Man arrested for 300 fraudulet Medicare Apps.

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This is what makes it so tough on the rest of us....


July 28, 2008 -- Archdale man Arrested, Charged in Medicare Advantage Scheme

For Immediate Release:
Contact: July 28, 2008 Chrissy Pearson
Kristin Milam
(919) 733-5238
Archdale Man Arrested, Charged in Medicare Advantage Scheme
RALEIGH -- Insurance Commissioner Jim Long today announced the arrest of Jason David Fishel, 33, of 106 Deerfield Place, Archdale. Fishel was arrested by a Department of Insurance investigator and charged with one count of obtaining property by false pretense. He was processed at the Randolph County jail under a $100,000 unsecured bond. Investigators allege the following: Fishel was a licensed agent with the Assurance Group Inc. on Prospect St. in Archdale. During a period of time between January 2007 and May 2007, he submitted nearly 300 applications for Medicare Advantage policies that were fraudulent, using information from prior clients without their knowledge. Fishel received advanced commissions on these policies of more than $83,000. The information was entered into the agency's database, but never actually processed, so no consumers were harmed, investigators believe. Fishel surrendered his agent's license to the Department in April. The Randolph County Sheriff's Office assisted with this case. The Department of Insurance employs 20 sworn law enforcement officers dedicated to investigating claims of insurance fraud. In 2007, these investigators saw more than 525 cases successfully closed with more than $14.5 million in restitution and recoveries, 53 criminal convictions and 109 arrests. To report suspected fraud, contact the Department of Insurance Investigations Division at (919) 807-6840. Callers may remain anonymous. Information is also available at the NC-DOI Web site.



Man charged in Medicare scheme

07/29/2008 09:56 AM

By: News 14 Carolina Web Staff





ARCHDALE, N.C. -- The department of insurance has arrested a 33-year-old Archdale man for an alleged Medicare scheme.
Investigators say that while Jason Fishel was a licensed agent with Assurance Group Inc., he submitted nearly 300 fraudulent Medicare applications using information from prior clients without their knowledge.

Fishel received advanced commissions on these policies of more than $83,000. He was charged with one count of obtaining property by false pretense.

Fishel was processed Monday at the Randolph County jail under a $100,000 unsecured bond.
 
This is what makes it so tough on the rest of us.........

People who NEED money and have questionable ethics are not to be trusted in any business with anyone's money. This is also why the reputable companies are slow to take on career agents with questionable credit history.
 
In a way it's too bad he had to surrender his license, because he'll probably come across a lot of eligibles in jail, and the season is upon us.....

Just kidding!
 
Reminds me of the guys in MN who submitted false DME claims for dead providers or created providers that didn't exist. It's the loopholes in the Medicare system that lure these gold hunters
 
SAD! I saw a lot of unethical behavior when I was in the mortgage industry, just makes you wonder how people like this sleep at night.
 
The most interesting part is that he was with The Assurance Group (Evil Empire). They don't retain any accountability. I would have questioned someone turning in so many apps. It is suspicious but considering he was with TAG, they ignored it.
 
That reminds me of a story. I was flown out to see the home office of an insurance company. I got to meet the underwriters, etc. They told me of one agent that was submitting alot of applications for Med supps. This particular company did phone interviews on each app. The agent listed his phone # rather than the clients on each app. On every phone interview he pretended to be the client and the policy would get issued. They issued over 100 of them before they realized what he was doing.

I know of another agent that would list everyone as just turning 65, so they'd have an open enrollment for the med supp. They could be 75 but he'd list them as 64. Lower premiums and guaranteed issue. They caught up with him also.

Every profession has it's bad apples....
 
I thought they caught a guy that used to sell at our MA office. He falsely just tells his book of business he's at their house to upgrade benefits, has them sign an electronic form on his laptop and then they find out later that they have a new plan. The big difference is inpatient hospital, former plan: $175 co-pay-3days $1500 OOP/year and the new plan is $175 co-pay-20 days $3900 OOP/year. He's a real tool. I can only hope Illinois has department of insurance cops like NC does.
 
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