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Falls Township Woman Sentenced for Six-Figure Insurance Scam

March 2, 2016

FOR IMMEDIATE RELEASE
Contact: Gregg Shore, 215.348.6202, gdshore@buckscounty.org

A Falls Township woman who defrauded an insurance company by filing a half-million dollars in phony medical claims was sentenced today to serve 11½ to 23 months in the Bucks County Correctional Facility.

Cynthia Clarey, 61, also was ordered to reimburse her insurer for nearly $135,000 in payments she received for cancer treatments that never happened. In addition to her prison sentence, Judge Wallace H. Bateman Jr. placed her on 10 years of probation, during which she will have to make full restitution.

When Clarey suggested in court that she could perform community service to help cancer patients, Bateman angrily cut her off, calling her crimes “an insult to every person who suffers from cancer.”

Bateman told Clarey that she needed “to take a look in the mirror and take a hard look at what you’ve done.”

Between February 2013 and December 2014, Clarey submitted claims for 462 cancer-related treatments with a total cost of $503,213. Along with the claims were fraudulent supporting documents that Clarey had created on her home computer and typewriter.

These included invoices, bills and correspondence bearing the names, purported signatures and other identifying information of physicians and facilities that Clarey claimed had provided cancer treatment for her husband and herself. Neither she nor her husband has cancer.

Clarey pleaded guilty in January to insurance fraud, theft by deception, attempted theft by deception and five counts of identity theft – all felonies. She said at the time that she had spent most of the insurance money to pay bills and to take care of her husband, who is unemployed and in poor health.

Bucks County Detective Eric Landamia, who helped investigate Clarey, testified today that she also had spent close to $4,000 for furniture and $8,900 for her daughter’s wedding during the time she was receiving the insurance payouts.

“It’s a bad case; there’s a lot of money involved,” acknowledged Clarey’s attorney, John Kerrigan. He nonetheless asked that Clarey be allowed to serve her sentence on house arrest so that she can tend to her seriously ill husband and continue working toward repaying the money she stole.

Assistant District Attorney Gregg Shore, head of the county’s insurance fraud unit, countered that Clarey had “used her husband as a tool to steal,” and now was using him to seek a lighter sentence.

Bateman said that Clarey would be screened for house arrest at the prison and that he would approve it if she qualified.

Landamia and fellow County Detective Timothy Perkins began investigating Clarey last summer after receiving information from Allstate Benefits, which provides supplemental insurance coverage for medical costs that exceed primary insurance coverage. The insured party is supposed to obtain bills or invoices from a medical provider, and then submit the documents to Allstate Benefits for reimbursement.

Clarey had obtained a cancer treatment policy in 2011, when a doctor had suspected that her husband might be suffering from cancer. That suspicion proved false, but in February 2013, Clarey nonetheless began submitting claims for reimbursement of prostate cancer treatment for her husband, primarily chemotherapy and radiation.

By June 2014 a claims examiner for Allstate Benefits reviewed Clarey’s file and insisted that medical records from treating physicians be submitted by Clarey before further payments would be made.

Allstate Benefits instructed Clarey to submit a form to St. Mary Medical Center in Langhorne so that the hospital would release her husband’s medical records. Clarey never did so, and Allstate Benefits denied all pending claims for her husband’s purported cancer treatments. Despite the denials, Clarey never complained to Allstate about them.

Instead, she began in July 2014 to submit claims for her own chemotherapy and radiation treatments. Clarey contended that she had been diagnosed with cancer and was being treated by Regional Gastro Consultants (RGC) in Yardley. She submitted bills, invoices and correspondence to Allstate Benefits, purportedly from RGC. But when an Allstate Benefits claims examiner contacted RGC for further documentation, an RGC representative stated that Clarey had never been seen there as a patient.

Allstate Benefits sent St. Mary and RGC packages of documents that the insurer had received from Clarey to support her claims. Both providers told Allstate that the documents – which contained repeated misspellings of basic words and incorrect address and phone information – had not been generated by them.

Detectives Perkins and Landamia interviewed Clarey on Aug. 26. She admitted creating fraudulent invoices and claims documents on her home computer and typewriter, and then faxing them from her employer’s office.  Investigators found that Allstate Benefits had paid Clarey $134,990 for the more than $500,000 in false claims she submitted.

Clarey told the detectives that she never had been diagnosed with or treated for cancer, and that her husband had not received any of the cancer treatments she had claimed in the phony invoices.

The Bucks County District Attorney’s Insurance Fraud Unit was created in 2015 with funding provided by the Pennsylvania Insurance Fraud Prevention Authority. The unit works closely with insurance company investigators and the Pennsylvania State Insurance Commission to identify and prosecute Homeowners, Auto, Medical and Workers Compensation Insurance fraud, as well as insurance fraud associated with illegal drug activity.

Approved for release by Matthew Weintraub, Chief of Prosecution.

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