See the full video at https://youtu.be/TBKSeProXMA and at https://rumble.com/v143exy-true-crime-of-insurance-fraud-video-number-70.html
Mischa came to Houston in 1990 directly from the former Soviet Union. His dream was to become a cowboy. He became a taxi driver.
Mischa quickly took up the English language and memorized the intricate streets of Houston. Within a year of his arrival, he could easily find any hotel, restaurant, or bar in the overgrown little town of Houston, Texas.
Mischa made a reasonable living by driving a taxi and drove the forty-five minutes in from the airport at least three times a day. He bought a small three-bedroom house outside of Houston and was building on the American dream. Mischa was not a criminal. He drove his cab twelve hours a day, six days a week to support himself and his young wife.
Misha’s life changed when the sender called him to Sophie Mendelson’s home. Sophie, an eighty-year-old Medicare patient, needed a ride to her doctor’s office, 40 miles from her home.
Upon arrival at the doctor’s office, Sophie Mischa provided the information necessary to bill Medicare directly for his services. He followed and within a few weeks received a check from the US Treasury Department. It seemed that all Medicare required before sending a check was information about the patient, a Medicare number and what he wanted for the miles driven. Mischa satisfied Medicare if the fare was reasonably related to the amount of miles he claimed.
Mischa was an intelligent man. He grew up in the Soviet Union, so he had no respect for the government. In fact, as a child and as an adult living in the Soviet Union, he learned that the only way to survive was to deceive the ever-present government.
He was surprised to learn how different the Soviet government was from the US government. Rather than expect fraud from its citizens, the US government seemed to believe everything its citizens told it.
The ride he gave Sophie Mendelson gave Mischa a plan to raise a fortune. Mischa advised his dispatcher that he would volunteer for all Medicare, Medicaid and patient trips called into his cabin. As the other drivers did not like to wait for the payments from the government, Mischa got all the calls. Within a month, he had created a ledger that contained 100 names, addresses and Medicare numbers.
With a calculator, a tax rate table and a receipt note, Mischa began her journey to earn her first million dollars. He created receipts for five doctor visits for each he actually drove. Mischa increased the distance to each doctor by a factor of three. In his first year, he raised more than $ 1 million from the United States, state and county governments. The following year, his fundraising (as his number of welfare and Medicare recipients had increased in his general ledger) had gone to two million dollars.
Mischa sold his three-bedroom house and bought a 500-acre ranch with a four-thousand-square-foot ranch, six bedrooms and stables. He started living his dream of becoming a cowboy. Mischa bought 500 steers with long horns and three quarters of horses.
Mischa, the Russian cowboy, continued his profitable taxi business for another three years. An auditor for the state of Texas, Department of Social Services, first noticed that Mischa’s taxi company had taken a client to the doctor who had died a month before the trip.
The auditor then found each receipt submitted by Mischa to the state of Texas and Harris County. When he finished, the auditor found that in 1994, if the information was correct, Mischa had driven a 1992 Chevrolet Caprice taxi for a total of 1,250,000 miles.
The auditor concluded that Mischa needed to drive more than 3,000 miles per day, sixteen hours a day, 365 days a year for more than 200 miles per hour to justify his claims. Later, the government came up with Misha’s fraud.
Texas Attorney General arrested, convicted and convicted Mischa of fraud by the state of Texas and Harris County Texas. The judge ordered him to pay a $ 50,000 fine and serve ninety days in prison. As a first-time perpetrator, Mischa was placed on probation for five years.
Mischa continues to live his dream as a cowboy and raises Texas longhorn cattle on his ranch outside Houston. The United States Government, even though it was informed of the crime by Harris County officials, refused to prosecute because the fraud would seriously embarrass the Medicare system.
Everyone involved, especially Mischa, believed that justice had been done.
When a person is convicted of insurance fraud, no deterrent is shown if the only punishment is to allow the criminal to be placed on probation and let him or her keep the fruits of the crime. Justice should never include allowing someone like Mischa to profit from the crime.
(c) 2022 Barry Zalma & ClaimSchool, Inc.
Barry Zalma, Esq., CFE, now limits his internship to the position of insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as a lawyer for insurance coverage and claims management and more than 54 years in the insurance industry. He is available at http://www.zalma.com and zalma@zalma.com.
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