Fraud of the Month

Slip and Fall

Street people, hundreds of them, stumbled and tumbled hard onto the pavement around New York City. They formed a gusher of fake falls maneuvered by a crime ring that sued businesses and their insurers for nearly $32 million for aching limbs and joints that didn’t ache at all.

Many of the ring’s recruits were homeless. They often were told to have surgery they didn’t need — even spinal fusions — to increase the payouts from false lawsuits for bogus slip-and-falls. The trip-and-slip insurance shakedown was one of the largest of its kind in recent memory.

Neighborhood scouts lured indigent people off the streets and out of homeless shelters. The recruits needed the money, and were happy to fake injuries for extra cash.

The recruits were arranged at pre-set points around the city. They were coached to fall into potholes and act hurt. Or trip on cracks in sidewalks outside restaurants, dry cleaners and other businesses. They were shown how to pretend they had painful injuries to sensitive body parts that plausibly needed surgery — knees, shoulders and backs. All the better to reap large insurance payouts.

Lawyers sue businesses, insurers

The “victims” were shuttled to colluding chiros and doctors for expensive treatment they didn’t need. Lawyers then entered the picture, and now the big money flowed. The lawyers sued the victim businesses and insurers on behalf of the seemingly hurt victims.

The catch: Patients were told to undergo surgery they didn’t need — usually twice. That greatly hiked the dollar value of the lawsuits. Surgeons wielded scalpels for procedures such as life-altering spinal fusions, knee and shoulder operations, and discectomies.

The low-income patients were desperate for money. The ring paid them tiny sums to get cut up — $1,000-$1,500 per surgery. The patients had a hard time turning down the little windfalls, no matter how much the surgeons sliced them open.

Ring members scout for patients

Bryan Duncan scouted for patients, organized the recruited their legal and medical appointments, and helped procure funding for the recruited patients’ medical treatment and lawsuits.  

Robert Locust and Ryan Rainford also recruited patients, drove them to medical and legal appointments, identified potential accident sites, made payments to recruited patients, and coached patients on how to convincingly fake injuries. 

The ring finally was euthanized. It was a victim of colony collapse disorder under the weight of investigators who broke open the criminal operation.

Duncan was convicted of four federal crimes — each of which carries up to 20 years in prison. Locust and Rainford each went down with two convictions, also with potential 20-year terms.

$400K ring broken, leader shoots himself

An attorney led a similar $400,000 slip-and-trip ring in Philadelphia. Andrew Gaber hired a small army of recruiters to bring him people he paid to act as phony injury victims. Many were homeless or drug addicts.

The phony victims were coached how to stage seemingly painful falls, and act injured. The fake victims often pretended to trip on small cracks in sidewalks in residential neighborhoods. Gaber’s recruiters acted as witnesses and “injured” victims.

Gaber then filed false injury claims against the homeowner policies. The scam lasted seven years and bilked 21 insurers.

Most ring members pled guilty under pressure from the Philadelphia District Attorney’s office. Gaber shot himself to death before going to trial.

Most slip-and-falls, however, appear to be one-off cons. People fake injuries in department stores, grocery stores, restaurants and other businesses. Yet many stores are loaded with all-seeing security cameras. Phony tumbles thus can be harder to get away with these days.

A New Jersey man claimed he tumbled on spilled ice by the soda fountain in the cafeteria of a business where he did subcontractor work. Jerry Goldinsky filed an insurance claim. Except the firm’s security cam shows him allegedly tossing the ice onto the floor, sitting down and waiting until someone discovers him. Jerry Goldinsky faces criminal charges.

As for the slippery slip ring in New York, federal prosecutor Geoffrey S. Berman had fun at the ring’s expense. “Duncan, Locust, and Rainford were tripped up by the justice system and have met their downfall,” he said.

About the author: Jim Quiggle is director of communications for the Coalition Against Insurance Fraud