News Briefs

Louisiana

Three Arrested for Accident Staging

The Louisiana State Police Insu-rance Fraud Unit arrested three Ville Platte residents on felony insurance fraud related warrants. The state police said the arrests were the result of an investigation into a staged accident, which occurred in Lafayette Parish.

Kenneth Wayne Guillory, Danielle Frilot Clark and Angelina Jack are believed to have planned and intentionally caused an automobile crash in order to obtain money from insurance companies for bogus injuries and property damage. Guillory is believed to have caused a three-vehicle collision by slamming on his brakes in front of a commercial van driven by an elderly man. The lives of several unsuspecting people were endangered, including an innocent driver’s one-year old daughter.

The elderly van driver had a pre-existing back condition, which was aggravated by the collision and he was not able to return to work. The total monetary loss incurred by the insurance companies involved is estimated at over $115,000, to date.

Guillory and Clark are being charged with Automobile Policy Insurance Fraud, three counts of Child Desertion, 1st Degree Injuring Public Records and Theft by Fraud. Jack is being charged with Insurance Fraud and Theft by Fraud.

Oklahoma

Fisher, Ellis to Stand Trial on All Charges

Former Oklahoma Insurance Commis-sioner Carroll Fisher, his former assistant, Opal Ellis, and the Fisher Foundation have been ordered to stand trial on all counts against them in Oklahoma County District Court, according the Oklahoma attorney general’s office.

Oklahoma County Special Judge D. Fred Doak issued the ruling after receiving evidence over 11 months in eight different cases concerning Fisher, Ellis and the Fisher Foundation. The three were initially charged Feb. 11, 2004, after an investigation by the state’s Multicounty Grand Jury. Fisher is named in a total of five cases on eight charges. Ellis is named in five cases on 11 charges and the Fisher Foundation is named in one case containing three charges.

Fisher and Ellis are charged with one count each of failure to pay over money to the state between April 1999 and March 2003. Fisher, Ellis and the Fisher Foundation are accused of one count each of failure to register a non-exempt charitable organization, failure to report contributions to a non-exempt charitable organization and failure to provide and keep a copy of written receipts for charitable contributions.

Ellis is also charged with one count of embezzlement or failure to pay money over to the state, one count of co-mingling state finances with personal finances, one count of embezzlement and four counts of making a false claim against the state.

Fisher is charged with one count each of accepting a bribe, embezzlement or failure to pay money over to the state, perjury and filing a false tax return.

The court also heard arguments regarding the jurisdiction of the Multicounty Grand Jury. Doak found it does have jurisdiction to investigate the cases pending concerning Fisher, Ellis and the Fisher Foundation.

If convicted on all counts, Fisher could be facing a maximum of 51 years in prison and a fine not to exceed $76,500. Ellis could face maximum of 74 years in prison and fines totaling $17,000. A court could also assess restitution.

The cases are scheduled for a pre-trial hearing Aug. 5 in Oklahoma County District Court before Judge Susan Caswell.

Texas

Truck Driver, Prison Guards Indicted Texas Mutual Insurance Company reported that in unrelated cases Texas grand juries indicted a truck driver and two prison guards on workers’ compensation fraud charges. The guards and the truck driver were allegedly “double-dipping,” a term investigators use for claimants who collect income benefits by saying they unable to work while they are actively employed.

The Travis County grand jury indicted Jerry Amaya of Cedar Creek, Texas. Amaya filed a workers’ compensation claim after he injured his head, chest, neck, right shoulder and arm while working as a truck driver. He claimed he was unable to work as a result of the injuries, and Texas Mutual began paying income benefits. Texas Mutual said its investigation uncovered evidence that Amaya was working-driving a truck for another company-while he received income benefits.

A Dallas County Grand Jury indicted Ron L. Dawson for aggregated theft over $1,500. Dawson received temporary income benefits (TIBs) after reporting he was unable to work due to his 2001 workplace injury. Dawson allegedly hurt his back while working as a security guard for a Dallas homeowners association. He said he was unable to work; however, it was discovered that he took a new job as a prison guard for Dawson State Jail from June 27, 2002, through February 13, 2003. During this time, he received over $6,300 in TIBs.

In Austin, the 299th Judicial District Grand Jury indicted Lloyd Davis, who applied for supplemental income benefits (SIBs) in December 2000, stating that he was not employed and was unable to work due to a workplace injury from his previous job. Davis had received over $8,600 in SIBs when a claim reviewer noticed irregularities in his file. The subsequent Texas Mutual investigation discovered that Davis had worked since 1999-without any disability-as a prison guard at the T. Don Hutto Correctional Facility, a state jail operated by a private company.

Texas Mutual immediately disputed Davis’ entitlement to further benefits and presented its case to the Travis County District Attorney’s Office. On May 4, 2005, a grand jury indicted Davis. He was arrested on May 20 and held in custody pending trial.

Gov. Signs Fraud Legislation

Texas Gov. Rick Perry has signed legislation making it tougher on criminals who commit insurance fraud in the state, according Texas Committee on Insurance Fraud, which strongly supported the measures.

Senate Bill 871 by State Sen. Eddie Lucio of Brownsville gives prosecutors a stronger hand in sentencing criminals who intentionally, knowingly or recklessly commit insurance fraud.

House Bill 2388 by State Rep. Senfronia Thompson of Houston will help state officials determine how bad insurance fraud is in Texas. HB 2388 calls for every insurance company in Texas to report their cases of insurance fraud to the Texas Department of Insurance Fraud Unit. For the first time fraud investigators will know how prevalent the crime is, its cost and where it is taking place.

HB 3376 by State Rep. Larry Taylor of League City extends the statute of limitations in fighting insurance fraud from three to five years, increases penalties, more clearly defines the act of insurance fraud and strengthens the money laundering statute.

The committee also supported language in HB 7 that addressed workers’ compensation fraud. HB 7 was signed on June 1.