Lynnwood auto repair shop charged with insurance fraud

A Snohomish County auto repair shop has been charged with insurance fraud after charging for repairs it didn't do and parts that it never installed.

Northwestern Collision, of Lynnwood, was charged Dec. 14 in Snohomish County Superior Court. Arraignment is set for Jan. 9.

In 2009, Farmers Insurance investigators inspected 11 vehicles that had been repaired by the shop between 2007 and 2009. Of the 11, 10 "had substantial and specific" deviations from the repair estimates that Farmers had agreed to.

Among the problems: parts missing and not replaced, repairs not performed, and repairing items that were supposed to be replaced.

On Dec. 8, 2010, officers from the state insurance commissioner's Special Investigations Unit, the State Patrol and the Snohomish County Sheriff's Office served a warrant at the company's Lynnwood office. They gathered up paper files on 10 of the 11 vehicles.

The records indicated that in some cases, new parts that were supposed to be installed were instead returned to the parts dealer.

The insurer was overcharged nearly $11,000, and had to buy one customer's car, which had been rendered unsafe to drive, for another $15,446.

Cease and desist order issued to TracGuard Services

The Washington state insurance commissioner's office has told a Florida-based vehicle service contract provider to stop selling unauthorized contracts in Washington state.

TracGuard Services LLC, Jose L. Terry and Alberto Tudela, all of North Miami, have been ordered "to immediately cease and desist from engaging in or transacting the unauthorized business of insurance" in Washington.

Neither the company nor the two men are authorized to solicit or transact insurance in the state. They have not registered as a motor vechicle service contract provider in Washington.

The three have been ordered to notify all Washington residents who have purchased a service contract from them. It also warns that, pursuant to Washington state law, unauthorized insurers "shall remain personally liable for performance of the contract."

Cease and desist order issued to Mill Creek man

A Mill Creek man and company have been ordered to stop selling unauthorized vehicle service contracts.

The order names Scott L. Stevens and RVProtection.net, Inc., both of Mill Creek, Wash. In August of 2010, they sold a consumer a vehicle service contract offered by Genuine Warranty Solutions, Inc.

The problem: Genuine Warranty Solutions, Inc. is not a registered vehicle service contract provider in Washington.

The Dec. 19 order took effect immediately. Stevens and the company have the right to appeal the order.

Public notices and hearings: Change of incorporation, proposed acquisition, etc.

Notices and upcoming hearings from our public notices web page:

Proposed acquisition: Humana is proposing to become the sole owner of Arcadian Management Services and its affiliates. We've completed our review of the application for acquisition of control. No hearing's been scheduled yet, but will be soon.

Incorporation change: The Safeco Companies have requested approval to have New Hampshire be their state of incorporation. The companies, which were acquired by Boston-based Liberty Mutual in 2008, say the change would not affect any Washington policyholders, and that there would be no interruption in coverage. A hearing is scheduled for Jan. 10, 2012 at 10 a.m. in our Tumwater office, which is at 5000 Capitol Blvd. Annual reports and other documents re: the request are posted here.

Change in port of entry/redomestication: Industrial Alliance Pacific Insurance and Financial Services have filed documents to change their port of entry/redomestication to Texas. A hearing is scheduled for Feb. 1, 2012 at 1 p.m. at our Tumwater office, which is at 5000 Capitol Blvd. Documents re: the request are posted here.

Judge issues insurance fraud ruling...in the form of a poem

And now for something completely different:

A Pennsylvania judge has issued a ruling in an insurance fraud case. What's unusual is that the judge issued his ruling in the form of a poem. From the Associated Press:

Justice J. Michael Eakin, writing for a 4-2 majority, concluded in six-line stanzas that a man's attempt to deposit a forged check appearing to be from State Farm didn't constitute insurance fraud.

"Sentenced on the other crimes, he surely won't go free, but we find he can't be guilty of this final felony," Eakin wrote. "Convictions for the forgery and theft are approbated — the sentence for insurance fraud, however, is vacated. The case must be remanded for resentencing, we find, so the trial judge may impose the result he originally had in mind."

A 3-page dissent by another judge, AP writer Marc Levy noted, did not rhyme.

GEICO fined $100,000 for overcharging customers in WA; company will also refund $7.5 million

A Maryland-based insurance company has been fined $100,000 after overcharging thousands of its Washington state customers.
The insurer, GEICO, is also refunding $7.5 million – plus 8 percent interest -- to the 25,267 affected auto insurance consumers by the end of the year.

“A computer database error caused the problem, which the company reported to us promptly,” said Washington State Insurance Commissioner Mike Kreidler. “GEICO has also agreed to a two-year compliance plan that includes multiple audits.”

An additional $50,000 fine was suspended, on the condition that the company abides by the terms of the compliance plan.

The refunds, many of which have already been paid, will average roughly $300. The company has been contacting active and former customers affected by the issue and expects to have all refunds paid by the end of the year.

On May 26, 2011, GEICO representatives self-reported the computer error, which resulted in 7 percent of the company’s Washington customers being overcharged for insurance between Aug. 24, 2009 and June 2011.

Fines collected by the insurance commissioner’s office do not go to the agency. The money is deposited in the state’s general fund to pay for other state services.

The complete order is posted at: http://www.insurance.wa.gov/oicfiles/orders/2011orders/11-0273.pdf.

Social media, liability and insurance

Social media and insurance? Hard to imagine those words together, but the new report by the Insurance Information Institute is pretty interesting reading.

Most of us rely on social media more and more these days - whether for work or to keep with friends and family. But we probably never think about the insurance impact (ie. liability issues).

Find out if you or your business could be at risk - here's the report.

Number of uninsured in WA hits 1 million

We posted a report this morning detailing our estimates of the number of Washingtonians with no health insurance, the amount of uncompensated care, and how those numbers are trending.

The upshot: We calculate that:

• The number of uninsured has reached 1 million, or 14.5 percent of the state's population.
• Uncompensated care (bad debt and charity care at hospitals, clinics, etc.) is nearly $1 billion.
• And that both numbers are likely to continue to rise until 2014, when the major provisions of federal health care reform are slated to take effect.
• The percentage of residents without health coverage worsened in 31 of 39 counties.
• In several counties, more than 1 in 5 residents has no health coverage.

“This is a grim milestone for the state, and we believe the situation will remain bleak for two more years,” said Kreidler. “But it’s important for people to know that there is hope is on the horizon.”

Counties with a particularly high percentage of uninsured residents include: Adams, Grant, Okanogan, Franklin and Yakima. But the problem also worsened in King, Pierce, Snohomish and Spokane counties.

The good news: Assuming that federal health care reform takes effect as planned, more than 800,000 uninsured Washingtonians will be eligible in 2014 for expanded Medicaid eligibility or subsidies to help low- and middle-income families pay for health coverage.

This is the third report on the uninsured our office has put out since 2006.

A $200,000 patio cover? Spokane man charged with insurance fraud

A Spokane man has been charged with insurance fraud and attempted theft after a snow-damaged patio cover worth about $4,000 mushroomed into a nearly $200,000 claim.

Keith R. Scribner, 47, was arraigned Monday in Spokane County Superior Court on one count of insurance fraud and one count of attempted theft.

In late July 2009, Scribner's mother, Marilyn Warsinske, filed a claim with Liberty Mutual insurance. She said a patio roof at a home she'd purchased had collapsed due to the weight of snow some 6 months earlier. The policy covered "like kind and quality" replacement. Her son, she told the company, would handle the claim.

Scribner told the insurance company that patio cover was an extensive structure, spanning the entire length of the patio and wrapping around the home's chimney. Claims officials, inspecting the site, wondered why was there no flashing or holes in the masonry. Scribner said that house painters must have made repairs.

He sent the insurance company three bids to replace the cover based on his description. The bids ranged from $195,586 to $213,815.

Claims officials asked Scribner for any photos of the roof prior to the damage or after it collapsed. Perhaps some were taken during a home appraisal prior to the purchase, they suggested. Scribner said there were no photos and was no appraisal.

But a claims handler discovered an aerial photo of the home on a real estate website. It showed a much smaller patio cover than Scribner claimed.

The company launched a fraud investigation and notified Insurance Commissioner Mike Kreidler's anti-fraud Special Investigations Unit.

As it turned out, there had been a home appraisal, the investigators discovered. In fact, Keith Scribner met with the appraiser. And the appraisal included photos of the patio cover. A real estate agent interviewed by investigators described the cover as being "small and nothing special or significant."

The home's previous owner also provided photographs of the structure. It was originally canvas. When that because troublesome to remove each year, the homeowner bought a polycarbonate cover. Cost: About $300.

An architect told a state fraud investigator that he'd met with Scribner in 2008 -- months before the snow collapse -- to discuss plans to replace the deck cover with new, larger one.

A local company, provided with measurements and photographs of the original structure, drew up replacement bids at the request of a state fraud investigator. The bids: $3,913 and $4,782.

Insurance problem? We can help

We're the state agency that regulates insurance in Washington state. If you're a Washingtonian, we're happy to help answer insurance questions and help try to solve problems with insurers/agents/etc.

What can you expect? If you file a complaint, for example, we will:

■ Contact the insurance company regarding your concerns, review their response, and share the results of our review with you.


■ Research and complete your complaint within 60 days.

■ Suggest steps you might take to resolve your issue.

■ Make your complaint a part of the company's public record.

■ Require the company to address your concerns and follow Washington state insurance laws and regulations.

And we get results. We get millions of dollars a year in delayed or denied claims paid to Washington consumers.

For a complete list of our customer service standards -- as well as links to easily file a complaint online -- please see our complaint help web page. You can also call our Insurance Consumer Hotline toll-free at 1-800-562-6900.

We'll try our best to help.

Medicare drug and Advantage plan enrollment ends Dec. 7

Medicare's open enrollment for prescription drug plans (Part D) and Medicare Advantage plans ends Dec. 7.

This year's enrollment period was moved and expanded, thanks to the Affordable Care Act, giving people additional time to consider their choices.

Still need to make a decision and need some help? Our Statewide Health Insurance Benefit Advisors (SHIBA) program can answer questions and help you evaluate plans. Call our Insurance Consumer Hotline at 1-800-562-6900 and ask to make an appointment with a SHIBA volunteer in your area.

Before you make your decision, consider these tips:

• Plan costs and coverage can change every year, so carefully review all letters and notices from your current plan.


• Make a list of all current prescription drugs you take, the doses, and how often. Then, use the Plan Finder at www.medicare.gov to compare Part D plans.


• Review the 2012 Medicare & You handbook. You should have received it in September.
  If you have questions, call 1-800- MEDICARE (1-800-633-4227) before you sign up.


• If you have limited income and need help paying for prescription drugs, check out Medicare’s “Extra Help” program. To see if you qualify, contact the Social Security Administration at 1-800-772-1213 or go to www.socialsecurity.gov and click on Medicare.

But most importantly, don't wait! Remember, open enrollment ends Dec. 7. Here's a list of prescription drug plans and Medicare Advantage plans