Welcome to the Hall of Shame(rs)
The newest entrants to the 2019 Hall of Shame are facing decades in prison for crimes ranging from faulty fires to unnecessary medical care.
Insurance fraud is an $80 billion a year industrial enterprise, churning out stolen insurance cash with the collective financial force of an overheated solar flare.
Say hello to the newest avatars of avarice, the freshly chosen members of the Insurance Fraud Hall of Shame … the No-Class of 2019.
The shamers are the year’s nine biggest moral pathogens and were dishonored by the Coalition Against Insurance Fraud.
Some shamers think big; their crime rings stole millions with steely audacity and bloated excess. Others are wobbly knuckleheads; their ethical DNA is missing genome coding for common sense. All shamers are convicted, yoked with lifetime criminal records.
These Tyrannosaurus Wrecks play a valuable deterrent role. They add a human face to the stolen insurance dollars. Their crimes call public attention to a brazen theft that many consumers view as a harmless prank. The shamers thus remind us that insurance fraud is a costly drain on all Americans.
Perhaps most important, the convicted shamers are a warning that highly trained fraud fighters are imposing their will. Their deterrent message: The risk isn’t worth the reward. Resistance is futile.
Fire flimflam. Wealthy socialite Claire Risoldi strafed her insurer with $20 million of swollen claims for ruined home possessions after her mansion mysteriously caught fire near Philadelphia.
Risoldi’s bling often wasn’t lost or didn’t exist — or she simply puffed up claims because she thought it was easy to get away with. Risoldi mostly invented $10 million worth of jewelry — blaming brave firefighters for stealing her rocks.
Then came an inflated $950,000 for hand-painted wall and ceiling murals that cost Risoldi a fraction of that amount. Not to mention, hundreds of thousands for draperies supposedly infused with crystals.
Insurance money flew into her bank accounts. Enough to buy more homes, six Ferraris, two Rolls Royces, a Cobra and other vehicles for her and her family members. Then came the final overdue bill: two years in prison thanks to the state attorney general’s effective courtroom pursuit.
Slip-and-fall stumbles. Street people and other down-and-outers were recruited to pretend they tripped on the sidewalks of New York in a $32 million strafing of insurers by a slip-and-fall ring.
Peter Kalkanis recruited hundreds of destitute people who needed spare cash. He coached them on how to fake injuries after tumbling on uneven or cracked pavement. Backs, knees or shoulders were badly hurt, Kalkanis’ troops told insurers. He forced some people to have life-altering — and unneeded — spinal fusions and other surgeries to inflate their claims even more.
Doctors on his payroll did bogus medical exams, and colluding attorneys pressured insurers in order to extract large settlements. Kalkanis awaits sentencing.
Singed scam. A roaring home arson fire began as a faulty $500,000 insurance theft. It ended with the arsonist heat-wrapped in searing flames, staggering from the burning home to die in Scranton, Pa.
Diomedes Ceballos hired his younger brother, Aurelio Ceballos DeLeon, to torch his home. Yet Aurelio knew nothing about fire. He lit gasoline with a lighter and was promptly engulfed by fire.
Aurelio lurched outside on fire; his clothes nearly all singed off. Somehow, Aurelio staggered to his apartment. A friend found him there, dying. Still, Aurelio wouldn’t call 911. His addled brain worried more about the police discovering the arson than about saving his own life. Aurelio died the next day.
Part of a firefighter’s arm was nearly torn off while combating the flames.
Diomedes bought his home for $86,000 and insured it for a $500,000 bonanza. His only windfall was a state jail term, up to 20 years.
Uncaring nursing care. One of the largest insurance crimes in United States history flew high and fell hard. Phil Esformes drove a $1.6 million Ferrari. His juiced-up wheels were among the stolen riches from what prosecutors touted as a $1.2-billion insurance plundering in South Florida.
Esformes stuffed 14,000 addicts, mentally ill and street people into assisted-living facilities and nursing homes. He overbilled their Medicaid and Medicare accounts for services people didn’t want, need or receive.
His network of corrupt homes served as little more than insurance billing machines. Insurance money bought Esformes his Ferrari, a private waterfront mansion and other princely trappings. They’re all gone. Esformes will be just another federal prisoner ID number as he serves a 20-year sentence.
Disability fright night. A thug wearing a creepy Halloween scare mask of movie slasher Michael Myers assaulted a terrified Boston trolley car driver. Or so it seemed. The driver, Thomas Lucey, planned the mugging to steal a paid disability vacation.
Lucey hired a crony to wear the scare mask and pretend to rough him up. So, the guy climbed onto Lucey’s trolley at a pre-arranged spot after midnight just before Halloween. The mugger also wore dark overalls and carried a plastic pumpkin.
He yanked Lucey from the trolley, shoved him to the ground, fake-mugged him and ran away. It was staged theater for the trolley security cameras.
Lucey claimed post-traumatic stress disorder, then left work and started pulling down long-term disability money. However, the masked mugger wasn’t very sharp. He dropped the pumpkin while fleeing. Fingerprints led investigators to break open the plot. Lucey awaits sentencing.
Slip scam iced. Over and over national news stories replayed the grainy security video of Alexander Goldinsky lying down on the floor, pretending he was hurt.
The New Jersey man became an instant news hit. Goldinsky was a subcontractor hired by a firm. Security cameras captured him wandering into the company’s cafeteria. He goes to the ice machine, fills a cup with ice, then spills the contents onto the floor.
Goldinsky then lies down amid the ice. He waits for someone to show up and discover him in seeming distress. Someone negligently left ice on the floor, Goldinsky falsely claimed, forcing him to fall hard in the damp mess.
He filed a dodgy ambulance and hospital claim, except the firm’s all-seeing security video captured his every staged-acted move. Goldinsky awaits sentencing.
Phony phone exams. Worthless ortho braces rained down on seniors in a $424 million Medicare plundering by Lester Stockett. He scored a large share of a vast transnational crime ring’s suspected $2.1 million theft. Stockett exploited the burgeoning trend of telemedicine — phone and video exams by doctors.
Boiler rooms of telemarketers operated in Latin America and the Philippines. Callers recruited hundreds of thousands of seniors, setting them up for bogus medical phone exams.
Stockett bribed doctors to give seniors brief phone exams of no medical value. The providers piled on prescriptions for expensive braces the seniors didn’t need or want. Stockett is scheduled for federal sentencing in December.
Alligator assassin. Hungry alligators ate Mike Williams, officials decided, after he seemingly drowned while boat fishing with his best friend on a chilly lake near Tallahassee, Fla.
In fact, his wife, Denise, had Mike’s seemingly good buddy shotgun him while fishing. She and Brian Winchester were having an affair and stood to reap $1.75 million of life insurance.
Winchester pushed Mike from the boat into Lake Seminole in December 2000. He shot Mike as he flailed in the chilly water. Winchester buried him in a remote area, lying that Mike had drowned. Investigators thought that alligators had eaten him when they didn’t find a body in the pond. The only problem is, alligators don’t eat in winter, so the case was reopened.
Denise Williams is headed for life in state prison. Winchester took a plea deal in exchange for immunity, although he was given 20 years for kidnapping Denise after they married.
Failed sobriety test. A corrupt rehab network forced desperate addicts to relapse in a $100 million plot to milk insurers in Pennsylvania. Jason Gerner co-founded Liberation Way, where he warehoused luckless addicts in allied sober homes.
Gerner shuttled addicts to crooked rehab centers every day. One center was called a “party house” — addicts could easily score drugs there. Employees also had sex with addicts.
The scam encouraged addicts to keep relapsing so Gerner could bill for overpriced drug tests and rehab. Some addicts returned for six or more painful rounds. Gerner awaits federal sentencing.
These shamers thought they were above the law and would never be caught. The promise of great riches outweighed the reality of spending years in prison. They gambled and lost.
Dennis Jay (dennisjay@insurancefraud.org) is the executive director of the Coalition Against Insurance Fraud.
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