The PA Insurance Fraud Prevention Authority (IFPA) recognized the exceptional work and dedication of eight individuals with 2013 Fraud Fighter Awards during the recent PA Insurance Fraud Conference and Awards Dinner.

Over 500 attendees from 23 different states gathered at the Hershey Lodge and Convention Center for this year’s PA Insurance Fraud Conference. This two-day event was hosted by the Delaware Valley and Greater Pittsburgh Chapters of the International Association of Special Investigation Units (IASIU); and the IFPA.

Highlights of this year’s conference included the presentation of the 2013 Fraud Fighter Awards. Presentations were jointly made by Mr. John Henry, president of the Greater Pittsburgh Chapter of IASIU and IFPA board member; Mr. Thomas Donahue, president of the Delaware Valley Chapter of IASIU; and Ralph Burnham, executive director of the IFPA. Burnham told attendees, “Today we are honored to recognize a number of your colleagues from Pennsylvania’s insurance and law enforcement communities, whose hard work and dedication have helped the IFPA carry out its mission to educate Pennsylvanians about the harms of insurance fraud.”

2013 Fraud Fighter Awardees

James Kopera, Special Agent, Insurance Fraud Section, Western Regional Office, Pennsylvania Office of Attorney General

Special Agent Kopera received a 2013 Fraud Fighter award for his dedication and expertise shown during a complex investigation of fraud affecting commercial insurance and business owners. The investigation resulted in charges against the owner of an Allegheny County insurance agency who had allegedly failed to remit to insurers upwards of $200,000 in premium payments given to the agency by 31 business owners. Reportedly, while the business’ liability insurance policies went unpaid, nearly one-half million dollars in claimed losses occurred.

Philip A. Saggione III CFE, AHFI, ACFE, Major Case Consultant, Nationwide Insurance, Wilmington, DE

Philip Saggione III received a 2013 Fraud Fighter award for his dedication and health care fraud expertise in uncovering a national diagnostic imaging firm that, in concert with a number of medical practitioners, allegedly defrauded insurers of millions of dollars across several states through abusive and duplicated billings for medical services.

James J. Fitzpatrick, Assistant District Attorney, Insurance Fraud Unit, Philadelphia District Attorney’s Office

ADA James Fitzpatrick was recognized for his 18 years of service to Philadelphia’s insurance consumers and insurers in combating insurance fraud. A career prosecutor with the Office since 1980, he assisted the drafting Pennsylvania’s Insurance Fraud Prevention Act and in 1995 played a key role in creating the Office’s Insurance Fraud Unit. In addition to assisting the administration of the Insurance Fraud Unit over 18 years, he personally conducted scores of insurance fraud prosecutions and has shared his expertise by developing and implementing a training program for law enforcement and insurance industry fraud investigators.

David A. Bano, Senior Vice President and Chief Claims Officer P&C Insurance Companies, Nationwide Insurance, Columbus, OH

David Bano was given special recognition for his past stewardship of Pennsylvania’s Insurance Fraud Prevention Authority (IFPA) and his championing, as IFPA Board Chairman, of the use of public fraud awareness education to safeguard consumers against the harms of insurance fraud. Burnham told attendees that, “while very large fraud cases frequently appear in the news, the lessons to be learned from the many smaller cases of fraud prosecuted each year do not reach consumers. To prevent insurance fraud we must educate people about the crime and its’ punishments.” Bano, a staunch supporter of the insurance industry’s special investigation professionals, had the vision and deep understanding of insurance and insurance consumers necessary to meet that challenge and set the IFPA on a true course of fraud prevention. His advocacy of statewide advertising aimed at consumers, during his 1995 to 2007 tenure on the IFPA’s board, helped create and evolve Pennsylvania’s consumer outreach. Today the IFPA’s consumer outreach is nationally acclaimed, and through the national Coalition Against Insurance Fraud, will soon be made available at little or no cost to other states’ anti-fraud organizations.

Dawn Holtz, Assistant District Attorney, Insurance Fraud Unit, Philadelphia District Attorney’s Office

ADA Dawn Holtz received a 2013 Fraud Fighter award for her prosecutions of SEPTA bus riders who made fraudulent personal injury claims after city buses were involved in minor traffic accidents. SEPTA, which self-insures for motor vehicle liability, was losing millions of dollars to false claims and the city’s emergency responders and taxpayers were victimized by fraudsters. The resulting widespread news coverage of fraudulent claims involving SEPTA buses has helped the IFPA educate people that minor accidents are not pay day opportunities to be exploited for unlawful gain.

Alfredo Quintile, Detective, Insurance Fraud Unit, Philadelphia District Attorney’s Office

Detective Alfredo Quintile received a 2013 Fraud Fighter award for his work done in several complex fraudulent auto bodily injury cases that gained national attention. One case involved uncovering a staged accident and fraudulent claim scheme that drained millions of dollars from auto insurers in Philadelphia and was showcased in an hour-long March 2012 episode of CNBC’s American Greed. Burnham remarked that, “when local coverage of insurance fraud cases goes national, the deterrence that comes with the threat of arrests and prosecutions is tripled.”

Jennifer Harrison, Special Agent, Insurance Fraud Section, Pennsylvania Office of Attorney General

Mark Bellavia, Senior Deputy Attorney General, Insurance Fraud Unit, Pennsylvania Office of Attorney General

Special Agent Jennifer Harrison and SDAG Mark Bellavia received 2013 Fraud Fighter awards for a case involving home health care insurance fraud that they investigated and prosecuted in Monroe County. Special Agent Harrison’s expertise and dedication helped obtain grand jury indictments of two women who, along with several relatives and acquaintances, served as caregivers to the ill and elderly to defraud insurers of over $1.0 million through false claims for services that were never provided. Bellavia’s skills secured guilty pleas or guilty court findings for all of the scheme’s participants, obtaining over $1.0 in restitution and significant terms of prison for the two ringleaders and one co-defendant who fought charges. Burnham noted that the resulting publicity gained locally and statewide from this successful case helped the IFPA educate Pennsylvanians that insurance fraud is not a victimless crime.

The IFPA was created in 1994 by the Pennsylvania General Assembly. Act 166, the Insurance Fraud Prevention Act, arms law enforcement and prosecutors with the resources necessary to fight insurance fraud in the Commonwealth. To learn more about IFPA visit www.helpstopfraud.org

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This website provides a listing of law enforcement agencies that fight fraud. To report anonymously, consumers can call the National Insurance Crime Bureau’s tip line at 1-800-TEL-NICB or the IFPA’s tip line at 1-888-565-IFPA.