Tag Archives: Insurance Fraud

Jacksonville Roofer Facing Charges Related to Insurance Fraud & Failing to Begin Work

Jacksonville roofer and owner of Kinnecorps LLC, Roger Van Den Bosch, has been arrested and charged with insurance fraud, grand theft, uttering and failing to begin work. The roofing company has been under investigation since 2018 due to complaints from homeowners who signed Assignment of Benefits allowing their insurance companies to pay Van Den Bosch who in turn never completed the work.

Two other Kinnecorps employees, Van Den Bosch’s sister and girlfriend both face felony charges of uttering and knowingly notarizing a false document.

Click here to read the article.

Comments Off on Jacksonville Roofer Facing Charges Related to Insurance Fraud & Failing to Begin Work

Filed under Insurance Fraud

Miami-Dade Public Adjusters Facing Charges for Insurance Fraud Ring

Public adjuster Barbara Gonzalez and at least eight more suspects were arrested in insurance fraud ring in Miami-Dade. Gonzalez ran a public adjusting company Rubicon Group and the alleged ringleader of the fraud scheme.

Gonzalez’s charges include a $75,000 claim for fake water damage and repairs from a plumber that did not exist. She is also on the hook for three other false damage claims dating back to 2013.

Click here to read the article.

Comments Off on Miami-Dade Public Adjusters Facing Charges for Insurance Fraud Ring

Filed under Insurance Fraud

Fort Myers Woman Arrested for Insurance Fraud

Crystal Danielle Clarkson of Fort Myers was arrested for submitting false claims to her insurance company for treatments she did not receive. She sent 34 extra claims totaling $70,546.12 although she had only been seen by hospital medical providers two times. Clarkson is facing up to 30 years for charges of organized scheme to defraud, grand theft, insurance fraud.

Click here to read the article.

Comments Off on Fort Myers Woman Arrested for Insurance Fraud

Filed under Insurance Fraud

Survey Finds More Insurers Fighting Fraud with Data Analytics

According to a survey by Coalition Against Insurance Fraud, insurers are turning to analytics to fight insurance fraud which they believe is on the rise. Of the 84 carriers surveyed, 65% reported an increase in fraud over the past three years, 10% said fraud decreased and 25% said it remained the same.

Survey results also say that 21% of the carriers plan to invest in artificial intelligence. There has also been an increase in the use of unstructured data.

Click here to read the article.

Comments Off on Survey Finds More Insurers Fighting Fraud with Data Analytics

Filed under Insurance Fraud

Orlando Woman Arrested for Arson and Burning to Defraud

Tondra Shenika Roberts was arrested for allegedly setting her car on fire on Christmas Eve. According to police reports, Roberts said the vehicle was supposed to be repossessed and she left the keys inside in case someone showed up to take it.

Investigators found the key in the ignition of the abandoned car as well as a box of matches on the driver’s seat and an empty Heineken bottle with a paper towel inside of it. Lab reports from the car came back positive for gasoline. Roberts said she filed an insurance claim for the damage.

Roberts is facing felony charges of arson and burning to defraud an insurer.

Click here to read the article.

Comments Off on Orlando Woman Arrested for Arson and Burning to Defraud

Filed under Fraud

Boynton Beach Man Accused of Selling Fake License Plates and Insurance Cards

Fedelin Pericles also known as “The Tag Man” was arrested by undercover officers after selling them fake temporary tags and a false insurance card. An anonymous tipster gave detectives Pericles’ phone number and told them that he was providing fraudulent temporary tags for $60 and insurance cards for $100.

On three occasions “The Tag Man” sold three undercover officers two temporary licenses and one fake insurance card. Pericles’ charges include counterfeiting a motor vehicle registration, falsifying records, uttering a forged instrument, organized fraud and driving with a suspended license.

Click here to read the article.

Comments Off on Boynton Beach Man Accused of Selling Fake License Plates and Insurance Cards

Filed under Fraud

Stuart OB/GYN Found Guilty in Health Insurance Fraud Scheme

A federal court jury found Dr. Sheetal Kanar Kumar, former Stuart obstetrician and gynecologist, guilty of 23 counts of health insurance fraud. Kumar faces up to 10 years in prison and fines of $250,000 for each charge as a result of her fraudulent claims to Medicare, Medicaid and Blue Cross Blue Shield. Kumar’s claims involved charges for patient office visits involving complex cystometrogram, anorectal manometry, uroflowmetry and voiding pressure studies.

Click here to read the article.

Comments Off on Stuart OB/GYN Found Guilty in Health Insurance Fraud Scheme

Filed under Healthcare Fraud

Ten People Arrested in $42.7 M Insurance Fraud Scheme

Florida Department of Financial Services detectives arrested ten people for using 15 fake clinics to submit 23,000 fraudulent claims totaling $42.7 million. They used fake clinics as drop boxes for insurance payments. Four more arrests are pending with the alleged ring leader, Jorge Valido, still on the run. He previously served time in prison for healthcare fraud.

Click here for the full article.

Comments Off on Ten People Arrested in $42.7 M Insurance Fraud Scheme

Filed under Insurance Fraud

Physical Assistant Pleaded Guilty for Role in $1B Medicare Fraud Scheme

Arnaldo Carmouze, a former physician assistant, is facing up to 10 years in prison time for his role in a Medicare fraud scheme. Carmouze was one of three defendants who pleaded guilty to conspiracy to commit healthcare fraud while working for a network of skilled nursing homes and assisted living facilities. The scheme involved admitting Medicare and Medicaid patients to these homes and facilities even if they did not qualify for placement and giving them unnecessary medical care as well as referring patients to certain healthcare providers for kickbacks. In addition to prison time, Carmouze is also facing a fine up to $250,000 and three years of supervised release for his role in the $1 billion Medicare fraud scheme.

Click here to read the article.

Comments Off on Physical Assistant Pleaded Guilty for Role in $1B Medicare Fraud Scheme

Filed under Healthcare Fraud

Kendall Man Arrested for Bogus Boat Accident Insurance Claim

Florida Department of Financial Services Bureau of Insurance Fraud investigators arrested Jose Alberto Vargas for allegedly attempting to defraud Boat U.S. out of $14,000. Vargas filed a false claim for a grounded 1993 Mako boat and willfully deceived his insurance company and submitted misleading information regarding the ownership, dates and damage to his boat.

Vargas submitted his false claim on May 31, 2015, a few days after a mechanic saw Vargas’ boat at Tavernier Creek Marina and found that the engine was full of water and one cylinder was bad. Investigators also found that Vargas’ father was the owner of the boat at the time of the “accident” and did not transfer ownership to his son until August of that year.

Click here to read the article.

Comments Off on Kendall Man Arrested for Bogus Boat Accident Insurance Claim

Filed under Insurance Fraud