• Dean Smith

Insurance Fraud Hall of Shame – Class of 2014

Every December, in an effort to raise public awareness, the Coalition Against Insurance Fraud chooses a new class of insurance fraud inductees, as posted by PropertyCasualty360, and it’s our favorite time of the year! We enjoy seeing these investigations lead to convictions, as many of the individuals listed below are true monsters and their crimes are NOT victimless.

According to Dennis Jay of PropertyCasualty360, “they represent the most brazen, vicious or klutziest insurance cons of the last year. Small wonder, they inflicted costly fakes and pains on consumers and insurers throughout the nation.”

1. Dr. Spyros Panos of Poughkeepsie, NY: Malpractice Fraud

Dr. Spyros Panos, an orthopedic surgeon, raked in approximately $35 million through the submission of fraudulent claims for an outrageous amount of botched/faked surgeries.

Orthopedic surgeons typically perform 20 surgeries a month. Well, Panos was rushing through up to 20 surgeries A DAY.

Dennis Jay writes, “Panos bounced from operating room to operating room in quick sequence. He performed substandard surgeries, or just sliced open patients and stitched them up without making repairs. Panos also billed routine arthroscopic procedures as expensive open surgeries.”

Victims have had useless surgeries, can’t walk, can’t recover, can’t work, and the list goes on.

Panos was convicted and will spend 4½ years in federal prison. In addition, Panos faces approximately 260 malpractice suits.

2. Angela Garcia of Cleveland, OH: Insurance Fraud

Angela Garcia set fire to her home using flammable liquid with her two infants, Nyeemah (whom Garcia tied up with a window blind cord to prevent escape) and Nija, inside. Both girls died from smoke inhalation before firefighters were able to reach them.

According to Jay, “She showed no grief or other emotions,” and “freely socialized afterwards.” She then proceeded to make claims for items she didn’t own, removed items from her home before she started the fire, all to collect $64,000 in insurance payments.

Prosecutors said Garcia’s alleged escape, crashing through a second-floor window and sliding down the roof, was impossible. She was not dirty, had no cuts, and did not receive treatment for smoke inhalation.

Prosecutors also proved that Garcia wanted nothing more to do with her children. She was convicted of insurance fraud and the murders of her two children. She will spend the rest of her life in prison.

3. Andy Lee House of Galveston, TX: Insurance Fraud

Andy Lee House decided to cash in on his $2.2 million car, a rare Bugatti Veyron, by crashing it into a swampy lagoon. House submitted the claim to his insurer, alleging that “a low-flying pelican forced him to swerve off the road into the muck.”

Luckily, a car enthusiast was at the right place at the right time, and in an attempt to record a video of the Bugatti, he caught House on video driving off the road and into the lagoon (no pelicans, skid marks, or other evidence for the cause of the crash in sight).

After crashing into the lagoon, House left the engine running for approximately 15 minutes, which allowed the salt water to engulf the engine and ruin the car. His excuse for not turning off the engine? Fighting off mosquitoes.

House pleaded guilty and faces up to 20 years in federal prison when sentenced.

4. Joseph Haddad of Bridgeport, CT: Medical Insurance Fraud

Joseph Haddad, a personal-injury attorney, gathered a network of (crooked) doctors, chiropractors, diagnostic clinics and recruiters.

“Recruiters” would visit police stations daily to buy accident/crash reports, which included victim’s identities. They were then tasked to hassle the crash victims to hire Haddad as their personal-injury lawyer.

Providers (doctors/chiropractors/clinics) then “diagnosed the victims, often without exams, then billed insurers for months of phantom or useless treatment.”

A sting operation in which federal agents posted as crash victims finally exposed Haddad. According to PropertyCasualty360, “One agent was billed for 11 chiro exams even though he only received four treatments. One of Haddad’s doctors, meanwhile, was operating with a suspended license.”

Haddad was sentenced to serve 51 months in federal prison with restitution payments totaling $1.8 million.

5. Christopher Inserra of New York, NY: Workers’ Comp Fraud

Former NYPD officer, Christopher Inserra, claimed he hurt his right arm while transporting an injured employee of the Port Authority to treatment. Even though medical exams showed there were no serious injuries, Inserra insisted he couldn’t bend his arm and the pain was extreme in his elbow and bicep. He collected over $31,000 in workers’ compensation benefits, until…

NOTE: DO NOT FIST PUMP WITH ARM INJURIES.

Turns out, Inserra was a member of a punk rock band, Cousin Sleaze, who went on a concert tour with stops in Athens, GA, Cocoa Beach, FL, and other locations. Photos and videos from the tour showed Inserra fist pumping, thrashing around, “repeatedly moving his arms in a punching motion” and “violently flailing his arm in an up-and-down motion” on the stage.

Inserra was sentenced to three years of probation.

6. Sara Ylen Port of Huron, MI: Healthcare Fraud

Sara Ylen Port claimed to have contracted cervical cancer, reaching stage four, after she had been raped in a store parking lot. She was now on her death bed.

Her insurance company paid over $120,000 in hospice care, the community raised thousands and the local church raised $10,000 to help with bills. She received recognition in her local newspaper about her “seemingly valiant fight.”

Tragic? No. Ylen made it all up.

Her actions (and actual testimony) sent an innocent man, James Grissom, to jail for almost 10 years as her falsely charged rapist.

According to tests, she did not have cancer. Her life was not in grave danger. She was not on her death bed. The hospice facility kicked her out. An investigation of her home computer found that she researched cancer. Doctors that Ylen named denied involvement and stated they never diagnosed her.

Ylen pleaded no contest and was sentenced to 1 year in jail.

7. Dr. Farid Fata of Detroit, MI: Medicare Fraud

This “doctor” administered “painful and debilitating chemo therapy” treatment to seniors who DID NOT have cancer. According to PropertyCasualty360, “Cancer specialist Fata made $225 million in false Medicare claims. About half went for needless chemo and other cancer treatments. He deliberately misdiagnosed patients who were in remission or had no chance of surviving.”

Medicare was out over $91 million. As if that wasn’t enough, Fata billed private insurers as well.

Jay writes, “Fata gave one patient 155 chemo treatments over 2½ years – though the patient was cancer-free. Other patients were pumped with useless blood therapy and iron treatments. And one patient fell down and badly injured his head at the office. Yet Fata insisted that the patient receive his chemo before going to the ER.”

Aside from administering chemo to seniors without cancer, Fata also handed out fraudulent diagnoses of anemia and fatigue so he could provide patients “dangerous levels of billable drugs.”

Fata faces up to 175 years in federal prison. He has not yet been sentenced.

8. Suzanne Basso of Houston, TX: Life Insurance Fraud

Suzanne Basso “befriended” Buddy Musso, a grocery bagger in Manhattan with the IQ of an 8-year-old. Buddy lived in an assisted living home and loved country music. He even dreamed of being one some day.

Basso saw a sick payday when she lured Buddy to Houston by promising to marry him. All she wanted was $150,000 in life insurance benefits (and another $60,000 policy with a violent-death clause) that she and her associates took out on Buddy. They tortured and killed Buddy, then left his body in a ditch covered in bleach.

Basso claimed several fake ailments and disabilities to avoid standing trial, but she was ultimately convicted and executed by lethal injection in February 2014.

9. Pamela Phillips of Aspen, CO: Life Insurance Fraud

Pamela Phillips and Gary Triano, according to PropertyCasualty360, “lived large in the posh foothills of Tucson, Ariz. Gary was a wheeler-dealer, creating businesses, running Indian bingo casinos and playing a lot of golf. They were rich and rubbed shoulders with well-known figures such as the Trumps.”

We’ve all heard the phrase, “More money, more problems.” However, this deemed irrelevant for Triano. Unfortunately, when his businesses collapsed and he lost his fortune, he had more problems than he would have imagined.

Phillips paid her ex-boyfriend, Ronald Young, $400,000 to kill her broke husband (with a car-bomb as he left the country club where he regularly golfed).

Unbeknownst to Phillips, Young recorded their conversations. And financial records were the nail in the coffin.

Phillips was sentenced to life in prison without parole.

Source

#2014 #fraud #hallofshame

0 views