Philadelphia Woman Pleads Guilty to Fraud in Staged Auto Accident Claim

New Jersey Attorney General Peter Harvey announced that a Philadelphia woman has pled guilty to insurance fraud-related charges for her reported role in participating in a staged automobile accident in order to collect more than $16,000 in insurance claim monies.

According to Vaughn McKoy, Director, Division of Criminal Justice and Insurance Fraud Prosecutor Greta Gooden Brown, Pauline Whitfield of Philadelphia pled guilty before Burlington County Superior Court Judge John Almeida to a criminal Accusation which charged her with Health Care Claims Fraud (2nd degree) and impersonation (3rd degree). A second degree crime carries a maximum sentence of up to 10 years in state prison and a fine of up to $150,000. A third degree crime is punishable by a sentence of up to five years in state prison and a fine of up to $15,000. Whitfield may also face civil insurance fraud fines pursuant to New Jersey’s Insurance Fraud Prevention Act. Whitfield is scheduled to be sentenced on Dec. 19.

According to Insurance Fraud Prosecutor Brown, Whitfield admitted that she was a passenger in the vehicle alleged to be involved in the staged accident and, as part of the scheme, fraudulently claimed to have been injured in the accident. Whitfield submitted a fraudulent injury claim totaling $16,908 to the State Farm Insurance Company. State Farm paid approximately $5,900 on the fraudulent claim.

Brown noted that Whitfield is the last of four defendants indicted by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor to plead guilty as part of a conspiracy to stage a fake automobile accident and submit fraudulent health insurance claims — claims which ultimately netted the defendants more than $31,000 in illegally obtained insurance monies.

Whitfield, along with Robin Ellison, 43, Willingboro, Burlington County; Deborah Thomas, 54; Denise Gaines, 40; and Patricia Oglesby, 52, all of Philadelphia, were indicted by a State Grand Jury in May, 2002 and charged with conspiracy, Health Care Claims Fraud and theft by deception. To support the false claims, each of the co-conspirators reported that they had sustained various injuries as a result of the purported accident. Each of the co-conspirators filed fraudulent Personal Injury Protection (PIP) claims with the State Farm Insurance Company for reimbursement for health care services for non-existent injuries.

At separate guilty plea hearings on Oct. 28, 2002 before Burlington County Superior Court Judge Almeida, Ellison and Thomas admitted their roles in the conspiracy to report a non-existent accident to police and to attempt to collect insurance monies. Specifically, Ellison admitted that on April 10, 1998 she was the driver of a vehicle when she and the three co-conspirators (Thomas, Gaines and Oglesby) concocted the story to falsely claim that they had been involved in an automobile collision while driving in the Philadelphia area. Ellison reported the non-existent accident to the Philadelphia Police Department and to the State Farm Insurance Company. Gaines and Oglesby pleaded guilty to charges of submitting false insurance claims and theft by deception on Oct. 21, 2002.

As a result of the fraud, State Farm paid more than $31,000 in property damage and PIP claims to medical service providers. Ellison obtained an automobile property damage claim in the amount of $6,961 for purported damage to her car and $9,780 for medical treatments. Gaines received $7,560 in PIP claims for medical treatments. Oglesby received $2,011 in PIP claims for medical treatments, while Thomas was paid $4,757 in PIP claims for medical treatments.

On January 17, 2003, Ellison was sentenced to three years in state prison, ordered to pay restitution to the State Farm Insurance Company in the amount of $16,741 and to pay a $5,000 civil insurance fraud fine. Thomas was sentenced to five years probation conditioned on serving 180 days in the Burlington County Jail, ordered to pay $7,560 in restitution to the State Farm Insurance Company and to pay a $2,500 civil insurance fraud fine. On Jan. 10, Judge Almeida sentenced Gaines to 180 days in the Burlington County jail and to three years probation. Oglesby was sentenced to 180 days in the Burlington County jail and to five years probation.