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Four NY Men Charged in Insurance Fraud Scheme with Over $10 Million in Fraudulent Claims

According to Insurance Journal and Damian Williams, the U.S. Attorney for the Southern District of New York, Kenan Tariverdi, Nazim Tariverdi, Dilshod Islamov, and Alvaro Geovanni Quijada Lemus, all of New York, have officially been charged late last month for their roles in a no-fault auto insurance fraud scheme for allegedly submitting over $10 million in fraudulent psychological services claims, and then laundering the money through illicit check cashers.

 

Here are the details of the indictment, provided by Insurance Journal:

 

  • “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.”


  • “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.”


  • “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.”

 

The Tariverdis and Islamov have officially been charged with conspiracy to commit healthcare fraud, wire fraud, aggravated identity theft, and money laundering. Quijada-Lemus has been charged with money laundering. They are presumed innocent until proven guilty.


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