Ambulette Companies, Two Principals Offer Guilty Pleas in N.Y. No-Fault Billing Scam

New York Attorney General Eliot Spitzer and State Insurance Superintendent Gregory Serio announced guilty pleas to two separate indictments by owners of several ambulette companies for submitting fraudulent transportation bills to insurance carriers.

The schemes reportedly involved false billings that stemmed from no-fault insurance claims made by motor vehicle accident victims. Among the charges the defendants pled guilty to were scheme to defraud, insurance fraud, forgery, larceny and attempted larceny. As part of their guilty pleas, both defendants are to be sentenced to terms of incarceration.

The defendants committed their reported crimes by billing insurance companies for round-trip ambulette transports when none were provided, or by over-billing insurance companies for ambulettes when the service was provided by private cars. An ambulette is a wheelchair-accessible vehicle used to transport patients who need assistance in traveling from their homes to medical facilities. In some cases, the defendants reportedly submitted to insurance carriers vouchers, or “trip tickets,” containing forged patient signatures, to support their fraudulent billings.

Spitzer said, “These guilty pleas send a message that you can and will go to jail for committing insurance fraud. We will continue to aggressively prosecute health providers and others who manipulate the no-fault system for their own gain.”

Serio added, “Those involved in this scheme defrauded the no-fault insurance system. This is money not just stolen from insurance carriers but is a direct theft from all honest auto insurance consumers. The New York State Insurance Department’s Frauds Bureau worked closely with the Attorney General’s Auto Insurance Fraud Unit to bring these defendants to justice.”

Under New York’s no-fault law, a person injured in a motor vehicle accident can receive up to $50,000 coverage for medical expenses incurred as a result of the accident. No-fault will also cover transportation costs to and from medical facilities and will reimburse at a higher rate for ambulette service when it is deemed medically necessary. Most health service providers, including ambulette companies, are reimbursed directly by the carriers for services provided.

In the first case, the defendants who pled guilty were Ivan Lopadtchak a/k/a Ivan Lopadchak, 48, and two companies owned by him, Ex-L Ambulette Service I.M.. Inc. and Almaz Ambulette Service I.M. Inc.

Lopadtchak pled guilty on Oct. 1, 2004 to a 57-count indictment before Kings County Supreme Court Justice John Walsh. Lopadtchak is scheduled to be sentenced on Dec. 3, 2004. The Court is expected to impose a sentence of a one-year, less one day, term of imprisonment, and restitution exceeding $60,000.

In the second case, Mark Pogoriler, 47, and his two corporations, Shark Transportation M.S. Inc. and LEM-M Ambulette Service Inc., pled guilty earlier this year before Kings County Supreme Court Justice Abraham Gerges to multiple felony counts stemming from a 47-count indictment. Pogoriler is scheduled to be sentenced by Justice Gerges on Nov. 18, 2004. The Court is expected to impose a sentence including at least one year of incarceration, and restitution exceeding $25,000.