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Fake Health Insurance Plans for Schools, Nonprofits, Small Businesses

by Barry Zalma, Esq., CFE

Handwritten Insurance Claim Form with pen and calculator

Gerald Rising Jr., a health-plan owner pleaded guilty to fraud and money-laundering that ruined the health insurance of school districts, nonprofits and small businesses, was sentenced in March 2012 to 5½ years in federal prison. Rising also was ordered to pay $3.5 million restitution to victims and must serve three years of supervised release after his term. … Continue Reading

Disaster Fraud: A Sad Example from a Katrina Victim

by Barry Zalma, Esq., CFE

Handwritten Insurance Claim Form with pen and calculator

This story provides yet one more example of how vultures take the opportunity of someone’s misfortune to profit and cause worse damage and pain than that caused by a disaster.

John Colvin, 63, of Rainbow City, Alabama had his 60-year prison sentence reinstated by the Louisiana Supreme Court. Colvin, a former Alabama state legislator, pleaded guilty to stealing more than $250,000 from Hurricane Katrina victims in New Orleans after they paid him for modular homes he never delivered. … Continue Reading

Insurance Fraud: Beware of Misappropriation of Premiums

by Barry Zalma, Esq., CFE

Insurance Agent

James K. Sokolis, 56, of Spokane, Washington, pleaded guilty March 22, 2012 in United States District Court in Coeur d’Alene, Idaho to three counts of insurance fraud. According to the plea agreement, Sokolis, an ex-insurance agent who previously owned and operated Rockwood Insurance in Coeur d’Alene, sold his book of business in August 2010, and a new company hired Sokolis to work the book of business he sold to them until late January 2011. … Continue Reading

Insurance Fraud: Exaggerating the Reports of Their Death

by Barry Zalma, Esq., CFE

Insurance_Policy

John William Amis, 48, pleaded guilty in December to four felony counts. Amis, a former Tulsa, Oklahoma area funeral home owner was sentenced in May 2012 to three years in prison for making false claims for insurance. Court records show that Amis was charged with falsely reporting the deaths of people who were still alive to obtain the proceeds of their prepaid funeral policies. … Continue Reading

Health Insurance Fraud Scams: Save Your Money and Save Your Life

by Barry Zalma, Esq., CFE

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According to the Coalition Against Insurance Fraud and the Department of Health and Human Services, health care fraud costs Americans billions of dollars each year. Taxpayer-funded programs … Continue Reading

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