Fraud News: Faked Car Crash, Vacationing Doctor Claims He Saw Patients

June 20, 2018

Delaware Couple Arrested for $100,000 Insurance Fraud

Diliana Legeros and Joseph Aubourg, of Milford, Delaware, were indicted by a Delaware Grand Jury on June 4th for insurance fraud, then arrested after turning themselves in to Capital Police on June 11th. The defendants were processed, arraigned, and released on $1,000 unsecured bond each. An investigation conducted by the Delaware Department of Insurance found that the defendants filed insurance claims for injuries from an automobile accident in New Jersey, which never occurred.

On November 16, 2016, Diliana Legros, Aubourg’s wife, reported an accident claim to their auto insurance company. The defendants claimed that on November 12, 2016, Legros, her husband Joseph Aubourg, and two of their children, were traveling from New Jersey back to Delaware when a Mini Cooper with New York tags merged into their lane and struck their vehicle. Legros and Aubourg reported that the driver of the Mini Cooper failed to stop. However, they were able to secure the Mini Cooper’s license plate number. Despite securing the tag number, neither defendant notified the police. All claimed injuries and were treated by a chiropractor located in Milford, as well as other medical professionals. Upon inspection of the reported striking vehicle and interviews of the vehicle owner, investigators were able to provide evidence which proved that the accident had never occurred. As a result of the false claims the insurance provider was billed over $100,000 in medical bills. The company had paid out over $55,000 related to this claim.

New York Doctor Claims He Examined Patients While on Vacation in Iceland

A central New York orthopedic surgeon was sentenced this month for running an ongoing scheme that defrauded the workers’ compensation system by nearly $87,000, according to an announcement by New York State Inspector General Catherine Leahy Scott.

Dr. Gregory B. Shankman, of Clinton, was sentenced in Oneida County Court today for his previous guilty
plea to two counts of Offering a False Instrument for Filing in the Second Degree. At sentencing, Shankman
surrendered his license to practice medicine and paid full restitution of $86,896. He was sentenced to a one year
conditional discharge.

An investigation by Inspector General Leahy Scott found Shankman, who maintained offices on Genesee Street
in Utica, defrauded the workers’ comp system by certifying he was overseeing claimant medical exams at his Utica office when he was instead traveling in western New York, out of state, and even out of the country. On multiple occasions, based on the investigation, Shankman was performing workers’ comp medical examinations in offices across upstate and western New York regions while also billing for examinations conducted simultaneously at his Utica office, where he was required to be under State law.

“This former doctor enriched himself by practicing fraud instead of medicine,” said Inspector General Leahy
Scott. “His criminal acts enabled him to travel extensively and vacation abroad while shunning the most basic
requirements of his job.”

The investigation found that Shankman was not in his Utica offices on more than 150 separate days between
January 2015 and August 2017 while certifying he was at the office each of those days overseeing multiple
workers’ comp exams. On many of the days when he indicated he was performing exams at his offices in Utica, he was in fact performing other exams in offices near Buffalo, was out of State, and even traveling in Iceland in the spring of 2016. As such, Shankman systematically submitted false bills for medical services rendered by a workers’ compensation medical provider to the State Insurance Fund, the County of Oneida and other insurance carriers, third party administrators, and self-insured entities.

Inspector General Leahy Scott thanked Oneida County District Attorney Scott D. McNamara and his office for
assisting with the investigation and for prosecuting this matter.

Was this article valuable?

Here are more articles you may enjoy.