TRENTON – Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor today announced that an Essex County man has been charged with insurance fraud and related offenses for allegedly obtaining $74,000 in disability payments by submitting dozens of forged documents to his insurance provider.
Major Smith, 48, a former teacher in the East Orange school district, was charged with insurance fraud (2nd degree), theft by deception (3rd degree), and two counts of impersonation (3rd degree) in connection with accident-related disability claims he filed with his insurer between 2012 and 2015. The indictment was handed up by a state Grand Jury in Trenton last week.
Smith, who was employed by the East Orange Board of Education until June 2012, allegedly filed 27 claims for disability with American Family Life Assurance Company of Columbus (“Aflac”) that contained forms purportedly filled out by his doctors and/or his employer. Smith filed the allegedly fraudulent claims between February 2012 and October 2015 in connection with injuries he purportedly sustained in several accidents.
“We allege that for years, Smith cloaked himself in the identities of his doctors and his employer to bilk his insurance provider out of thousands of dollars in disability payments,” said Attorney General Grewal. “Even after his employment with the East Orange schools was long over, the defendant allegedly continued to submit forged documents from the district in order to keep the illegal gravy train running.”
“Disability insurance is a critical financial safety net for employees who have fallen on hard times, but this defendant allegedly exploited it as a source of easy cash,” said Acting Insurance Fraud Prosecutor Christopher Iu. “We will continue to prosecute individuals whose phony claims and payouts compromise the insurance market and drive up premiums for honest policyholders.”
Smith allegedly impersonated his doctors in claim forms documenting treatments he purportedly received on various dates for injuries he allegedly sustained in several slip and fall accidents. Smith also allegedly pretended to be a representative of the East Orange Board of Education in claim forms verifying his employment in the district, even after he no longer worked there.
Second-degree crimes carry a sentence of five to 10 years in state prison and a criminal fine of up to $150,000. Third-degree crimes carry a sentence of three to five years in state prison and a criminal fine of up to $15,000.
The indictment is merely an accusation and the defendant is presumed innocent until proven guilty.
Deputy Attorney General Kelly Levy presented the case to the Grand Jury. Detectives Wendy Berg and Grace Proetta coordinated the investigation.
Acting Insurance Fraud Prosecutor Iu noted that some 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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