West Virginia Offices of the Insurance Commissioner 2009 Annual ...
West Virginia Offices of the Insurance Commissioner 2009 Annual ...
West Virginia Offices of the Insurance Commissioner 2009 Annual ...
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Training<br />
In <strong>2009</strong>, <strong>the</strong> Fraud Unit obtained specialized training for multiple employees from a variety <strong>of</strong><br />
sources:<br />
a) Twenty-three investigators completed <strong>the</strong> NSC Defensive Driving Course 8.2<br />
Edition<br />
b) Forensic Accountant III completed Certification in Financial Forensics, as well as<br />
Accredited Fraud Investigators Program and exam.<br />
c) Forensic Computer Specialists completed 47 hours <strong>of</strong> annual training, as well as<br />
Advanced SPADA/RAM Analysis and CFCE Coaching Program.<br />
d) Applicable Research Analyst completed specialized training in Intelligence Analyst<br />
Training Program IATP-902, as well CPT Code Training for Investigators.<br />
e) Effective Investigation and Testimony was attended by several investigators.<br />
In <strong>2009</strong> <strong>the</strong>re were many cases involving a broad spectrum <strong>of</strong> criminal activity when it came to<br />
investigations and prosecutions <strong>of</strong> insurance fraud. The following cases are <strong>of</strong>fered as examples <strong>of</strong> <strong>the</strong><br />
types <strong>of</strong> cases <strong>the</strong> Fraud Unit were involved in for calendar year <strong>2009</strong>:<br />
<strong>2009</strong> Case Highlights<br />
Leonard H. Cline Jr, age 41 <strong>of</strong> Gilbert, WV, who owned and operated H & H Trucking, was indicted<br />
by a Kanawha County Grand Jury on May 15, <strong>2009</strong> on forty-five (45) felony counts <strong>of</strong> workers<br />
compensation fraud that included failure to file premium tax reports, failure to subscribe to workers<br />
compensation, false testimony and statements to <strong>the</strong> <strong>the</strong>n state run Workers Compensation<br />
Commission. Mr. Cline, Jr., pleaded guilty to five (5) felony counts in exchange for <strong>the</strong> o<strong>the</strong>r forty (40)<br />
counts being dismissed. On <strong>the</strong> five (5) counts in which Mr. Cline, Jr., plead guilty, <strong>the</strong> state had<br />
determined it had paid out over $148,811 in workers compensation claims to date. In <strong>the</strong><br />
approximately ten (10) years during which Mr. Cline, Jr., operated his businesses he had defrauded <strong>the</strong><br />
workers compensation system <strong>of</strong> over $500,000 in unpaid premiums, penalties, and workers<br />
compensation claims for benefits.<br />
Jennifer Michelle Hamilton, age 25 <strong>of</strong> Roanoke, <strong>Virginia</strong> plead guilty to one (1) misdemeanor count<br />
<strong>of</strong> insurance fraud on September 2, <strong>2009</strong> and agreed to repay restitution in excess <strong>of</strong> $19,000 to Omni<br />
<strong>Insurance</strong> Company. Ms. Hamilton was indicted on June 2, <strong>2009</strong> on (1) one felony count <strong>of</strong> filing a<br />
fraudulent claim to an insurance company. In exchange for her plea and agreeing to pay full restitution<br />
<strong>the</strong> charge was reduced to a misdemeanor. Ms. Hamilton had reported she was changing a flat tire on<br />
her Jeep Liberty and it rolled over a cliff in a remote area <strong>of</strong> <strong>the</strong> Monongahela National Forest on<br />
February 29, 2008. It was later determined by <strong>the</strong> <strong>Offices</strong> <strong>of</strong> <strong>the</strong> <strong>Insurance</strong> <strong>Commissioner</strong>’s Fraud Unit<br />
that Ms. Hamilton had been behind in her car payments and <strong>the</strong> story provided by <strong>the</strong> defendant did<br />
not match <strong>the</strong> evidence found at <strong>the</strong> scene <strong>of</strong> <strong>the</strong> crash.<br />
John M. Dignazo, age 57 <strong>of</strong> Martinsburg, plead guilty to a reduced misdemeanor charge <strong>of</strong> forgery<br />
and uttering <strong>of</strong> a pro<strong>of</strong> <strong>of</strong> insurance form which he presented to <strong>the</strong> Department <strong>of</strong> Motor Vehicles. On<br />
January 31, 2005 Mr. Dignazio was operating a 1984 Toyota Corolla and was involved in a traffic<br />
accident. As a result <strong>of</strong> <strong>the</strong> crash, Mr. Dignazio was issued a traffic citation for No Pro<strong>of</strong> <strong>of</strong> <strong>Insurance</strong>.<br />
On November 27, 2007 Mr. Dignazio faxed a false certificate <strong>of</strong> insurance for a 1984 Toyota Corolla<br />
to <strong>the</strong> WV Department <strong>of</strong> Motor Vehicles. Mr. Dignazio was sentenced to six (6) months in <strong>the</strong><br />
regional jail, which was <strong>the</strong>n suspended in lieu <strong>of</strong> one year probation, and a fine <strong>of</strong> $500.00.<br />
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