Former N.Y. CSR Arrested for Reportedly Submitting False Health Claims

New York Superintendent Gregory Serio announced that Dawn M. Hogue, a former customer service representative for Excellus Blue Cross Blue Shield in Rochester, was charged with two counts insurance fraud in the third degree and two counts grand larceny in the third degree.

It is alleged that while employed in the above capacity, Hogue, 29, submitted fraudulent claims to Excellus Blue Cross Blue Shield of Rochester. On Sept. 9, 2002 she went out on medical disability, but in fact reportedly started working full-time at Unity Health. She continued to collect disability benefits and claimed she was not working. In addition, on her employee insurance benefit application at Excellus Blue Cross Blue Shield, she reportedly indicated she had a spouse and one dependent which was incorrect. She was not married. The premium benefit gained from a family policy compared to a single policy is over $8,000.

Hogue of Rochester, was arrested July 14 and released to her attorney. The arrest is the result of a joint investigation conducted by the Insurance Department’s Frauds Bureau, the Rochester Police Department and Excellus Blue Cross Blue Shield of Rochester.