TRENTON - Attorney General Stuart Rabner
and Criminal Justice Director Gregory A.
Paw announced that an Essex County woman
has pleaded guilty to theft for her role
in a health insurance underwriting fraud.
According
to Insurance Fraud Prosecutor Greta Gooden
Brown, Insurance Fraud Prosecutor, Carol
Magnes, 54, of Short Hills, pleaded guilty
before Superior Court Judge Nancy Sivilli
in Essex County to a criminal accusation
which charged her with third-degree theft
by deception.
At
the guilty plea hearing, Magnes admitted
that between July 28, 2003 and Nov. 28,
2005, she filled out paperwork for the medical
insurance for her husband’s medical
practice, fraudulently claiming that their
son and their housekeeper worked at the
practice. Magnes admitted that by enrolling
them as employees she was able to obtain
lower cost small employer group health insurance
for the “employees” even though
they were not employees of the medical practice.
Furthermore, she admitted that more than
165 medical claims, worth more than $60,300,
were submitted to Oxford for medical treatments
for “employees” even though
they were not entitled to the medical coverage.
“Far
too often, people cheat insurance companies
by adding so-called employees to small-employer
sponsored group health insurance in order
to take advantage of lower group rates,’’
Attorney General Rabner said. “This
conduct constitutes a serious crime that
we will investigate and prosecute where
appropriate.”
State
Investigator Robert Stemmer, and Deputy
Attorney General Lewis J. Korngut coordinated
the investigation. Korngut represented the
Office of Insurance Fraud Prosecutor at
the guilty plea hearing.
Prosecutor
Brown noted that some important cases have
started with anonymous tips. People who
are concerned about insurance cheating and
have information about a fraud can report
it anonymously by calling the toll-free
hotline 1-877-55-FRAUD or
visiting the Web at www.njinsurancefraud.org.
State regulations permit an award to be
paid to an eligible person who provides
information that leads to an arrest, prosecution
and conviction for insurance fraud.
The
Office of Insurance Fraud Prosecutor was
established by the Automobile Insurance
Cost Reduction Act of 1998. The office is
the centralized state agency that investigates
and prosecutes both civil and criminal insurance
fraud, as well as Medicaid fraud.
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