Ambulette Companies And Four Principals Indicted In No-fault Billing Scam
Attorney General Spitzer and State Insurance Superintendent Gregory Serio today announced the filing of charges against four owners of ambulette companies for submitting fraudulent transportation bills to insurance carriers under no-fault. The schemes are alleged to involve false billings for hundreds of motor vehicle accident victims for whom the billed transportation services were not provided.
Among the felony charges the defendants face are scheme to defraud, insurance fraud, forgery, larceny and attempted larceny. Four defendants and five corporations were charged with carrying out the billing scam in three indictments.
The defendants submitted bills to insurance companies for patient transportation services that were never rendered. According to the indictment, the defendants billed insurance companies claiming they had provided round-trip ambulette service for patients when no transports were provided. The defendants also transported accident victims using livery cars or private cars and then billed insurance carriers claiming that ambulettes, which are billed at a higher rate, were used. An ambulette is a specially equipped, wheelchair-accessible vehicle used to transport patients who need assistance in traveling from their homes to medical facilities. The defendants submitted to the insurance carriers vouchers, or "trip tickets," containing forged patient signatures.
"Average New Yorkers are footing the bill for those who commit insurance fraud. These schemes result in increased premiums for the honest consumer and losses for insurance companies," said Attorney General Spitzer. "Our office will aggressively prosecute those involved in scamming the insurance industry."
"The arrests of ambulette company owners provide a clear example of how the crime of no-fault fraud is evolving and how new methods are being employed by criminals to steal money from the no-fault insurance system," said NYS Superintendent of Insurance Serio. "The announcement of these arrests proves that through the aggressive collaborative work with the Attorney General no one involved in no-fault insurance fraud in New York State will escape arrest and prosecution."
Under New York's no-fault law, a person injured in a motor vehicle accident can receive up to $50,000 coverage for medical expenses incurred as a result of the accident. No-fault will also cover transportation costs to and from medical facilities and will reimburse at a higher rate for ambulette service when it is deemed medically necessary. Most health service providers under no-fault, including ambulette companies, are reimbursed directly by the carriers for services provided.
One indictment, consisting of 134 counts, charged defendants Alla Bronshteyn, 57, and Vitaly Tsimerman, 60, with submitting phony bills through a corporation they owned, Ex-L Ambulette Service, Inc. Charges were also brought against the corporation. The defendants are charged with submitting more than 40 phony claims to 10 insurance carriers, beginning in 2000. The fraudulent billing totaled approximately $50,000. Bronshteyn and Tsimerman, who are married, are residents of Staten Island.
The top counts of the indictment charge the defendants with Insurance Fraud in the Third Degree, a D felony, Forgery in the Second Degree, a D felony, Grand Larceny in the Fourth Degree, an E felony, Falsifying Business Records in the First Degree, an E felony, and Scheme to Defraud in the First Degree, an E felony. The defendants face up to seven years in prison if convicted of the top count of the indictment.
In a second, 47-count indictment, defendant Mark Pogoriler, 46, and two corporations owned by him, Shark Transportation M.S. Inc. and LEM-M Ambulette Service Inc., were charged with submitting approximately $80,000 in fraudulent bills for ambulette round-trips to numerous insurance carriers. Neither transportation company owned any ambulettes.
The top counts of the indictment charge Grand Larceny in the Third Degree, a D felony, Insurance Fraud in the Third Degree, a D felony, Forgery in the Second Degree, a D felony, Falsifying Business Records in the First Degree, an E felony, and Scheme to Defraud in the First Degree, an E felony. The defendant faces up to seven years in prison if convicted of the top count of the indictment.
In a third, 57-count indictment, defendant Ivan Lopadchak, 47, and two companies owned by him, Ex-L Ambulette Service I.M.. Inc. and Almaz Ambulette Service I.M. Inc., are charged with submitting approximately $45,000 in fraudulent bills for ambulette round-trips to insurance carriers. Lopadchak's companies also owned no ambulettes.
The top counts of the indictment charge Insurance Fraud in the Fourth Degree, an E felony, Attempted Grand Larceny in the Third Degree, an E felony, Insurance Fraud in the Fourth Degree, an E felony, Forgery in the Second Degree, a D felony, Falsifying Business Records in the First Degree, an E felony, and Scheme to Defraud in the First Degree, an E felony. The defendant faces up to seven years in prison if convicted of the top count of the indictment.
The four defendants were arraigned earlier last week before Kings County Supreme Court Justice Cheryl Chambers. Pogoriler and Lopadchak are being held in on bail; Bronshteyn and Tsimerman posted a bond and were released. The charges against the defendants are merely accusations, and the defendants are presumed innocent until and unless proven guilty.
Attorney General Spitzer thanked Progressive Insurance Company, Allstate Insurance Company, Lancer Insurance Company, and the Robert Plan for assisting in the investigation.
The cases are being prosecuted by Assistant Attorney General Irwin Weiss of the Auto Insurance Fraud Unit, under the Supervision of Unit Chief Steve Nachman. Investigators William Schwab and Joseph Bizzarro, under the supervision of Supervising Investigator Frank Orlando and Deputy Chief James Conway, conducted the investigation.