N.J. Woman Pleads Guilty to Health Care Claims Fraud

February 5, 2004

New Jersey Attorney General Peter Harvey announced that an Ocean County woman has pleaded guilty to using false identities in order to illegally collect death benefits from a life insurance policy and to obtain dental treatments to which she was not entitled.

According to Vaughn McKoy, director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, Mary Ann McCue, 49, of Ocean County, pleaded guilty before Ocean County Superior Court Judge Peter Giovine to charges contained in a criminal Accusation filed by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor. The Accusation charged theft by deception and Health Care Claims Fraud (both 3rd degree). When sentenced on March 11, McCue faces up to ten years in state prison and a fine of up to $30,000.

In entering the guilty plea, Gooden Brown noted that McCue reportedly admitted using a false identity in March of 1999 to submit a fraudulent life insurance claim to Metropolitan Life Insurance Company. In filing the fraudulent claim, McCue purported that she was the widow of a man who had died in February, 1999. Metropolitan Life settled the life insurance claim for $2,628. McCue admitted that she forged the widow’s name when she endorsed the claim check. McCue also admitted that in January, 1999, she used a roommate’s name and identity to obtain dental services from Kamy Dental in Toms River.

In order to obtain the dental services, McCue is reported to have fraudulently completed a patient information form and presented the roommate’s dental insurance card. The investigation determined that the roommate had no knowledge of the incident.

As a result, Kamy Dental submitted a bill in the amount of $312 to Horizon Blue Cross for payment of the dental treatment.

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