On April 27, 2021, Jaison Kelly was arrested in Allegheny County.  According to the criminal complaint, the case was referred to the Office of Attorney General’s Insurance Fraud Section by the Pennsylvania Insurance Department. The Insurance Department allegedly received a complaint from State Farm Insurance concerning Kelly, who was employed as a State Farm agent between June 1, 2016 and April 13, 2018.  The complaint stated that an investigation and audit conducted by the Insurance Department revealed that during his tenure as a licensed agent, Kelly submitted two fraudulent credit applications to State Farm Bank. On September 14, 2017, Kelly allegedly submitted an application to refinance a loan in the amount of $111,000.00 for a 2017 Maserati Levante. On December 4, 2017, Kelly allegedly submitted an application for credit in the amount of $125,700.00 for the purchase of a 2017 Thor Motor Coach Ace.  According to the complaint, both applications were submitted in the name of Kelly’s grandfather. The complaint further stated that the applications contained false information about the purported applicant’s income. When State Farm Bank requested verification of income, Kelly allegedly provided nothing pertaining to the first application, but submitted fabricated pay statements in support of the income listed on the second application. State Farm Bank denied both of the credit applications. Kelly was charged with two counts of Criminal Attempt/Theft by Deception (F2), and one count of Tampering with Records or Identification (M1). 

On April 30, 2021, Cain Barnett was arrested in Allegheny County.  According to the criminal complaint, on January 30, 2020, the passenger side of Barnett’s 2017 Hyundai Elantra was damaged when the car struck a parked Jeep. Barnett allegedly drove away from the scene and his car was found abandoned a short distance away.  Police responded to the incident and wrote a report.  According to the complaint, the owner of the Jeep took pictures of the Elantra and filed a claim with his insurance company, USAA.  The complaint further stated that on June 12, 2020, Barnett purchased a vehicle policy from Progressive Insurance which included comprehensive and collision coverage.  On November 12, Barnett allegedly phoned in a claim to Progressive for the damage to his Elantra. According to the complaint, Barnett stated that on October 12 or 13, his car struck a guardrail and damaged the car’s entire passenger side. Barnett allegedly provided a repair estimate and photos of the damage to Progressive. The insurer conducted an investigation and learned that a claim was filed with USAA by the Jeep’s owner in January, 2020.  According to the complaint, photos taken by the Jeep’s owner shortly after the January accident revealed that Barnett’s Elantra was damaged before he obtained comprehensive and collision coverage from Progressive. During a November 23, 2020, recorded interview, Barnett allegedly admitted to a Progressive representative that he purchased the Progressive insurance policy and filed a claim after his Elantra was damaged, in hopes of getting the insurer to cover the repair costs. The claim was denied. Barnett is charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (F3).

On April 29, 2021, Xhasa Green was arrested in Allegheny County.  According to the criminal complaint, at 10:23 PM on December 13, 2020, Green telephoned Pittsburgh police and reported that her 2016 Nissan Altima was stolen minutes earlier. Police responded and wrote a report detailing the date and time.  On December 14th at 12:27 AM, Green allegedly purchased a Progressive Insurance policy for the vehicle.  The complaint stated that at 11:00 AM that morning, Green filed a vehicle theft claim with Progressive. She allegedly told the insurer that the Nissan was stolen sometime between 1:00 AM and 2:00 AM on December 14. The complaint stated that on February 25, 2021, a Progressive representative spoke with Pittsburgh police and learned that Green’s 2016 Nissan Altima was stolen and subsequently damaged when it was involved in a crash. According to the complaint, a Progressive investigation revealed that the theft and crash occurred before Green obtained insurance.   On March 17, 2021, Green allegedly admitted to investigators that she purchased the policy and filed the claim after the vehicle was stolen and damaged, because she wanted Progressive to cover the loss.  Green was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (F3).

On April 27, 2021, Edwin Garcia was arrested in Lancaster County.  According to the criminal complaint, on November 2, 2020, at 3:05 PM, Garcia went online and obtained a Progressive Insurance policy for a Ford Focus and a Toyota Camry. At 12:38 PM on November 3, Garcia allegedly called Progressive and reported that a tree branch had fallen on both vehicles. According to the complaint, Garcia claimed that the tree branch damaged the Ford’s hood and front window, as well as the Camry’s rear door. Garcia allegedly reported that he discovered the damage at approximately 12:15 PM on November 3, when he left his residence to run errands. According to the complaint, a claims adjuster reviewed photos of the damage submitted by Garcia. The adjuster allegedly determined from the metadata that the photos were taken on November 2, approximately one hour before the inception of Garcia’s Progressive policy. On November 28, Garcia withdrew his claims. According to the complaint, an investigation revealed that Garcia misrepresented the date and time of the loss in order to obtain insurance proceeds. Garcia was charged with one count of Insurance Fraud (F3), one count of Theft by Deception (F3), and one count of Criminal Use of a Communication Facility (F3).

On April 21, 2021, Jodi Payton was arrested in Lycoming County.  According to the criminal complaint, On September 11, 2019, Payton obtained an Erie Insurance automobile policy which included collision and comprehensive coverage. On July 4, 2020, Payton allegedly used Erie’s mobile app to file a claim for damage to her vehicle which was caused by a hit and run driver that day.  On July 9, a material damage adjuster from Erie conducted an inspection of Payton’s vehicle. From the inspection, Erie allegedly determined that the currently claimed vehicle damage was identical to the damage documented in a prior claim from 2018. The complaint stated that on July 10, Erie questioned Payton about the prior damage during a recorded phone conversation. Payton allegedly stated that the recently claimed damage was not the same. However, the complaint further stated that Erie compared photos of the vehicle from both sets of claims and determined that the front end damage was indeed the same. When an Erie representative called Payton on July 14 to schedule an interview, Payton allegedly declined and advised that she wanted to withdraw her claim. Erie made no payment on the claim. Payton was charged with one count of Insurance Fraud (F3) and one count of Theft by Deception (F3).

On April 20, 2021, Zoey Black was arrested in Adams County. According to the criminal complaint, Black’s automobile policy with Progressive Insurance lapsed for non-payment of premium on October 5, 2020.  On October 12 at 11:48 AM, Black allegedly used Progressive’s mobile app to complete an auto policy reinstatement questionnaire. According to the complaint, Black responded to a question on the application by indicating that she had been involved in an accident. She allegedly canceled the reinstatement, then immediately began a new reinstatement process at 11:52 AM. This time, according to the complaint, Black answered “no” in response to the accident question. On October 12, 2020, Progressive received a report from another driver who allegedly claimed that he was involved in an accident with Black’s vehicle at 11:37 AM that morning. When Black was contacted about the accident claim by Progressive, she allegedly stated that the accident occurred after her coverage was reinstated. However, according to the complaint, a Maryland State Police accident report confirmed that the crash had occurred at 11:37 AM on October 12, which was prior to the reinstatement of Black’s coverage. Black allegedly admitted to investigators that she did not have insurance when the accident occurred and that she reinstated her policy after the fact. Black was charged with one count of Insurance Fraud (F3), one count of Application Fraud (M1), and one count of Criminal Use of a Communication Facility (F3).

On April 20, 2021, Melissa Anne Benner was arrested in Centre County.  According to the criminal complaint, on January 31, 2020, Benner obtained a Progressive Insurance automobile policy, for three vehicles. The policy listed Benner and her husband as insured drivers. The complaint stated that at 4:51 AM on September 1, 2020, Benner went online and added her son as a driver on the policy. During the policy change process, Benner allegedly denied that her son had been involved in any prior accidents. At 11:00 AM that day, Benner allegedly telephoned Progressive and reported that her son was involved in an accident while driving her 2010 Nissan. The complaint stated that Benner claimed that the single car accident occurred at 5:00 AM. During an investigation, Progressive allegedly obtained copies of phone records which showed that Benner’s son called Benner shortly before she added him to the policy. The complaint stated that when Progressive contacted Benner’s son, he admitted that he had been driving the Nissan for the past two years and kept it at his own residence during that time. Progressive determined that the accident occurred before Benner’s son was added to the policy. The claim was denied. Benner was charged with one count of Insurance Fraud (F3), once count of Criminal Attempt/Theft by Deception (F3), and one count of Insurance Fraud (M1).

On April 19, 2021, Alsatia West was arrested in Chester County.  According to the criminal complaint, on February 13, 2020, West’s Progressive Insurance automobile policy was canceled due to non-payment of premium. On April 14, 2020, West allegedly obtained a new Progressive auto policy at 3:52 PM. The complaint stated that at 4:28 PM that same day, West reported to Philadelphia police that her vehicle had been stolen on April 12. Police recovered the vehicle on April 15. According to the complaint, West went online with Progressive on April 17 and reported that her car was stolen at 11:20 PM on April 14. Progressive subsequently took a recorded statement from West. West allegedly claimed that she parked her Nissan at her apartment parking lot on April 12, 2020, at 10:00 PM. According to the complaint, West advised that she discovered her vehicle missing at approximately 11:00 AM on April 13, 2020. The complaint further stated that later during the interview, West admitted that she obtained her current Progressive policy after the vehicle’s lienholder advised West that the vehicle was not insured. Progressive denied the claim. West was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (F3), one count of Criminal Use of a Communication Facility (F3), and one count of Unlawful Use of a Computer (F3)

On April 16, 2021, Jemelle Ford was arrested in Allegheny County.  According to the criminal complaint, on December 13, 2019, Ford was operating his uninsured 2018 Hyundai Sonata when it rear-ended another vehicle. On August 5, 2020, Ford allegedly obtained a Progressive Insurance policy for the Sonata. The complaint stated that on October 8, Ford filed a claim with Progressive in which he maintained that the Hyundai’s front end was damaged by a hit and run driver on October 3, 2020. However, an investigation allegedly revealed that the damage actually was caused by the December, 2019 accident. The complaint further stated that an investigator confronted Ford, who admitted that he had tried to get Progressive to cover the prior damage to his car. Progressive denied the claim. Ford was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt (F3).

On April 15, 2021, Tristan Reed and Kai-Lyn Farlow were arrested in Cameron County.  According to the criminal complaint, Reed incepted a Progressive Insurance policy during September, 2018, which provided liability coverage for his 2011 Subaru.  On January 1, 2021, at 2:53 AM, Reed allegedly added comprehensive and collision coverage to his 2011 Subaru, effective January 6, 2021. The complaint stated that at 8:20 AM on January 6, 2021, Reed contacted Progressive Insurance and reported that his insured vehicle had been involved in a deer strike accident ten minutes earlier. Reed allegedly stated that he and his girlfriend Kai-Lyn Farlow were driving on Route 46 in Emporium when the accident occurred. A Progressive Insurance representative subsequently contacted Farlow about the accident. According to the complaint, Farlow stated that she and Reed were heading to his grandmother’s residence in Emporium when the deer strike occurred at approximately 10 AM on January 6. However, two foremen from the PennDot parking lot where Reed left his car after the accident allegedly told investigators that the loss occurred prior to the New Year holiday. According to the complaint, the witnesses stated that the vehicle sat in the PennDOT parking lot until it was towed the following week. On March 16, 2021, Reed allegedly admitted to an investigator that the accident actually had occurred at 6:00 PM on December 31, 2020. No money was paid by Progressive.  Reed and Farlow were each charged with one count of Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (F3) and one count of Criminal Conspiracy/ Insurance Fraud (F3).

On April 15, 2021, Eric Holzman was arrested in Westmoreland County.  According to the criminal complaint, on October 19, 2020, at 4:09 PM, Holzman reduced his Progressive Insurance vehicle policy collision and comprehensive deductibles from $2,000.00 to $250.00. The changes took effect at 12:01 AM on October 30, 2020. On November 12, 2020 at 2:47 AM, Holzman allegedly phoned Progressive and reported that the passenger side of his 2018 Mustang was vandalized at approximately 3 PM the previous day. Progressive subsequently obtained a copy of a body shop’s estimate of repair costs. According to the complaint, the estimate was prepared at 12:00 PM on October 19, 2020, which was prior to when Holzman’s lower policy deductibles took effect. Holzman allegedly admitted to investigators that he requested the lower deductibles after the repair estimate was prepared. The claim was not paid. Holzman was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (M1)

On April 14, 2021, Nikia Cromartie was arrested in Montgomery County.  According to the criminal complaint, on October 15, 2016, Cromartie reported to Erie Insurance that her insured car was struck by a hit-and-run driver. Both Cromartie and her passenger filed claims.  According to the complaint, Cromartie subsequently sued Erie for up to $50,000 under the uninsured/underinsured motorist provisions of her policy.  Cromartie was deposed on August 22, 2019, but her case was ultimately dismissed when she failed to appear for an arbitration hearing in March 2020.  The investigation allegedly determined that while there was a crash, it occurred several hours later than Cromartie reported and that she was the one who had fled the scene.  Cromartie was charged with one count of Perjury (F3), one count of Insurance Fraud (F3), one count of Criminal Attempt/Theft by Deception (F3), one count of Criminal Use of a Communication Facility (F3) and one count of False Swearing (M2).

On April 14, 2021, Edward Baurle, Jr., was arrested in Butler County.  According to the criminal complaint, on August 20, 2020, Baurle added a Utility Terrain Vehicle (UTV) to his existing Nationwide Insurance motorcycle policy. On November 9, 2020, Baurle telephoned Nationwide and filed a claim in which he allegedly stated that he was riding the UTV on November 7, when he lost control and the vehicle rolled down a hill. Nationwide inspected the vehicle and estimated the damage at $12,641.21. According to the complaint, Nationwide received a tip that Baurle had wrecked and totaled his UTV on August 14, 2020, before he insured the vehicle with Nationwide. The complaint stated that Nationwide discovered several Instagram posts of the damaged UTV which pre-dated Baurle’s coverage. A witness to the accident allegedly confirmed that the accident occurred before Baurle added the UTV to his policy. According to the complaint, Baurle eventually admitted to Nationwide that the damage occurred before he insured the UTV. Baurle was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (F3).

On April 14, 2021, Brian Wilkinson was arrested in Westmoreland County.  According to the criminal complaint, on July 22, 2020, Wilkinson purchased an auto insurance policy from the Permanent General Assurance Corporation which included collision and comprehensive coverage. On August 11, 2020, The General mailed a notice to Wilkinson which indicated that his policy would be cancelled on August 28, 2020, for non-payment of premium. On September 4, Wilkinson allegedly reported to The General that his 2006 Range Rover was involved in an accident on August 26, two days before Wilkinson’s policy was cancelled. According to the complaint, the police accident report, tow records and video from the accident scene confirmed that the loss occurred on August 30, 2020, two days after Wilkinson’s policy was cancelled. The claim was denied. Wilkinson was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (F3).

On April 13, 2021, Nathan Christ was arrested in Chester County.  According to the criminal complaint, on October 5, 2020, Christ filed a claim with the Capital Insurance Company in which he reported that his 2012 Mazda 3 was rear-ended by a motorcycle on October 4, 2020. The complaint further stated that Christ was the only driver covered by the policy. However, the police accident report allegedly stated that another person had been driving Christ’s vehicle at the time of the accident. According to the complaint, Christ told the insurer that the other person was a passenger in the vehicle when the crash occurred. The insurer interviewed the purported passenger, who allegedly confirmed that he was driving Christ’s Mazada at the time of the accident.  Capital Insurance denied the claim. Christ was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt/Theft by Deception (F3).

On April 6, 2021, David Palermo was arrested in Lancaster County.  According to the criminal complaint, Palermo is the owner and president of Automotion Unlimited, a used car dealership located in Lancaster. The complaint further stated that Automotion Unlimited has maintained an Erie Insurance policy which includes coverage for five unspecified dealer license plates. Investigators obtained paperwork from PennDOT which allegedly revealed that between 2017 and 2020, the Lancaster dealership filed applications to renew 19 PA dealer license plates registered to Automotion Unlimited. Palermo also allegedly filed applications to replace several PA dealer tags registered to Automotion Unlimited which reportedly were lost or stolen at locations in New Jersey and New York. By signing the applications, Palermo allegedly verified the truthfulness of the information provided. According to the complaint, the paperwork falsely asserted that Automotion Unlimited’s Erie policy covered the 19 PA tags registered to the dealership, when in fact the policy insured only 5 dealer tags. The complaint further stated that the filed paperwork included several letters purportedly issued by Erie, which appeared to verify that the dealership’s policy insured certain specific dealer plates. An investigation allegedly revealed that the letters were forgeries. According to the complaint, the investigation also revealed that the PA dealer plates registered to Automotion Unlimited were primarily utilized primarily in New York and other locations outside of Pennsylvania between 2016 and 2020. The investigation allegedly revealed that Palermo lives in New York and is CEO of a dealership in Ozone Park, New York, which is also named Automotion Unlimited. The complaint stated that Erie Insurance confirmed that it never insured Palermo’s New York dealership. Further, according to the complaint, the Lancaster dealership’s Erie policy, if rated for Palermo’s New York dealership location, would require a significantly higher annual premium payment. Palermo was charged with three counts of Insurance Fraud (F3), four counts of Insurance Fraud (M1), one count of Theft by Deception (F3), two counts of Forgery (F3), one count of Criminal Conspiracy (F3), and three counts of Unsworn Falsification to Authorities (M3).  Palermo’s Lancaster dealership, Automotion Unlimited, was charged with three counts of Insurance Fraud (F3), four counts of Insurance Fraud (M1), one count of Theft by Deception (F3), two counts of Forgery (F3), and one count Criminal Conspiracy (F3).

On April 30, 2021, Kimberly Balthazar was sentenced in Erie County after entering a negotiated plea to one count of Criminal Attempt/Theft by Deception (M1) and one count of Theft by Failure to Make Required Disposition of Funds Received (M1). On June 24, 2019, Balthazar rented a Nissan Altima when her own vehicle became inoperable. Balthazar’s Esurance vehicle policy lapsed on July 9 for non-payment. On October 5, while she was renting the Nissan, Balthazar purchased a policy from Esurance which included rental car coverage. On October 16, 2019, Balthazar filed a claim with the insurer in which she reported that the rental vehicle had been vandalized the previous evening and as a result, the car’s driver’s side rear door had a basketball-sized dent. When Esurance contacted the dealership which had rented the Nissan to Balthazar, the insurer discovered that a claim had been filed with a different insurer in July, 2019, pertaining to a two-vehicle accident that damaged the Nissan’s driver’s side rear door. During the course of that prior claim, Balthazar had represented herself as the owner of the Nissan. She received $2,254.76 from Penn National Insurance as a result of the prior claim. An investigation revealed that Balthazar never repaired the prior damage to the Nissan. Esurance denied Balthazar’s October claim. Balthazar sentenced to serve three years of probation for each count, to run consecutively.  She was further ordered to pay restitution in the amount of $2,254.74 to Interstate Nissan, perform 50 hours of community service, and pay court costs.

On April 29, 2021, Katherine Yova was sentenced in Butler County after entering a negotiated plea to one count of Insurance Fraud (M1). When she applied for vehicle coverage through Erie Insurance, Yova was asked whether any driver or member of her household had been “arrested for any reason.” Yova answered “no.” If Yova had responded affirmatively, Erie would not have issued the policy. On August 22, 2018, Yova submitted a vehicle claim to Erie Insurance for damage which occurred that day when her vehicle struck a guardrail. Erie issued payment to Yova in the amount of $2,793. Erie conducted a background investigation of Yova which revealed that she had been arrested approximately 30 times prior to the date of her coverage inception. Yova was sentenced to serve 12 months of probation, ordered to perform 25 hours of community service, and pay all costs.

On April 27, 2021, Allen Linnell, Jr., was sentenced in Chester County after entering a negotiated plea to one count of Insurance Fraud (F3).  In September of 2015, insurance agent Allen Linnell Jr. submitted two life insurance policy enrollment forms to Unity Financial Life Insurance along with two checks which were made payable to Unity. One check, for $15,000, represented his client’s payment in full for a funeral benefits policy insuring the client’s life.  The other check, for $91,000, was the client’s payment for a standard life insurance policy.  Unity issued the funeral policy as requested, but, because its rules prohibited insuring any individual under policies with total premiums in excess of $75,000, it issued a smaller life policy with a reduced premium of $60,000.  Unity issued a refund check for the $31,000 balance and mailed it to the client’s residence. After the client passed away in 2018, Unity paid policy benefits on the two existing policies.  Several months later, the client’s nephew contacted Unity and inquired about a supposed third life policy. The nephew provided paperwork that Linnell had provided to the client in which Linnell confirmed that he had used the $31,000 to purchase a third policy.  Included in that paperwork was what purported to be a certificate for a life policy with a $31,000 premium.  Unity researched the policy number provided by the nephew, but found no corresponding policy for the client.  Investigators also confirmed that Unity had not received a third set of policy enrollment forms and premium payments on the client’s behalf and that the policy certificate that Linnell gave the client was forged.  Investigators also determined that the $31,000 check issued by Unity had been deposited into Linnell’s account and that he had never forwarded those funds to the client.  Linnell was ordered to serve seven years of probation and pay $31,000.00 in restitution to Unity Financial Life Insurance Company and United Integrity Group, Inc.

On April 26, 2021, Susan Mathieson was sentenced in Mercer County after entering a negotiated plea to one count of Theft by Deception (M1) and one count of Insurance Fraud (M1). On June 25, 2020, Mathieson contacted Allstate Insurance and requested reinstatement of her auto policy which cancelled at the beginning of the month.  On June 25, 2020, Mathieson also purchased comprehensive, collision and rental coverage for a 2008 Ford Taurus which she purportedly owned. Mathieson contacted Allstate on July 9 and filed a claim for damage to the Ford Taurus which she said had occurred earlier that morning. Mathieson submitted photos of the damage to the insurer. The insurer noted that the photos were timestamped prior to the time when Mathieson obtained coverage for the Taurus. During the claims process, Allstate received information that Mathieson did not own the vehicle and was not driving it at the time of the accident. Allstate contacted the actual owner of the vehicle, who stated that the accident occurred on June 15, 2020, which was prior to the policy inception. Mathieson was ordered to pay a fine of $400.00 to Enterprise Car Rental, perform 100 hours of community service, and serve four years of probation.

On April 23, 2021, Christopher Sharp was sentenced in Blair County after entering a negotiated plea to one count of Criminal Attempt/Theft by Deception (M1).  Sharp made a false statement in support of a claim in which his friend’s uninsured vehicle was struck by another vehicle. Sharp’s friend had no driver’s license at the time of the accident. The friend subsequently obtained vehicle coverage from Esurance. Ten days later the friend filed an online claim for the accident and reported that the loss occurred after the policy’s inception.  When Esurance called to take a recorded statement, Sharp pretended to be someone else and stated that he had been driving his friend’s vehicle at the time of the accident. An investigation revealed that the collision happened prior to the policy inception. Sharp was ordered to serve three years of probation, perform 50 hours of community service, and pay all court costs.

On April 21, 2021, Ronnie Knight, Jr., was sentenced in Erie County after entering a negotiated plea to one count of Insurance Fraud (F3). On September 21, 2017, the Pennsylvania Insurance Department received a letter indicating that Transamerica Life Insurance Company had terminated for cause an employee of Knight’s business, Knight’s Brokerage.  Transamerica had received a complaint from a woman who alleged that a policy was opened in her name without her authorization and that the policy contained banking information which did not correspond to hers. Transamerica learned of other, similar complaints which concerned the same employee. According to the criminal complaint, an investigation revealed that Knight, not his employee, had produced and submitted the fraudulent applications to Transamerica. As a result, Knight had unlawfully received approximately $2,392.27 in commissions from Transamerica between November 14, 2015 and April 21, 2016. Knight was ordered to serve four years of probation, perform 50 hours of community service, and pay $2,392.27 in restitution to Transamerica Life Insurance Company.

On April 20, 2021, Amanda Ottersen was sentenced in Chester County after entering a negotiated plea to one count of Insurance Fraud (F3) and one count of Criminal Conspiracy (F3).  Ottersen’s boyfriend, Michael Rodriguez was involved in a motor vehicle accident on January 4, 2020, at approximately 1:14 PM.  At 5:52 PM, Rodriguez and Ottersen went online and obtained a GEICO insurance policy for Rodriguez’s vehicle.  Rodriguez contacted the insurer on January 5 at 10:09 AM and stated that his vehicle was involved in a crash at approximately 6:00 PM on January 4.  Rodriguez and Ottersen confirmed the 6:00 PM time of loss when they subsequently were interviewed by investigators. During the course of the interview, Ottersen admitted that she purchased coverage for Rodriguez’s vehicle after the accident occurred and subsequently claimed that the crash happened later.  Ottersen was ordered to serve two years of probation and pay costs of prosecution. Rodriguez was arrested in December, 2020, and his case is still pending.

On April 9, 2021, Nathaniel Laws was sentenced in Montgomery County after entering a negotiated plea to one count of Insurance Fraud (F3). On September 18, 2019, Laws filed a claim with Homesite Insurance Company for the loss of a diamond valued at more than $2,000. In support of his claim, Laws provided Homesite with a purchase receipt, a Diamond Certificate Report and photograph of the ring setting for the missing gem. An investigation revealed that in 2016, Laws filed a claim with Farmers Insurance Company for the theft of the same diamond. That prior claim was denied. Additionally, investigators discovered that Laws filed a claim with State Farm Insurance in 2014 for the loss of another diamond from the same ring setting. Homesite denied Laws’ claim. Laws was sentenced to serve nine months of house arrest, followed by 3 years of probation. He was also ordered to pay a penalty of $2000.00.

On April 7, 2021, Jennifer Allen was sentenced in Montgomery County after entering a negotiated plea to one count of Criminal Attempt/Theft by Deception (M1). On May 2, 2019, Allen and her spouse obtained a Progressive Insurance policy. On May 7, Allen filed a claim with Progressive via mobile phone in which she indicated that the vehicle struck a deer on May 6, 2019 at 1:13 AM. Allen provided Progressive with photographs of the damage to the driver’s side front end and door. However, investigators found that in March of 2019, a claim for deer strike damage had been filed by the vehicle’s previous owner, Allen’s former roommate. That claim was denied by the insurer because the coverage was not in effect at the time of the loss. Investigators determined that the photos submitted by Allen in support of her claim had previously been submitted to the insurer in support of the March, 2019 deer strike claim. Progressive denied Allen’s claim.  Allen was ordered to pay a fine of $250.00 and all costs and fees.

On April 7, 2021, Kevon Smith was sentenced in Allegheny County after entering a negotiated plea to one count of Criminal Attempt/Theft by Deception (M1).  On May 23, 2020, Smith was riding as a passenger in a car that he had purchased, when the vehicle was involved in an accident.  Smith had used another person’s name to register the vehicle and to obtain liability coverage through Progressive Insurance, because Smith did not have a valid driver’s license. On May 24, 2020, Smith contacted Progressive and allegedly identified himself as the policyholder by providing the insured’s name, date of birth and Social Security information.  Smith then added comprehensive and collision coverage to the vehicle’s insurance policy.  The Progressive representative informed Smith that the additional coverage would take effect on May 29, 2020, following a five-day waiting period.  Smith contacted the insurer on June 2 and again posing as the policyholder, claimed that the car was involved in an accident on May 30.  A subsequent investigation and review of the Pennsylvania State Police crash report revealed that the accident actually occurred on May 23, prior to the effective date of the additional coverage.  Progressive denied the claim.  Smith was sentenced to serve 12 months of probation. He was also ordered to perform 50 hours of community service and 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.