Friday, October 30, 2009

Snohomish County woman pays $69,000 in restitution for insurance fraud

A Snohomish County woman who admitted to forging thousands of dollars in receipts for an insurance claim has paid $69,610 in restitution to her insurance company, State Farm. The case was investigated by the company and the Office of the Insurance Commissioner’s Special Investigations Unit.

Juli-Anna Rowe, 45, of Issaquah, has signed a diversion agreement with the Snohomish County Prosecutor’s Office. She agreed to pay full restitution of $66,610 – which she has done – and to attend a theft-awareness program and therapy. After three years, if Rowe completes the program as agreed, the insurance-fraud charge of “false claims or proof” will be dismissed.

The case stems from a 2005 insurance claim. On June 3, 2005, Rowe said, she loaded a rented U-Haul moving trailer with $85,370 in personal property and drove from her home in Washington toward her destination in California. In Oakland, Calif., she stopped to rest at a hotel. While there, she said the contents of the trailer were stolen.

State Farm paid Rowe $54,421 for the value of the property she said had been stolen. Her policy also allowed for nearly $31,000 in additional claims when she replaced some of the missing property.

In filing those additional claims, however, Rowe submitted numerous altered and forged receipts. In an interview with a detective from the state insurance commissioner’s special investigations unit, Rowe admitted to altering receipts by cutting and pasting increased amounts onto them, photocopying the forged papers and submitting those to State Farm. She also admitted that she did not replace all of the items she claimed she had.

Under the terms of her policy, intentionally concealing or misrepresenting any fact involved in a claim voids the entire claim. So Rowe paid back the $54,421 that State Farm had paid out, plus $15,189 in investigation expenses incurred by the insurer.

Special Investigations Unit Detective Sgt. Dan Sharp praised the work of State Farm on the case.

“They identified the fraud and did much of the initial investigation, making it easier for us to move ahead with this case,” he said.

Insurance news, the Halloween edition

Lots of scary stories in the news today.

First off, pay and benefits are rising at the slowest rate since 1982, according to the Associated Press.

And today brings a long list of stories expressing reservations about the federal health care reform debate in Congress. A sampling:

-Health Care Businesses at Risk in House Overhaul (AP),
-Will the Public Plan Have Higher Premiums than Private Insurance? (WA Post's Ezra Klein)
-and the Magic of Financing Health Care Reform (The New York Times Economix blog has a down-to-earth -- and worrisome -- explanation of the budget-savings assumptions in the health reform plan)

Also in the scary department is a New York Times column written by an economics professor, who argues that federal health reform "is due to explode." Why? He says that requiring everyone to buy coverage or get it through their employers would drive down wages: "In other words, millions of people would be compelled to spend lots of money on something they previously did not want, at least not at prevailing prices."

National licensing group names OIC staffer "Regulator of the Year"

The Securities and Insurance Licensing Association (SILA) has named a Washington state insurance program manager “Regulator of the Year,” in recognition of his contribution to the state’s efforts to modernize and streamline licensing of insurance agents and brokers. (In Washington, agents and brokers are now known as “insurance producers.” )

Award winner Jeff Baughman, who works for Washington Insurance Commissioner Mike Kreidler as the Licensing and Education Program Manager, was named this week at a ceremony in Phoenix, Ariz.

SILA’s “Warren E. Spruill Regulator Recognition Award” is given annually to a regulator who works to better the relationship between insurance departments and the industry.

Washington’s Office of the Insurance Commissioner has been working hard to make it possible for all licensing transactions, including accepting new applications and renewals, to be performed over the Internet. The online system was completed earlier this year.

Baughman also served as the agency’s business lead in implementing statutory changes on July 1st that brought the state very close to full compliance with the national standards for uniformity and reciprocity in the licensing of agents and brokers. Kreidler is proposing legislation to complete that goal, including dropping a fingerprinting requirement for background checks for non-resident applicants.

“We couldn’t be more pleased to see the work of Jeff and the agency recognized at the national level,” said Deputy Insurance Commissioner John Hamje. “We’re very proud of Jeff, and are equally proud of the numerous other agency staff members who’ve worked to make these projects a reality since they were first initiated in 2004. Everyone involved in this process should take great pride in this award.”