With insurance fraud on the rise across the country, Rytech reached out to the most recognized authority in America for examples on what’s going on.
Barry Zalma, ESQ, CFE is a lawyer, author, consultant and respected expert witness. In this article he shares 2020’s “Extreme Schemes” of fraud as released by the Coalition Against Insurance Fraud.
Coalition Against Insurance Fraud’s Hall of Shame
Welcome the newest members of the Insurance Fraud Hall of Shame. These Masters of Disaster are the nation’s most-brazen convicted insurance scammers of 2020 as inducted by the Coalition Against Insurance Fraud.
The 2020 Hall of Shame puts a human face on the other expensive U.S. pandemic — the collective cost of insurance fraud through direct economic loss and the resulting increase of insurance premiums for all Americans—showcasing an $80-Billion Pandemic.
They appear in no particular order and along with their sentence, as follows:
Slip ring stumbles–Bryan Duncan hired hundreds of homeless people to fake $31.7 million of painful injuries from setup slip-n-falls against businesses in New York City. Many had unneeded surgery. Federal sentence: 80 months.
Fired up, watered down–Dozens of old houses were burned and flooded in a $1.7-million scheme by Patrick Wayne Bronnon in Texas. They also insured fake possessions. State sentence: 78 years in state prison, though Bronnon died in July 2020.
Stolen Valor–Richard Meleski claimed he was a Navy SEAL wounded in Beirut, Lebanon, the Pennsylvania man said. Yet Meleski never served in the military. He invented the heroics to steal more than $300,000 of federal disability money. Federal sentence: pending.
Food folly–Tainted food sickened Jacqueline Masse, the New Hampshire woman said. She filed nearly $400,000 of false claims against innocent restaurants and grocery stores. Masse also stole her children’s identities for claims. State sentence: 18 months.
Bribery boondoggle–Billionaire insurance mogul Greg E. Lindberg tried to bribe North Carolina’s insurance commissioner $2 million to ease state regulation of his firms. Instead, Mike Causey and the FBI wired Lindberg’s bribery attempt. Federal sentence: seven years.
Sex, drugs, betrayal–Christopher Bathum traded sex for drugs to addicted women at his rehab facilities in a $175-million insurance scam. The Los Angeles-area man also gave patients drugs so they’d relapse for more expensive rehab. State sentence: 52 years.
Medicaid murder–Sherry Paulo starved to death a developmentally disabled resident of her care facility. The Missouri woman falsely billed Medicaid nearly $107,000 for Carl DeBrodie’s bogus care. Federal sentence: 17 ½ years.
Arthritis offense–Dr. Jorge Zamora-Quezada lied to patients that they had debilitating arthritis. The Texas man gave them painful chemotherapy and injections in a $325-million scheme. Federal sentence: pending.
Skin-deep scam–Dr. David Morrow billed uninsured beauty surgery as medically essential in a $50-million scam. The Beverly Hills surgeon charged tummy tucks as hernia repairs, and nose work as fixing deviated septum’s. Federal sentence: 20 years.
Rapper fraud racket–Would-be Chicago rapper Qaw’mane Wilson had his mother shot for life insurance and her savings so he could flaunt money and build up his fan base. State sentence: 99 years.
To read full-length descriptions of 2020’s worst insurance fraud crimes visit Coalition Against Insurance Fraud.
Impact of Insurance Fraud
- Insurance fraud steals at least $80 billion every year from American consumers. (Coalition Against Insurance Fraud estimate).
- Fraud occurs in about 10% of property-casualty insurance losses.
- Medicare fraud is estimated to cost $60 billion every year. (AARP 2018)
- The FBI estimates non-medical insurance fraud to be at least $40 billion every year.
- Property-casualty fraud steals about $30 billion each year. (Insurance
- Information Institute, March 2020)
- Want the big picture? Share these infographics.
Barry Zalma, ESQ., CFE–The experience and skill of Mr. Zalma as a consultant can make the difference before a jury, other trier of fact, or mediator. Mr. Zalma has more than 53 years as a claims person and insurance coverage attorney who has advised insurers on claims handling, interpreted coverages and testified as an insurance coverage, insurance bad faith, insurance claims handling and insurance fraud expert. To learn about Barry Zalma’s services for insurers go here. To learn about and subscribe to Zalma’s free Newsletter go here.