From the December 2011 issue of Claims Magazine • Subscribe!

The Not-So-Invisible Circus

Inducting the year’s Most Shameless Fraudsters

Hold your noses; bolt your front doors; and hide your children. America’s most-brazen, cunning, or just plain dumb insurance criminals have earned election to America’s most notorious thiefdom, the 2011 Insurance Fraud Hall of Shame.

These cellar dwellers lurking on the dark side of the moral universe were either convicted or experienced other legal closure this year.

Showcasing these insurance mea-culprits serves a very serious and valuable purpose. The Hall of Shame provides an up-close and personal look at real-life crime dramas that illustrate how fraud damages innocent people and insurers.

Publicly blaming and shaming these crooks helps stoke consumer outrage, ultimately waking up more Americans to the realities of insurance fraud’s destructive impact and underscoring the necessity of adequate fraud detection and mitigation strategies. To fight this epidemic, insurers, organizations, and the public must present a unified front. Let’s begin the harrowing journey with America’s latest rank and vile.

Jewel of a Scheme
Two down-on-their-luck diamond dealers got unluckier by hiring cronies disguised as Hassidic Jews to stage a robbery of their struggling Manhattan, N.Y. business in order to collect insurance money.

Indian immigrants Atul Shah and Mahaveer Kankariya paid their cohorts to wear beards and black clothes and hats, and carry realistic toy guns. The fake Hassids marched into the office, seemingly to stick up the business and steal thousands of dollars in diamonds.

However, somewhat incredibly, Shah and Kankariya let their own security cameras document the entire plot. The all-seeing lens even recorded Shah moving diamonds from drawers in the safe, and granting the so-called crooks entrance without so much as asking for their identities. Shah and Kankariya subsequently made a $7 million claim, which Lloyd’s never paid out. Each received a maximum of 20 years in jail.

Unholy Insurance Con
A pastor from Baltimore, Md. had a developmentally disabled, blind man killed for $1.4 million in life insurance money.

Kevin Pushia was tens of thousands of dollars in debt and faced foreclosure on several properties.

He befriended Lemuel Wallace and gained his trust. Then posing as Wallace’s brother, Pushia fraudulently took out a half-dozen life policies in Wallace’s name. Pushia then stole $50,000 from his own church's bank account to pay the hitman. Wallace was found shot several times in the head and back after the hitman lured him into a public bathroom at a city park.

Investigators found Pushia’s day planner with the note “LW project complete.” He faces life in prison when sentenced.

Inconvenient Witnesses
William Craig Miller massacred a family to prevent witnesses from testifying against him for burning down his house for insurance money.

He hired Steven Duffy, an employee of Miller’s home-restoration firm, to help barbecue the tony Scottsdale, Ariz. home. But afterward, Duffy’s wife Tammy Lovell convinced him to spill the plot to the police.

Miller grew desperate. Duffy and Lovell were witnesses; they had to go. He entered their house and shot them. Lovell was in a fetal position when Miller pumped three bullets into the back of her head.

Three kids inside saw the murders, so they were deemed expendable. Miller shot 10-year-old Jacob Lovell in his forehead at point-blank range. Shane Duffy, 18, and Cassandra Lovell, 15, also died in the charnel house. Miller received 14 years for the arson, and faces a potential death sentence for the murders.

Shooting Pain
A Los Angeles, Calif. school police officer shot himself to scam workers’ comp money. Jeff Stenroos radioed that a pony-tailed burglary suspect in a black leather jacket pumped a bullet into his bullet-proof vest while he patrolled a public school’s perimeter.

Hundreds of officers combed the area. Nine schools also were locked down. More than 9,000 students were ordered to stay in their classrooms for up to 10 hours. They had little food and no bathroom breaks for up to six hours. Some had to use trash cans as toilets. An 8-square-mile area also was locked down, snarling traffic and disrupting people’s lives.

The school district paid out $57,000 in medical care for Stenroos. However, he gave police conflicting stories about the incident, and avoided investigators who wanted to question him. Stenroos now faces up to five years when sentenced.

An Explosive Scheme
The house blew up in a seething fireball, engulfing the hired torch whose amateurish attempt to help the owners launch an insurance arson ended in his fiery death. Victor and Olga Barriere wanted to get rid of their Long Beach, Calif. home. The rundown building was besieged by code violations. The Barrieres also were stuck with a $315,000 mortgage and rickety home nobody wanted to buy. Fed up, they hired handyman Thomas Trucios to finish off the place.

But Trucios spread dangerously large amounts of gasoline around. The fumes reached critical mass and exploded when he tried to light the fire. Trucios never had a chance. He had third-degree burns on more than 95 percent of his body, and died in the hospital.

Victor received 14 years and four months in state prison, while Olga received six years.

Fake Deaths, Real Fraud
Bridgette Buckner received 10 years in state prison for stealing life-insurance money by lying that her child and husband had died. The Chicago, Ill.-area woman had life policies through her employer, Hallmark Services. First she said her preschool child, Briajay, had died recently of an illness. But the youngster had actually died four years prior. Buckner gave her insurer a fake death certificate and collected $10,000 in life insurance money. Five months later, she said her hubby was shot and killed in the line of duty as an FBI agent. She filed a $15,000 death claim.

Buckner provided an investigator with vivid detail—her husband was shot in the lungs and died while awaiting surgery. But the fraud investigator was a former FBI agent. He grew suspicious because he would have heard about the husband’s death through the FBI grapevine. Buckner didn't place an obituary, and officials couldn’t even locate a burial plot. Her hubby never was an FBI agent and was quite alive. The couple was estranged, and he was unaware of the plot. Buckner skipped out on bail and lived as a fugitive before turning herself in.

Night of the Undead
How sad that Jim Davis died of a heart attack. He had a proper funeral, and was laid to rest for eternity in a Los Angeles, Calif. cemetery. But Davis didn’t die. In fact, he didn’t exist. A fraud ring with mortuary worker Jean Crump among the lead players tried to steal $1.2 million in life insurance money by forging death certificates, buying a burial plot, staging a funeral, and burying an elaborate but empty casket. The gang even hired fake mourners to attend the service in case anyone was watching.

When insurers started getting nosy, a panicky Crump and her sidekick dug up the casket, and filled it with cow parts and a mannequin so mortuary workers wouldn’t get suspicious when carrying it. The pair then had “Davis” and the casket cremated. Next, they filed fake documents stating the remains were cremated and buried at sea. Crump and her crony bribed a doctor with $50,000 to create fake medical records to support the phony death.

Another plotter lied to insurers that she was Davis’ niece and the beneficiary of the policies. Crump now awaits sentencing.

Diagnosis: Fraud
Carlos Quijada made a living posing as a physician. The Hawthorne, N.J. man fraudulently charged Medicaid more than $9 million in drugs in just one year. Quijada and another make-believe doc at the clinic owned by Yousuf Masood saw more than 20,000 patients.

Quijada got his start by posting an ad on Craigslist, seeking employment. Masood­—a real doctor—offered him the job.

He told Quijada to treat and diagnose patients, and prescribe meds. Quijada introduced himself to patients as “Dr. Quijada.” The prolific Medicaid billings were made to look as if Masood had treated the patients himself.

Masood gave his two deceptive “docs” pre-signed, blank prescription pads. The penurious pair provided patients with meds for schizophrenia, bipolar disorder, anxiety, insomnia, and other illnesses. As many as 100 patients visited the clinic each day. Masood often wasn’t in the office or was in another room watching TV while his phony docs rang up insurance bills. “Dr. Quijada” faces up to 10 years in federal prison when sentenced.

Deadly Dessert
Tami Duvall poisoned her estranged husband, Alan, for a $100,000 life policy she had bought just a month before he died.

The Columbus, Ind.-area woman slipped morphine and muscle relaxants into his dessert of whipped cream and crushed chocolate cookies. Duvall called 911 the next morning, saying she found Alan dead on their back porch. He drank himself to death, she claimed. He had a blood alcohol level of 0.436 percent.

But Alan also had more than 80 times the recommended dosage of morphine and muscle relaxants in his bloodstream. Duvall then changed her story, lying that he drank the morphine and took the muscle-relaxant pills to commit suicide.

Suspicion quickly fell on Duvall. She was anxious to have him cremated, kept asking when she could collect the insurance money, and didn’t seem upset at a dinner after the memorial service. Duvall awaits sentencing.

More Masters of Mayhem
To learn about this year’s dishonorable mentions and access Claims’ compendium of shameless menaces to our insurance community, go to the Claims channel on www.PropertyCasualty360.com and select “Investigative” from the navigation bar.

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