TRENTON
- Division of Criminal Justice Director
Vaughn L. McKoy announced that the Division
of Criminal Justice - Office of Insurance
Fraud Prosecutor has charged an Essex
County man with insurance fraud for falsifying
medical records in order to obtain more
than $1,000 in Personal Injury Protection
(PIP) payments.
According to Insurance Fraud Prosecutor
Greta Gooden Brown, Reginald Smithson,
43, Mt. Vernon Avenue, Orange, Essex County,
was charged via an Essex County Grand
Jury indictment with theft by deception,
insurance fraud (3rd degree), and two
counts of forgery (4th degree). If convicted
on all charges, Smithson faces up to 13
years in state prison and a fine of up
to $40,000. In addition, Smithson faces
possible civil insurance fraud fines pursuant
to the Insurance Fraud Prevention Act.
Smithson will be ordered to appear in
Essex County Superior Court for arraignment
and bail.
The Essex County indictment charged that
Smithson submitted a false claim to the
State Farm Insurance Company for out-of-pocket
expenses purportedly incurred in a Feb.
19, 2003 automobile accident. It is charged
that five days after the accident, Smithson
sought medical attention at Mountainside
Hospital in Montclair, Essex County, and
failed to mention the car accident. Since
Smithson did not have health care insurance,
the hospital did not charge for the visit.
An investigation by the Division of Criminal
Justice - Office of Insurance Fraud Prosecutor
determined that in August 2003, after
obtaining a property damage estimate for
the car, Smithson allegedly returned to
Mountainside Hospital in an attempt to
obtain a blank receipt so he could submit
a claim to State Farm Insurance for out-of-pocket
expenses incurred as a result of the accident.
When the hospital refused to provide a
blank receipt, Smithson paid $1.00 toward
the balance of his account and was given
a receipt which reflected the $1.00 payment.
The investigation revealed that Smithson
falsified the hospital receipt so that
it purported to be in the amount of $1,001
and submitted it to State Farm Insurance
Company in order to obtain money to repair
his vehicle. Smithson also allegedly submitted
a fraudulent $550 receipt to State Farm,
falsely claiming that it was for a rental
car.
State Investigator Laura Parisi, Civil
Investigator Lisa Yildiz, and Deputy Attorneys
General Steven B. Farman and Michael Troso
were assigned to the investigation into
this case. DAsG Farman and Troso represented
the Office of Insurance Fraud Prosecutor
before the Essex County Grand Jury.
The indictment, which was returned on
June 16, is merely an accusation. The
defendant is presumed innocent unless
and until proven guilty beyond a reasonable
doubt.
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