On September 10, 2021, Kenneth Neeld was sentenced in Chester County Common Pleas Court after pleading to one count each of the following charges: Theft by Unlawful Taking (F2), Theft by Deception (F3), Theft by Failure to Make a Required Disposition of Funds Received (F3), Forgery (F3), Misapplication of Entrusted Property (M2), Insurance Fraud (F3), False Swearing (M2), Criminal Use of Communication Facility (F3), Unlawful Use of Computer (F3), and Making False Inheritance Return (M3). The charges resulted from a Statewide Investigative Grand Jury’s findings that Neeld had schemed to steal money from an 84-year-old terminally ill victim and from the victim’s estate. Neeld was a funeral director and the head of a consulting firm which purported to offer financial advice to the elderly. In early 2016, the elderly Bucks County victim authorized Neeld to exercise power of attorney over his financial affairs. The victim signed a will which named Neeld executor of his estate and which designated three charities as beneficiaries of the estate. The victim died in September of 2016. Between March of 2016 and December of 2020, Neeld abused his authority and used funds belonging to the victim and the estate for his own benefit. Neeld transferred funds directly from the victim’s account into his own and used the victim’s funds to pay his own debts and expenses. Neeld used the money to pay such things as federal, state and local taxes, orthodontic and veterinary bills, auto repair costs, insurance premiums, credit card bills, and a vacation home rental. Neeld concealed the victim’s death from Integrity Life Insurance Company in order to have the insurer deposit more than $35,000 in annuity funds into an account controlled by Neeld, rather than directly paying the deceased victim’s charitable beneficiaries.  Neeld falsely claimed to have provided a funeral for the victim, in order to obtain more than $10,000 in funeral benefits from Unity Financial Life Insurance Company. In total, Neeld stole more than $257,916. He was ordered to serve a period of 2 ½ - 5 years of incarceration, along with a concurrent term of 7 years of probation. Neeld was ordered to pay a total of $257,916.61 in restitution to three Chester County charities: Amigos de Jesus, Rawadi Fund, and Brandywine Valley Active Aging.  In keeping with the terms of his plea agreement, Neeld must relinquish his funeral director and insurance agent licenses and is barred from conducting business as a funeral director, insurance agent or financial advisor while he is under court supervision.

On September 29, 2021, Austin Arnold was arrested in Lawrence County.  According to the criminal complaint, on April 17, 2021, Arnold was off-roading in his uninsured 2018 Polaris Utility Terrain Vehicle when the UTV flipped and Arnold was injured.  On April 18, Arnold purchased a motorcycle policy for the UTV from Progressive Insurance. On May 16, Arnold filed an insurance claim with Progressive and allegedly reported that he was injured when the UTV rolled during a May 15, 2021 trail ride. The complaint stated that during the claim investigation, Progressive representatives located a video of the crash which was posted on Arnold’s Facebook page on April 17, 2021. Further, Progressive reviewed Arnold’s medical records and allegedly found that he sought treatment for his injuries on April 17, prior to the inception of his Progressive policy. According to the complaint, when the insurer confronted Arnold with the video, Arnold admitted that he had obtained coverage after the crash occurred. Progressive denied payment of the claim. Arnold was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (F3).

On September 28, 2021, Laura Elizabeth Hunsperger was arrested in Montgomery County.  According to the criminal complaint, on April 26, 2021, Hunsperger was operating her uninsured Hyundai Santa Fe when it struck the rear of a Honda Civic.  A Warminster Township police officer arrived at the accident scene at 3:44 PM.  Hunsperger allegedly presented a Liberty Mutual Insurance Company card to the owner of the Honda Civic and to the officer as purported proof that she was insured at the time of the accident.  However, the complaint stated that Hunsperger’s Liberty Mutual policy had been cancelled for non-payment on July 7, 2019.  The complaint further stated that at 5:17 PM on April 26, 2021, Hunsperger used her mobile phone to access the internet and to purchase a vehicle policy from Progressive Insurance. During the online application process, Hunsperger allegedly represented that she had active coverage for the Hyundai through Liberty Mutual. On April 27 at 9:29 AM, Hunsperger used Progressive’s mobile app to file an accident claim. Hunsperger allegedly reported that the crash occurred at 5:45 PM on April 26, after she had completed the online policy application questionnaire. According to the complaint, Hunsperger submitted photos of her vehicle damage to the insurer in support of her claim. After obtaining a copy of the police accident report and examining the photo metadata, Progressive investigators allegedly determined that the crash had occurred before 4:00 PM on April 26, 2021. The claim was denied. Hunsperger was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (F3), one count of Application Fraud (M1), and one count of Criminal Use of a Communication Facility (F3).

On September 28, 2021, Yafarrah Kaii Ashia Brown was arrested in Montgomery County.  According to the complaint, Brown was involved in an accident on September 23, 2020, at approximately 3:30 PM.  Cheltenham Township police responded to the accident at 3:40 PM. The complaint stated that a few minutes after the accident occurred, Brown purchased a policy with Progressive Insurance using her mobile device.  Brown allegedly filed a claim for the accident. During the claim investigation, Brown allegedly told a Progressive representative that she was not sure exactly what time she obtained the policy, but maintained that it was in effect when the accident occurred. However, according to the complaint, an investigation revealed that the crash occurred before the policy inception. Brown was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (M1), and one count of Criminal Use of Communication Facility (F3).

On September 28, 2021, Christopher Wilson was arrested in Lancaster County.  According to the criminal complaint, on August 27, 2018, Wilson’s Progressive Insurance automobile policy lapsed due to nonpayment.  On September 1, 2018, Wilson allegedly reinstated the policy, telling the Progressive representative that his vehicle had not been in any accidents during the lapse period. On September 3, 2018, Wilson added comprehensive and collision coverage to his policy, effective September 8, 2018. According to the complaint, on September 14, Wilson filed a claim with Progressive in which he advised that his vehicle sustained water damage when he drove it across a flooded roadway on September 11, 2018. During a recorded statement to the insurer, Wilson allegedly reiterated that the damage was caused by flooding on September 11. However, according to the complaint, an investigation revealed that the vehicle’s engine was damaged before Wilson added comprehensive and collision coverage to his Progressive policy. The claim was denied. Wilson is charged with Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (M1), and one count of Insurance Fraud (M1).

On September 28, 2021, Jason DiSalvatore was arrested in Lawrence County.  According to the criminal complaint, on November 17, 2017, DiSalvatore added his fiance’s engagement ring to his Nationwide Insurance homeowner policy. On August 18, 2018, DiSalvatore allegedly reported to Nationwide that his fiancé lost the engagement ring while she was at a swimming pool.  However, according to the complaint, the ring was not lost and DiSalvatore’s fiancé was unaware that he had filed the claim. On August 28, DiSalvatore received $9,776.38 in claim proceeds from Nationwide. According to the complaint, DiSalvatore’s fiancé ended their relationship in March of 2019, but kept her engagement ring.  The ex-fiancé allegedly remembered that DiSalvatore once claimed that he could get insurance money by reporting the ring lost, so she and her new fiancé contacted Nationwide and learned that DiSalvatore had filed a claim for the ring. Investigators subsequently confirmed that DiSalvatore’s ex-fiancé still was in possession of the ring. DiSalvatore was charged with one count of Insurance Fraud (F3) and one count of Theft by Deception (F3).

On September 23, 2021, Kesha Torres was arrested in Berks County on a warrant that was issued previously.  According to the criminal complaint, Torres is employed at The Children’s Hospital of Philadelphia (CHOP) as a Respiratory Therapist and typically works 12 hour shifts. The complaint stated that Torres had been working on November 7, 2020, when she was head-butted by a patient. Torres suffered a concussion, contusion of the scalp, and a cervical strain. She was treated for her injuries at CHOP and then at the University of Pennsylvania hospital. On November 9, Torres was evaluated at Worknet Occupational Medicine and was ordered to remain off work. At a follow-up evaluation on November 13, Torres allegedly was ordered to work only 4 hours a day, effective November 16, 2020. The complaint further stated that Torres sought a second opinion from her primary care physician and was ordered to remain off of work until December 1, 2020. On November 18, a Tristar claims examiner interviewed Torres by telephone. Torres allegedly told the representative that Worknet wanted her to return to work for 4 hours a day, but Torres did not feel that she could do so. The complaint further stated that Torres reported that her primary care doctor had ordered her to remain off of work until December 1, 2020. On December 2, Torres was again evaluated by Worknet and allegedly was advised to remain on four hour shifts effective November 16, 2020. According to the complaint, an investigation subsequently revealed that although Torres claimed that she was unable to return to work at CHOPS, she had been working multiple 12 hour shifts as a respiratory therapist at Einstein Medical Center during November and December of 2020. The complaint stated that Torres never disclosed this employment to Tristar. As a result, Torres allegedly received more than $5,000 in Workers’ Compensation benefits to which she was not entitled. Torres was charged with one count of Insurance Fraud (F3), one count of Theft by Deception (F3) and one count of Workers’ Compensation Fraud (F3).

On September 22, 2021, Keith Henry Graft, Jr., was arrested in Fayette County.  According to the criminal complaint, at approximately 8:14 PM on December 20, 2020, Graft was driving his 2019 Toyota RAV4 when it struck a deer.  At approximately 8:21 PM, while he was still at the scene of the accident, Graft allegedly went online and reinstated his lapsed vehicle policy with The General.  The complaint stated that a few hours later, Graft filed an online insurance claim for the accident and reported to The General that the crash had occurred at 8:30 PM. During a recorded phone call with the insurer, Graft allegedly claimed that he had reinstated his lapsed policy prior to the accident. However, according to the complaint, the insurer reviewed accident photos that Graft had submitted and found that they were taken several minutes before his coverage became effective. The claim was denied.  Graft was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (M1).

On September 21, 2021, Kadaycia Crockett was arrested in Philadelphia County.  According to the criminal complaint, in November 2020, Crockett rented a vehicle from Enterprise. At the time, Crockett allegedly had no vehicle insurance policy of her own and did not purchase insurance from Enterprise. According to the complaint, the vehicle was damaged by a hit and run accident on December 4, 2020. On December 3, 2020, Crockett allegedly applied for an automobile policy through New Jersey Manufacturers Insurance (NJM) and subsequently submitted a claim to the insurer for the damage to the vehicle. Following an investigation, Crockett allegedly admitted that she had purchased the policy after the vehicle was damaged and had lied to NJM about the date and circumstances surrounding the claim.  Crockett was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (F3), and one count of Criminal Use of a Communication Facility (F3).

On September 21, 2021, Angel Lebron was arrested in Berks County.  According to the criminal complaint, on October 24, 2020, at 3:19 PM, Lebron purchased liability vehicle coverage from Progressive Insurance Company.  At 6:48 PM, Lebron filed an accident claim with Progressive and allegedly told the insurer that his vehicle had been involved in an accident with another vehicle at 3:30 PM that afternoon. According to the complaint, an investigation revealed that the accident occurred before Lebron purchased his automobile insurance policy from Progressive.  The claim was denied. Lebron was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (F3).

On September 15, 2021, Deatra Beamon was arrested in Montgomery County.  According to the criminal complaint, Beamon was involved in an accident on June 21, 2021, at 12:30 PM.  On that same day, at 5:45 PM, Beamon allegedly purchased a policy from Progressive Insurance. The complaint stated that she filed a claim for the accident the next day and reported that the accident occurred on Jun3 21, 2021, approximately 5:00 PM. During an ensuing claim investigation by Progressive, Beamon allegedly denied knowing the exact time of the accident. According to the complaint, investigators obtained a copy of the crash report which revealed that Philadelphia Police received notification of the accident at 12:34 PM. The complaint further stated that photographs of the damage were examined and that the metadata revealed that they were taken at 12:31 PM and 12:33 PM, hours before Beamon obtained her policy. Beamon allegedly admitted to investigators that she did not have insurance at the time of the accident.   Beamon was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (F3), and one count of Criminal Use of a Communication Facility (F3).

On September 9, 2021, Christopher Smart and Coleen Schrecengost were arrested in Allegheny County.  According to the criminal complaint, on March 31, 2021, Smart reinstated his previously cancelled automobile policy with The General. On April 6, Smart filed an accident claim with the insurer. Smart allegedly reported that on April 1, he was driving through an intersection when a vehicle driven by Schrecengost turned in front of him, causing Smart’s vehicle to strike the rear passenger side of Schrecengost’s vehicle. The complaint stated that Schrecengost verified that the accident occurred on April 1. However, the complaint further stated that metadata from photographs that Schrecengost provided to the insurer revealed that the crash occurred on March 21, 2021, before Smart reinstated his policy. Both Smart and Schrecengost allegedly acknowledged that they had agreed to misrepresent the accident date in an effort to get The General to cover the claim. The claim was denied.  Both Smart and Schrencengost were charged with two counts of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).

On September 8, 2021, Cassandra Miller was arrested in Bucks County.  According to the criminal complaint, on September 4, 2020, an attorney representing Cassandra Miller filed a claim with Selective Insurance, alleging that Miller was struck on the back of her head by a sign on December 1, 2019. The incident allegedly occurred as Miller and her daughter were walking past a store at the Willow Grove Park Mall. According to the complaint, Miller maintained that the impact from the sign left a noticeable contusion on the back of her head and caused her to fall to the floor. On November 20, 2020, a Selective Insurance representative took a recorded statement from Miller. Miller allegedly told the insurer that she did not know what caused the sign to fall. According to the complaint, Miller initially reported that the sign was heavy, but that she managed to remove it herself. However, later in the interview, Miller allegedly told the insurer that the sign had to be removed by her eight-year-old daughter and several other customers. According to the complaint, a video recording of the incident revealed that the sign did not strike Miller's head and that she never fell to the floor or required assistance from others. Selective Insurance denied the claim.  Miller was charged with one count of Insurance Fraud (F3), one count Criminal Attempt/Theft by Deception (F3), and one count of Criminal Use of Communication Facility (F3).

On September 29, 2021, Shaquinda Kotay was sentenced in Butler County after pleading to one count of Criminal Attempt/Theft by Deception (M1). Kotay contacted Nationwide Insurance and claimed that her 12 year old daughter suffered back pain and bruising due to injuries that she sustained from a school bus accident on October 26, 2018. Kotay demanded $20,078 in damages. However, video evidence revealed that the girl was not on the bus when the accident occurred. Kotay was ordered to serve 12 months of probation and to pay all costs.

On September 27, 2021, Randcliff Oliver was sentenced in Allegheny County after entering into an open plea to one count of Theft by Deception (M1) and one count of Tampering with Records or Identification (M1).  Oliver claimed that low back pain prevented him from performing his job at Zoll Medical Corporation, beginning on November 13, 2018. Oliver received short term disability benefits from December 3, 2018 through March 2, 2019, then transitioned to long term benefits. On May 15, 2019, Oliver received verbal confirmation from The Standard Insurance Company that his claim for long term benefits was approved. The insurer subsequently sent a letter notifying Oliver that his benefit payment would be reduced if Oliver received any other income. The letter also instructed Oliver to notify Standard if he returned to work. On May 30, Oliver signed an EFT Disability Payment Option Request. By signing, Oliver acknowledged that he would be receiving benefits because he was disabled and that in accepting each payment, he would be certifying that he “made no false claims or statements or concealed any material fact.” Oliver returned to work at Zoll Medical Corporation on June 17, 2019, but failed to inform the insurer that he did so. Standard subsequently received a Physician’s Report Form dated December 16, 2019, on which Oliver asserted that he was unable to work due to his medical condition. An investigation ultimately revealed that Oliver received more than $16,000 in disability benefits from Standard to which he was not entitled. Oliver was sentenced to 3 years of probation. He was ordered to perform 50 hours of community service, pay $16,333.60 in restitution and pay costs.

On September 27, 2021, Angela Rider was sentenced after entering a negotiated plea to one count of Insurance Fraud (M1) one count of Insurance Fraud (M1) and one count of Theft by Deception (M1). Rider’s Progressive automobile policy was cancelled for nonpayment on July 22, 2020. On July 28, Rider called Progressive to make a payment and was advised that her policy had been cancelled. Rider told the insurer that her vehicle had not been involved in any losses since the date of the policy cancellation. Rider then made a payment to Progressive and her policy was reinstated without a lapse in coverage at 6:49 PM on July 28, 2020. On August 3, 2020, Rider reported to Progressive that her daughter struck a deer while driving the insured vehicle at 4:39 AM that morning. Rider claimed that police were not involved and that she rented a tow dolly to tow the vehicle to her house. However, when Progressive spoke with Rider’s daughter later that day, she reported that the vehicle was towed from the scene by Taylor’s Towing at a cost of $170.00. Progressive contacted Taylor’s Towing and was advised that the vehicle was towed on July 28, 2020. Additionally, the Pennsylvania State Police confirmed that they received a call about the vehicle accident at 4:39 AM on July 28, 2020. Rider and her daughter maintained that the accident had occurred on August 3. Progressive denied the claim. Rider subsequently admitted to investigators that she had lied to Progressive. Rider was sentenced to concurrent terms of 12 months of probation and ordered to pay fines and costs.

On September 27, 2021, Zoey Black was sentenced after entering a negotiated plea to one count of Insurance Fraud (M1).  Black’s automobile policy with Progressive Insurance lapsed for non-payment on   October 5, 2020.  On October 12 at 11:48 AM, Black used Progressive’s mobile app to complete an auto policy reinstatement questionnaire. Black responded to a question on the application by indicating that she had been involved in an accident. She canceled that application, then immediately began a new application at 11:52 AM. This time, Black answered “no” in response to the accident question. On October 12, 2020, Progressive received a report from another driver who claimed that at 11:37 AM that morning, he was involved in an accident with a vehicle driven by Black. When Progressive contacted Black about the accident, she stated that the crash had occurred after her coverage was reinstated. However, the insurer obtained a copy of a Maryland State Police accident report which confirmed that the crash had occurred at 11:37 AM on October 12, prior to the reinstatement of Black’s policy. Black admitted to investigators that she did not have insurance when the accident occurred and that she reinstated her policy after the fact. Black was ordered to serve 12 months of probation. She was ordered to pay a $250 penalty to Insurance Fraud Prevention Authority and to perform 50 hours of community service.

On September 23, 2021, Jennifer Fezza was sentenced after entering into a negotiated plea to one count of Acquisition of a Controlled Substance by Fraud (F), one count of Identity Theft (M1), and one count of Theft by Deception (M1). A Butler Memorial Hospital representative reported to the Office of Attorney General that Fezza had used a hospital physician’s DEA number and other identifying information to obtain a prescription for the schedule II controlled substance Methylphenidate. Investigators spoke with the physician who confirmed that she did not authorize or sign the prescription in question.  The physician told investigators that Fezza was a current patient, but had been issued only three prescriptions during an office visit on February 22, 2019.  The doctor advised that any prescriptions that she purportedly wrote for Fezza after April 21, 2019, were fraudulent. Investigators determined that a total of 13 prescriptions for Methylphenidate were illegally filled by Fezza. Fezza used her UPMC and You prescription insurance plan to pay for the pills. Fezza was sentenced to serve 3 years of probation, the first 6 months of which she is to serve under House Arrest.  Fezza was ordered to undergo Drug & Alcohol and Mental Health evaluation, and to pay all court costs.

On September 14, 2021, Jorge Lara-Castro was sentenced after entering a negotiated plea to two counts of Insurance Fraud (M1), and one count of Criminal Attempt/Theft by Deception. On April 30, 2020 at 5:22 PM, Lara-Castro obtained an automobile insurance policy from Progressive Insurance. On May 1, 2020, at 11:09 AM, Lara-Castro’s daughter called Progressive Insurance and reported that a tree had fallen on her vehicle early that morning. At the request of Progressive, the daughter sent in three photographs of the damage, which was estimated at more than $15,000.00. On May 13, 2020, Lara-Castro spoke to a claims representative and stated that the loss had occurred at approximately 3:00 AM on May 1. Lara-Castro advised that he purchased the vehicle about 6 months earlier and that he obtained the Progressive policy on April 30^th after learning that his prior coverage with Allstate had been cancelled. An investigator took a recorded statement from Lara-Castro’s daughter on May 19, 2020. During the statement, she maintained that the accident occurred on May 1 and advised that the vehicle was towed. The investigator spoke to a representative at Fling’s Towing who reported that the company responded to the scene at 3:19 PM on April 30, 2020, but that the driver ultimately did not tow the vehicle. Progressive Insurance denied the claim. Lara-Castro was ordered to serve 18 months of probation, pay a $200 penalty to the Insurance Fraud Prevention Authority, and pay $250 in costs.

On September 9, 2021, Raheem Schell was sentenced after entering a negotiated plea to one count of Insurance Fraud (F3).  At approximately 3:00 AM on December 8, 2018, a Progressive insured driver reported striking a parked vehicle at 2:30 AM. At 3:30 AM, Schell called Progressive and stated that the driver struck at least five parked cars and a pedestrian. Schell claimed that his 2000 Chevy Tahoe was one of the parked vehicles damaged in the accident. The Progressive insured driver cooperated with the insurance company investigation and told investigators that his vehicle struck only one car and did not strike a pedestrian. Schell gave a recorded statement to Progressive in which he claimed that his vehicle was damaged in the accident and that he had photos. On December 10, 2018, Schell provided the insurers with photos of his damaged vehicle. However, the metadata revealed that the photos were taken on November 2, nearly a week before the accident in question. When a Progressive representative asked Schell about the date discrepancy, Schell did not provide an explanation. Schell told a Progressive inspector that he had repaired the Tahoe and provided the inspector with a receipt for the purported purchase of approximately $3000 in repair parts from Stone Auto. Progressive was unable to locate Stone Auto. During Progressive’s investigation, a witness to the accident confirmed that the Progressive insured vehicle struck only one parked vehicle, a GMC Denali. A Philadelphia police report confirmed that only the Denali was damaged in the accident. Schell subsequently admitted to an investigator that his vehicle was only slightly damaged and that he actually paid only $800 for the repair parts. Schell was ordered to serve 12 months of probation, perform 15 hours of community service, and pay a $250 penalty to the Insurance Fraud Prevention Authority. 

On September 9, 2021, Yousef Akanan was sentenced after entering into a negotiated plea to one count of Criminal Attempt/Theft by Deception (M1) and one count of Theft by Deception (M1).  Akanan paid $73,000 to his brother for a home in Johnstown, which the brother had bought for $5,000 in 2016. The home purportedly was renovated and furnished before Akanan purchased it. Akanan bought a Liberty Mutual Insurance homeowner policy which insured the property for $475,606.10. The residence was destroyed by fire on May 30, 2016. Akanan filed a claim with Liberty Mutual for damage to the structure and contents. Akanan provided the insurer with lists of items which he claimed were lost in the fire and received a total of approximately $82,000 from Liberty Mutual for the depreciated value of the contents. During the claims process, the insurer asked Akanan to provide receipts for items damaged by the fire. He provided receipts totaling $74,282.33 for purchases that he claimed were made at a Walmart store in Somerset. In order to recover any of the depreciation amount withheld by the insurer, Akanan was required to provide Liberty Mutual with receipts for items that he purchased to replace those lost in the fire. Akanan provided the insurer with receipts for items that he claimed to have purchased from a Walmart store in Texas. Liberty Mutual paid Akanan a total of $1,129.35 in recoverable depreciation. When investigators contacted the Walmart stores to verify the purchases, it was determined that both sets of receipts were fraudulent. Akanan was ordered to serve 15 days of incarceration followed by 22 ½ months of probation. He was further ordered to pay a total of $5,360.35 in restitution, a fine of $1,500.00, and to pay court costs.

Pennsylvania Bulletin Notice 2016-04 (issued April 30, 2016) reminded insurers of their obligations to report suspected arson or insurance fraud to law enforcement agencies within the Commonwealth.  The bulletin also announced a decision by the Pennsylvania Department of Insurance to allow licensees to satisfy their reporting obligation when they electronically submit reports of suspected fraud to the National Insurance Crime Bureau (NICB).

 

On July 6, 2017, Pennsylvania began participating in this online service which enables member companies to electronically forward reports of suspected fraud to the Pennsylvania Office of Attorney General’s Insurance Fraud Section or other appropriate law enforcement agencies at the same time the companies report suspicious claims to the NICB. NOTE: The NICB is not a law enforcement agency. Therefore, a licensee cannot satisfy the fraud reporting requirement by submitting a non-electronic (paper) referral only to the NICB.

 

Important: When utilizing electronic filing through NICB, users should take careful note of the provided instructions regarding the “Party” to a claim.  Information entered about a Party will only be transmitted to law enforcement if users select one of two options: “This Party was subject to an SIU investigation” or “This Party was subject to an enforcement action.”  Some users have missed this notation about individual Party data and consequently have submitted incomplete information to law enforcement.