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ALBANY, N.Y., October 19 – A fraud sweep conducted by Queens District Attorney Richard Browns Office has resulted in the arrests of nine individuals who allegedly committed workers compensation fraud, according to NYSIF CEO David P. Wehner.
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ALBANY, N.Y., October 19 – Eight individuals, including a New York State corrections officer, have been arrested for workers compensation fraud against NYSIF in a sweep conducted by the Westchester and Putnam District Attorneys Offices.
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Allstate appealed from an order of the Civil Court, Bronx County (Larry S. Schachner, J.), which, after a nonjury trial, granted plaintiffs motion to preclude defendants expert testimony and awarded judgment in favor of plaintiff.
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For the first time, the Appellate Term has resolved an issue on which the trial courts have differed: whether a fraudulently incorporated medical clinic may collect benefits for services rendered prior to the enactment of the new no-fault regulations (which took effect April 5, 2002. The answer is no.
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POUGHKEEPSIE, N.Y., August 3 – Compensation Risk Managers, LLC (CRM), an administrator for workers compensation group self-insurance programs has announced the successful identification and prosecution of a fraudulent workers compensation claim, involving a claimant who purported to be disabled but was instead working as a bartender and bouncer.
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WASHINGTON, D.C., July 26 – State lawmakers have adopted a model law making it a crime to stage car crashes and recruit for the rings, the Coalition Against Insurance Fraud announced.
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CHICAGO, Ill., May 22 – The Property Casualty Insurers Association of America (PCI) has filed suit challenging the transfer of money, by the Illinois state government, from the Motor Vehicle Theft Prevention Trust Fund to the state general revenue fund and other state funds.
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In this no-fault benefits suit, State Farm denied plaintiffs claims on the basis that the alleged injuries do not arise out of an insured incident. At the start of the trial, the parties stipulated to plaintiffs prima facie case and defendants denial based on the ground of lack of coverage due to no true accident. Defendant State Farm presented one witness, State Farm Special Investigative Unit (SIU) investigator Don Willsey. Plaintiff did not present any witnesses.
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CONCORD, N.H., May 3 – A new insurance fraud prosecutor position has been established within the Department of Justice by Insurance Commissioner Roger A. Sevigny and Attorney General Kelly Ayotte.
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The fight against insurance fraud remains an uphill battle in New York because, according to most within the industry, the Legislature has failed to agree on an effective legislative package that would deter criminals. This, however, is not the case across the river in New Jersey.
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This issue we begin a two-part series on no-fault insurance fraud. I touched on the problem last summer in this column, noting that the Legislature in New York should set aside its differences and pass at least the most obvious beneficial measures, such as a runners law. As of now, however, the story in New York remains the inability to get these reforms onto the Governors desk.
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It is an unfortunate reality that, in general, wherever there is an idea rooted in the desire to do good, there is someone bent on distorting that concept to satisfy selfish ends. This notion is painfully obvious to those familiar with the no-fault systems in New York and New Jersey.
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TRENTON, N.J., March 16 – The New Jersey Supreme Court lowered the standard for insurance companies to sue policyholders who file fake insurance claims.
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WASHINGTON, D.C., March 16 – Efforts to make insurance fraud a specific crime in Vermont moved a step forward when a bill cleared the state House of Representatives yesterday, according to the Coalition Against Insurance Fraud.
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The plaintiffs in this lawsuit are no-fault insurance companies. Plaintiffs claim they owe nothing to defendant medical providers because of defendants violation of various statutes pertaining to the organization of medical corporations and because of defendants fraudulent billing. Plaintiffs seek to recover, from defendants, no- fault payments that plaintiffs made to them for medical services that defendants rendered to persons covered under automobile insurance policies that plaintiffs issued. Plaintiffs also seek a declaratory judgment that they have no obligation to pay defendants for claims defendants have submitted, but which plaintiffs have not yet paid.
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TRENTON, N.J., March 3 – For the Office of Insurance Fraud and the car insurance industry as well, it was a good year all around.
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Long-abused New York drivers have paid among the nations highest auto premiums while octopus-like staged accident rings ran amok for years.
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The question in these 12 consolidated no-fault suits was: Should the decision of the New York Court of Appeals in State Farm v. Mallela, also known in the no-fault bar as Mallela III, be applied retroactively? That case denied no-fault benefits to plaintiff providers that were organized fraudulently.
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