First a little background:

Mike has a distant cousin, Steve Combs, who used to work for the FBI. 
About 
a year ago I contacted Steve and much to my surprise found out that he
had gone
to law school and was now working for the Massachusetts Insurance Fraud
Bureau.
I asked him if he'd look into this matter. Last September 10th, on the
day I
also visited the Massachusetts Department of Insurance, I went to the
Mass. IFB. 
I had 2 notebooks full of information for Mr. Combs.  He was not in the
office
but another investigator, Michael Gray, listened to my story for 45
minutes. 
At the end he threw up his hands, and with no explanation, says
something to the 
effect that he wishes he could help but he can't.  I left the notebooks
for Mr. Combs. 
When I saw Steve at Thanksgiving I asked him what he was doing and he
said nothing.  
I asked him to reconsider.  The next time I saw Steve at a family
gathering I asked 
him, why, if this is the INSURANCE FRAUD BUREAU, they will not
investigate UNUM, since
I've provided them with ample evidence.  His response "I can't
investigate if I'm told 
NOT to investigate."  The only reason I didn't name him in the lawsuit
is because Mike
asked me not to, and because Steve's mother is a very nice lady.  I am
however suing 
the IFB and Michael Gray for dereliction of duties.

Meanwhile State Senator Stephen Brewer had written a few letters to the 
Massachusetts Department of Insurance asking them how they could have
claimed I had Independent Medical Examinations that I insist I never
had.
They wrote back some BS and in Jan. 1998, Senator Brewer dropped the
ball,
never followed up despite the fact that they totally ignored his
request.

Last month, his aide, April Anderson, came to Monson in one of those
"meet
the people" sessions.  I was the only one who showed up, of course.  I
went
into detail with her about what was going on, gave her copies of my
letters, 
the Insurance Commission letters and Senator Brewer's letters and she
told me 
they would write some more letters to the Department of Insurance.  I
told her
that would be a waste of time, that Senator Brewer needed to meet with
my other
State Senator Mary Rogeness  and put pressure on the AG to criminally
investigate
UNUM.  I had spoken to Mary Rogeness, in person, at length, 2 months
prior and
given her copies of the documentation.  She had told me she'd get
together with 
Brewer.  She never did and I never heard from her again.

So what Brewer did was right ANOTHER letter to the Dept. of Insurance
and one to
the Insurance Fraud Bureau. First though he wrote me a letter trying to
tell me that
the IFB only investigates auto insurance fraud, but as I said, I checked
it out. 
So the IFB has not yet recieved their copy of the lawsuit but I got the
following 
call today:

This is a verbatim transcipt from the tape recording that Mr. Skelly
agreed on:
The first sentence was cut off because I was asking permission to tape
record:

JM: ".since Massachusetts is a two-party state, do I have your
permission?"
DS: "My name is Dan Skelly.  I'm the Chief Investigator for the
Insurance 
    Fraud Bureau of Massachusetts."
JM; "OK, what can I do for you?"
DS: "I recieved a letter from State Senator Stephen Brewer concerning
your 
    claim against UNUM Insurance Company."
JM: "Yup"
DS: "In that letter he also sent me copies of letters from you to him."
JM: "Yes"
DS: "What I don't have is what the status of your claim is or the reason 
    for any denial."
JM: (I was surprised that he was just addressing the issue of this
letter and 
    seemed to have no idea that it went much deeper than this)
    "You're about to get a lawsuit. Because I was at the Insurance Fraud
Bureau 
    last Novermber (actually September 10, 1997) and 
    talked to Michael Gray.  I also talked to and gave lots of
information to, UM...
DS: "So we already have this case in house?"
JM: "Steve Combes and they told me they couldn't investigate unless they
were told 
   to investigate."
DS: "Um Hm"
JM: "And, um, when you get the lawsuit you'll understand what's going
on."
DS: "Oh, Fine."
JM: "if you want to wait for that, basically this insurance company is
engaging
     in massive fraud, extortion, and they've driven at least one person
to suicide
     and another one attempted suicide, and I have it all documented."
DS: (Silence) Then, "so evidently there's nothing you want to talk to me
about in this case."
JM: "Well, I would have liked you to investigate, but it's a little bit
late for that."
DS: "Oh, OK, fine."
    (Silence)
JM: "That's it?"
DS: "Well that's strictly up to you, I'm calling you as...
JM: (interrupting) "well, let me ask you, do you investigate insurance
fraud?"
DS: "Of course we do."
JM: "Is it against the law for an insurance company to lie to deny a
claim?"
DS: "Well it's probably more of a regulatory function.  Market conduct
is handled 
   by the Insurance Commissioner."
JM: "Well, I've been to the insurance commissioner and they wrote me a
letter with 
    an outright lie in it claiming I'd had medical exams I    
    never had, and then told me they didn't see where that was a lie."
DS: "Doctor, let me tell you something.  I'm doing a favor of the
Senator by reaching 
    out to you.  I didn't realize that you had spoken to some of my
people earlier on.
    Uh, if you want...
JM: "Well, it seems to me it would have been their job to have gone to
you to discuss 
    this case with you considering that both the insurance company and
the insurance
    commissioner have told outright lies to me in writing.  That there
is a pattern 
   of abuse going on throughout the     country, and, um, ..I'm sorry,
I'm out of
    breath, um..and, uh, nobody seemed to want to do anything about it."
DS: (Silence)
JM: "I'm going to ask you again. Is it legal for an insurance company to
lie 
   to deny a claim?"
DS: "No, it certainly seems like a contractual violation."
JM: "Alright, if an insurance company writes outright lies about a
person, in 
    writing, and then the insurance commissioner also writes outright
lies about a person, 
   in writing, and that person is forced to attempt to file a
contentious, lengthy and 
   expensive lawsuit in order to collect what they are contractually
entitled to, is that fraud?"
DS: "It could be."
JM: "Could be" (Laughs) "What exactly is fraud?"
DS: "A deliberate deception."
JM: "Alright, well, there was plenty of deliberate deceptions."
DS: "Get you."
JM: "Plenty of deliberate deceptions in my case and in the rest of the
ones I've
    documented.  I'm sorry, what did you say your name was again?"
DS: "Skelly."
JM: "Skelly?  You're not the director of it?"
DS: "I am the Chief."
JM: "The Chief....because I addressed it to Dan Grabauski, I think...is
that...no,
    that's the..Skelly, um...was there another Chief before        you?"
DS: "No, I was the first one and the only one."
JM: "You're from the Insurance FRAUD BUREAU?"
DS: "Correct."
JM: "That's on Arch Street."
DS: "Correct."
JM: "I was in your office....last November (As I said, it was actually
September), or 
    December, I can't remember which..and, um, somebody told     me
that, in fact I
    called there a few days ago, to find out the name of the Chief,
um...
DS: "You probably got the name of my Executive Director."
JM: "Who was that?"
DS: "Dan Johnston."
JM: "That's the one. That's who the suit is addressed to. And I mailed
it out yesterday."
DS: "Are you represented by counsel?"
JM: "No I'm represented by myself."
DS: "OK"
JM: "so you can't, uh,..uh, try and um, ..um, influence them against
me."
DS: "I'm sorry?"
JM: "So you can't try and influence my lawyer against me, as is
happening in many 
    of these cases."
DS: (Chuckle) "I wouldn't be interested in doing that."
JM: "I'm sure you wouldn't....no, everybody in this entire,whole thing,
has been 
    totally honest and up front.  Well I think a jury will have a    
little bit different view of that."
DS: "Well, we'll probably see you in court in about 7 years."
JM: "Seven years.  I'm sorry, is that a threat?"
DS: "No, I'm just saying that's the way the system is on the Civil side,
you know."
JM: "Well, I was told that in a Federal Case you get to court within a
year, unless 
    there's discovery abuses."
DS: "I wish you well." (silence)
JM: "Well, are you denying that there's any problem? Are you not going
to investigate?"
DS: "I have no idea.  I haven't seen the file."
JM: "Well let me ask you a question.  Are you going to go to...."
DS: (unintelligible)...two letters to a State Senator....."
JM: "You had no idea anything else was going on? Let me ask you a
question."
DS: "I never heard your name before, Doctor."
JM: "If somebody comes to two members of the Insurance Fraud Bureau with
evidence of 
    fraud and extortion wouldn't it be their duty to talk to 
    the director?  Is he not responsible, vicariously for the behavior
of his subordinates?"
DS: "Oh, yes, certainly, vicariously responsible, yes.  Understand we
have 18,000 cases here."
JM: "Right, and so they did not bother to talk to you about the
allegations, believe me, 
    I didn't come just once, all right.  And I gave Steve Combs two
notebooks full
    of information."
DS: (Silence)
JM: "Now are you going to look into it?"
DS: "Well I'm going to certainly speak to the people you spoke to."
JM: "Unfortunately I'm a little too busy to resend you all that
information."
DS: "No, don't."
JM: "As it's already in your office."
DS: "Did you leave it here with him?"
JM: "yes"
DS: "OK, then it must be here then."
JM: "Steve Combs should have it...and the other fellow I talked to for
45 minutes 
    and he threw up his hands and said 'Sorry, we wish we could help you
but we can't'
    and without any reason why."
DS: (Silence)
JM: "OK, um, you caught me off guard. I don't have any questions for you
right now. 
    Your lawsuit should be arriving to your Johnston guy within a day or
two."
DS: "Uh mmm"
JM: "And it's pretty self explanatory.  It's racketeering.  Do you know
what
    racketeering is?"
DS: "I've been around, yup, I have."
JM: "Do you know what it is when an insurance company has a pattern of 
    misdiagnosing people, practicing medicine without a license across
state borders, 
    harassing people, inappropriate....oh, here's a good question for
you. Um. When
    an insurance company sics private     investigators on somebody,
your division
    for instance, do they have to have some rationale for doing this? Or
can they just
    say, 'Oh, I think I'll have some people follow this person around?"
DS: "No it's not done without reason or cause."
JM: "Are there laws for this? I'd like a copy of them."
DS: "Are there's laws dictating...
JM: "laws, regulations, guidelines, something that, um, dictates the
conduct of
     Private Investigators? Particularly in insurance cases."
DS: "Well, there is a licensing authority by the Massachusetts State
Police 
     licenses Private Investigators."
JM: "Would you please send me, um..."
DS: "I don't have that. That's a whole different..."
JM: "And you can't get them."
DS: "I don't have it.  I don't have it at my fingertips."
JM: "I know.  I'm not asking you to give it to me right now.  I'm asking
you
     to DO something."
DS: "That's not what I do for a living, Doc."
JM: "Alright, I can see.  Alright, so in other words, pass the buck
again.  
    You can't even.  I mean you are in touch with these people on a
regular basis 
    and you can't get a copy of the laws and have them sent to me."
DS: "Well, maybe State Senator Stephen Brewer could do that for you."
JM: "No I can do it myself.  It's just that it will take me an entire
day to go to
    the law library whereas this is your regular business. You use
Private Investigators ..."
DS: "We don't use Private Investigators, Doctor."
JM: "Yes it does.
DS: "I don't have anything to do with Private Investigators."
JM: "Private Investigators were misused in my case."
DS: "I understand that but I don't have anything to do with Private
Investigators.."
JM: "The Insurance Fraud Bureau doesn't use Private Investigators to
investigate
     insurance fraud?"
DS: "Do I? No."
JM: "Not you personally. Your division. Stop playing with words."
DS: "Not at all, not at all. Not once."
JM: "Well how DO you investigate insurance fraud. What about that case
where I saw
    on television where you had the woman videotaped?"
DS: "It was probably done by the company."
JM: "No they said it was the insurance fraud bureau."
DS: "Don't believe everything you read in the paper."
JM: "It was on television.  So you never use private investigators in
your division?"
DS: "I'm sorry?"
JM: "You never use Private Investigators."
DS: "We never outsource any investigation."
JM: "Well do you have inside investigators that...."
DS: "Yeah, of course."
JM: "videotape people?"
DS: "Sure, we have the capability."
JM: "All right. So you just tried to decieve me by claiming that you did
not use 
    investigators to videotape people."
DS: "You said PRIVATE Investigators.  That's what your question was. 
You wanted 
    to know....."
JM: "I didn't know there was a difference between a Private
Investigator...I asked
    you if they would send out investigators to videotape        
people.....You
    intentionally tried to decieve me."
DS: "Doc, you got to listen to yourself."  (He may be right, here, I'll
be A LOT 
    MORE SPECIFIC WHEN TALKING TO THESE people in the future. Good
practice for when I 
    get in front of the judge and they try to weasel.)
JM: "Look I don't know the difference between Private and Public.  The
point is...."
DS: "I'm trying to point that out to you."
JM: " It is your duty, if I am mis...if I am slightly mistaken, that I
mentioned the 
    word PRIVATE and you DO have investigators that you send    out to
videotape people, 
    that it is your fiduciary duty and your duty as a public servant to
attempt to clear 
    up the misperception."
DS: "Which is what I just tried to do."
JM: "Only after I asked you repeatedly because I could not believe that
your division
     DIDN'T go out and investigate and videotape people."
DS: "You didn't ask me that. Doc, you asked me if we had used Private
Investigators."
JM: "Just stop playing with words, All right.  You knew what I meant."
DS: "Geez, I really did not.  That's beside the point."
JM: "Well we'll let a jury decide about that."
DS: "I'll talk to Mr. Gray and see what paperwork is in here.  If I have
anything else
    to say, I'll...."
JM: "Wait, I had another question that I would like answered..."
DS: "...Or I'll get back to you."
JM: "I have another question about your division There was a report in
the newspaper 
    by Peter Canellos that said your division receives, you're a public
uh, division, 
    you're a division of the Attorney General's office, is that
correct?"
DS: "Mmmm, well it's created by legislation, privately funded."
JM: "Privately funded.  How much, I'd like to know the source of your
funding."
DS: "It's 50% from the Worker's Compensation Insurance Companies and 50%
from the 
    Automobile Insurance Companies."
JM: "Is there, where I can get a list of these, uh funding sources, and
how much?"
DS: "Sure, the Division of Insurance, the Commissioner's office."
JM: (laughs) "Hmm, OK....Let me get your phone number in case I have any
other questions."
DS: "Sure, 617-"
JM: "617"
DS: "439"
JM: "439"
DS: "0439"
JM: "O439.  And your name again?"
DS: "Skelly."
JM: "How do you spell it?"
DS: "S-K-E-L-L-Y"
JM: "First name"
DS: "Daniel"
JM: "Dan Skelly.  And you're the director of the Insurance Fraud Bureau.
     And you never heard of me before."
DS: "No, I never have, and I'm the Chief."
JM: "The Chief.  OK. All Right.  Well that means your subordinates are 
    not keeping you informed then.'
DS: "That might be true."
JM: "um hmm. OK.  If I think of any other questions I'll give you a
call."
DS: "All right, all the best."
JM: "Bye."

Well I'm dizzy from spinning around in circles. So, despite the fact
that
it's called the Massachusetts Insurance Fraud Bureau, it was created by
an act 
of the State Legislature, they admittedly investigate INSURANCE FRAUD, 
I believe 
they work with the A.G.'s office (although I didn't get a straight
answer to that 
question),  BUT they are FUNDED BY THE INSURANCE INDUSTRY.  He didn't
come right out
 and say they don't INVESTIGATE insurance companies but did refer me
back to the 
very division I'm accusing of collusion - The Department of Insurance. 
And despite
 the fact that they have internal investigators who investigate fraud
and use
 videotapes, he cannot get me a copy of the guidelines for this type of
activity. 
 He also can't get me a copy of the funding sources for his division.
Despite the
 fact that I gave one of their investigators, my boyfriend's cousin 2
large notebooks 
of evidence, and spoke with him and wrote him on several occasions
thereafter. 
 Despite the fact that on Sept. 10, 1997 I spent 45 minutes talking to
another one 
of his senior investigator's Michael Gray in person, neither of these
men EVER went 
to the Chief to ask if they could investigate this case.  Excuse me, but
it's smelling 
awfully fishy around here.

Judydoc

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The URL for this document is:


http://graham.main.nc.us/~bhammel/INS/DOCS/txs102898.html


Created: October 29, 1998


Last Updated: May 28, 2000