Essex County Man Pleads Guilty to Illegally Obtaining $74,000 in Disability Insurance Payments by Submitting Phony Documents
TRENTON – Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor today announced that an Essex County man has pleaded guilty in a scheme to obtain $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, pleaded guilty to second degree insurance fraud during a hearing before Superior Court Judge Alfonse J. Cifelli in Essex County on Monday. Under the terms of the plea agreement, the State will recommend that Smith be sentenced as a third-degree offender and receive a 3-year prison term. Smith is scheduled to be sentenced in March 2019.
Smith, who was employed by the East Orange Board of Education until June 2012, admitted filing more than two dozen 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.
“This kind of exploitation of the insurance system is a prime example of why we’re calling on New Jersey residents to report fraud when they see it,” said Attorney General Grewal. “Insurance fraud drives up the cost of premiums for everyone. By actively working to shut down insurance thieves, honest policy holders can finally stop paying the price for crimes they did not commit.”
“Disability insurance is meant to serve as a financial safety net for individuals who have fallen on hard times, not a source of easy cash for criminals,” said Acting Insurance Fraud Prosecutor Tracy M. Thompson. “The prison term this defendant is facing as a result of his actions is proof that insurance fraud is a serious crime with serious consequences.”
The OIFP investigation revealed that Smith 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 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.
Deputy Attorney General Jennifer L. Menjivar represented the State in the plea hearing. Detectives Wendy Berg and Grace Proetta coordinated the investigation.
Acting Insurance Fraud Prosecutor Thompson 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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