Ohio DOI Announces October Fraud and Enforcement Cases

Ohio Lieutenant Governor and Insurance Director Mary Taylor announced several fraud and enforcement cases closed by the Department in October.

“These cases represent the Department’s commitment to fighting fraud and taking action against those who seek to harm consumers,” Taylor said. “Thanks to cooperation between the Department and our local partners across the state we were able to close several significant cases.”

The Ohio Department of Insurance Fraud Division investigates allegations of insurance fraud, such as the submission of false or inflated insurance claims, and works with prosecutors to criminally prosecute those who commit fraud. The Enforcement Division investigates allegations of unlicensed insurance activity as well as agent/agency misconduct.

Duo Sentenced for Role in $1 Million Billing Scheme (Coshocton, OH)

Doug Bolden and James Ireland were sentenced on Oct. 16 in U.S. District Court in Akron for their earlier involvements in the federal obstruction case regarding Three Rivers Infusion and Pharmacy Specialists’ health care billing scheme. Bolden was given two months in prison, six months on home detention and three years of probation. He was ordered to pay a fine of $131,043.75. Ireland was sentenced to two months in prison with six months on home detention and one year of probation. He was ordered to pay a fine of $16,933.63.

Fraudulent Insurance Claim Nets Prison Time for Man (Columbus, OH)

Richard Bolen pled guilty to insurance fraud in Franklin County Common Pleas Court on Oct. 9. Bolen filed a false insurance claim for structural damages at his home, which had been paid in a prior claim. He also submitted false information for additional damages at his home. Bolen served jail time and was also sentenced to four years on community control with 12 months suspended incarceration. He paid nearly $18,000 in restitution.

Man Placed on Probation for Providing False Insurance Information (Columbus, OH)

Benjamin Day pled guilty to insurance fraud in Franklin County Common Pleas Court on Oct. 9. Day submitted false receipts and documents to support losses on a homeowner’s insurance claim. He was sentenced to 12 months on community control with 12 months of suspended incarceration.

Woman Fined for Claiming False Losses (Celina, OH)
Carol Kohn pled guilty to insurance fraud and was sentenced in Auglaize County Common Pleas Court on Oct. 29. Kohn claimed false losses in a legitimate storm-related homeowner’s insurance claim. Kohn was given one year of community control and fined $1,000.

Men Plead Guilty for Staging Accident (Grove City, OH and Columbus, OH)

Brent Gibney, of Grove City, pled guilty to insurance fraud in Franklin County Common Pleas Court on Oct. 30. Gibney staged an accident with Steven Ward using a U-Haul rental truck to obtain insurance proceeds. Gibney was sentenced to six months on community control with 30 days of suspended incarceration. Ward, of Columbus, pled guilty to insurance fraud and was sentenced in Sept.

Fake Health Insurance Entity United States Contractors Trust Issued Permanent Cease and Desist Order (Atlanta, GA)
The Department issued a final order on Oct. 24 to United States Contractors Trust making the previous order to cease and desist permanent. The fake health insurance entity sold fictitious health insurance coverage to at least four Ohioans. The entity is not licensed to sell insurance in Ohio and has also been ordered to stop its unauthorized insurance business in South Carolina, North Carolina, Vermont, Florida and Maine.

Agent’s License Revoked for Conflict of Interest (Urbana, OH)

The Department issued a final order on Oct. 3 to agent Harley Davidson, also a local bank director, revoking his agent license. Ohio law prohibits a person engaged in the business of banking from acting as an agent for a title insurance company.

Agents Penalized for Falsifying Continuing Education Information (Cincinnati, OH and Independence, KY)

The Department issued consent orders to agents Jonathan E. Thornberry, of Independence, KY, and Paul G. Sittenfeld, of Cincinnati, on Oct. 7 for falsifying continuing education information. Sittenfeld allowed Thornberry to complete an on-line Ohio continuing education course on his behalf. The agents agreed to both pay a $1,500 civil penalty and $500 in administrative costs.

Source: Ohio Department of Insurance