Insurance fraud is any deliberate deception committed against or by an insurance company, insurance agent, or consumer for the purpose of unjustified financial gain. This occurs during the process of buying, using, selling, and underwriting insurance.
The Insurance Fraud Prevention Division is a certified law enforcement division whose duties and responsibilities are to conduct investigations independent of, or in conjunction with, law enforcement agencies when the Division has cause to believe that an act of insurance fraud has been or is currently being, committed.
Quarterly Court Actions Highlights
Sarpy County District Court, Case CR23-496
State v. Rebeca R. Antunez
Fraud Type: Auto Property - Past Posting
Rebeca Antunez was charged in Sarpy County with one felony count of insurance fraud.
Rebeca Antunez took out an auto policy providing comprehensive and collision coverage for her vehicle. Later that day she filed a collision claim stating she was just in an accident. Ms. Antunez provided the policy information to the other driver, who filed a liability claim for damage to her vehicle. Ms. Antunez provided a statement to the claims handler and affirmed her policy was incepted prior to the accident. However, the claimant's scene photos and the police report confirmed the accident occurred prior to the inception of her policy. As a result, Ms. Antunez's collision claim was denied, and the claimant suffered an out-of-pocket loss of $9,027.37.
Ms. Antunez pled guilty to an amended count fo fraudulent insurance act, a Class I misdemeanor. Ms. Antunez was sentenced to two years' probation, community service 20 hours, court costs and fees.
Sarpy County District Court, Case CR22-881
State v. Stephanie N. Lysholm
Fraud Type: Auto Property - Vehicle Theft
Stephanie Lysholm was charged in Sarpy County with one felony count of insurance fraud.
Stephanie Lysholm took out an auto policy providing comprehensive and collision coverage for her vehicle. Ms. Lysholm lowered her comprehensive deductible and added rental coverage. Approximately one-week later Ms. Lysholm reported her vehicle stolen. During the claim investigation it was discovered that Ms. Lysholm gave her vehicle to a known party to settle a debt. As a result of Ms. Lysholm's misrepresentation, the insurer suffered a potential loss of $5,056.04 based on the vehicle's valuation.
Ms. Lysholm pled no contest to an amended count of attempted fraudulent insurance act, Class I misdemeanor. Ms. Lysholm was sentenced to two years' probation, community service 20 hours, court costs and fees.
Douglas County District Court, Case CR23-3196
State v. Tenisha E. Roddy
Fraud Type: Medical/Health - Falsified/Forged Documents
Tenisha Roddy was charged with one felony count of insurance fraud.
Tenisha Roddy was employed as a claim handler with a national insurer. Ms. Roddy obtained three supplemental medical benefit policies through her employer. During the course of her employment, Ms. Roddy processed and received supplemental payments for six invalid claims pursuant to her policies. In addition, Ms. Roddy changed the direct deposit information on six unrelated policies to a bank account under her control. Ms. Roddy then processed and paid 57 invalid claims against those policies. As a result of Ms. Roddy's actions her employer suffered and actual loss of $3,085 and a potential loss of $450.
Ms. Roddy pled no contest to an amended count of attempted insurance fraud, a Class I misdemeanor. Ms. Roddy was sentenced to 18-months' probation, ordered to pay restitution to the insurer and the Insurance Fraud Prevention Division's investigative costs, court costs and fees.