N.J. Woman Sentenced for Health Care Claims Fraud

March 25, 2004

New Jersey Attorney General Peter Harvey announced that an Ocean County woman has been ordered to pay more than $3,600 in restitution for using false identities as part of an insurance fraud scheme 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, was sentenced on March 18 by Ocean County Superior Court Judge Peter Giovine to two years probation and ordered to pay $3,628 in restitution to Wachovia and $312.00 to Kamy Dental.

Gooden Brown noted that on Feb. 3, McCue pleaded guilty to charges contained in a criminal Accusation filed by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor. The Accusation charged McCue with theft by deception and Health Care Claims Fraud.

In pleading guilty, McCue reportedly acknowledged that she used 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 reportedly admitted that she forged the widow’s name when she endorsed the claim check.

McCue also reportedly 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 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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