Insurance Fraud Casebook

Real case studies on insurance fraud written by real fraud examiners Insurance Fraud Casebook is a one-of-a-kind collection consisting of actual cases written by fraud examiners out in the field. These cases were hand selected from hundreds of submissions and together form a comprehensive picture of the many types of insurance fraud—how they are investigated, across industries and throughout the world. Entertaining and enlightening, the cases cover every type of insurance fraud, from medical fraud to counterfeiting. Each case outlines how the fraud was engineered, how it was investigated, and how perpetrators were brought to justice Written for fraud examiners, auditors, and insurance auditors Other titles by Wells: Fraud Fighter and Corporate Fraud Handbook, Third Edition Edited by Dr. Joseph T. Wells, the founder and Chairman of the Association of Certified Fraud Examiners (ACFE), the world's leading anti-fraud organization, this book reveals the dangers of insurance fraud and the measures that can be taken to prevent it from happening in the first place.

Preface ix Insurance Fraud Classification System xiii Chapter 1 Needles in a Paystack 1 Charles Piper Chapter 2 The Good Doctor and Insurance Consultant 11 Michael King Chapter 3 Greasing the Wheels in the Oil Business 21 Abdulrazaq Al-Morjan Chapter 4 Living the Dream, Keeping Up the Lie 31 Andries J. Brummer Chapter 5 Extinguishing an Arson Fraud 39 Barry Zalma Chapter 6 Weakest Link in the Chain 47 Angela Bisasor Chapter 7 Everyone Gets Hurt: A Study in Workers’ Compensation Fraud 57 Michael Sputo Chapter 8 The Hazards of Doing Business with Friends 67 Bill Maloney Chapter 9 There’s Gold in Them Thar Malls! 75 Carl Knudson Chapter 10 Damsel in Diamonds 83 Michael Skrypek Chapter 11 Operation Give and Go 93 Edward P. Buttimore Chapter 12 An Inspection Is Worth a Thousand Photos 103 Ed Madge Chapter 13 The Danger of Trusting Too Much 113 Joe Bonk Chapter 14 The Twin Cities Machine 121 Bob Weir Chapter 15 With Friends Like These . . . 131 John Fifarek Chapter 16 All the Buzz 139 Dalene Bartholomew Chapter 17 Getting Rich from the Elderly 149 John R. Holley Chapter 18 Transparent Greed 159 Joseph Licandro Chapter 19 Fault of Fortune 169 Jyoti Khetarpal Chapter 20 Going Blind to Fraud 179 Karen Wright Chapter 21 Going Against the Cartel 191 Loftin C. Woodiel Chapter 22 Falling Prey to Online Charms 199 Tina Hancock Chapter 23 Big Bills in Little Cuba 209 Mark Starinsky Chapter 24 Rushing an Insurance Claim 217 Peter Parillo Chapter 25 Ignorance Is Bliss, While It Lasts 229 Rebecca Busch Chapter 26 The Name Game 239 William D. Meader Chapter 27 Woo, Wed, Insure, Murder 249 William P. Hight Chapter 28 Mystery Shopping for Fraud 259 Stephen Pedneault Index 269