BY MARK JOHNSON
Frank Houghtaling is accused of running an insurance fraud ring. (LORI VAN BUREN/Albany Times Union via AP)
ALBANY, N.Y. — Investigators across the country are trying new tactics to crack down on the old problem of auto insurance fraud.
The tools to combat the crime from health insurance fraud mills in New York to “swoop and squat” schemes in California include wiretaps, undercover agents and prosecutors who view auto fraud as organized crime.
In 2001, New York Gov. George Pataki appointed state Attorney General Eliot Spitzer as special counsel to investigate the fraud that has helped drive up New Yorkers’ auto insurance premiums to second highest in the nation, trailing only New Jersey.
New York Deputy Attorney General Peter Pope, who oversees 100 lawyers and 100 investigators statewide as the head of the office’s criminal division, said that going after street-level perpetrators isn’t enough.
Instead, he’s taken an organized crime approach, using wiretaps, undercover agents and investigative grand juries to nab doctors, lawyers and the “silent owners” of medical fraud mills that bilk the insurance industry out of $25 billion to $30 billion a year.
In many cases, syndicates running fraud operations have been charged under New York’s Organized Crime Control Act, which is used to go after larger criminal enterprises. Perpetrators are often charged with enterprise corruption, a major felony calling for longer and mandatory prison time. A conviction can carry a sentence of up to 25 years in prison.
The New York law is patterned after the 1970 federal racketeering statute, known as RICO, to combat organized crime including the Mafia and gangs in several states.
Frank Scafidi of the National Insurance Crime Bureau said fraud causes higher rates for everyone, though he and others say there are no reliable estimates of how much it adds to the average consumer’s bill.
The yearly cost is “enough that it’s really hurting everyone’s wallet,” said Howard Goldblatt of the Coalition Against Insurance Fraud.
In March, an Albany, N.Y., boxer and his family were charged with running a ring that staged minor car crashes and made false insurance claims. Frank Houghtaling, his brother, sister-in-law, father, wife and another woman were named in a sealed indictment after a two-year investigation, prosecutors said. Authorities alleged the 30 to 40 incidents typically involved unwitting drivers of other vehicles in fender benders. The charges are still pending court action.
In New York City in March 2004, 11 people and seven companies were charged in connection with a scheme that prosecutors said defrauded insurance carriers out of $1 million. Doctors, lawyers and others were accused of soliciting accident victims to be treated at IK Medical, a clinic run by Dr. Irina Kimyagarova. The indictment alleged that the clinic was controlled by Emil Izrailov and Robert Shimunov, two silent owners who had no medical training.
Once patients came to the clinic, they received a wide range of unnecessary treatments, including physical therapy, acupuncture, psychotherapy and dental care, according to the indictment. The case is scheduled for trial this month.
“You don’t really make an impact until you make a jump into clinics and the silent owners,” Pope said, referring to the scam organizers who set up bogus corporations and hire doctors to run them. Under New York law, only doctors are allowed to run medical clinics.
Traditionally, prosecutors focused on the people claiming false accidents and the “steerers” who recruited them to take part in the fraud.
The shift in tactics led to the arrests of “those higher up the ladder,” Spitzer’s office said in a report released in July.
In California, police are trying to educate the public about potential fraud schemes.
In one common scam, called the “swoop and squat,” a motorist is driving along at a safe distance from the vehicle in front of him. Another car will then begin to tailgate the unsuspecting driver while another vehicle will pull up alongside, honking and swerving to draw attention. Just as the unwitting driver is distracted, the car in front slams on the brakes, causing a rear-end collision.
The hit car is usually filled with people who then claim injuries, said Rich Halberg of the Sacramento, Calif., office of Allstate Insurance.
“Consumer awareness is really important,” he said, noting that California has about $1 billion in auto insurance fraud annually.