DENVER, CO – A proposed new law in Colorado would make it harder for insurers and PIs in that state to investigate possible insurance fraud. Insurance companies often hire PIs to investigate claimants they think might be exaggerating or falsifying injuries. Under the suggested new law, companies would have to present a case before an administrative judge and show that they have some evidence or cause to think that a claimant may be committing fraud. Currently, insurance companies require no reason or proof to launch an investigation, and some companies use random checks to track down fraudsters.

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SACRAMENTO, CA – June Ann Lucena was a prison guard at Folso, but has since been found guilty of insurance fraud. Now, she is being required to repay $244,000 in restitution for her fraud. Lucena sustained a workplace injury in 1999. She continued collecting payments after a disability retirement, alleging that her injuries left her severely injured and unable to perform many physical tasks. A PI who discovered the fraud, however, filmed her going down water slides at a water park in 2002 and then jet skiing.

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OTTAWA, CANADA – In May, the Office of the Privacy Commissioner created and released guidelines to the private insurance sector. These guidelines were in response to consumer complaints and essentially recommended that the industry stop using covert surveillance against customers. PIs in Canada have fired back, telling insurance companies to disregard the guidelines. PIs allege that customers should have only some rights to privacy in public places and that surveillance can and should be used when indicators of insurance fraud are present. Insurance companies have also been legally challenging the Privacy Commissioner, arguing in court that surveillance laws and guidelines do not apply in these privacy interest instances.

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DETROIT, MI – Insurance companies are setting up a program to investigate arson in the Detroit area. In Wayne County, arson is the official or suspected cause of 50% of all fires, and insurance companies have formed the Michigan Insurance Fraud Awareness Coalition and have earmarked over a million dollars for a two-year project to investigate arson in the area. The program will include two PIs and an assistant prosecutor, in charge of investigating the fires.

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AUCKLAND, NEW ZEALAND – New rules in parts of New Zealand will mean that PIs and local police will work together more closely. Search warrants will be available for joint investigations, and police will be required to investigate cases examined by PIs. Advocates of the new rules believe that the rules will help prevent private investigations that are not considered by police. In the past, PIs and their clients have been frustrated when evidence is collected by PIs but police do not act on the information.
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A Sherman Oaks, Calif., man has been arrested for insurance fraud, grand theft, identity theft, and federal charges, the California Department of Insurance reported. Moshe “Sanny” Assoulin, 35, was arrested in Israel on Aug. 19, 2007 by Israeli National Police. Assoulin is an Israeli national who grew up in California’s San Fernando Valley.

A warrant for Assoulin’s arrest was issued in October 2005, following the results of an investigation by the CDI. The investigation revealed multiple fraudulent automobile insurance claims were allegedly submitted to car rental and insurance companies by Assoulin and co-conspirators. Nine defendants have pleaded guilty to various insurance fraud related charges in connection with this case. In May 2005, Assoulin was awaiting sentencing for federal charges when he became aware of CDI’s insurance fraud investigation. At that point, Assoulin fled to Israel.

A McDowell County man who earlier pleaded guilty to a felony count of insurance fraud was in a regional jail last week after being sentenced, West Virginia Insurance Commissioner Jane Cline said.

Bradley Vernatter pleaded guilty in February to one felony count of conspiracy to commit insurance fraud, Cline’s office said. Vernatter admitted to his role in committing staged auto accidents and was sentenced Wednesday to one year in a regional jail and ordered to pay State Farm Insurance Co. $2,000 in restitution, Cline’s office said.

Insurance companies should be careful they only employ private investigators that operate to high standards and within the law, says the Association of British insurers.

The ABI has worked with the Information Commissioner’s Office and the private investigator (PI) industry to publish guidelines on the use of PIs by insurers when investigating potentially fraudulent claims.
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A New Jersey doctor pleaded guilty Thursday to falsifying medical records and insurance claims.

Dr. Farouk Al-Salihi, of Jersey City, admitted making the fraudulent claims in January and February 2006. The patient whose papers Al-Salihi forged turned out to be an undercover investigator from the New Jersey Office of Insurance Fraud.

Al-Salihi will appear before Hudson County Judge Vazquez on June 15 for sentencing. He faces up to 18 months in prison and a $10,000 fine.

An insurance adjuster who embezzled more than $45,000 from the Woodland Hills company where he worked pleaded guilty to conspiracy and fraud charges and was sentenced to a year in county jail and five years probation, a prosecutor said Thursday.

Van Nuys Superior Court Judge Michael Kellogg also ordered Jacinto Antonio Barrientos to pay $45,199 in restitution to Unitrin Insurance Co., where the San Fernando Valley man, 35, committed the crimes over a 13-month period beginning in June 2005, prosecutor Loren Naiman said.

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