Three Residents Indicted for Insurance Fraud by Grand Jury

Late last month in New Castle County, a Grand Jury indicted multiple residents for insurance fraud. The indictments stem from Department of Insurance Fraud Prevention Bureau investigations, in partnership with the Delaware Department of Justice. They allege that following vehicle accidents, each indicted resident did knowingly present false information to auto insurers or otherwise caused false information to be presented.

“I want to commend our Fraud Prevention Bureau for their work identifying deceitful activity and helping to bring those who would defraud Delaware residents and companies to justice. Their efforts continue to send a strong message that fraud will not go unnoticed here, which can prevent future crimes,” said Insurance Commissioner Trinidad Navarro. “Through this work, we can help keep insurance premiums from rising by helping to make sure companies do not have to pay out fraudulent claims, and we can educate residents that engaging in fraud is very costly.”

A resident of Wilmington was indicted on September 27 following a two-vehicle auto accident and a fraudulent claim filed with Permanent General Insurance. The resident had no insurance at the time of the accident but obtained it afterward, and intentionally misrepresented the date of the accident to obtain a benefit that they were not entitled to. Video evidence was uncovered that confirmed the accurate date of the accident.

A resident of Newark was indicted on September 27 for knowingly misrepresenting the time of an auto accident. During the investigation, evidence was obtained that confirmed that the resident had no auto insurance coverage at the time of their accident and that their auto insurance policy was obtained after the accident had occurred. They engaged in insurance fraud through intentionally providing false information in order to obtain a benefit that they were not entitled to from Good to Go Insurance.

An additional resident was indicted for similar activity in an attempt to defraud Progressive Insurance. The resident obtained an auto insurance policy and filed a claim two days later, stating that their vehicle was struck by an unknown vehicle while parked at their residence. An examination of vehicle damage was inconsistent with this depiction, and the investigation further identified that the vehicle was involved in an accident three days prior to obtaining insurance coverage.

An indictment is merely an allegation and is not evidence of guilt. In all cases, defendants are presumed innocent until and unless proven guilty. Insurance Fraud is a felony.

Commissioner Navarro has a background in law enforcement and serves as Chair of the National Association of Insurance Commissioner’s Antifraud Task Force. The Delaware Department of Insurance Fraud Prevention Bureau is fully funded by annual assessment fees, not taxpayer dollars, and employs staff with extensive law enforcement and insurance investigative backgrounds and training, including credentials such as Certified Fraud Specialists and Accredited Healthcare Fraud Investigators.

The Bureau facilitates the detection of insurance fraud and works to reduce fraud occurrence through enforcement and deterrence. Additionally, the Bureau requires restitution for deceptively obtained insurance benefits, and by doing so reduces the amount of premium dollars used to pay fraudulent claims, in turn decreasing the likelihood of premium increases. The Bureau can be reached by toll free hotline (800) 632-5154, or (302) 672-7350, or by emailing fraud@delaware.gov. Reporting known or suspected fraud is free of charge and can be done confidentially.


Department of Insurance Celebrates Response to Fraud in 2019

Fraud Bureau saw a 10% uptick in reports last year

The Delaware Department of Insurance made great strides in fraud detection and response during 2019. Throughout the year, 6 criminal arrests that included 21 charges were recommended from the Department’s Fraud Prevention Bureau to the Department of Justice, and 16 civil cases were brought forward resulting in more than $21,000 in fines. The Bureau received 551 referral cases in 2019.

“I want to commend our Fraud Prevention Bureau for their work identifying deceitful activity and helping to bring those who would defraud Delaware residents and companies to justice. Their efforts continue to send a strong message that fraud will not go unnoticed here, which can prevent future crimes,” said Commissioner Trinidad Navarro. “Through this work, we can help keep insurance premiums from rising by helping to make sure companies do not have to pay out fraudulent claims.”

Commissioner Navarro, who has a background in law enforcement, served as Vice-Chair of the National Association of Insurance Commissioners’ Antifraud Task Force over the last year and has championed fraud awareness and reporting. He was named Chair of the national Antifraud Task Force last week. The Department has experienced an increase reports over the past several years, with an approximate 23% increase since 2015.

In one prominent 2019 case, a resident was arrested after posing as family member who was terminally ill and facing imminent end-of life to open a life insurance policy. This was conducted through forgery of the family member’s identification, confirmation, and consent. After naming themself the sole beneficiary, the individual then attempted to collect $50,000 on the policy two days after the family member’s death. Charges included insurance fraud, identity theft, second-degree forgery, and crime against a vulnerable adult.

From identity theft to insurance healthcare fraud, hundreds of tips are investigated every year. In 2019, the most common schemes were seen through the application for auto insurance process, with individuals living outside the state attempting to save on premium costs by using Delaware addresses. Suspected to have risen due to possible economic factors, instances of application submissions occurring after an accident took place also grew. In addition to investigating tips from the public and insurance companies, the Bureau works with law enforcement in locating life insurance policies in death investigations.

The Fraud Prevention Bureau is fully funded by annual assessment fees, not taxpayer dollars, and employs 13 fulltime staff with extensive law enforcement and insurance investigative backgrounds and training, including credentials as Certified Fraud Specialists and Accredited Healthcare Fraud Investigators.

The Bureau facilitates the detection of insurance fraud and works to reduce fraud occurrence through enforcement and deterrence. Additionally, the Bureau requires restitution for deceptively obtained insurance benefits, and by doing so reduces the amount of premium dollars used to pay fraudulent claims, in turn decreasing the likelihood of premium increases.

The Delaware Department of Insurance Fraud Bureau can be reached toll free at (800) 632-5154, or (302) 672-7350, or by emailing fraud@delaware.gov. Reporting known or suspected fraud is free of charge and can be done confidentially.

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Sussex County Woman Arrested for Insurance Fraud

 Sussex County Woman Arrested for Insurance Fraud

June 14, 2019

DOVER, DE – Arlene Belfield, 51, of Lincoln DE, was arrested on Thursday, June 13th, 2019 by Capital Police, following an investigation by the Delaware Department of Insurance Fraud Prevention Bureau.

The charges allege that in November, 2017, Arlene Belfield, pretending to be her terminally ill mother, contacted AAA Insurance by phone to obtain a $50,000 Life Insurance policy with the intent to defraud. To facilitate this fraud, the charges allege that Arlene Belfield used her mother’s personal identifying information without her consent. Arlene Belfield attempted to collect on the policy two days after her mother’s death, with the sole beneficiary of the policy being Arlene Belfield. Upon review, AAA Insurance suspected that an imposter submitted the application. It is further alleged that Arlene Belfield knew that her mother’s death was imminent when she submitted the application to the insurance company.  Belfield was charged with insurance fraud, identity theft, forgery 2nd degree and crime against a vulnerable adult.  She was arraigned in Superior Court and released on her own recognizance.

If you know of insurance fraud taking place, report it to the Delaware Department of Insurance at 302-674-7350, or email fraud@delaware.gov.

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Contact: Vince Ryan

Office: (302) 674-7303

Email: vince.ryan@delaware.gov

 

                                                         

 

Delaware Department of Insurance


Insurance Commissioner Stewart Accepts “Challenge Medal” Bestowed by U.S. Dept. of Homeland Security

Dover, DE-Insurance Commissioner Karen Weldin Stewart was recently recognized at the annual conference of the Society of Financial Examiners (SOFE), held this year in Philadelphia, for her Department’s assistance with a major insurance fraud investigation that has led to extensive federal charges. Commissioner Stewart was presented with the Challenge Medal, an award bestowed by the Department of Homeland Security in special recognition of the work her forensic information technology team, INS Services, did in uncovering an elaborate web of bogus web sites, misleading internet addresses and diverted email accounts that were used to confirm assets thought to be held by insurance entities.

In fact, the “confirmed” financial accounts were non-existent. The web of deceit was not discovered by other state regulators, certified public accountants and rating agencies for several years before being exposed by Stewart’s examination and receivership teams. At the SOFE presentation, Commissioner Stewart received thanks in front of insurance financial examiners from across the United States for her leadership and resolute determination to expose insurance fraud.

Commissioner Stewart’s examination and forensic teams are in the process of recovering assets for payment to claimants and policyholders of the former Indemnity Insurance Corporation RRG, a company that insured restaurants, bars and night clubs. The Department’s discovery of the elaborate frauds has also led to a myriad of federal charges pending in Maryland against Jeffrey Cohen, Indemnity’s founder.

At the presentation, Commissioner Stewart gave praise to the diligence of Delaware’s examiners and analysts. “Insurance Companies choose Delaware as their preferred home for many reasons” said Stewart. “We strive to be the most professional and advanced regulatory environment, and companies that want to put forth new products and properly serve insurance customers are happy to be in Delaware. But we certainly are not easy to fool, and we will be relentless in uncovering fraud.” Stewart thanked her receivership team and all the examiners who work for Delaware for their talent, diligence and tenacity in performing financial examinations. “This is due to your great work,” Stewart told her team.

Commissioner Stewart has a special expertise in the rehabilitation and liquidation of troubled insurance companies. Prior to becoming Delaware’s insurance commissioner, Stewart worked as a receiver for several states in need of insolvency assistance and was a founder of the International Association of Insurance Receivers. She holds the designation “Certified Insurance Receiver – Multi Lines” (CIR-ML).

This is the second such company in the past few years where Stewart’s team has discovered fraud hidden by a complex scheme of interlocking companies and financial institutions. Commissioner Stewart’s Receivership team seized Security Pacific Insurance Company in 2012 after discovering that the company’s assets had been syphoned away. Detection was hidden from its auditors. Security Pacific had relocated to Delaware in 2007 with the certification of auditors that its assets were secure. Delaware’s insolvency department has a tradition and well-earned national reputation for working in cooperation with several branches of federal law enforcement to punish wide-ranging national and international fraud.

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Commissioner Karen Weldin Stewart, CIR-ML, at right, is pictured with Jerry Link, middle, and Terry Ryals, left, receiving the medal from the Department of Homeland Security. Link and Ryals were part of the IT forensic team that uncovered the fraud.


Insurance Commissioner Stewart Announces Extended Office Hours to Provide Assistance for Consumers Post-Hurricane Sandy

Dover – In the days following Hurricane Sandy, those who suffered damages will begin filing insurance claims. Today, Delaware Insurance Commissioner Karen Weldin Stewart announced that she will extend office hours to better assist consumers with storm-related questions or problems. Commissioner Stewart stated that “In the wake of Hurricane Sandy, The Delaware Department of Insurance is here to provide guidance to both residents and the insurance industry. Delawareans should call their insurance company or agent with their policy number and relevant information as soon as possible after experiencing storm-related damage and keep a diary of all conversations with insurance company representatives, creditors, and relief agencies.”

Commissioner Stewart explained that the Department of Insurance will be operating extended hours until 8 p.m. in the Consumer Services division starting tomorrow, November 1st and continuing through Friday, November 2nd. Before calling your insurance company, residents are advised to locate their policy number and other relevant information to expedite processing their claim. If possible, take photographs or video of the damage before clean-up or repairs. After you’ve documented the damage, take steps to prevent further damage to your property (cover broken windows, leaking roofs and damaged walls). These tips and other useful information can be found on our website at www.delawareinsurance.gov.

Consumers seeking assistance in navigating the insurance claim process can contact the Delaware Department of Insurance by calling 1-800-282-8611. We also advise residents to contact our Fraud Bureau at 1-800-632-5154 if you suspect fraud regarding home repair.