New York Residents Charged with Making False
Statements to Insurer, PennDOT
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Tishon Dodd-Gray and Richard Anderson were arrested in Dauphin County in May 2024. According to the criminal complaint, a law enforcement investigation concluded that New York residents Dodd-Gray, Anderson, and others fraudulently represented that they lived in Pennsylvania, in order to obtain PA vehicle coverage at a lower premium rate. The complaint stated that insurers use the vehicle garaging location as a factor in determining the rating of risk presented in offering coverage and the amount of premium to charge. The complaint further stated that vehicle insurance premiums generally are lower in Pennsylvania than they are in New York. On December 29, 2021, Dodd-Gray allegedly obtained a GEICO Insurance policy for his three BMWs. According to the complaint, he listed a Harrisburg, Pennsylvania address on policy documents that were electronically submitted to GEICO. On January 1, 2022, Dodd-Gray allegedly contacted GEICO and reported that his 2013 BMW had been stolen from an impound lot in New Jersey. During a recorded statement, Dodd-Gray allegedly asserted to a GEICO representative that he had lived alone at the Harrisburg policy address since 2018. The complaint stated that when GEICO tried to send an electronic claim payment with the Harrisburg address to Dodd-Gray’s bank account, the payment initially did not go through, because the bank had Dodd-Gray’s address listed as Uniondale, New York. The complaint further stated that Dodd-Gray subsequently changed his address on the bank account to the Harrisburg address, and the GEICO payment was accepted. A separate criminal complaint stated that Anderson obtained coverage from GEICO for a 2014 Infiniti Q50 in 2019. He allegedly listed a Harrisburg address as his residence and provided his Pennsylvania driver’s license number to the insurer. The complaint stated that an updated GEICO policy document dated February 25, 2023, indicated that Anderson had added a 2017 Audi A4 to his policy and that his residential address had changed to Lansdowne, Pennsylvania. According to the complaint, on April 23, 2023, Anderson filed a claim for flood damage to the Audi. Tow receipts and estimates allegedly revealed that the vehicle had been towed to a repair shop in Jamaica, New York. GEICO paid the claim. Both the complaints filed against Dodd-Gray and Anderson stated that an investigation revealed that both men were issued PA driver’s licenses by PennDOT after they fraudulently represented that they lived in Pennsylvania. The investigation allegedly revealed that Dodd-Gray and Anderson were residents of New York. Dodd-Gray was charged with two counts of Insurance Fraud (F3), one count of Conspiracy to Commit Insurance Fraud (F3), one count of Tampering with Public Records or Information (F3), one count of Insurance Fraud (M1), and one count of Unsworn Falsification to Authorities (M2). Anderson was charged with one count of Insurance Fraud (F3), one count of Conspiracy to Commit Insurance Fraud (F3), one count of Tampering with Public Records (F3), one count of Insurance Fraud (M1), and one count of Unsworn Falsification to Authorities (M2).
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On May 23, 2024, Thomas Bowman was arrested in Beaver County. According to the criminal complaint, on February 17, 2024, at 7:55 PM, Bowman obtained a Progressive Insurance policy for his 2018 Ford Explorer. On February 18, Bowman allegedly reported to a Progressive representative that he had been driving the Explorer in inclement weather when the vehicle was involved in a motor vehicle accident at approximately 9:00 PM or 10:00 PM on February 17. A Progressive representative contacted the driver of the other involved vehicle who allegedly reported that the crash occurred on February 16, at approximately 9:15 PM. The complaint stated that Progressive obtained accident scene photos from the other driver. The photo metadata allegedly revealed that the pictures were taken on February 16, 2024, at 9:29 PM, which was prior to Bowman’s policy inception. Progressive denied the claim. Bowman was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 22, 2024, James Baker was arrested in McKean County. According to the criminal complaint, on November 8, 2023, Baker obtained a GEICO Insurance policy for his 2020 Kia Optima. The complaint stated that the policy was scheduled to take effect the following day. On November 13, Baker contacted GEICO and allegedly claimed that on November 12, he had been driving his vehicle to work when it struck an animal. GEICO allegedly asked Baker to provide photographs of the damage. According to the complaint, representatives reviewed the photo metadata and found that the photos were taken prior to Baker’s policy inception. When the representatives advised Baker of the findings, he allegedly blamed the discrepancy on his malfunctioning phone. He subsequently requested to withdraw his claim. Baker was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 22, 2024, La’Keiya Jarvis was arrested in Philadelphia County. According to the criminal complaint, at 10:47 AM on October 11, 2023, Jarvis went online and purchased a Root Insurance automobile policy for her 2018 BMW. At approximately 7:44 PM that evening, Jarvis allegedly contacted the insurer and reported that her BMW was in an accident with a hit-and-run vehicle at approximately 4:00 PM that afternoon. The complaint stated that Jarvis emailed photos of the damage to her car to Root Insurance. A representative of the insurer reviewed the photo metadata and allegedly found that one picture had been taken at 3:12 PM on October 5, 2023, which was six days before the purported accident date. The complaint further stated that according to a Philadelphia Police Department report, officers responded to an accident on October 5, 2023, that involved Jarvis’ vehicle. According to the complaint, the police report description of the crash matched Jarvis’ description to Root Insurance about her purported October 11 crash. Jarvis 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 Insurance Fraud (M1).
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On May 20, 2024, Matthew Himes was arrested in Clearfield County. According to the criminal complaint on January 7, 2024, Himes added comprehensive and collision coverage to the Progressive Insurance policy for his 2019 Dodge Ram 1500, with an effective date of January 12. The complaint stated that on January 13, Himes contacted Progressive and advised that he had been driving his Dodge Ram earlier that same day when it struck an object, damaging the truck’s undercarriage. According to the complaint, an investigation revealed that Himes received an Accident Response Notification from the Progressive app at 6:40 PM on January 6, 2024. Progressive records allegedly showed that Himes clicked on the notification to confirm that an accident had occurred. However, the complaint stated that Himes did not complete the online claims process because he did not have the proper coverage. Himes allegedly admitted to investigators that the damage to his truck occurred on January 6, 2024, which was before he added comprehensive and collision coverage to his policy. The claim was denied. Himes was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 16, 2024, Sheena Shelton was arrested in Blair County. According to the criminal complaint, Shelton purchased an Allstate Insurance Company policy that included comprehensive and collision coverage for her 2023 Mitsubishi Eclipse Cross. The complaint stated that the policy became effective on January 20, 2024. The complaint further stated that Shelton had an overlapping liability policy with Progressive Insurance. On January 26, Shelton contacted Allstate and filed an accident claim, allegedly stating that her Mitsubishi struck a guardrail on January 25, 2024. According to the complaint, a subsequent investigation revealed that on or about January 9, 2024, Shelton reported to Progressive that her Mitsubishi had been in an accident on January 9. She allegedly provided the same facts of loss to Progressive that she subsequently provided in her claim to Allstate. The complaint stated that Progressive denied the earlier claim because Shelton’s policy did not include collision coverage. Investigators compared photos from the Progressive and Allstate claims and allegedly determined that the damage was the same in both. The complaint stated that Allstate determined that Shelton’s car was damaged before she obtained her Allstate policy. Allstate denied her claim. Shelton was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 15, 2024, Roberto Garcia-Perez was arrested in Montgomery County. According to the criminal complaint, at approximately 10:00 AM on April 1, 2023, Garcia-Perez obtained a Progressive Insurance auto policy through an insurance agent. The policy allegedly took effect at 10:21 AM that day. The complaint stated that on April 2, 2023, Garcia-Perez called Progressive and reported that his vehicle had been stolen at approximately 11:00 AM on April 1, 2023 and that he had reported the theft to local police. According to the complaint, the Philadelphia Police Department took Garcia-Perez’s theft report at 9:15 AM on April 1. He allegedly told police that the theft occurred between 11:00 PM on March 31, 2023, and 9:00 AM on April 1, 2023. The complaint further stated that the vehicle information was entered into the police department’s stolen vehicle system at 9:30:55 AM, on April 1. Progressive allegedly determined that the theft occurred before Garcia-Perez’s policy took effect and denied the claim. Garcia-Perez 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).
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On May 14, 2024, Ursula Bradford was arrested in Lancaster County. According to the complaint, on November 14, 2022, Ursula Bradford filed a stolen/lost ring claim under her Liberty Mutual Insurance Company renter’s policy. Bradford allegedly reported to the insurer that her wedding ring was either lost or stolen while she was at a convention in Indianapolis, Indiana. According to the complaint, Bradford claimed that the ring had been in a tote bag that she accidentally left in the hotel lobby on November 13, 2022. The complaint stated that Bradford provided Liberty Mutual with a receipt purportedly from Reeds Jewelers in Lancaster, which listed the value of the ring at $6,249.76. However, a Liberty Mutual investigator contacted the jewelry store and allegedly found that the receipt was not from Reeds Jewelers. According to the complaint, investigators relayed this information to Bradford. The complaint stated that Bradford subsequently told the insurer that she wanted to withdraw her claim because the hotel had found her missing ring. Liberty Mutual denied the claim. Bradford was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 9, 2024, Amanda Brosius was arrested in Clearfield County. According to the criminal complaint, Brosius added comprehensive and towing coverage to her Progressive Insurance auto policy at 3:34 PM on November 1, 2023. The complaint stated that on November 11, 2023, at approximately 2:24 AM, Brosius went online and filed an accident claim with Progressive. She allegedly told the insurer that she had been driving her vehicle home from work at approximately 2:00 AM when it struck a deer. The complaint stated that Brosius provided photos of the damage to Progressive in support of her claim. Investigators reviewed the photo metadata and allegedly found that the pictures had been taken at 1:36 AM on November 1, before Brosius added comprehensive coverage to her policy. Progressive denied the claim. Brosius was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 8, 2024, Don Georges was arrested in Montgomery County. According to the criminal complaint, at 12:11 PM on April 21, 2023, Georges went online and obtained a new Progressive Insurance vehicle policy. At 5:52 PM on the following day, Georges filed a claim with Progressive, in which he allegedly indicated that his vehicle had been involved in an accident at approximately 5:00 PM on April 21. Georges allegedly provided Progressive with a video of the damage. The complaint stated that investigators subsequently reviewed the video’s metadata and found that the video was made after the policy inception, but before the time that Georges provided for the time of loss. According to the complaint, investigators reviewed the police accident report and learned that officers were dispatched to the crash scene at 11:56 AM on April 21, 2023, which was before Georges obtained his vehicle policy. Progressive denied the claim. Georges was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt / Theft by Deception (F3), one count of Criminal Use of Communication Facility (F3), and one count of Insurance Fraud (M1).
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On May 8, 2024, Clinton Webb was arrested in Allegheny County. According to the criminal complaint, on August 24, 2023, Webb obtained insurance coverage from the Permanent General Assurance Corporation (The General). The complaint stated that on August 30, 2023, Webb reported to The General that at approximately 9:30 PM on August 27, a tornado-like storm caused a tree branch to fall onto his vehicle and damaged it. Webb allegedly submitted a photo of the damage to The General. The complaint stated that investigators reviewed the photo’s metadata and found that the picture was taken at 9:26 PM on August 12, 2023, more than a week before Webb obtained his policy. Investigators reviewed recent reports of weather in Webb’s area and allegedly found that high winds occurred on August 12, the date of the photo. The complaint further stated that no strong winds were reported on the claimed date of loss, August 27. The claim was denied. Webb was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 6, 2024, Mindy Gillin was arrested in Lawrence County. According to the criminal complaint, on November 1, 2022, Gillin obtained MetLife Insurance Group accident and health insurance through her employer. On November 30, 2022, Gillin filed a claim, allegedly reporting that she fell down a flight of stairs and fractured her foot on November 14. The complaint stated that Gillin claimed that she received treatment at a local hospital. While reviewing a medical invoice that MetLife received from Gillin, a claims specialist allegedly noted discrepancies in the font and color of the document. According to the complaint, the claims handler contacted the medical facility and requested a copy of records on Gillin’s injury and treatment. The complaint stated that the provider was unable to locate any records of Gillin’s treatment on the dates in question. According to the complaint, MetLife issued Gillin a new policy on January 1, 2023, which included coverage for one of her relatives. On March 2, 2023, Gillin allegedly submitted a claim for injuries that her relative purportedly suffered on February 12, 2023. The complaint stated that investigators reviewed records that MetLife received pursuant to the claim and asked the providers to authenticate the medical documents. According to the complaint, the providers advised MetLife that they did not author the forms in question. Investigators interviewed Gillin, who allegedly admitted that she had created the documents herself. MetLife denied the claims. Gillin was charged with two counts of Insurance Fraud (F3), two counts of Criminal Attempt / Theft by Deception (F3), and two counts of Forgery (M1).
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On May 6, 2024, Daivon Ellison was arrested in Lycoming County. According to the criminal complaint, on August 1, 2022, Ellison filed a claim with Progressive Insurance for damage to his 2018 Jeep Compass. Ellison allegedly reported that he had been driving the Jeep at approximately 8:30 PM on July 30, 2022, when it struck a deer. The complaint stated that Ellison provided the insurer with photos of the vehicle damage. Investigators reviewed the photos and accompanying metadata and allegedly found that the pictures were taken on November 4, 2021. According to the complaint, investigators learned that Ellison had previously filed a claim with GEICO Insurance for damage to his Jeep that occurred on November 4, 2021. The complaint stated that when Progressive representatives questioned Ellison, he denied having previous coverage with GEICO. After further investigation, Ellison allegedly admitted that he had not repaired his Jeep after the initial GEICO claim, and subsequently filed the claim with Progressive. Progressive denied the claim. Ellison was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (F3).
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On May 2, 2024, Hawa Kamara was arrested in Delaware County. According to the criminal complaint, at 4:19 PM on May 24, 2023, Kamara contacted Progressive Insurance by phone and obtained a new policy covering her 2019 Toyota Rav4. The complaint stated that at 10:52 PM on the same day, Kamara called Progressive and claimed that her Rav4 was involved in a two-vehicle accident at approximately 5:00 PM that afternoon. She allegedly told the insurer that Lansdowne Borough Police had responded to the accident scene. According to the complaint, the police crash report stated that the accident occurred at 2:35 PM on May 24, 2023, which was prior to Kamara’s policy inception. During a subsequent conversation, Kamara allegedly told a Progressive representative that the time listed on the report was incorrect. Kamara also allegedly claimed that she obtained her vehicle policy before the crash occurred. According to the complaint, Lansdowne Police confirmed that the accident occurred at 2:35 PM and advised that Kamara had originally presented officers with an invalid insurance card. The complaint stated that Kamara was cited for driving without insurance at the time of the accident. Progressive denied the claim. Kamara was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt / Theft by Deception (F3), one count of Unlawful Use of Computer (F3), and one count of Criminal Use of a Communication Facility (F3).
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On May 2, 2024, Jacob Salvador Ruiz was arrested in Berks County. According to the criminal complaint, on December 16, 2022, Ruiz obtained an automobile policy from Hugo Insurance Company, a subsidiary of First Acceptance Insurance Company. The complaint stated that the policy was scheduled to take effect at 3:28 PM. Later that same day, Ruiz allegedly telephoned Hugo Insurance and reported that his vehicle was involved in an accident at 3:30 PM. The complaint stated that Ruiz told the insurer that his vehicle was a total loss and had been towed from the scene. During a recorded statement taken by a First Acceptance Insurance Company claims representative on December 21, Ruiz allegedly confirmed that the accident occurred between 3:20 PM and 3:30 PM on December 16. According to the complaint, the claims representative later obtained a copy of the police crash report, which revealed that police were dispatched to the accident scene at 3:17 PM, prior to the inception of Ruiz’s policy. First Acceptance denied the claim. Ruiz was charged with one count of Insurance Fraud (F3) and one count of Criminal Attempt / Theft by Deception (M1).
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On May 1, 2024, Payton Balogh and Trenton Mason were arrested in Indiana County. According to the criminal complaint, on June 5, 2023, Balogh purchased a Progressive Insurance policy for her Kawasaki Teryx. The complaint stated that on June 13, 2023, Balogh reported to Progressive that she had been operating the Teryx on June 11, 2023, when she swerved to avoid hitting a deer and crashed. Balogh allegedly reported that her boyfriend, Trenton Mason, was a passenger on the Teryx at the time of the accident. The complaint stated that Balogh advised the insurer that the Teryx sustained body and suspension damage. On June 14, 2023, representatives from Progressive conducted a recorded interview of Mason. According to the complaint, Mason gave the same accident details as Balogh had, except that Mason said the accident had occurred on June 10. Progressive investigators reviewed the photos' metadata of the damage that Balogh had provided and allegedly determined that the pictures were taken on June 4, the day before Balogh purchased her Progressive policy. Progressive denied the claim. Balogh and Mason were each charged with one count of Insurance Fraud (F3), one count of Criminal Attempt / Theft by Deception (F3), and Insurance Fraud (F3).
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On May 1, 2024, Jeffrey Zettlemoyer was arrested in Dauphin County. According to the criminal complaint, at approximately 4:46 PM on March 7, 2023, Zettlemoyer obtained a Progressive Insurance policy for his 2015 Hyundai Accent. On March 8, Zettlemoyer allegedly filed a claim with Progressive in which he advised that one of the Hyundai’s doors was damaged in a crash that occurred at approximately 5:00 PM on March 7, 2023. The complaint stated that a Progressive representative obtained a copy of the police report, which revealed that the accident had occurred at 1:15 PM, which was several hours prior to the policy inception. Progressive denied the claim. Zettlemoyer was charged with one count of Insurance Fraud (F3), one count of Criminal Attempt / Theft by Deception (F3), and one count of Insurance Fraud (M1).
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On May 1, 2024, Qualinah Bligen was arrested in Montgomery County. According to the criminal complaint, Bligen was driving her 2018 Jeep Compass between 3:00 PM and 4:00 PM on May 7, 2023, when it struck a parked 2002 Toyota Tundra, resulting in significant damage to both vehicles. Bligen fled the scene of the accident on foot. The owner of the Tundra allegedly observed the incident and Philadelphia Police Department officers responded to the scene. According to the complaint, officers used the Jeep’s license plate number to determine that Bligen was the vehicle’s owner. At approximately 10:04 AM on May 12, Bligen allegedly telephoned Progressive Insurance to purchase coverage for her Jeep Compass and advised the insurance representative that her Jeep Compass had no pre-existing damage. On June 15, 2023, Bligen allegedly filed an electronic claim with Progressive, indicating that her Jeep had been damaged in a hit-and-run accident at approximately 2:00 PM on June 14, 2023. According to the complaint, Progressive representatives investigated the purported hit-and-run and located a claim made by the owner of the Toyota Tundra, which pertained to the May 7 accident. The complaint stated that during the investigation, Progressive representatives obtained and reviewed video footage of the May 7 accident, which a neighbor’s Ring camera had captured. According to the complaint, the representatives determined that the vehicle damage in the May 7 footage matched the damage that Bligen allegedly claimed had occurred on June 14, 2023. Progressive denied the claim. Bligen 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 Insurance Fraud (M1).
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During the month of May, Alvaro Rodriguez, John Mulea, Edgar Collado, Edward Saldivar, Oleg Zelenko, Jorge Santos-Hernandez, and businesses ALZ Auto Sales, Saldivar Group, Amatti Auto Sales, and Santos Auto Gallery, entered negotiated guilty pleas and were sentenced in Dauphin County. On October 4, 2022, charges were filed in Dauphin County against 19 individuals and 13 businesses who allegedly participated in a “title-washing” ring in Lackawanna, Monroe, Lebanon, Carbon, and York Counties. The charges followed a lengthy investigation conducted by the 47th Statewide Investigating Grand Jury and involved the cooperative efforts of the Office of Attorney General’s Insurance Fraud Section, the Pennsylvania State Police Auto Theft Task Force, and the Lackawanna County District Attorney’s Office. Following the conclusion of its investigation, the Grand Jury issued two written Presentments of its findings and recommended the filing of criminal charges. The Grand Jury found that participants in the scheme, including used car dealers, enhanced vehicle safety inspectors, and tag agents, worked in concert to fraudulently obtain Pennsylvania Reconstructed Titles for totaled vehicles that purportedly were restored to a roadworthy condition, but did not undergo the mandatory safety inspections for reconstructed vehicles. In many cases, participants completed title and inspection paperwork for vehicles that they never saw, because the vehicles never entered Pennsylvania. The Grand Jury noted that some Pennsylvania dealers were paid to “wash” out-of-state titles, which enabled the vehicle owners to circumvent the rigid inspection requirements in other states and/or export the vehicles to Central America, Eastern Europe, and elsewhere around the world. The Grand Jurors also found that titles to several stolen vehicles were “washed” to conceal the thefts. On May 7, 2024, Alvaro Rodriguez entered a negotiated plea to one count of False Application for Certificate of Title (M1). Rodriguez was sentenced to serve two years of probation, directed to forfeit his PA Dealer Salesperson License during the term of probation, and ordered to pay the costs of prosecution and to pay a $1,000 fine. Rodriguez entered a negotiated plea on behalf of his business, ALZ Auto Sales, to one count of False Application for Certificate of Title (M1). ALZ Auto Sales was directed to notify the Pennsylvania Department of State and PennDOT of the conviction, surrender any business licenses, and shut down all operations. On May 28, 2024, John Mulea entered a negotiated plea to one count of False Application for Certificate of Title (M1). Mulea was sentenced to serve 12 months of probation, to forfeit his PA Dealer Salesperson License during the term of probation, ordered to pay the costs of prosecution, and to pay a fine of $2,500.00. On May 28, 2024, Edgar Collado entered a negotiated plea to one count of Insurance Fraud (F3). Collado was sentenced to serve one year of probation, ordered to pay the costs of prosecution, and to pay a fine of $500.00. On May 28, 2024, Edward Saldivar entered a negotiated plea to one count of Insurance Fraud (F3). Saldivar was sentenced to serve two years of probation, ordered to pay the costs of prosecution, and to pay a fine of $500.00. Saldivar entered a negotiated plea on behalf of his business, Saldivar Group, to one count of Insurance Fraud (F3), one count of Unsworn Falsification (M3), and one count of Conspiracy (M1). Saldivar acknowledged that the business is no longer operating. On May 28, 2024, Oleg Zelenko entered a negotiated plea to one count of Insurance Fraud (M1), one count of Unsworn Falsification (M3), and one count of Conspiracy (M1). Zelenko was sentenced to serve two years of probation, ordered to complete 40 hours of community service, to pay a $5,000 fine, and to pay a civil penalty in the amount of $5,000. Zelenko entered a negotiated plea on behalf of his business, Amatti Auto Sales, to one count of Insurance Fraud (M1), one count of Unsworn Falsification (M3), and one count of Conspiracy (M1). Zelenko acknowledged that the business had been closed and shut down. On May 28, 2024, Jorge Santos-Hernandez entered a negotiated plea to one count of Conspiracy (F3) and one count of Washing Vehicle Titles (F3). Santos-Hernandez was sentenced to serve two years of probation and was ordered to pay a $10,000 fine. Santos-Hernandez also entered a negotiated plea on behalf of his business, Santos Auto Gallery, to one count of Conspiracy (F3) and one count of Washing Vehicle Titles (F3). The sentencing of the business was deferred in order to confirm that all business operations have ceased.
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On May 30, 2023, Austin Reges was sentenced in Butler County after entering an open plea to one count of Theft by Deception (M1). A couple hired Reges’ company, Triple B Landscape and Construction, to pour a stamped concrete patio at the couple’s home. On September 6, 2022, a Triple B employee was using equipment to clear the area for the patio, when the machine unearthed the main electrical wire to the house. The wire was damaged further when Reges tried to disconnect it with a pickaxe. The couple hired Stewart Electric to repair the damaged line. The work was completed on November 9, 2022. The couple paid Stewart Electric in full for the job and provided Reges with a copy of the paid repair bill, expecting that he would reimburse the couple for the repair costs. Reges filed a claim for the repair charges on his business insurance policy with Western World Insurance Company. On December 26, 2022, Reges provided the insurer with a copy of the paid bill from Stewart Electric. The insurer issued a check to Reges for the full amount, minus the $1,000.00 policy deductible. Reges cashed the insurance check on January 30, 2023. On February 3, the couple contacted Western World Insurance Company to inquire about the status of the claim and were advised that Reges had been paid. When the insurer learned that Reges had not reimbursed the couple, the insurer unsuccessfully tried to contact Reges. Western World Insurance then issued payment directly to the couple. Investigators interviewed Reges, who stated that he was unable to reimburse the couple because his ex-girlfriend had emptied his bank account. Reges was sentenced to a period of 30 days to 12 months in jail, the first 30 days of which he will serve under house arrest. Reges also was sentenced to a consecutive term of two years of probation. He was ordered to pay full restitution to Western World Insurance and to pay all other related costs.
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On May 22, 2024, Desiree Riley was sentenced in Westmoreland County after entering a negotiated plea to one count of Criminal Attempt / Theft by Deception (M1). On September 29, 2023, Riley’s Progressive Insurance vehicle policy was canceled for non-payment. On November 8, 2023, at approximately 6:21 PM, Riley purchased a new Progressive policy that included comprehensive and collision coverage. At 5:46 AM on November 15, 2023, Riley went online and filed a claim with Progressive for deer strike damage to her vehicle. Riley reported that the accident occurred as she was driving to work at 5:15 AM on November 15. When a claims representative contacted her several days later, Riley reiterated that the deer strike occurred on November 15, 2023. During an investigation of the claim, investigators interviewed one of Riley’s relatives. The relative provided investigators with a screenshot of a text message that she received from Riley, which included a photo of Riley’s damaged vehicle. Progressive representatives noted that the text was dated November 8, 2023, at 7:36 PM, and included a daylight photo of the damaged vehicle. Progressive investigators confirmed that the sun had set at 5:37 PM on November 8 and concluded that the photo of Riley’s damaged vehicle was taken before she purchased the Progressive policy at 6:21 PM. Riley admitted during questioning that the deer strike occurred before she obtained coverage. Progressive denied the claim. Riley was sentenced to serve two years of probation, ordered to complete 50 hours of community service and to pay the costs of prosecution.
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On May 15, 2024, Patty Tyler was sentenced in Beaver County after entering a negotiated plea to one count of Criminal Attempt / Theft by Deception (M1). On October 4, 2022, Tyler purchased coverage from Progressive Insurance for her 2015 Toyota Camry. On March 30, 2023, she contacted Progressive and claimed that her Camry was vandalized. Tyler informed the insurer that she last operated the Camry in January 2023, and stated that the vehicle had no prior damage. When a Progressive representative reviewed photographs of the vehicle submitted by Tyler, the representative noticed that the Camry’s front bumper appeared to be detached and that the car’s front fender appeared to exhibit significant rusted collision damage. On April 5, 2023, investigators inspected Tyler’s vehicle and noted that the primary damage appeared to be the result of a collision that had occurred more than six months earlier. The investigators reviewed a Center Township Police Department accident report, which stated that Tyler’s vehicle struck a guardrail at approximately 8:30 PM, on November 29, 2020. Witnesses confirmed the time and date of the accident, as well as the damage. When investigators confronted Tyler with evidence that her car was totaled in a crash that occurred in November 2020, Tyler admitted to having misrepresented the facts of the loss to Progressive. Tyler was sentenced to serve 24 months of probation, to complete 50 hours of community service, and to pay all court and supervision costs.
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Accelerated Rehabilitative Disposition (ARD)
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During the month of May, 9 additional defendants received
Accelerated Rehabilitative Disposition (ARD).
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Anti-Fraud Compliance
Reporting of Insurance Fraud to Law Enforcement Agency
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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.
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