Guilty of Theft By Deception
New Hampshire Attorney General Michael Delaney and NH Insurance Commissioner Roger Sevigny recently announced that Phyllis Graham of Manchester pleaded guilty in Hillsborough County Superior Court, North to Class A felony charges of theft by deception and attempted theft by deception.
Ordered to Repay $30,051 to Sedgwick Claims Management
As part of the negotiated plea, Graham will serve 12 months at the House of Corrections, and repay $30,051 in restitution to Sedgwick Claims Management Services, the third party administrator for United Health Group of Hooksett, NH.
Graham also pleaded guilty to unrelated felony charges of forgery and identity theft investigated by the Manchester Police Department prosecuted by the Hillsborough County Attorney’s Office. Graham’s jail time on the theft by deception scheme, will run consecutively to a jail sentence imposed on the identify theft and forgery charges. Graham’s case was referred to the NH Insurance Department by the Manchester Police Department and Sedgwick Claims Management Services.
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In 2009 and 2010, authorities note Graham created fictitious bills and sought reimbursement for bills she said she had paid from Sedgwick, the administrator for her 2007 workers comp settlement. Investigators discovered that Graham never received the services claimed, and that the bills submitted and the information on them were fraudulent.
Created Multiple Fraudulent Bills
Graham pleaded guilty to deceiving Sedgwick into paying her $20,500 for fabricated bills purporting to be from Dartmouth Hitchcock Medical Center in Bedford, NH. Graham admitted to creating a fictitious massage therapist who she claimed provided over $4,000 in massage therapy to treat her workers comp claim related sciatica. Graham also pleaded guilty for deceiving Sedgwick into paying her $5,551.00 for emergent care she claimed to have received at St. Anne’s Hospital, in Fall River, MA.
Account Audited and Fraud Scheme Discovered
In September of 2010, Graham submitted a fraudulent bill to Sedgwick and called the office demanding immediate reimbursement of $5,920 for treatment at St. Anne’s, her account was audited and the fraud scheme was discovered.
Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: [email protected].
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
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