Agent Arrested on Insurance Fraud Charges

December 23, 2003

Attorney General Peter C. Harvey announced that the last of five South Jersey/Philadelphia-area women indicted by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor has been sentenced in Burlington County Superior Court for her participation in a staged automobile accident scam which netted the defendants more than $31,000 in illegally obtained insurance money.

According to Vaughn L. McKoy, director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden-Brown, Pauline Whitfield, 65, Fairmont Avenue, Phila., PA, was sentenced on Dec. 19 by Burlington County Superior Court Judge John A. Almeida to 364 days in the Burlington County Jail, five years probation, and ordered to pay $5,913 in restitution to the State Farm Insurance Company. Whitfield was also ordered to pay a $5,000 civil insurance fraud fine pursuant to the Insurance Fraud Prevention Act.

Insurance Fraud Prosecutor Gooden Brown noted that Whitfield pleaded guilty on Aug. 4 to an Accusation which charged her with Health Care Claims Fraud and impersonation. In pleading guilty, Whitfield admitted that she was a passenger in a vehicle involved in a staged accident and, as part of the scheme, fraudulently claimed to have been injured in the accident. Whitfield submitted a $16,908 fraudulent injury claim to the State Farm Insurance Company. State Farm paid approximately $5,900 on the fraudulent claim.

Prosecutor Gooden Brown said that Whitfield, along with Deborah Thomas, 54, Denise Gaines, 40, Patricia Oglesby, 52, all of Philadelphia, and Robin Ellison, 43, Willingboro, Burlington County; were indicted by a State Grand Jury in May, 2002 and charged with conspiracy, Health Care Claims Fraud and theft by deception. To support the false claims, each of the co-conspirators reported that they had sustained various injuries as a result of the purported accident. Each of the co-conspirators filed fraudulent Personal Injury Protection (PIP) claims with the State Farm Insurance Company for reimbursement for health care services for non-existent injuries.

At separate guilty plea hearings before Judge Almeida, Ellison and Thomas admitted their roles in the conspiracy to report a non-existent accident to police and to attempt to collect insurance monies. Ellison admitted that on April 10, 1998 she was the driver of a vehicle when she and the co-conspirators (Thomas, Gaines and Oglesby) concocted a story to falsely claim that they had been involved in an automobile collision while driving in the Philadelphia area. Ellison reported the non-existent accident to the Philadelphia Police Department and to the State Farm Insurance Company. Gaines and Oglesby subsequently pleaded guilty to charges of submitting false insurance claims and theft by deception.

As a result of the fraud, State Farm paid more than $31,000 in property damage and PIP claims to various medical service providers. Ellison obtained an automobile property damage claim in the amount of $6,961 for purported damage to her car and $9,780 for medical treatments. Gaines received $7,560 in PIP claims for medical treatments. Oglesby received $2,011 in PIP claims for medical treatments, while Thomas was paid $4,757 in PIP claims for medical treatments.

Ellison was sentenced to three years in state prison, ordered to pay $16,741 restitution to the State Farm Insurance Company and to pay a $5,000 civil insurance fraud fine. Thomas was sentenced to 180 days in the Burlington County Jail, five years probation, and ordered to pay $7,560 in restitution and a $2,500 civil insurance fraud fine. Gaines was sentenced to 180 days in the Burlington County jail and three years probation. Oglesby was sentenced to 180 days in the Burlington County jail and five years probation.

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