N.J. Trio Charged in $25,000 Staged Accident Insurance Fraud Scam

New Jersey Criminal Justice Director Vaughn McKoy reported that the Division of Criminal Justice – Office of Insurance Fraud Prosecutor has obtained a State Grand Jury indictment charging three Passaic County residents with conspiracy, Health Care Claims Fraud and attempted theft for their alleged involvement in a staged accident insurance fraud scam.

According to Insurance Fraud Prosecutor Greta Gooden Brown, Iris Ojeda, 43, of Paterson, her daughter, Sacha Ojeda, 26, same address, and Felix Nieves, 54, of, Paterson, were charged with conspiracy and Health Care Claims Fraud, (both 2nd degree), as well as attempted theft by deception (third degree). If convicted of all charges, each defendant face more than 20 years in state prison and a criminal fine of more than $300,000. In addition, the defendants face civil insurance fraud fines.

The indictment alleges that between Feb. 2, 2000 and May 9, 2001, Iris Ojeda, Sacha Ojeda, and Felix Nieves agreed to stage an automobile accident. An investigation by the Division of Criminal Justice – Office of Insurance Fraud Prosecutor determined that the defendants underwent MRI testing and multiple visits to a chiropractor in order to submit phony Personal Injury Protection (PIP) and bodily injury insurance claims worth more than $25,000 to Robert Plan/GSA Insurance – Iris Ojeda submitted claims for more than $10,900 for injuries purportedly sustained; Nieves submitted more than $10,800 in claims and Sacha Ojeda submitted more than $5,000 for injuries purportedly sustained.

Upon receiving the fraudulent billings, Robert Plan/GSA referred the billing to the Office of Insurance Fraud Prosecutor for further investigation.