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Cuyahoga County resident receives 5-year prison sentence in $229K insurance fraud scheme

By
Ohio Department of Insurance, Press Release

Ohio Department of Insurance Director Judith L. French announced that Justin Mack, a native of Buffalo, N.Y. and a resident of Cleveland, Ohio, was sentenced Nov. 25 in the Cuyahoga County Court of Common Pleas to five years in prison and ordered to pay restitution for filing 24 fraudulent claims with multiple insurance companies, totaling more than $229,000.

Mack, who was also charged with related offenses brought by the Lakewood Police Department and the Cuyahoga County Sheriff’s Office, pleaded guilty to 13 felony counts for insurance fraud, telecommunications fraud, tampering with records, identity fraud, forgery and attempted theft.

"This case underscores the Ohio Department of Insurance’s commitment to protecting consumers and maintaining the integrity of the state's insurance industry," French said. "Thanks to the diligence of our investigative team, the cooperation of the insurance industry, local authorities and the work of the Cuyahoga County Prosecutor's Office, this individual has been held accountable for his illegal actions. Insurance fraud is a serious crime.”

A report from the Coalition Against Insurance Fraud estimates that the economic impact of insurance fraud is a $308.6 billion annual cost to U.S. consumers and businesses, equaling about $932 annually for every American and more than $70,000 over a person's lifetime.

An extensive investigation uncovered Mack’s pattern of submitting altered documentation, falsified claims and using other people's identities to fraudulently secure payouts from multiple insurance companies:

• American Strategic Insurance Claim: In April 2022, Mack filed a fraudulent claim alleging $42,134.14 in personal property damage and theft following an alleged apartment vandalism. An investigation revealed no such incident occurred. Mack fabricated ownership documentation and photos, altered receipts and altered a police report to support his narrative.

• Lemonade Insurance Claim: In April 2022, Mack submitted a fraudulent $17,960.00 claim for stolen property related to a rental car. The investigation determined the car was not stolen and no property was in the vehicle. Mack fraudulently used another person’s identity, recycled items previously reported as damaged or stolen in the American Strategic Insurance claim and submitted falsified receipts along with an altered police report to support his claim.

• Aetna Insurance Claims: Between November 2022 and October 2023, Mack filed 21 fraudulent claims as an employee of Aetna. He received $162,150.00 for false hospitalizations, accidents and a fabricated cancer diagnosis. It was confirmed the claims were supported by altered medical records and that Mack deposited the payments across eight financial institutions.

• Liberty Mutual Pet Insurance Claim: In November 2023, Mack submitted a fraudulent $7,288.05 claim with altered documentation for extensive veterinary services, including hospitalization, for his dog. It was confirmed the actual charges were $214.60 for a basic consult and prescription medication.

Ohioans who suspect insurance fraud or professional misconduct are encouraged to report it to the Ohio Department of Insurance at 800-686-1527 or insurance.ohio.gov. Referrals can be made anonymously, and the law protects those who report fraud from civil liability in the absence of fraud or bad faith.

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