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Insurance fraud doesn’t pay

April 8, 2015 by  
Filed under Blog

Even though it may come across to many as an easier crime, with a victim that is too well-endowed to suffer any lasting consequences, insurance fraud leads to prison sentences and fines just the same. In fact, because of the highly trained investigators that insurance companies hire in order to detect fraudulent clients, average Joes considering a simple slip and fall accident as a viable experiment before moving on to bigger escapades, do not have a great chance. Surveillance teams hired by concerned third parties, who may be suffering from unpopularity or a loss of clients due to repeated accidents, use cutting edge technology and investigation techniques to uncover the fraud.

Slip and fall

Consider the highly elaborate scheme allegedly hatched by the late Andrew Gaber, an attorney accused of running an insurance scam ring that had 46 participants. The plan, which was seven years in the making, involved paying “runners” anywhere between $100 to $500 for acting out a slip and fall, after which they would claim insurance. The arrested claimants reported that Gaber, an attorney, extracted a 40% fee, and after other medical and legal deductions, the rest belonged to them. In total, they managed to defraud 21 insurance companies and earned around $400,000 in claims.

According to them, Gaber trained them to find pavements with subtle defects such as cracks that were still large enough to be legally significant. In fact, Gaber’s office had a ruler that was used to help these “runners” get an idea of how big the cracks or gaps should be. They then described how Gaber sent them to stage dramatic falls on these pavements, call for help, and exaggerate the extent of their injuries. Gaber was accused of preparing fake insurance claims that were supported by the actual fall, the statements of witnesses and ambulance records. Furthermore, the runners stated that he directed them towards “expensive white neighborhoods” and transit lines, his background in law affording him the knowledge that insurance for these areas would be filed more reliably and lucratively.

Crime and punishment

Prosecutors soon caught on to the similarities between Gaber’s personal injury clients, who were mostly homeless or without a job. They got their first break when neighborhood representatives in the Southwest City Center noticed that there were too many similar falls occurring in the area, and approached the authorities with their concerns. As they moved in to arrest Gaber, whose accounts were already frozen, he committed suicide.

Plans even as complex as this one, which would not have been possible without an attorney’s connivance, fell apart upon scrutiny by surveillance investigators. Public records and legal assistance allowed the insurance companies’ insurance fraud investigation unit to bust the racket. Lured by a few hundred dollars, many of the participants in this apparently innocuous crime faced up to 20 years in prison.

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