Fraud News Around the Nation

June 3, 2016
Former California Claim Adjuster Pleads Guilty to Embezzling $289K

Elizabeth Louise Brown, 48, of Canyon Country, Calif., a former claims adjuster with Explorer Insurance, pleaded guilty to two counts of insurance fraud with a white collar crime enhancement penalty for crafting an elaborate scheme to defraud her employer of more than $289,000.

Brown was sentenced to four years in state prison and ordered to pay $289,999 in restitution.

According to California Department of Insurance detectives, between January 2013 and September 2015, while employed by Explorer Insurance as a claims adjuster, Brown embezzled from the company by adding friends and family members to claims, which resulted in the insurer issuing fraudulent payments to Brown’s co-conspirators.

In the end, Brown reportedly embezzled more than $289,999 from her employers.

Evidence of Brown’s alleged crimes were discovered by Explorer Insurance when they identified fraudulent checks issued in 87 claims assigned to her. Explorer terminated Brown’s employment and reported the suspected crimes to the department, which launched a criminal investigation.

Fifteen of Brown’s co-conspirators were also arrested and to date, seven have entered guilty pleas. Another four suspects remain at large and are being sought by department detectives.

This case is being prosecuted by the Los Angeles County District Attorney’s Office Auto Insurance Fraud Division.

Alaska Couple Charged With Faking Burglary, Insurance Fraud

An Anchorage couple suspected of hiding jewelry and other items and claiming they were stolen has been indicted on federal fraud charges.

Prosecutors say 41-year-oid Arnold Flowers II and 31-year-old Miranda Flowers are charged with 14 counts of wire fraud and scheming to defraud.

Arnold Flowers also faces narcotics and gun charges.

Prosecutors say the couple on Jan. 19 reported their home had been burglarized. They filed an insurance claim for $82,000 in damage and stolen electronics, jewelry and clothes.

Investigators found many of the items March 29 in a storage unit belonging to the couple.

A search of their home turned up cocaine and guns. Prosecutors say Arnold Flowers’ past convictions prohibit him from possessing guns.

Online court records did not list an attorney for the couple.

Mexico Doctors Convicted in U.S. Insurance Scheme

Federal prosecutors say two physicians from a family medicine clinic in Mexico have been convicted of conspiracy to commit wire fraud in a nearly $2.6 million insurance claim scheme.

U.S. Attorney Kenneth Magidson says 59-year-old Dr. Mayolo Melchor and 61-year-old Dr. Bertha Hernandez-Melchor, of Reynosa, Mexico, pleaded guilty Wednesday in McAllen to conspiring with policyholders of the American Family Life Insurance Company to prepare and submit fraudulent claim forms and accident reports for accidents and injuries that never occurred.

Prosecutors say forms listing fake accidents and injuries were delivered to the doctors’ family clinic in Mexico, then were faxed to AFLAC headquarters in Columbus, Georgia. The scheme went on for nine years through 2010.

They face up to 20 years in prison and a $250,000 fine at their August sentencing.

The Associated Press contributed to this content.

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