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Monthly Archives: June 2012

New Jersey Social Worker Confesses to Insurance Fraud

New Jersey Social Worker Confesses to Insurance Fraud

Post Date June 27, 2012 –  A New Jersey social worker will be facing a probation sentence after pleading guilty to committing third degree health insurance –related fraud.   State Attorney General Jeffrey Chiesa had announced recently that Rashmi Gupta, 39 years old, had pleaded guilty to the act of defrauding Medicaid by submitting unscrupulous time sheets pertaining to counseling services of troubled teenagers.  Gupta’s sentencing was scheduled on June 22 before Judge Clark. With her pleading guilty, New Jersey’s Office of the Insurance Fraud Prosecutor had recommended her to probation, and that she will be banned from reimbursement through the Medicaid for five years. With regards to her profession, Gupta’s case has already been brought up to the New Jersey Board of Social Work Examiners for possible actions on her social work license.

Gupta who worked with the TYSN (The Youth Success Network) in Passaic, had disclosed that between July and December 2010, time sheets for counseling services even if none was provided.  With her fraudulent time sheets, TYSN demanded claims from the Medicaid and then paid Gupta. Based on the social worker’s timesheets, she was paid for $10,177.50 for services that never existed.  Ronald Chillemi, Insurance Fraud Prosecutor, had said Gupta’s fraud schemes and other fraud on health insurance in NJ continues to thrive, stealing huge amounts of the state’s tax dollars.

Gupta’s scheme was discovered when one client reported to TYSN that the social worker did not render them such services. With this information, TYSN notified the Office of the Insurance Fraud Prosecutor. The case was then thoroughly investigated by Medicaid Fraud Control through unit acting chief Nicole Rizzolo, Deputy Atty. Gen. Dolores Blackburn, and Detective Luisa Sanchez. Gupta’s probation sentence is due to a state law that if a person is found guilty with a third-degree crime but not previously convicted of any indictable offense, that person’s incarceration sentence can be presumed against.

On a personal note; insurance fraud is on the rise.  Anyone whom has followed my Blog knows I focus a fair amount of attention to car insurance fraud and the effect this has on the auto insurance industry. Sadly, there are far more people whom are aware of those whom commit insurance fraud than actually perpetrate the crime.  The sad thing is; the cost of insurance fraud is built into the premium of every car insurance policy in New Jersey.  Believe it or not, a $1000.00 auto insurance premium would be less than $700.00 if there was no insurance fraud.  The next time you hear about someone about to defraud an insurance company – think about how much that act has cost you over the last 10 years.

-Mike

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762  ext. 602


 

 

New Jersey Insurance Commissioner Calls For Hurricane Readiness

New Jersey Insurance Commissioner Calls For Hurricane Readiness

Post Date June 24, 2012 –  With all the natural disasters which have hit the Garden State the last few years; New Jersey’s Acting Insurance Commissioner, Ken Kobylowski, recently called on to New Jersey residents to prepare for this year’s hurricane season.  The state insurance department encouraged its residents, especially those living near coastal areas,… Continue Reading

NJ Homeowners Encouraged To Review Homeowners Insurance

NJ Homeowners Encouraged To Review Homeowners Insurance

Post Date June 21, 2012 –  Since wildfires ravaged parts of New Jersey, NJ State Authorities call for homeowners to review their Homeowners Insurance policies to assure their homes have sufficient protection from such type of disasters.  New Jersey’s Department of Banking and Insurance (DOBI) together with the Department of Environmental Protection (DEP) and the… Continue Reading

PA Insurance Company Chief Faces Assault Charges

PA Insurance Company Chief Faces Assault Charges

Post Date June 14, 2012 – After figuring out the husband of an employee to whom he alleged to having an affair with his wife, the chief executive officer of an established insurance company in Pennsylvania is now facing charges of defiant trespass and simple assault.  The insurance CEO identified as Kenneth Melani, 58 years old,… Continue Reading

Pennsylvania University Researches Risk And Insurance

Pennsylvania University Researches Risk And Insurance

Post Date June 10, 2012 – In order to further promote and circulate research materials on risk and insurance, University of Pennsylvania’s Wharton School recently establishes the new Wharton/Penn Risk and Insurance Program (WPRIP).  According to a university press release, WPRIP will promote the interdisciplinary study on the theoretical, empirical, domestic and global topics on the… Continue Reading

National Flood Insurance Program Expires This Summer

National Flood Insurance Program Expires This Summer

Post Date June 8, 2012 – The United States Senate and House of Representatives have now agreed on extending the National Flood Insurance Program (NFIP) until July 30, giving it 60 days more.  The program should have ended on May 31.  Now, the Senate and House Representatives legislation to extend the flood insurance program and… Continue Reading

Pennsylvania Law Makers Empower Residents Against Obama Care Insurance Purchase

Pennsylvania Law Makers Empower Residents Against Obama Care Insurance Purchase

Post Date June 1, 2012  –Pennsylvania senators are now working on a proposal that will empower the state’s citizens to prohibit laws that will force them to buy health insurance.   This particular attempt is aimed at striking off the “individual mandate” provision of the Patient Protection and Affordable Care Act (PPACA). The said proposal which… Continue Reading