Four Charged In $10 Million No-Fault Insurance Fraud Scheme

Four men have been charged with defrauding New York auto insurers by allegedly submitting more than $10 million in fraudulent claims for psychological services —and then laundering the proceeds of that fraud through a network of illicit check cashers.

Damian Williams, the U.S. Attorney for the Southern District of New York, on Thursday announced the unsealing of an indictment charging Kenan Tariverdi, Nazim Tariverdi, Dilshod Islamov, and Alvaro Geovanni Quijada Lemus.

The defendants were arrested Thursday morning and were presented before U.S. Magistrate Judge Sarah L. Cave in Manhattan Federal Court.

According to allegations in the indictment, Kenan Tariverdi, Nazim Tariverdi, and Islamov took illegal advantage of New York’s no-fault insurance law, which enables New York insureds to obtain benefits of up to $50,000 per person for injuries suffered in a car accident, regardless of fault.

Under New York State law, medical corporations are unable to bill insurance companies for no-fault benefits if the medical facilities are controlled by non-physicians. The indictment alleges that the defendants defrauded insurance carriers by submitting insurance claims from medical corporations that were nominally owned by licensed medical professionals but were in fact owned and controlled by the Tariverdis and Islamov, who were not licensed medical practitioners.

If insurance companies had known who the true owners of the medical corporations were, they would have denied payment for the claims, according to the indictment.

The Tariverdis and Islamov have been charged with conspiracy to commit healthcare fraud, wire fraud, aggravated identity theft, and money laundering.

According to the indictment, Quijada-Lemus was an unlicensed check casher who, in exchange for a fee, provided cash in exchange for checks sent to shell companies that were created as part of the scheme. Quijada-Lemus, in turn, sold approximately 50 checks from the shell companies for approximately $200,000 to an individual cooperating with law enforcement. He has been charged with money laundering.

The charges are merely accusations, and all of the defendants are presumed innocent unless and until proven guilty.

Prosecutors say the Tariverdis and Islamov billed insurers for services that were not actually performed, frequently using the license information and signatures of psychologists and medical professionals, and billing for expensive procedure regardless of medical necessity.

The defendants and their co-conspirators are accused of implementing protocols at various clinics in and around New York City to maximize the dollar amounts on insurance claims, rather than to provide necessary medical and psychological treatment.

The Tariverdis and Islamov have also been charged with laundering the proceeds of their conspiracy by taking control over various bank accounts that received payments derived from the fraudulent claims submitted to insurance companies. They gained control over them through various means, including by directing the psychologists and medical professionals to sign stacks of blank checks drawn on their accounts. They then used those checks to transfer funds into a network of shell companies that were controlled by the money laundering conspiracy, according to prosecutors.

Source: U.S. Attorney’s Office, Southern District of New York