Insurance Fraud Casebook: Paying a Premium for Crime

Mystery Shopping for Fraud

STEPHEN PEDNEAULT

Sang Min Lee and his wife, Soo Jin Lee, both middle-age natives of South Korea, owned a small, single-location jewelry store, where Soo Jin was responsible for the day-to-day sales and operations. On many days when not in school, the Lees' three small children stayed at the store, sitting behind the counters coloring, playing with their electronic devices or running in and out of the back storage area. Sang Min's mother occasionally worked at the store when Soo Jin could not. However, Soo Jin almost always ran the store during operating hours.

Matthew Morrison was a property and casualty claims adjuster with National Insurance. Nearing the end of his professional career, Morrison counted 24 years with National. Another National investigator, John O'Connor, worked with Morrison. O'Connor was a retired police officer who served with a local police department for nearly 30 years and concluded his law enforcement career as a sergeant. Too young to permanently retire, O'Connor launched a second career with National and had already logged four years.

Silver Star

The Lees operated Silver Star Jewelers, a small, local jewelry store in a strip plaza on an edge of Westford known for problems. The store occupied fewer than 1,000 square feet, with a public entrance facing the parking lot and a private rear entrance accessible from behind the plaza. ...