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The Fraud Report

FL Chiropractor and Wife Arrested for Fraud

by FraudReport 25. May 2017 10:39

A Central Florida chiropractor and his wife were recently arrested on insurance-fraud charges, allegedly for fraudulently billing a patient’s insurance company for over 20 un-needed treatments.

Investigators with the Florida Department of Financial Services say Chet Barton of Elite Health and Wellness scammed GEICO out of over $6,000 for services he never provided. His wife, Dana Lewis, who is a receptionist at the practice, also was arrested.

According to the Orlando Sentinel andtheir arrest affidavit, the couple billed GEICO more than 20 times between November 2015 and January 2016 for treatments for a patient’s back pain.

But detectives say there were never any treatments. Barton and Lewis, 27, used the name of a friend who was in a minor car accident in October 2015, but the woman told detectives she was not injured, the affidavit said.

Barton blamed the problem on an accounting error and gave detectives the name of a woman he claimed actually received the treatments; though detectives could not find any record of the woman.

Barton and Lewis were taken to the Orange County Jail and have since bonded out. They were charged with filing false and fraudulent insurance claims, third-degree grand theft and violating the Florida Communications Fraud Act.

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Categories: Scandalous Schemes

FL Comp Fraud Caught on Tape

by FraudReport 12. May 2017 07:16

In our line of work, we know there are people willing to do almost anything to fraudulently obtain money from their insurance companies. This story is on the tamer side, but it serves as proof of how consumers will try to get money that doesn’t belong to them.

Taking place in Fort Lauderdale, FL, this example from Fox News shows Sheyla Veronica White sitting at her desk on a normal day. After a little while, the sprinkler head that was in the ceiling above her falls down onto her desk, after which she grabs it and proceeds to hit herself in the head with it. You can watch the video by clicking here.

Florida's Division of Investigative and Forensic Services was on the case after her employer’s insurance got suspicious and referred the incident to the incident to them. Detectives later requested security cam footage and were able to prove she staged the whole thing.

White was convicted for third-degree felony workers' compensation insurance fraud and sentenced to 18 months of probation. Luckily (kind of) for her, she didn’t have to pay any restitution because they caught the claim before any benefits went out to her.

Lt. Doreen Rivera, from the Florida Dept. of Financial Services' Fraud Division, says faking injuries is a common way that people try to cheat the system, though "claim fraud" is only the beginning. She says a lot of times it’s not even the employee, but the businesses, that try to defraud the system, either by lying about how many people they employ or how risky the work is, to avoid buying the proper level of insurance. She explained, “not having it is a felony and not having it is serious.  And why is it serious?  Because if a worker gets injured on the job and there's no coverage, they're going to have to cover their own medical costs and those medical bills can, you know, be staggering.”

She says she's seeing a new trend emerging; “it’s well identified down south and now it's emerging here. And that is basically when a business is created for the purposes for taking out a minimal workers’ comp policy.”

Rivera says contractors are paying a fee to these so-called shell companies to use their workers comp and not purchase their own, meaning a lot of people could be hidden under a policy designed for a few, thus defrauding the insurance company.

But no matter if it’s the employee or the business committing the fraud, authorities say it’s YOU who is getting hit with the higher costs.

“When they're defrauded, eventually that cost is going to trickle to higher premiums to businesses and trickle down to consumers as well.”

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Categories: Scandalous Schemes