N.J. Woman Keeps Busy Submitting More than 40 Fraudulent Health Claims

February 10, 2005

New Jersey Division of Criminal Justice Director Vaughn McKoy announced that a Hunterdon County woman has pleaded guilty to Health Care Claims Fraud and forgery for submitting more than 40 fraudulent health insurance claims worth more than $13,900.

According to McKoy and Insurance Fraud Prosecutor Greta Gooden-Brown, Carol Severe, 65, of Annandale, Hunterdon County, pleaded guilty before Hunterdon County Superior Court Judge Robert Reed to a criminal Accusation filed by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor.

The Accusation charged Severe with Health Care Claims Fraud (3rd degree) and uttering a forged document (4th degree). When sentenced on May 6, Severe faces up to six and a half years in state prison and a fine of up to $25,000. Severe may also face civil insurance fraud fines pursuant to the civil Insurance Fraud Prevention Act.

At the guilty plea hearing, Severe reportedly admitted that between Jan. 5, 2000 and May 4, 2004, she collected more than $13,947 from Horizon Blue Cross/Blue Shield as the result of submitting false health insurance claims. Severe admitted that she submitted more than 40 claims, stating that a psychologist has provided services to her on 192 dates.

An investigation by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor determined that these services had not been provided and that Severe had signed the psychologist’s name to the claims form.

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