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Philadelphia Federal Insurance Fraud Charges: Healthcare, Auto and Disability

March 21, 2024

Philadelphia Federal Insurance Fraud Charges: Healthcare, Auto and Disability

Hey there! Insurance fraud is a big deal here in Philadelphia. Lots of folks try to cheat insurance companies out of money by faking injuries or damage. The feds don’t take too kindly to that, and they’ve been cracking down hard on insurance fraudsters lately.

Let me break it down for you by type of insurance: healthcare, auto, and disability. Buckle up, because this is going to get a bit technical, but I’ll try to keep it simple.

Healthcare Insurance Fraud

Healthcare fraud is when someone lies to get more insurance benefits than they’re entitled to. Some common healthcare fraud schemes include:

  • Billing for services that were never provided
  • Billing for more expensive services than were actually given
  • Performing unnecessary medical procedures just to bill insurance
  • Accepting kickbacks for patient referrals

A recent healthcare fraud case here in Philly involved Dr. Richard Kaul. Prosecutors said Kaul performed unnecessary heart stent surgeries on patients just so he could bill insurance. He made millions before he got caught. Kaul ended up pleading guilty to healthcare fraud and is now serving 10 years in federal prison. Yikes!

Another big case was against Dr. Javaid Perwaiz from Virginia. He wasn’t from Philly, but his case made headlines nationwide. Perwaiz performed hundreds of unnecessary surgeries on women, including hysterectomies and tubal ligations. He also billed for cancer screenings that patients didn’t need. The feds hit him with dozens of fraud charges, and he was sentenced to 59 years in prison. Talk about a dishonest doctor!

Healthcare fraud often involves kickbacks too. A few years ago, a bunch of Philly-area personal injury lawyers pleaded guilty to paying kickbacks to get client referrals. They’d pay chiropractors and doctors to send them injury cases, then bill the accident insurance. This went on for years before the feds caught wind. The lawyers got prison time and had to pay millions in restitution. Moral of the story: don’t pay kickbacks, people!

Auto Insurance Fraud

Now let’s talk car insurance scams. In Philly, we see a lot of staged accidents and inflated injury claims. Staged wrecks are when a group of people intentionally cause a crash and then file injury claims even though no one was really hurt. They’ll do things like slam on their brakes so the car behind hits them. Totally dishonest!

A recent auto fraud investigation called “Operation Crash and Burn” snagged a Philly crime ring that staged over 100 car wrecks. The crew recruited people to play crash victims, then they’d split the insurance money. Nearly 50 people got charged with fraud and conspiracy. Many pleaded guilty and got jail time. But the ringleader who organized all the bogus crashes fled the country! What a mess.

Inflated injury claims are another common car insurance scam. That’s when someone pretends their minor fender-bender injuries are way worse, to get a huge insurance payout. Soft tissue neck and back injuries are easy to fake or exaggerate. One local chiropractor got indicted for helping patients inflate their injury claims. When insurance companies got suspicious, the patients sued them for “bad faith,” claiming the insurers wrongfully denied benefits. Sneaky!

Disability Insurance Fraud

Last but not least, we have disability insurance fraud. This is when someone lies about being too injured or sick to work, to collect disability benefits. Recent Philly cases include:

  • A SEPTA employee who claimed he couldn’t work due to a bad knee, but was spotted regularly golfing, bowling, and doing yardwork.
  • A former cop who said he was too depressed to work, but posted Facebook pics of his fishing and jetskiing vacations.
  • A financial advisor who faked cognitive problems from a car accident, but was caught on tape giving lectures and doing radio interviews.

They all got busted by insurance investigators or prosecuted for disability fraud. Turns out it’s hard to keep up the act when you’re out living an active life!

The feds don’t play around with disability fraud involving federal programs like Social Security or Medicare. A local attorney named Eric Conn infamously had over 600 clients submit bogus disability claims. The scam cost the government more than half a billion dollars! Conn is now a fugitive with a $200,000 reward for his capture. What a bold disability fraudster.

So there you have it – a quick overview of the major healthcare, auto and disability insurance frauds happening around Philadelphia. Insurance companies aren’t afraid to sic their investigators and the feds on scammers. Maybe just submit honest claims and avoid the courtroom drama – works for me! Let me know if you have any other questions.


Philadelphia Doctor Sentenced to 10 Years in Prison for Performing Unnecessary Surgical Procedures

Chesapeake Doctor Sentenced to 59 Years in Prison for Performing Unnecessary Surgeries and Fraud Scheme

Three Philadelphia-Area Personal Injury Lawyers Sentenced to Prison for Insurance Fraud Scheme

Final Defendant Pleads Guilty in Connection with “Operation Crash and Burn” Insurance Fraud

Philadelphia Chiropractor Arrested for Health Care Fraud in Connection with Automobile Insurance Claims

Former Philadelphia Police Officer Convicted of Disability Fraud

Social Security Disability Lawyer Eric C. Conn Pleads Guilty in $600 Million Social Security Fraud Scheme

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