NYSIF Chief Deputy Executive Director Francine James announced a series of investigations leading to seven arrests in a continuing crackdown on fraud by the state’s largest workers’ compensation insurance carrier.
The arrests, in cases totaling an estimated fraud value of more than $600,000, included a former corrections officer allegedly working as a bouncer at an upstate night club, a Bronx beverage distributor, a Department of Motor Vehicles estimator, and a Nassau County crane erection company allegedly operating without workers’ compensation insurance.
“As the state’s single largest carrier for workers’ compensation insurance NYSIF has an obligation to crack down on fraud and that’s an obligation we take very seriously,” Ms. James said in making the announcement. “Workers’ compensation fraud is a felony that leads to an enormous drain on New York State resources, and taxes every law abiding citizen and business through increased costs for insurance, goods and other services.
“NYSIF is grateful for the efforts of law enforcement officials who continue to assist us in pursuit of this crime across the state and who, like us, view insurance fraud as an illegal, multi-billion dollar enterprise that must be stopped.”
Ms. James added, “We have a top-rated anti-fraud unit committed to fighting fraud by businesses, claimants and medical providers.”
NYSIF’s Division of Confidential Investigations (DCI) has been responsible for more than 1,200 workers’ compensation fraud arrests in the past 10 years. DCI worked in cooperation with the NYS Insurance Department Frauds Bureau, the Workers’ Compensation Board Fraud Inspector General’s Office, the NYS Attorney General’s Office and local law enforcement in the following cases: Brian Haight, 46, of Beacon, NY, faces charges of violating Section 114 of the Worker’s Compensation Law, fraudulent practices, grand larceny and two counts of offering a false instrument for filing following his arrest by New York State Police on October 21.
Mr. Haight allegedly fraudulently obtained $5,684 while collecting $196 per week for an injury he sustained as a NYS corrections officer. Investigators found that he allegedly returned to work as a bouncer for a local night club. Estimated potential future savings on his claim is $135,734. Tiffany Ford, 38, of Brighton, NY, faces charges of offering a false instrument for filing, insurance fraud and fraudulent practices following her arrest by the NYS Insurance Department Frauds Bureau on October 13. During a NYSIF audit, the Monroe County woman, doing business as Village Roofing, allegedly told NYSIF she had one worker employed to do casual labor. Investigators later learned she allegedly acted on behalf of another NYSIF policyholder who did roofing jobs while employing more than one worker. Domenick Capelli, 52, was charged with offering a false instrument for filing following his arrest by the NYS Attorney General’s Office on October 2, in a case of more than $30,000 in alleged fraud. Investigators said the Bronx man, who owns restaurant and supermarket beverage distributor Pelham Bay Beverage, allegedly underreported payroll to avoid paying the proper premium for his workers’ compensation policy.
Peter Veltri, 47, of Floral Park, NY, was charged with offering a false instrument for filing following his arrest by the NYS Attorney General’s Office on October 2. Mr. Veltri allegedly fraudulently obtained $30,124 by collecting $340 per week in workers’ compensation payments while working as a Department of Motor Vehicles estimator. Estimated potential future savings on his claim is $240,603.
Three following three arrests were part of a sweep in Nassau County announced by District Attorney Kathleen Rice: Thore Foss, 42, of Lake Ronkonkoma, doing business as Thore Construction Company, allegedly used a forged insurance certificate to show proof of workers’ compensation coverage to perform crane erection work at a job site in Syosset, NY.
Marcos Gamboa, 26, of Sea Cliff, NY, allegedly fraudulently obtained $8,074 by collecting $117 per week in workers’ compensation payments while working at a bagel shop in Sea Cliff. Estimated potential future savings on his claim is $107,000.
Robin Ardiano, 30, of Hempstead, NY, allegedly fraudulently obtained $7,175 by collecting $175 per week in workers’ compensation payments while employed as a maintenance worker for an apartment complex on Long Island. Estimated potential future savings on his claim is $36,000. Criminal complaints and indictments are accusations only. Defendants are presumed innocent until proven guilty