– A Hoboken couple has been sentenced
to one year probation and ordered to pay $49,054
in restitution for stealing health care insurance
benefits, Attorney General Anne Milgram announced
According to Division of Criminal Justice
Director Deborah L. Gramiccioni, James P.
O’Connor, 52, and his wife, Debbie M.
O’Connor, 50, were sentenced Friday
and each ordered to pay a $2,500 civil insurance
fraud fine in addition to paying restitution
to a number of health insurance companies.
The couple had pleaded guilty in April before
Judge Michael L. Ravin in Superior Court,
Hudson County, to accusations which charged
them each with third degree theft by deception.
The O’Connors admitted that they divorced
in 2001, but failed to notify James O’Connor’s
employer, the Hoboken Board of Education,
of the change in their marital status. The
couple remarried in April 2007. During the
six years that they were divorced, James O’Connor
misrepresented the couple’s marital
status and obtained health care insurance
coverage for and submitted $49,054 in fraudulent
claims for Debbie O’Connor.
The O’Connors admitted that they caused
the Oxford Insurance Company, the New Jersey
State Health Benefits Program, which is administered
by Horizon Blue Cross Blue Shield, the Hoboken
Board of Education, whose benefits program
is also administered by Horizon Blue Cross
Blue Shield, Delta Dental Insurance Company,
Bollinger Insurance, and Maxor Pharmaceutical
Services to pay a total of $49,054.72 for
medical services for Debbie O’Connor
to which she was not entitled.
The Accusations to which the defendants pled
guilty were filed by the Division of Criminal
Justice’s Office of the Insurance Fraud
Prosecutor, which investigates and prosecutes
both civil and criminal insurance fraud related
Thomas Ference, Civil Investigator Megan Flanagan,
and Deputy Attorney General Geraldine Zidow
were assigned to the investigation into this
case. DAG Zidow represented the State at the
guilty plea hearing.
This case was referred to OIFP by the Special
Investigative Unit of Horizon Blue Cross Blue
Shield which initially uncovered the fraud
and assisted OIFP in the investigation. Director
Gramiccioni thanked the insurance companies
for their assistance in this matter.
People who are concerned about insurance cheating
and have information about a fraud can report
it anonymously by calling the toll-free hotline
at 1-877-55-FRAUD, or visiting
the Web site at www.NJInsurancefraud.org
.” State regulations permit a reward
to be paid to an eligible person who provides
information that leads to an arrest, prosecution
and conviction for insurance fraud.