NJ Insurance Adjuster Created and Approved $190K in Fraudulent Claims, Funneled into his Bank Accounts

According to Insurance Journal, former New Jersey insurance adjuster, John Philbin of Clementon, NJ, has officially been charged last month with creating and submitted fraudulent claims, approving them, and funneling approximately $190,000 into bank accounts under his control.

Insurance Journal writes that, “According to court documents, Philbin was a property claims adjuster for Assurant Insurance Co. and had authority to approve insurance claims. From October 3, 2022, to May 22, 2023, Philbin allegedly knowingly created or caused to be created 11 fictitious claim files under false identities. According to prosecutors, he also fabricated vendor estimates and invoices purporting to reflect emergency mitigation or restoration work by non-existent companies.”

Additionally, “Philbin allegedly assigned the claims to himself and approved the claims under his individual authority. To facilitate the scheme, prosecutors maintain Philbin had Post Office boxes in Clementon and Blackwood. Internal audit logs and document metadata bearing Philbin’s unique identifier allegedly linked him to the creation and approval of the fabricated documents. The insurer paid out approximately $191,163 on these fictitious claims.”

Philbin was charged with insurance fraud and theft by deception, and is presumed innocent unless proven guilty.

“The cost of insurance is something all families must be concerned with,” said Attorney General Platkin. “Insurance fraud only adds to that cost. In this case, the defendant is someone who worked in the industry. We need to be able to trust the people who are working for insurers to do their jobs fairly and honestly.”

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