Florida Claims Adjuster for Zurich, 4 Others Charged with Fraud

March 15, 2010

Florida officials reported the arrests of five individuals involved in defrauding Zurich Insurance Group, including a Zurich claims adjuster Donald Alfred Toohey, III.

Those arrested were accused of creating multiple falsified and fabricated claims in excess of $240,000.

The arrests were the result of an investigation by the state’s Division of Insurance Fraud (DIF). If convicted, each faces up to 15 years in prison.

Detectives said they received an anonymous tip in September 2009 of possible fraudulent activity by Toohey, and the resulting investigation uncovered that Toohey as well as four more individuals were committing illegal acts. Each participant received payments from 26 different claims totaling over $240,000 from August 2004 through June 2009 in various counties throughout the state.

According to investigators, Toohey used his position as a claims adjuster to create fictitious claims for monetary gain for himself as well as Scott J. Kincaid, Brian Frederick Kneifer, Anthony Michal Kneifer and Tricia Ann Allen. The scam was initiated by Toohey, who had access to the paperwork to file the fraudulent insurance claims. Toohey would create a fraudulent file and claim on of each of the participants, showing reason for reimbursement to the individual for injuries occurring either to the person or their automobile during a car accident. The participant would then receive a check in the mail with the understanding that a portion would be paid to Toohey.

The initial investigation into Toohey led DIF Detective Steve Firestone to further investigate and he confirmed three or more checks were received and cashed by each of these individuals with thefts ranging from $8,800 to over $67,000. None of the five individuals were insured with Zurich at the time of payment, or at any other time, and payment audits confirmed the payouts were fraudulent.

All five participants have been charged with grand theft and were booked into the Pasco County Jail.

Source: Florida CFO

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