"Fake Deaths Abroad Are Growing Problem for Insurers"

July 1, 1997 - NEW YORK TIMES -Front Page; Business Section

Swinging his car out to pass on a country road in South America, Javier Mozo found himself in the path of a roaring, smoke-belching cross-country bus. Swerving off the road, the car flipped and rolled. Somehow, Javier crawled out of the wreckage alive. But his brother Ernesto was not so lucky. He died in Javier's arms.

Or at least that is what Ernesto's wife, Maria Magdalena Santos, and Javier Mozo told the Northwestern National Life Insurance Co., which had insured Ernesto Mozo's life for $500,000.

As confirmation of the death, Ms. Santos sent the small Minnesota insurer -- since renamed the Reliastar Life Insurance Co. -- a death certificate issued by the city morgue in the Colombian town of Santa Marta. And when an investigator came calling, Javier Mozo provided a moving account of his brother's death and showed him a stone vault in the San Miguel Cemetery with Ernesto Mozo's name inscribed on an ornate bronze plaque.

But in yet another instance of a fraud that has been increasingly plaguing the American life insurance industry, everything about Ernesto's supposed demise turned out to be false.

The death certificate had been forged. The stories that Javier Mozo and Ms. Santos told suggested promising careers as screenwriters. The cemetery vault had been rented. And eventually, Ernesto Mozo even turned up, very much alive.

People have been trying to collect on life insurance policies without actually dying almost since life insurance was invented. But in the last few years, a new twist has emerged. Never mind the heavily insured swimmer who is supposedly carried out to sea by a riptide. Or the fisherman whose empty boat turns up bobbing in the Atlantic. Or the climber lost on a snowy mountainside. These days the deception is being carried out mostly on paper, from forged police and hospital reports to false death certificates.

Though the latest cases may number only in the hundreds or thousands every year, they are setting off alarms among life insurers. Why? More and more residents of the United States have ties to developing countries, where it is easier to fake deaths. And as American insurance companies extend their global reach, they are aggressively selling policies in countries with less rigorous standards for record-keeping and documentation. Moreover, there is growing concern that organized groups are getting into the game.

As a result, even though it is exceedingly difficult to prosecute people for false death claims, insurance companies are trying to get tougher to set an example.

In most of these fraud cases, a central thread is a trip abroad, preferably to some place trying to cope with an upheaval like an earthquake, a flood, or, perhaps, a civil war. But any place will do where official record-keeping is slipshod, civil servants earn survival wages and baksheesh is a cultural hallmark.

Ronald Poindexter, the director of Florida's Division of Insurance Fraud, says that in Haiti, medical examiners are not even required to view a body before issuing a death certificate, provided that three people swear that a death has occurred.

The typical con artist, investigators say, is a Third World native who has lived in the United States for a few years, has bought life insurance and decides to take a trip back home. During the visit, calamity strikes and the beneficiary files an insurance claim. Ernesto Mozo, for example, had been visiting Colombia from his new home in Miami, where he and his wife worked for an import-export firm. (Ernesto Mozo was jailed briefly in Colombia, and an American warrant is out for his wife's arrest. Javier Mozo merely walked away.)

"There are lots of claims coming out of Haiti, Jamaica, Mexico, Nigeria, Yemen and other Middle Eastern countries, Eastern Europe and the former Soviet states," said Steven Rambam, the head of Pallorium Inc., a private investigation firm in Manhattan that has handled a dozen of these cases.

Richard Marquez, who oversees foreign investigations for the Prudential Insurance Co. of America, scans the news every day for potential trouble spots. "Right now," he said, "we're looking at Congo to see what develops there," referring to the former Zaire.

Sometimes, people with no foreign ties have been discovered trying life insurance hoaxes, investigators say. Certainly, forgery is not an unknown art in the United States. But putting together the proof necessary for collecting on a life insurance policy is much harder here.

The swindlers are usually not career criminals, insurance executives say, but men and women who see their life insurance policies as irresistible opportunities to take a lot of money from some enormously wealthy, faceless corporation. That may be changing, though. Rambam says he has investigated several cases that he is convinced involved members of political and criminal organizations in the former Soviet Union, West Africa and the Middle East. They filed false insurance claims, he says, to raise money for their groups.

Nobody knows for sure the extent of this fraud. But trade association officials say it is clearly on the rise. Larry LaPointe, the chief of the fraud division at the New York state Department of Insurance, said his investigators were handling 20 to 30 cases a year, up from hardly any just two years ago. In California, the number of fake death claims has more than tripled to 40 or 50 a year. And no one knows how many people are getting away with fraud without raising suspicions.

Compared with fraudulent health care and auto claims, which run into the billions of dollars, the cost of fake deaths is relatively trivial. Still, said Dennis Jay, executive director of the Coalition Against Insurance Fraud, it may run into the hundreds of millions of dollars a year.

In April, for the second consecutive year, investigators from half a dozen insurance companies convened in Florida to share ideas on how to counter the phenomenon. One of the speakers was Rambam, who spoke of "how easy it is to manufacture alternative identities" as a first step in defrauding an insurer.

For con artists, the beauty of taking out an insurance policy on an imaginary friend or relative is that they can name themselves as beneficiaries. First, armed with false identity papers, they pose as their own creations, undergoing the physical examinations required for most large insurance policies. Then, using other forged documents, they tearfully report the deaths of these fictional loved ones. This approach has advantages over faking their own deaths: They can retain their true identities, and they do not have to share the proceeds with anybody.

Most people still follow the less complex route of taking out insurance on themselves and naming a spouse or some other relative as the beneficiary. The big catch, of course, is that to escape detection, they have to assume a fake identity for the rest of their lives. Many people forget that and are caught.

Yet, for the most part, filing bogus life insurance claims carries little risk. Criminal prosecution is rare, even when a malefactor is caught red-handed. When insurance companies bother to go to the authorities, they often have a hard time getting the attention of prosecutors who have their hands full with violent crimes.

In even the strongest cases, obtaining a conviction is problematic. "All your documentation and your witnesses are overseas," said Kenneth Kensler, a senior investigator for the California Department of Insurance. "So you have a hearsay problem to overcome."

And that washes out most cases.

"To get a witness to come in from Nigeria or Cameroon or Ghana is virtually impossible," said Ronald Sallow, who heads Maryland's insurance fraud unit. "It's prohibitively expensive. And they are extremely reluctant witnesses because they fear retribution."

There have been exceptions. Two years ago, Daniel Skelly, the chief of the Insurance Fraud Bureau in Massachusetts, won the conviction of Samson Omosefunmi, a Nigerian businessman who collected $134,000 after contending that his wife had died in an auto accident back home. Skelly did not have the budget for the overseas work. But he persuaded the insurance company to pay $5,000 to fly in a Nigerian government official who testified that the death certificate and its adorning seals were fakes. Omosefunmi, who had previously been convicted of welfare fraud, went to prison.

In another case, Skelly succeeded in getting a guilty plea from Francois C. Maisonneuve, a Haitian who posed as his brother, Louis, and took out a $100,000 policy naming himself as beneficiary. Then, on paper, he killed his brother, even sending the insurer a photograph of himself standing beside an open coffin with a body that was supposed to be his brother's. But Skelly's investigators found the real brother, alive, in Massachusetts, and he testified that the claim was false. Maisonneuve had never before been in trouble with U.S. authorities, though, and his punishment was two years of probation and $10,000 in restitution.

In Florida, Poindexter has yet to catch up with Maria Magdalena Santos, who filed the false claim for the death benefits of her husband, Ernesto Mozo. But he has issued an arrest warrant that can become effective the next time she tries to enter the United States. She was the only one of the three conspirators, including Ernesto's brother Javier, who committed crimes -- such as submitting the paperwork for the $500,000 policy to her Miami agent -- within Florida's jurisdiction.

As a result of the work of a private investigator hired by Reliastar, Ernesto Mozo was jailed briefly in Colombia for forging the signature of the Santa Marta morgue director. But as far as the Americans know, no one ever went after Javier Mozo.

Because the cost of insurance fraud is ultimately passed on to the customer in the form of higher premiums, more and more states are creating special investigative units and requiring insurance companies to investigate suspicious cases and report them to the authorities. Michael Diegel, an official of the Coalition Against Insurance Fraud in Washington, says some companies still think it is more cost effective to pay some questionable claims, particularly small ones, than to start an investigation.

But others, including Prudential, the Metropolitan Life Insurance Co. and relatively small Reliastar, a unit of the Reliastar Financial Corp., make a fetish of checking out claims. Lawrence Vranka, who oversees claims for Metropolitan, said his company spent $30,000 on a single Indonesian case to win a conviction in which the con artist was jailed. Not long ago, Reliastar spent $3,500 to investigate what turned out to be a fraudulent claim in the Philippines on a $5,000 policy.

"We believe that being aggressive is a deterrent to people fooling around with our company," Gary Dunn, a Reliastar executive, said.


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