Assessor suspected ‘something not right’

The trial of two brothers accused of forging health insurance claim forms with intent to defraud has heard how a claims examiner at the Castleisland branch of the New York Life Insurance company saw “something was not right” when she came across two entirely different insured persons wanting to change address — to the same apartment.

Patrick Enright, aged 52, a Castleisland-based solicitor, of Glenlarehan, Castleisland, and his brother Denis Enright, aged 48, a farmer, Knockardtry, Castleisland, are charged with nine separate counts of forging documents purporting to be New York Life Insurance Company health insurance claim forms between Jan and Aug 1994.

A total of €31,850 was claimed, in the name of a Dr John Coyle, of 8th Avenue New York it is alleged. Both men have pleaded not guilty and they are represented by junior as well as senior counsel.

Tom Rice, prosecutor, has told the jury “there is no such person” as Dr John Coyle and the nine claims documents for various amounts from £1,900 to £4,800 were forged with the intent to defraud.

Patrick Enright worked for Nylerin the Castleisland branch of the insurance company between 1988 and 1994 before becoming a solicitor, Mr Rice has said.

The prosecution yesterday heard from Mary Sheehan- Dennehy, a claims examiner with Nylerin 1994.

On Aug 24, 1994 she was processing a claim dated Jul 18, 1994, for a knee injury for $2,780. A letter with the claim form asked that the insured person’s address be amended to an apartment in West 32nd St.

Ms Sheehan-Dennehy said: “I had got similar paper work the day before (from a different insured person) and I had gone in and changed the address to exactly the same as here.”

Ms Dennehy said she knew “something was not right”. She went to the storage room and manually went through the documents she had signed from the day before (Aug 23) and found a different insured person, with a different social security number and different employer and different telephone number had placed a similar request for a change of address to the same apartment in West 32nd St.

The claim dated Jun 30 was for $2,750 for a knee surgery claim and it was to be paid to a Dr John Coyle of 8th Avenue New York. She had paid out $2,200, which was what the person was entitled to given his kind of policy.

Scrutinising further records, she also found that in Apr 1994 a third insured person had requested his address be changed too to West 32nd St. That person also suffered a knee injury and the payment was being claimed by Dr John Coyle of 8th Avenue.

Tom Creed, senior counsel for Patrick Enright, put it to Ms Sheehan-Dennehy that “it would be common enough if you had a service provider who was a specialist that you would get a number of claim forms from that specialist.” She agreed with this.

The trial continues before a jury of nine men and three women and presided over by Judge Carroll Moran.