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With Friends Like These . . .

JOHN FIFAREK

James Anthony was in his early 20s, and, like so many other people living in Detroit, he had no job and no prospects. In fact, he had never held down any kind of work for very long at all. He made his money the same way everyone else he knew did — by taking what the streets had to offer. That's where he was born and raised, and it was a place where petty crime and drug dealing are career choices. Friends and family came and went. Some escaped by finding long-term work, while others ended up in prison or dead. James had been to jail a few times for possession of narcotics and drug trafficking, but now that he was free he set his sights on a different goal.

Martin Davidson had been friends with James since childhood, and they grew up together. However, Martin tried to find a more respectable path in life than the one James chose, and eventually the two men drifted apart. Martin lived with his mom in Detroit and was saving money for college tuition. He liked to tell his mom about his plans to get a good job after school and move her out of their dangerous neighborhood.

The American National Insurance Company was a national leader in the industry. It was often described with the words prestigious, strong, stable and conservative. The company reputation was sterling and well deserved. It was also one of the company's greatest assets, and executives were mindful to maintain and preserve it. “Doing the right thing by our policyholders” was engraved on the wall inside the lobby at company headquarters. Every business practice and decision was driven by the client, sometimes to the detriment of the bottom line. When a claim was made, customer service was king. Professional skepticism had to take a backseat.

I was a fraud investigator with American National, one of six in the Special Investigations Unit (SIU). We were there to protect the company and its reputation, customers and assets. We worked investigations for people across the company with diverse needs. One day we might be investigating a case for a claims examiner and the next for an attorney in the legal department. Being a fraud examiner at American National wasn't without intrigue, but, like any other job, it had its fair share of the routine and mundane as well.

We received cases from a variety of sources, and one way for people to contact us was through our anti-fraud tip line. It was set up so that any employee, customer or a Good Samaritan in the general public who saw something suspicious could call in and alert our group. The incoming calls bounced around from phone to phone in the SIU until they were answered or went to a dedicated voice mail if the office was closed. The nature of the calls ran the gamut from benign to outlandish, but we looked into each one regardless. That being said, it was natural to let out a little groan when a call bounced to you. That's what I did when I picked up the phone on a Tuesday afternoon in late summer. The call was from Steve Kennedy, the branch manager at a bank in downtown Detroit. “We have someone here trying to cash one of your checks, and we have some questions,” Steve said.

“Okay, what can I do for you?”

“Well, it's for $25,000, and something just doesn't seem right about this. Can I fax you a copy of it? This guy does not look like he should be cashing a $25,000 check.”

False Alarm?

Steve was able to buy time with the customer and place a hold on the check for further review. I received the copy he faxed and knew what kind of check it was right away — an access check. When life insurance proceeds are paid to a beneficiary, they typically do not go out as one check for the lump sum of the policy. Instead, the funds are put into an access account, and the beneficiary is issued a book of checks to use to draw funds from the account. I studied the check. The handwriting looked like it was made out by the beneficiary to himself — but who was he, this James Anthony? From the number on the check, I surmised that it wasn't the first one written he had written on the access account. I needed to review the claim file to gather more information.

I called our records department and asked to be sent full documentation for the policy number. After I reviewed the claim file, a few things were evident. First, the policy had been taken out by the deceased, Martin Davidson, fewer than two years ago and was therefore still within its two-year contestable period. Claims filed in the first two years of a policy require a more stringent review because of the increased risk of fraud, but Martin's case avoided the enhanced scrutiny because it was a relatively low payout and because of the cause of death — multiple gunshot wounds. The policy was for $250,000, which is not significant compared to most that American National Insurance Company agents issued. Claims for life insurance policies typically required only one piece of evidence for payment, a death certificate. As for the claim on Martin's policy, the death appeared tragic for certain, but suspicious? Certainly no one would purchase insurance planning to be killed in the street. According to the file, the claim was made by the beneficiary on record, the insured's uncle. He called in the notice, provided a copy of the death certificate and was promptly paid. Claim closed.

As far as my review was concerned, everything appeared relatively straightforward. However, before closing the case I took a quick look at the policy papers since it was so new. Everything looked in order there as well, but one thing caught my eye. The policy had been in force only a few months, yet there had been three beneficiary changes. When Martin took out the policy, he designated his mother, Jolene Davidson, as the beneficiary. A couple of months later, he changed it to his stepfather. Then, only a couple of weeks before his death, he changed the beneficiary yet again to an uncle, the James Anthony who had been trying to cash an access check at Steve Kennedy's bank branch. It was odd, for sure, but was it anything more than that? It is a policyholder's prerogative to make beneficiary changes as he sees fit. It seemed strange, but I didn't think it was overtly fraudulent.

Investigations can be expensive, and a $250,000 policy with no clear red flags of fraud is unlikely to warrant the time or money required to review something as seemingly trivial as a few beneficiary changes. Fraud investigations are designed to protect the customer and the company, and in this situation it didn't look like either party needed protection. In addition, I had a full caseload of work and couldn't afford to spend time chasing vaguely odd behaviors. I put the matter aside and went back to work on more important things. The suspicious check was paid.

Nagging Suspicions

There's an old saying, “Out of sight, out of mind,” that might ring true most of the time, but it certainly did not apply to this situation. Sure, I went about my other business just fine, but that one detail in Martin's policy just kept thee claim in the back of my mind. It just kept bothering me, and I would find myself harking back to it in my head, asking myself the same questions: Why so many beneficiary changes in such a short amount of time? And what about the timing of that very last change? It was only weeks before Martin was murdered. Does it mean anything? Does it matter? A policyholder was killed and we paid out the benefit. Isn't that what is supposed to happen? Nobody was being cheated here.

After a few days I decided I just couldn't let it go. I revisited the claim file and decided to start with the beneficiaries named through the life of the policy. I had no idea what sort of information I was looking for but figured I needed something to put the matter to rest.

The policy documentation provided contact information for the three beneficiaries, but my efforts to reach them with the phone numbers provided failed; the numbers were all disconnected. I did, however, also have addresses to work with. I performed some online research with the information I had and found it curious that none of the beneficiaries seemed to be related or even know each other, despite being Martin's mother, stepfather and uncle. How does that work? There were no shared addresses, no shared family members and no shared last names among the beneficiaries. In fact, the only person I could positively connect to the deceased was his mother, Jolene Davidson, who was the original beneficiary on the policy.

I decided to visit the address on file for Jolene. She was easy to locate and was friendly and cooperative. She told me that her son had lived with her his whole life and was found dead only a few streets away from the house. Obviously grieving, she initially thought that I was there to talk about the search for Martin's killer. She said that the police had already come to talk to her and she hoped I had new information for her. When told that the purpose of my visit was to talk about her son's life insurance policy, she was surprised, confused and skeptical. She was unaware that Martin had an insurance policy; after all, he was only 22 and unemployed. “Why on earth would he have insurance?” she asked. “He had no money to pay for something like that.”

She told me about the time leading up to her son's death, how he spoke of going back to school and getting away from the neighborhood that he felt was holding him down. When I asked if anything different or unusual had happened prior to his death, she thought for a minute. She told me that for a couple of months, she was having a lot of problems with her mail. After going for weeks without receiving any mail, she contacted the post office and was told that someone had changed her address on file, and not once but twice. She remembered the trouble she went through to get it straightened out and then, after it was finally fixed, happened to see someone stealing mail from her mailbox. She said the man ran off when she opened her front door to see what was happening, but it was too fast for her to see what he looked like. For the life of her, she just couldn't understand why she was having so many problems with her mail.

This information was useful, but she didn't stop there. What she shared next would transform an oddity into to a full-blown insurance fraud case, and more. She told me that Martin had no other family besides her. When I told her that the final insurance benefit was paid to Martin's uncle, she protested.

“How on earth would my boy have an uncle without me knowing about it?” she asked.

“James Anthony is not your son's uncle?”

“I know James, but he is no relation!”

She knew James Anthony all right. She said he was Martin's childhood best friend. They had known each other since kindergarten and all the way into high school. They were inseparable when they were kids, she said, but then they started to drift apart in their teens. James, she said, had begun to get himself into trouble and started running with the wrong crowd. It was only recently that she began to see him around the neighborhood again, and he and Martin had rekindled their friendship over the last couple of months before he died. She said she thought Martin was a good influence on James. Nevertheless, she couldn't believe that Martin would leave his insurance money to James, and definitely not over his own mother.

Mounting Dread

The interview with Jolene answered some of my questions but left others glaringly unanswered. Just who was James Anthony? Why was he the beneficiary on Martin's policy? Had he and Martin really become that good of friends again in the few months before Martin's tragic demise? Worst of all, I dreaded the possibility that American National's insurance policy played a role in a murder. A dark premise was beginning to form in my mind.

My attempts to locate the second beneficiary — supposedly Martin's stepfather — were fruitless. The phone number listed on the policy was disconnected, and my visit to the address revealed a different resident with no knowledge of Martin or the others involved in my case. With nothing else to go on, I decided to ask around Martin's neighborhood to see if anyone could provide any new information. A few people who lived in the neighborhood and were willing to talk about Martin's death said they knew that he was shot but nothing more than that.

I approached the case from every angle but had little to go on. I searched the Internet and various databases for information about everyone involved. I was searching for something — anything — that would get me out of the dead end and give me another avenue to investigate. The online searches revealed that the individuals associated with the phone numbers and addresses on Martin's policy had changed, and then changed again, and then yet again. Overall, there were dozens of names associated with various phone numbers and addresses. While I was sifting through my search results, I noticed a theme. Often once, twice and three times removed, one name reappeared: James Anthony. Some databases even showed him sharing an address with Martin and Jolene Davidson. I also noticed shared addresses between James Anthony and Martin's second beneficiary, the phantom stepfather.

Next I decided to reach out to the agent who sold Martin's life insurance policy, Woody Klein. His office was in the affluent Detroit suburb of Bloomfield, Michigan, miles away from the inner city where the insured lived. During our interview, Woody said he hardly ever remembered the details of any given policy he sold, but one thing made his exchange with Martin Davidson more memorable than most. He said Martin had just walked into his office one day, without an appointment, and asked to buy a life insurance policy. Woody said that had never happened to him before and that most of his sales came from cold calls and referrals. He pulled out Martin's file and read from his notes that Martin said that he wanted the insurance for his mother and baby sister if something were ever to happen to him. Woody gave me a copy of Martin's driver's license that was filed with the application. After the interview my leads were exhausted and I was left with was a grainy copy of a driver's license and chilling hunch. The photo in the license looked nothing like the photos that Jolene Davidson showed me of her beloved son.

Now What?

At this point I had a tough question to answer, and I knew I couldn't do it myself. I took it to my supervisor and the five other fraud examiners in American National's SIU. I filled them in on my findings thus far and then asked, “What should we do?”

Almost instantly we split into two camps. The first camp could not believe what we thought we were seeing. It seemed far-fetched, sensational and potentially damaging to American National's good name and reputation. Then there was my camp. We advocated that the case had turned out to have little with insurance fraud and money and much more to do with justice. Could it be that James Anthony had something to do with Martin Davidson's death? To me it was clear, and I had a responsibility to do something. We held meetings to discuss the case — emotional meetings — and finally my camp was able to convince the others of our moral obligation. We had enough information and I was going to contact Detroit's homicide police.

Before the series of events that my call set into motion, Detective Shirley Mathis only knew one thing for sure, that 22-year-old Martin Davidson was dead. His body had been found on the edge of a street, gunned down during the night in what appeared to be a random act of violence with no clues or leads. His death was another unsolvable crime that would see little to no police resources, which were already stretched so thin in Detroit. My phone call changed all of that.

Justice

In my line of work, interaction with law enforcement was common, but this situation was different. Typically I was the one contacted by police officers or government agents who needed information and leads for cases. However, in the case of Martin Davidson, the onus was on me to find a way to convince a police detective that my case was relevant to a recent homicide. Somehow I had to find a way to pique Detective Shirley Mathis' interest. It ended up being easier than expected.

Detective Mathis told me the Martin Davidson investigation was at a standstill because the few leads they had went nowhere. I could almost hear her attitude change from near resignation to renewed interest as she listened to my story, chronicling the series of events that had led me to contact her. During our conversation, she shared some information with me that validated our decision to reach out to her. One thing she said was that the police didn't know an insurance policy for Martin existed; however, they were familiar with James Anthony, having interviewed him as part of the preliminary investigation. We discussed my case and the possible new motive. She thanked me for calling her and said she would be renewing the investigation.

From there it was out of my hands and into Detroit homicide's, but I continued to follow the case as best as I could. The information I shared provided vital missing pieces to the puzzle and allowed the police to complete the picture of an innocent victim done in by a friend turned identity thief and murderer. James Anthony, a trusted boyhood friend of Martin Davidson, betrayed his trust by posing as him to fraudulently obtain a life insurance policy, only to kill him in cold blood for the insurance payout. With our new evidence, Detective Mathis built a solid case against James Anthony, and the district attorney agreed to prosecute.

Six months after I received that fateful call from Steve Kennedy about a suspicious check, a jury convicted James Anthony of first-degree premeditated murder, illegal possession of a firearm by a felon and false application for state identification. The police investigation revealed that James Anthony exploited his friendship with Martin Davidson for financial gain. James devised a scheme to rekindle his broken friendship, but the whole time he planned to assume Martin's identity and insure his life. He named Jolene Davidson as the beneficiary to avoid suspicion when he took out the policy, but then he intercepted the insurance mailings by unlawfully changing her address and, finally, by stealing her mail.

James then orchestrated a series of beneficiary changes that involved an accomplice who played the role of Martin's phantom stepfather. However, this accomplice backed out of the agreement for fear of his life after learning details of James' plan. After the accomplice dropped out, James had no choice but to name himself as Martin's final beneficiary and pose as Martin's uncle. When all the pieces were in place, he committed the final act in his grand scheme. He asked Martin, his childhood best friend, to meet him late one night. Then James shot Martin multiple times and left him to die in the street. Today he is serving a life sentence for his crimes.

Lessons Learned

Looking back, this was one of my most memorable cases. Most investigators might describe their most memorable cases as the ones that required a lot of work, or the ones that saved a lot of money, or even the ones that garnered some recognition for their part. This case will stay with me for one simple reason — it was a key to serving justice. As anti-fraud professionals, our focus is generally on the dollars. It is the white-collar criminal whom we typically pursue, after all, and we tend to assume these criminals are nonviolent. This case taught me how dangerous that perception can be; as anti-fraud experts, we should never underestimate the lengths that some people will go to for money.

This case was also a reminder of the personal side of insurance fraud. The victim was American National, which lost about $100,000 (the amount James Anthony had already taken from the access account before the investigation), but the real victims were Martin and Jolene Davidson.

Recommendations to Prevent Future Occurrences

The case highlighted various strengths and weaknesses in American National's business processes and red flag recognition. As a result, my team and I made the following recommendations to our controls department.

  1. James Anthony might have never been brought to justice had it not been for a phone call to a fraud hotline. We now hold frequent training for our staff and vendors to spread awareness of our hotline and the red flags of insurance fraud they should be watch for. Third-party awareness worked in the case of James Anthony, and we want to make sure it continues to work in the future.
  2. This case emphasized the importance of knowing your customer. James Anthony found it too easy to impersonate the victim with a false state ID. All of our agents are now required to conduct background checks on new clients and verify their identities.
  3. American National's practice of streamlining the payment process for low-dollar claims was also called into question. We recognize the importance of good customer service, but it should never be to the detriment of effective review practices.

About the Author

John Fifarek is a Certified Fraud Examiner who currently resides in Denver, Colorado. He is an experienced investigative professional who has performed investigations for the insurance, credit card and banking industries.

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