This story is reprinted with permission from FC&&S Legal, the industry's only comprehensive digital resource designed for insurance coverage law professionals. Visit the website to subscribe.

The owner of a Rockland County, New York, automobile window tinting business and his wife have been charged with defrauding the workers' compensation system after the wife allegedly crashed a client's new Mercedes SUV while on a joyride and then claimed the car was being used as part of her employment.

Tammy Pena was charged with Grand Larceny in the Third Degree, two counts of the workers' compensation crime of Fraudulent Practices, two counts of Falsifying Business Records in the First Degree, and Insurance Fraud in the Third Degree, all felonies, and Unauthorized Use of a Vehicle in the Third Degree, a misdemeanor.

Her husband Samuel was charged with two counts of Grand Larceny in the Third Degree, two counts of the workers' compensation crime of Fraudulent Practices, two counts of Falsifying Business Records in the First Degree, and two counts of Insurance Fraud in the Third Degree, all felonies.

'Fraudulent claim filings'

New York State Inspector General Catherine Leahy Scott said, “With profane disregard, this couple violated and abused a client's trust and went on to conceal and exacerbate their own wrongdoing with fraudulent claim filings. These two elevated a joyride and car crash into and elaborate insurance fraud scheme and will now be held accountable for their actions. I will continue to use the powers of my office to protect the workers' compensation system which is a vital protection for honest employees and employers.”

An investigation by Inspector General Leahy Scott found that Mr. Pena owns and operates Sam's Professional Window Tinting, an automotive window tinting business based in Nanuet, New York, and his wife Tammy is listed as one of several employees. In May 2015, Ms. Pena filed a workers' compensation claim with the business' insurer for injuries sustained in a one car motor vehicle accident when she drove a client's brand new Mercedes SUV off of a road near the Penas' home and into a tree, totaling the vehicle.

According to prosecutors, Ms. Pena claimed to the business' insurance company that the accident had occurred shortly after picking up a client's vehicle for services. The government asserted, however, that, contrary to Ms. Pena's claim, she was not engaged in any work activity at the time of the accident.

As alleged, the vehicle had been in the Penas' possession for more than a week before the accident and, prior to the accident, Mr. Pena and the vehicle's owner were in communications regarding when the vehicle would be finished. According to the government, Mr. Pena texted the vehicle's owner minutes before the accident stating that more work was being done and the vehicle would not be finished until later that day. In fact, the government contended, at the time of the crash, the work on the vehicle had already been completed.

After Ms. Pena filed the workers' compensation claim, Mr. Pena filed multiple documents with the workers' compensation board and his business' insurance company supporting his wife's claim that the accident was work-related, exaggerating her wages, and requesting reimbursement for wages allegedly paid to his wife after her accident, the government asserted.

More than $45K paid

More than $45,000 was paid by the workers' compensation insurance company for medical bills and wage indemnity benefits for Ms. Pena's allegedly fraudulent claim. Mr. Pena also was alleged to have submitted fraudulent documentation to the insurance company when applying for workers' compensation insurance in order to obtain a reduced premium.

Steven A. Meyerowitz, Esq., is the director of FC&S Legal, the editor-in-chief of the Insurance Coverage Law Report, and the founder and president of Meyerowitz Communications Inc. Email him at smeyerowitz@meyerowitzcommunications.com.

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Couple charged with workers' comp fraud after crashing Mercedes during joyride

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