TRENTON – Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that seven individuals, all either family members or acquaintances, were indicted for allegedly submitting fraudulent disability insurance claims to their provider, which paid the defendants benefits totaling approximately $128,000.
OIFP is alleging that from 2010-2013, the defendants submitted the false claims to their insurer, Aflac, from which they received disability insurance coverage during their purported employment with Chicken Steak & Chocolate Cake Catering (Union), Chandler Sound (Union) and Epic Abodes (Holmdel). The defendants allegedly submitted claims to Aflac with their doctor’s names and signatures either forged or at least altered. In some cases they submitted disability claims forms for allegedly fake injuries, while in other cases the targets submitted disability claims covering real injuries for which doctors did not place them on disability. In a third category of fraudulent cases, a doctor placed a target on disability, but forms were submitted with allegedly altered return to work dates.
The seven defendants were charged by the state grand jury with various crimes including second-degree conspiracy, second-degree theft by deception, second-degree insurance fraud, third-degree insurance fraud, third-degree conspiracy, third-degree theft by deception, third-degree failure to file a tax return, third-degree failure to pay taxes, third-degree filing a false return, and fourth-degree forgery. The defendants are:
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Shonda Mark, 43, of Perth Amboy, allegedly received approximately $3,883
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Jeannine Smith, 55, of Union, allegedly received approximately $24,333
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Alexa Stewart (Smith’s daughter), 30, of Union, allegedly received approximately $11,940
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Brittany Stewart (Smith’s daughter), 28, of Union, allegedly received approximately $11,940
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Arnold Chandler (Smith’s fiancée), 54, of Union, allegedly received approximately $61,639
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Danielle Jackson, 41, of Cantonsville, Maryland allegedly received approximately $14,240
- Scott Talmadge, 51, of Conyers, Ga., received no payout, but submitted an allegedly fraudulent claim
“Disability insurance is a critical financial backstop for employees who have fallen on hard times, but these defendants allegedly viewed this backstop as an exploitable revenue stream,” said Acting Attorney General Hoffman. “The crimes in this alleged conspiracy were complex and numerous, but they were all motivated by greed.”
“Phony claims and payouts imperil the insurance market, which means much-need financial support systems, like disability insurance, could see severe spikes in premium rates,” said Acting Insurance Fraud Prosecutor Ronald Chillemi. “This means that business-owners and employees alike will be bearing the cost of insurance fraud.”
The charges announced today are merely accusations and the defendants are presumed innocent until proven guilty. Second-degree crimes carry a sentence of five to 10 years in state prison and a criminal fine of up to $150,000, while third-degree crimes carry a sentence of three to five years in state prison and a criminal fine of up to $15,000. Fourth-degree crimes can carry a prison sentence of up to 18 months and a fine of up to $10,000.
Deputy Attorneys General Michael Locke presented the case to the grand jury. Detectives Natalie Brotherston, Taryn Seidner and Ryan Kirsh coordinated the investigation.
Acting Insurance Fraud Prosecutor Chillemi noted that important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting the Web site at www.NJInsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.
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