Fraud Files: Financial and Medical Fraud Schemes

In this edition of Fraud Files we take a look at two schemes that occurred in New Jersey. One involving a financial scheme with auto loans and the other regarding medical fraud with a dishonest doctor.

The first part of the video describes how an owner of a used car dealership, along with three employees and a bookkeeper, were charged with conspiracy, money laundering, and other offenses in connection with bank financing scam that allegedly netted $1.4 million in fraudulent loans for luxury cars.

In the second half of the report, we tell the story of a family physician in New Jersey who was sentenced to 37 months in prison for defrauding Medicare, Medicaid and private insurance companies out $280,000.

Surveillance Footage Used in Wisconsin Workers’ Comp Claim

A man on workers' compensation lifts heavy groceries and shovels snow while collecting benefits.

A man on workers’ compensation lifts heavy groceries and shovels snow while collecting benefits.

In this edition of Fraud Files we focus on a Wisconsin man on workers’ compensation who had over $1.2 million paid out for the claim in 5 years. Only video surveillance shows the injury isn’t all that severe. In the footage the man is seen chopping ice, shoveling snow and lifting groceries.

The man allegedly continued to receive ongoing pain management treatment from his Wisconsin doctor. Evidence later showed the doctor was billing $15,000-$20,000 a month for these treatments.

A judge found the insurance company was not liable for unpaid bills and stated they were not required to continue to pay for future treatments. Those unpaid bills amounted to over $250,000 and future medical expenses that were estimated as high as $11 million.

 

Insurance Fraud Headlines for June 19, 2015

Here are the top insurance fraud stories for today:

* Authorities Arrest Doctor, 3 Others in Complex Insurance Fraud Scam (NewsChief)

* Twelve charged in Western District of Kentucky as part of largest national Medicare fraud take-down in history (WHAS-TV)

* Car Thieves Now Targeting Vehicles for Parts (Insurance Journal)

* Car Shopping? How to Identify Flood Damage Before Buying (NY Times)