Insurance Fraud Casebook
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Commercial Fraud

Insurance Fraud Casebook Paying a Premium for Crime

Edited by Laura Hymes · Joseph T. Wells
John Wiley & Sons July 2013

Specifications

ISBN-13
9781118617717
Publisher
John Wiley & Sons
Publication
July 2013
Format
Hardback , 288 pages
Jurisdiction
International ? Countri(es) for reference only

Details

Real case studies on insurance fraud written by real fraud examiners

Insurance Fraud Casebook is a one-of-a-kind collection consisting of actual cases written by fraud examiners out in the field. These cases were hand selected from hundreds of submissions and together form a comprehensive picture of the many types of insurance fraud—how they are investigated, across industries and throughout the world. Entertaining and enlightening, the cases cover every type of insurance fraud, from medical fraud to counterfeiting.

  • Each case outlines how the fraud was engineered, how it was investigated, and how perpetrators were brought to justice
  • Written for fraud examiners, auditors, and insurance auditors
  • Other titles by Wells: Fraud Fighter and Corporate Fraud Handbook, Third Edition

Edited by Dr. Joseph T. Wells, the founder and Chairman of the Association of Certified Fraud Examiners (ACFE), the world's leading anti-fraud organization, this book reveals the dangers of insurance fraud and the measures that can be taken to prevent it from happening in the first place.

Table of Contents

Preface ix

Insurance Fraud Classification System xiii

Chapter 1 Needles in a Paystack 1
Charles Piper

Chapter 2 The Good Doctor and Insurance Consultant 11
Michael King

Chapter 3 Greasing the Wheels in the Oil Business 21
Abdulrazaq Al-Morjan

Chapter 4 Living the Dream, Keeping Up the Lie 31
Andries J. Brummer

Chapter 5 Extinguishing an Arson Fraud 39
Barry Zalma

Chapter 6 Weakest Link in the Chain 47
Angela Bisasor

Chapter 7 Everyone Gets Hurt: A Study in Workers' Compensation Fraud 57
Michael Sputo

Chapter 8 The Hazards of Doing Business with Friends 67
Bill Maloney

Chapter 9 There's Gold in Them Thar Malls! 75
Carl Knudson

Chapter 10 Damsel in Diamonds 83
Michael Skrypek

Chapter 11 Operation Give and Go 93
Edward P. Buttimore

Chapter 12 An Inspection Is Worth a Thousand Photos 103
Ed Madge

Chapter 13 The Danger of Trusting Too Much 113
Joe Bonk

Chapter 14 The Twin Cities Machine 121
Bob Weir

Chapter 15 With Friends Like These . . . 131
John Fifarek

Chapter 16 All the Buzz 139
Dalene Bartholomew

Chapter 17 Getting Rich from the Elderly 149
John R. Holley

Chapter 18 Transparent Greed 159
Joseph Licandro

Chapter 19 Fault of Fortune 169
Jyoti Khetarpal

Chapter 20 Going Blind to Fraud 179
Karen Wright

Chapter 21 Going Against the Cartel 191
Loftin C. Woodiel

Chapter 22 Falling Prey to Online Charms 199
Tina Hancock

Chapter 23 Big Bills in Little Cuba 209
Mark Starinsky

Chapter 24 Rushing an Insurance Claim 217
Peter Parillo

Chapter 25 Ignorance Is Bliss, While It Lasts 229
Rebecca Busch

Chapter 26 The Name Game 239
William D. Meader

Chapter 27 Woo, Wed, Insure, Murder 249
William P. Hight

Chapter 28 Mystery Shopping for Fraud 259
Stephen Pedneault

Index 269

About the Author

LAURA HYMES, CFE, is the Managing Editor of the ACFE's Research Department, where she oversees the editing of books, manuals and other publications related to the prevention, detection and investigation of fraud. She also collaborates with authors and speakers who are experts in the anti-fraud industry to produce high-quality educational material. She has a master's degree in publication management and years of experience in editing and publishing.

Dr. JOSEPH T. WELLS, CFE, CPA, spent nearly a decade as a U.S. FBI Special Agent and is the founder and Chairman of the Association of Certified Fraud Examiners (ACFE) as well as the author of twenty-one books. For his landmark research in fraud detection and deterrence, Dr. Wells has been inducted into the American Institute of Certified Public Accountants' Business and Industry Hall of Fame and named to Accounting Today's list of the 100 most influential people for nine years in a row. He holds a doctorate in commercial science from York College, The City University of New York.

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