Body Shop Owner Charged in Bait Car Insurance Fraud Sting
A California body shop owner is facing felony insurance fraud charges after an undercover sting operation revealed he inflated a damage estimate on a bait car. Sting Operation Uncovers Fraudulent Claims Investigators from the Santa Clara County District Attorney’s Office, working with the Organized Auto Insurance Fraud Task Force, discovered that Jairon Escobar, 49, owner of Radiator & Body Parts, exaggerated damages on a vehicle with only a single dent. According to authorities, he added thousands of dollars in fake damages to the estimate. The task force—comprised of officials from the Santa Clara County D.A.’s Office, California Highway Patrol, and the California Department of Insurance—conducted the operation in May 2024. They targeted body shops suspected of insurance fraud and encouraging customers to engage in fraudulent claims. How the Bait Car Scheme Worked California Body Shop Owner: For the sting, the task force used a Toyota Camry supplied by the National Insurance Crime Bureau. The vehicle only had a small dent above the front wheel fender. However, Escobar reportedly advised an undercover officer to claim more than $3,000 in additional damages when filing with the insurer. Authorities say he then submitted an inflated repair estimate to Mercury Insurance. Legal Consequences Escobar was arraigned on felony attempted insurance fraud charges on Tuesday. If convicted, he could face incarceration. For more updates on fraud cases and legal developments, visit JacobiJournal.com. Stay informed. Sign up for our newsletter today!
Maryland Woman Convicted in $20M Life Insurance Fraud Scheme
Maryland Woman Convicted: A federal jury convicted Maureen Wilson of Owings Mills, Maryland, for orchestrating a massive insurance fraud scheme involving over 40 life insurance policies worth more than $20 million. She now faces sentencing on June 20. How Wilson Pulled Off the Scam According to court records, Wilson and her husband, James Wilson, misrepresented applicants’ health, wealth, and existing life insurance coverage to secure fraudulent policies. She also misled investors into funding the premium payments, promising high returns. To hide the scheme, Wilson and her husband funneled fraud proceeds through multiple bank accounts, including trusts. Authorities revealed that she failed to report millions in income, filing false tax returns for 2018 and 2019. Criminal Charges and Sentencing Maryland Woman Convicted: Wilson faced multiple charges, including conspiracy to commit mail and wire fraud, mail fraud, wire fraud, conspiracy to commit money laundering, money laundering, and filing false tax returns. While the jury acquitted her on one mail fraud charge, she was found guilty on all other counts. Investigation and Prosecution The IRS Criminal Investigation unit led the probe, with assistance from the Maryland Insurance Administration and the Maryland Attorney General. Justice Department attorneys Shawn Noud and Richard Kelley, along with Assistant U.S. Attorneys Matthew Phelps and Philip Motsay, handled the prosecution. Read More Fraud Cases Stay Informed on Financial Fraud For the latest updates on fraud cases and consumer protection, visit JacobiJournal.com. Source: U.S. Attorney for the District of Maryland
Maryland Woman Scams USAA for $58K—Then Tries Again
Maryland Woman Scams USAA: A Maryland woman defrauded USAA Insurance out of $58,000 using fake invoices and internet photos. When she attempted a second scam for more than $124,000, investigators uncovered her scheme. First Fraudulent Claim: $58K Payout In 2020, Rhonda K. Jackson, 39, of Upper Marlboro, also known as Rhonda Powell, filed a false insurance claim. She reported severe water damage from a broken pipe in her rented home, claiming losses on furniture, electronics, and clothing. As a result, USAA paid her $58,373. However, she never informed her landlord about the supposed leaks. Moreover, the invoices and receipts she submitted were fabricated or altered. Despite this, USAA processed her claim without immediate suspicion. Second Attempt: A $124K Mistake Maryland Woman Scams USAA: In 2022, Jackson tried again, filing a new claim for $124,034. This time, USAA became suspicious and denied her request. Upon further review, they found that she had recycled fake documents and used photos from the internet to support her claim. Consequently, the insurer referred the case for investigation. Investigation and Sentencing After a thorough inquiry by the Maryland Attorney General’s Office, Insurance Administration Investigator Edward Spragg, and Forensic Auditor Suzzanne Jones, authorities charged Jackson with felony insurance fraud. In October 2024, she pleaded guilty. Judge Lawrence Hill sentenced her to five years in prison, though he suspended all but 45 days. Additionally, she must repay $58,737 in restitution to USAA. Key Takeaway: Fraud Doesn’t Pay This case serves as a warning to those attempting insurance fraud. Insurers are increasing their fraud detection efforts, and individuals who submit false claims may face serious legal consequences. For more fraud prevention news, visit JacobiJournal.com. Read the full statement from the Maryland Attorney General’s Office here.
Healthcare Software VP Pleads Guilty in $1 Billion Medicare Fraud Scheme
Healthcare Software VP Pleads Guilty: A Kansas man has pleaded guilty to orchestrating a massive Medicare fraud scheme that scammed the government out of over $1 billion, officials said. How the Fraud Worked Healthcare Software VP Pleads Guilty: Gregory Schreck, a former vice president at a healthcare software company, helped run DMERx, an internet-based platform that generated fraudulent doctors’ orders for medical braces, pain creams, and other supplies. To find patients, Schreck and his co-conspirators used misleading ads, direct mail, and offshore call centers. They convinced Medicare beneficiaries to share personal details and accept unnecessary medical products. Bribery and Fake Medical Orders Rather than conduct real medical evaluations, DMERx partnered with telemedicine companies willing to accept bribes. Doctors signed orders without seeing patients, often based on a brief call—or no interaction at all. Schreck’s team then sold these fake orders to DME suppliers, pharmacies, and telemarketers, who paid kickbacks for the documents. These businesses later billed Medicare and other insurers, collecting more than $360 million in fraudulent claims. Legal Consequences Schreck pleaded guilty to conspiracy to commit healthcare fraud. He now faces up to 10 years in prison. A federal judge will decide his sentence based on legal guidelines and case details. Ongoing Investigation The FBI, HHS-OIG, VA-OIG, and DCIS continue investigating the case. For more on fraud prevention and healthcare compliance, visit JacobiJournal.com. Read the full DOJ statement here.
NY Doctor Convicted in $24M Medicare Fraud Scheme
Washington, D.C. – A New York doctor, Alexander Baldonado, M.D., has been convicted of orchestrating a $24 million Medicare fraud scheme. A federal jury found him guilty of submitting fraudulent claims for medically unnecessary lab tests and orthotic braces. How the Scheme Worked Medicare Fraud Scheme: According to court documents and trial evidence, Baldonado received illegal cash kickbacks for ordering unnecessary cancer genetic tests and orthotic braces. These fraudulent claims were billed to Medicare by two New York-based laboratories. In 2020, Baldonado authorized hundreds of cancer genetic tests for Medicare patients at COVID-19 testing events in assisted living facilities, adult day care centers, and a retirement community. However, he never treated or examined these patients before ordering tests. Many testified that they had never met or spoken to him. Additionally, Baldonado billed Medicare for office visits he never conducted. He never followed up with patients about their test results, and some never received them. Bribes for Orthotic Braces Baldonado also accepted illegal kickbacks from a medical equipment supplier in exchange for prescribing unnecessary orthotic braces. Undercover video evidence showed him receiving a large sum of cash for signing prescriptions. Financial Impact The fraudulent claims totaled more than $24 million. Medicare paid over $2.1 million to the laboratories and the medical equipment company involved in the scheme. Conviction and Sentencing A jury found Baldonado guilty of: Following his conviction, authorities took him into custody. He faces up to 10 years in prison per fraud-related charge and up to 5 years per kickback charge. His sentencing is scheduled for June 26. Investigation and Prosecution The FBI Newark Field Office and HHS Office of Inspector General led the investigation. Assistant Chief Rebecca Yuan and Trial Attorney Hyungjoo Han from the Justice Department’s Fraud Section prosecuted the case. Stay Informed on Healthcare Fraud For more insights on healthcare fraud cases, compliance updates, and industry trends, visit Jacobi Journal. Stay ahead with expert analysis and in-depth coverage. For more updates on Medicare fraud, visit DOJ.gov.
Texas Man Sentenced to 13 Years for $5M Insurance Fraud
Texas Man Sentenced: A Texas man, Jordan Ford, 32, will serve more than 13 years in prison for leading a $5 million insurance fraud scheme. The U.S. Attorney’s Office for the Northern District of Texas announced the sentencing last week. Fraud Scheme and Sentencing Ford pleaded guilty in September 2024 to conspiracy to commit wire fraud after being charged in June. On Thursday, U.S. District Judge Mark Pittman sentenced him to 157 months in prison and ordered him to pay $4.47 million in restitution to the defrauded insurance companies. How the Scheme Worked Texas Man Sentenced: Ford and his co-conspirators recruited insurance company employees to steal client information from legitimate claims. These employees provided confidential details, which Ford then used to pose as clients. He contacted insurance companies, requested payment updates, and directed funds to accounts controlled by his team. In some cases, he paid employees to loan him their company-issued laptops. Once inside the system, Ford authorized fraudulent payments to his group’s accounts. In total, the scheme stole more than $4.4 million from at least three insurance companies. Others Involved and Guilty Pleas All nine defendants have pleaded guilty, including: Investigation and Prosecution The FBI’s Dallas Field Office and the Texas Department of Insurance led the investigation. Assistant U.S. Attorney Matthew Weybrecht prosecuted the case. For more insurance fraud updates, visit JacobiJournal.com. Read the full U.S. Attorney’s Office statement here.
Former Ohio Insurance Agent Sentenced for $1.4M Fraud Scheme
Probation and Restitution Ordered in Funeral Insurance Theft Case A former Ohio insurance agent, Rhonda Chandler, must serve five years of probation for stealing more than $1.4 million from pre-need funeral insurance policies. The Ohio Department of Insurance (ODI) uncovered her fraudulent activities, which affected 14 funeral homes. How Chandler Misused Funeral Funds Chandler took insurance premiums meant for funeral expenses and trust settlements. Instead of allocating the money properly, she used it for personal and business expenses. The insurer responsible for these policies has reimbursed the funeral homes. Chandler now owes restitution to the insurer. Investigation Uncovers Fraud Former Ohio Insurance Agent: The case surfaced when a civil lawsuit accused Chandler of failing to transfer pre-need funeral funds to a funeral home. ODI then investigated her financial dealings. Chandler had worked with funeral directors to manage insurance policies and trusts, but instead, she diverted funds for personal gain. ODI Director Judith L. French emphasized the importance of protecting consumers. “This case highlights our commitment to holding fraudsters accountable,” she stated. License Revoked After Multiple Violations Chandler’s insurance license was revoked in 2021 due to 25 violations, including: A November 2023 indictment charged her with felony theft (second-degree) and falsification (third-degree). At first, Chandler denied the allegations, but she later admitted her wrongdoing. Sentencing and Restitution Chandler has repaid $350,500 so far but must pay the remaining balance. The court sentenced her to five years of probation, during which she will remain under strict supervision. For more updates on insurance fraud cases, visit JacobiJournal.com. Read the full ODI statement here.
Former Florida Broker and Others Indicted in Major Insurance Fraud Schemes
Fraud Rings Uncovered in Florida and Texas Major Insurance Fraud Schemes: Authorities in Florida and Texas have charged five individuals in separate insurance fraud schemes, including a former licensed broker accused of ACA enrollment fraud and a medical clinic group allegedly staging auto accidents for financial gain. Staged Auto Accidents in Hialeah In Hialeah, Florida, law enforcement arrested three individuals connected to a medical clinic fraud operation. The suspects allegedly orchestrated staged car accidents to file fraudulent insurance claims. The Miami-Dade Sheriff’s Office identified the accused as: Authorities uncovered the fraud after a driver involved in a staged crash attempted to add an unrelated person to the accident report. Bodycam footage from an officer revealed inconsistencies in the damage and crash description, leading to further investigation. Individuals claiming to be victims of the crash later admitted they had been directed to MO Medical Center to report fake injuries for insurance payouts. Charges Against the Florida Defendants Miami-Dade arrest records indicate that Macias faces multiple charges, including: As of late Wednesday, his bond had not been set. ACA Fraud Scheme Tied to Ex-Broker Separately, federal prosecutors have charged Cory Lloyd, 46, a former Florida-licensed insurance broker, and Steven Strong, 42, of Mansfield, Texas, in a scheme to fraudulently enroll homeless individuals in ACA insurance plans to collect commission payments. According to the U.S. Department of Justice (DOJ), Lloyd and Strong orchestrated a deceptive enrollment scheme by: The fraudulent enrollments led to over $161 million in government payouts. Lloyd’s Insurance Background and Licensing History Records from Florida’s Department of Financial Services (DFS) show that: Lloyd and Strong now face federal indictment and potential severe penalties. For more updates on insurance fraud cases, visit JacobiJournal.com. Read the full DOJ bulletin here.
North Carolina Insurance Agent Accused of Forgery and Identity Theft in Life Insurance Scam
Mount Airy Man Allegedly Obtained Policy Without Consent, Filed Fraudulent Claims Forgery and Identity Theft: Authorities have charged a North Carolina insurance agent with forgery and identity theft, accusing him of fraudulently obtaining a life insurance policy and later attempting to claim benefits. Matthew Jackson Swift, 42, of Mount Airy, is now awaiting a court appearance scheduled for February 19. Details of the Allegations According to the North Carolina Department of Insurance (DOI), Swift forged documents twice in late 2023 to secure a life insurance policy from Southern Farm Bureau Life Insurance Co. Investigators revealed that the policyholder had no knowledge of the transaction. Shortly after, Swift allegedly submitted claims against the fraudulent policy, aiming to collect payouts unlawfully. Law enforcement officers arrested Swift earlier this month. However, he posted a $75,000 bond and was released shortly after. His upcoming court hearing will determine the next steps in the case. Swift’s Insurance Background and Previous Arrest Forgery and Identity Theft: Records from the National Association of Insurance Commissioners (NAIC) indicate that Swift holds a valid insurance producer license in North Carolina. However, his broker license expired in 2023. Despite this, he remains authorized to sell life, health, property, and casualty insurance. In the past, he worked with both Progressive Southeastern Insurance and Southern Farm Bureau Life. Notably, this is not the first time Swift has faced similar allegations. Four months ago, authorities arrested him on related charges. In response, he denied any wrongdoing, claiming his former spouse had fabricated the accusations. Ongoing Investigation and Consumer Protection Efforts As the investigation continues, officials emphasize the importance of cracking down on insurance fraud to protect policyholders. The North Carolina DOI remains committed to holding fraudulent agents accountable and ensuring the integrity of the insurance industry. For more updates on this case, visit JacobiJournal.com. Read the official statement from the North Carolina Department of Insurance.
Philadelphia Man Admits to Stealing Deceased Classmate’s Identity for Fraudulent Schemes
Felony Guilty Plea Covers Identity Theft, Insurance Fraud, and Firearms Permit Application Stealing Deceased Classmate’s Identity: A Philadelphia man has pleaded guilty to multiple felony charges after authorities discovered he had stolen the identity of a deceased classmate and used it to commit fraud. Attorney General Dave Sunday announced that Anthony Percell admitted to identity theft, insurance fraud, theft by deception, and forgery in Philadelphia County Court. Decades-Old Identity Theft Uncovered Investigators found that Percell had assumed the identity of a former classmate who died in 1986. He used the stolen information to obtain a driver’s license, register a vehicle, apply for a concealed carry firearms permit, and secure insurance. In a more elaborate scheme, he even filed a fraudulent workers’ compensation claim under the deceased individual’s name. Percell’s crimes extended beyond state violations. Federal prosecutors also charged him for using the false identity to obtain a U.S. passport and gain airport access—both serious offenses that raised national security concerns. Sentencing and Legal Consequences Stealing Deceased Classmate’s Identity: Under a plea agreement, Percell will serve a prison sentence ranging from six to 23 months, followed by seven years of probation. Additionally, he is permanently barred from using anyone else’s identity for any reason. The court also ordered him to forfeit all assets and documents obtained through fraud. Attorney General Sunday condemned the scheme, emphasizing its potential risks: “This defendant brazenly stole the identity of a classmate who died decades ago and used that information to apply for a concealed firearms permit and other privileges, potentially putting the public at risk.” A Warning on Identity Theft and Fraud Cases like this highlight the dangers of identity theft, especially when used to commit multiple forms of fraud. Law enforcement agencies continue to crack down on individuals who manipulate personal information for financial and legal gain. For more updates on legal and fraud-related cases, visit JacobiJournal.com. Read the full report from the Pennsylvania Attorney General’s Office.