Two Washington men plead guilty to insurance fraud

12/28/2022

OLYMPIA, Wash. — Two Washington state men pled guilty in separate insurance fraud cases this fall after investigations by Insurance Commissioner Mike Kreidler’s Criminal Investigations Unit (CIU).

Joseph David Calvert, of Selah, pled guilty to two counts of false claims or proof and one count of making a false or misleading statement to a public servant. In November of 2022, he was ordered to serve 120 days of electronic home detention and to pay $600 in court fees.

Tory McMillen, of Friday Harbor, pled guilty to one count of false claims or proof and one count of theft in…

Sovereign Nations Insurance ordered to stop selling unauthorized health insurance in Washington

12/21/2022

OLYMPIA, Wash. — Insurance Commissioner Mike Kreidler has ordered Sovereign Nations Insurance, LLC, to stop selling unauthorized health insurance in the state of Washington. 

Kreidler’s office issued the cease-and-desist order on December 20, 2022. 

The company is domiciled in Utah and describes itself as a tribally owned and tribally controlled domestic health insurance company, regulated by the three tribes that created it. The McCarran-Ferguson Act gives states regulatory authority over insurance. 

The company has sold health insurance policies in…

Kreidler issues $367,500 in fines for violations in November

12/13/2022

OLYMPIA, Wash. — Insurance Commissioner Mike Kreidler issued fines in November totaling $367,500 against insurance companies, producers, brokers, and individuals who violated state insurance laws and regulations.

Insurance companies

Aetna Life Insurance Company, Hartford, Conn.; fined $50,000 (order 22-0615).

Aetna failed to include a required Balance Billing Protection Act standard message in correspondence with providers and did not provide a timely response to predetermination and prior-authorization requests.

American Family Mutual Insurance Company S.I., Madison,…

Sunnyside couple pleads guilty to insurance fraud in 2017 case

12/01/2022

OLYMPIA, Wash. — Andrew M. Rodriguez and Marissa L. Lopez, both of Sunnyside, Wash., pleaded guilty to first degree theft in an insurance fraud case in Yakima County. 

Rodriguez, 31, and Lopez, 28, were sentenced on October 20, 2022 to 80 hours of community service and ordered to pay $17,022.41 in total restitution. The case was investigated by the Criminal Investigations Unit of the Office of the Insurance Commissioner. 

In October 2017, Rodriguez filed a claim with National General Insurance Company after damage sustained to the loaner car — a Nissan Versa — he…