filing a false report of a crime.
The third investigation involved Haaruwn Prince, Bryant Orlando Tanner, 46, Sherrod Herschel James, 22, and Darnez Rashod Cotton, 22. Prince struck the vehicle Tanner was driving, which contained two minors, after which the four offenders allegedly attempted to collect over $50,000 in claim payments from their insurers.
Each individual was charged with one count of insurance fraud.
Prince and Tanner were each charged with two counts of cruelty to children in the second degree and with one count each of filing a false police report.
2-Year Florida Fraud Investigation Leads to Multiple Arrests
The Florida Department of Financial Services’ Division of Insurance Fraud (DIF) has made multiple arrests related to a large-scale personal injury protection (PIP) fraud scheme spanning across Central Florida.
Five individuals have been arrested for their alleged various roles in the scheme, and arrest warrants have been issued for three additional individuals whose arrests are pending. Three related arrests have been made in the Fort Myers area.
DIF partnered with the FBI to conduct investigations into two personal injury clinics, First Medical Rehab of Bradenton (FMRB) and Kirkman Family Chiropractic Care (KFCC) in Orlando, after insurers and former patients raised allegations of potential illegal activities.
In 2014, a DIF detective infiltrated the Bradenton clinic by going undercover and posing as a patient. As a direct result, investigators were able to prove that FMRB was allegedly billing for medical treatments on injuries that did not exist.
The investigation into Kirkman Family Chiropractic revealed an organized plot to circumvent clinic licensure requirements set by the Agency for Health Care Administration. Because licensed health care professionals can operate clinics without the necessity of an additional clinic license, co-conspirators solicited licensed chiropractors to serve as straw owners, or owners on paper only.
To date, more than $100,000 in fraudulent claims has been paid by multiple insurers.
Those who were arrested include: Dadline Prospere, Shona S. Johnson, Dieufort Irilus, Evelyne Franclin and Barry Sutphin. Charges are varied based upon each individual’s alleged role and include: patient brokering, conspiracy to commit patient brokering, false and fraudulent insurance claims, solicitation, grand theft, organized scheme to defraud and conspiracy to commit insurance fraud.