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Insurance company investigation leads to four guilty pleas August 11, 2009

Posted by jefhenningeresq in News.
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Many (if not most) insurance fraud convictions in New Jersey start off with an investigation conducted by an insurance company and not the government.  Each insurance company has a team of investigators that focus on insurance fraud.  For example, Horizon has (at last count) over two dozen investigators. 

This is important for a number of reasons.  Insurance companies, as private entities, are not bound by the same laws and restrictions as police.  Thus, you have no Miranda rights if they question you. However, you can still implicate yourself and anything you say will be used against you.  At the same time, an attorney can work with the insurance companies to get them off your back while limiting your criminal exposure.  While the insurance companies must inform law enforcement at some point, there are ways to make cases very unattractive to law enforcement. 

These four defendants probably did not have an attorney working this case from the start.  As a result, they all will have felony criminal record and Tucker will get free housing courtesy of NJ tax payers.

TRENTON – Attorney General Anne Milgram and Criminal Justice Director Deborah L. Gramiccioni announced that a former Essex County insurance company employee pleaded guilty today to conspiring to steal more than $94,100 through fraudulent disability insurance claims.

According to Acting Insurance Fraud Prosecutor Riza Dagli, LaShondrea Tucker, 32, of Plainfield, pleaded guilty before Superior Court Judge Michael A. Petrolle in Essex County to second-degree insurance fraud, a charge contained in a Dec. 18, 2008 state grand jury indictment.

Judge Petrolle scheduled Tucker’s sentencing for Sept. 23. The state will recommend a sentence of five years in state prison.

Three of Tucker’s co-defendants – Erick Streeter, Louise Fedrick and Deborah Ruffin are also scheduled to be sentenced on Sept. 23. Streeter, 44, of Newark, pleaded guilty on April 6 to third-degree theft by deception. Fedrick, 40, of Irvington, pleaded guilty on April 6 to third-degree forgery. And Ruffin, 49, of Newark, pleaded guilty on June 18 to third-degree theft by deception. All of the charges were contained in the Dec. 18, 2008 state grand jury indictment.

In pleading guilty, Tucker, who was employed as a disability claims manager for Prudential Insurance Company, admitted that between Sept. 22, 2003 and March 23, 2004, she created fraudulent disability claims using the names and other identifiers of actual people enrolled in a teachers’ disability plan. Tucker admitted that she diverted 21 checks and two electronic fund transfers totaling over $94,100.

Tucker admitted that she issued the diverted checks, which totaled $66,700, in the names of the insured individuals and sent them to Streeter. Streeter engaged Fedrick and Ruffin to assist him with the cashing of the claims checks. Fedrick admitted to forging the signatures on the checks for deposit.

The investigation further revealed that Tucker opened an Internet bank account with Net Bank. Two electronic fund transfers in the approximate amount of $27,400 were subsequently deposited into the Net Bank account representing fraudulent sick pay from Prudential Insurance Company.

Detective Weldon Powell, Civil Investigator Robert Brescia and Deputy Attorney General Joan M. Burke were assigned to the investigation. Burke represented the state at the guilty plea hearing. This case was referred to OIFP by the Special Investigative Unit of the Prudential Insurance Company which initially uncovered the fraud and assisted OIFP in the investigation. Acting Prosecutor Dagli thanked Prudential for its assistance in this matter.

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