ZIFL- Volume 26, Issue 9 - May 1, 2022

Zalma's Insurance Fraud Letter - May 1, 2022

Read all of the articles in this Issue including the Following Articles by clicking on ZIFL-05-01-2022.

Chutzpah By Insurance Criminal, Committing Insurance Fraud & Forgery While on Probation Requires Jail Time

Dustin Jungvirt, appealed the sentence imposed following his guilty plea to insurance fraud, claiming the district court failed to properly consider which sentencing option would best rehabilitate him. In State of Iowa v. Dustin Jungvirt, No. 21-1130, Court of Appeals of Iowa (April 13, 2022) the Iowa Court of Appeals resolved the dispute.

Insurer Sentenced for Fraud & Bankruptcy Violations

Jacques Andres Frym, 53, who owned businesses in the Savannah area, pleaded guilty last year to lying under oath about his income. Frym at one time owned Federal Employee Benefits LLC, an insurance company, along with real estate and other interests, federal court records show.

Indiana Travel Agent Sentenced for Insurance Fraud
Links to Fraud Bureaus, Fraud Divisions & Anti-Fraud Organizations
Good News From the Coalition Against Insurance Fraud
Health Insurance Fraud Convictions

In one of Dozens: California Chiropractor Sentenced to Five Years in Prison for Fraud.

Susan Poon, a 57-year-old former Orange County, California chiropractor was sentenced to more than 5 years in federal prison for defrauding health insurers out of around $2.2 million as part of a scheme that lasted more than three years.

Nearly a year after she was convicted of health care fraud and aggravated identity theft, among other charges, Poon submitted false reimbursement claims to several health insurance providers that included false diagnoses and claims of services that were not actually performed, as well as fraudulent prescriptions containing fake diagnoses of dependents of Costco and United Parcel Service employees.

To facilitate the fraud, prosecutors said Poon stole the personal identification information of her victims by attending health fairs at various UPS and Costco locations and soliciting the info from employees.

In a sentencing brief filed with the court, prosecutors described a scheme involving “interdependent moving parts” in which Poon “lied about visits with, diagnosis of, and treatments given to actual people and their children.”

During her sentencing hearing, Poon told U.S. District Judge David O. Carter that she was “sincerely sorry” for her mistakes and promised that “for the future I will lead with a moral compass in my soul.” Poon spoke of her family history – which included parents who immigrated to New York with nothing and established a successful restaurant – to her own work helping the hungry and homeless.

“There is not one day since this incident that I am not truly sorry,” Poon told the judge. “I mentally punish myself daily.”

Carter acknowledged what he described as Poon’s “extraordinary” family history, and said that prior to the fraud scheme she appeared to live an “exemplary life.” But the judge also noted that the fraud went on for years and required information taken from more than 500 people, including some toddlers.

“You represent a person I intuitively feel has turned a corner,” Carter said. “By the same token, the harm here is extraordinary.”

The judge ultimately decided on a sentence slightly shorter than the seven years and three months requested by prosecutors. He also ordered her to pay more than $1 million in restitution.

Does the Covenant of Good Faith & Fair Dealing in Canada Restrict Report to Police?

Other Insurance Fraud Convictions

More reports at ZIFL.

Announcement from the Justice Department re Covid-19 Fraud
New Book on Ethics for the Insurance Professional
Go To Jail, Go Directly to Jail, Do Not Pass Go

Eleventh Circuit Explains How Doctor Defrauded Medicare and Medicaid

Doctor Who Treated Georgia Patients More than 70 hours a Day While he Gambled in Las Vegas Goes to Jail

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE,http://www.zalma.com and zalma@zalma.com.

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