Fraud News: Chiropractor Billing Scheme, Scammers Change Auto Policies

Colorado Woman Gets 2 Years in $5 Million Medical Billing Scheme

A Colorado woman has been sentenced to about two years in federal prison for fraudulently billing insurance companies for $5 million by using unsuspecting chiropractors in the Louisville area.

A federal judge sentenced 40-year-old Claudia Lopez, of Fountain, Colorado, this week in Louisville. Lopez will also serve 3 years of supervised release.

The U.S. Attorney’s office in Louisville says around 2012, Lopez and five others recruited the chiropractors in order to obtain and use the chiropractors’ names to fraudulently bill insurance providers.

After that, they recruited employees from a nearby business to seek chiropractic services from the clinics. Federal prosecutors say the clinics billed more than $5 million for muscle relaxant injections that never occurred using the employees’ personal identification.

The court also ordered Lopez to pay more than $232,000 in restitution.

Five Washington Residents Charged With Fraud in Connection With Auto Claims

Two people pleaded guilty and three people are facing insurance fraud charges after investigations by Washington Insurance Commissioner Mike Kreidler’s Criminal Investigations Unit (CIU).

Kaitlyn Parker-Lee of Trout Lake, Wash., pleaded guilty in Klickitat County Superior Court to one felony count of filing a fraudulent insurance claim in connection with an auto collision. She was sentenced to serve 240 hours of community service and to pay $600 in court fees. She has paid restitution to Nationwide Insurance.

On Jan. 3, 2016, Parker-Lee filed a claim with Nationwide Insurance after she was involved in a collision with her 2001 Mitsubishi Mirage. She purchased the policy at 4:54 p.m. that day, but the other driver reported the collision occurred at 3:30 p.m. The other driver’s vehicle was a total loss, estimated at nearly $11,000.

David H. Shen of Seattle pleaded guilty in King County Superior Court to one felony count of filing a fraudulent insurance claim in connection with an auto collision. Shen was sentenced to serve 160 hours of community service and to pay $600 in court fees.

In December 2015, Shen added a 2010 Lexus to his PEMCO auto insurance policy, opting to purchase only liability and uninsured motorist coverage. In January 2016, his daughter collided with a parked car in Seattle. Minutes after the collision, Shen logged into his PEMCO account, added collision coverage and then filed a claim for the car’s total loss, estimated at $19,518. Shen gave PEMCO altered phone records in an attempt to prove he had collision coverage on the car before the accident. PEMCO denied the claim and referred the case to Kreidler’s CIU.

Three others were charged in King County Superior Court.

Jonathan Franciuc of Bothell pleaded not guilty to one felony charge of filing a fraudulent insurance claim. According to the investigation, Franciuc purchased a State Farm insurance policy for his 2005 Volvo V70 on Feb. 8, 2017. On Feb. 15, he filed a claim for damage to his vehicle that was caused when he collided with a highway divider. The investigation showed the collision actually occurred on Feb. 4, four days before Franciuc bought the policy. State Farm paid Franciuc $6,785 for the total loss of his vehicle and a rental car, which he paid back in May 2017 when he withdrew the claim. State Farm referred the case to Kreidler’s CIU.

Quoc Thang-Hoang Tran of Renton pleaded not guilty to one felony charge of filing a fraudulent insurance claim. According to the investigation, GEICO canceled Tran’s motorcycle policy for nonpayment in June 2017. Tran reinstated the policy on Aug. 6, 2017, and filed a total loss claim for the 2010 Bucati motorcycle on Aug. 22, estimated at $6,848. Washington State Patrol records showed the accident happened on Aug. 5, the day before Tran reinstated coverage. GEICO denied the claim and referred the case to Kreidler’s CIU.

Enrique DeAnda-Morales of Auburn pleaded not guilty to one felony charge of filing a fraudulent insurance claim. According to the investigation, DeAnda rear-ended another driver on Aug. 8, 2017. On Aug. 9, he contacted Allstate, his insurer, to change the coverage on his 2011 Chevy Silverado from liability only to comprehensive coverage. On Aug. 10, he filed a claim with Allstate, stating that the Silverado had been stolen while he was at work. Allstate denied the claim and referred the case to Kreidler’s CIU.