Former NJ Insurance Adjuster Charged with $191K Fraud Scheme

John Philbin of Clementon allegedly created fake claims, approved them himself, and diverted funds to personal accounts while employed by Assurant Insurance.

TRENTON, NJ — A former property claims adjuster from Clementon, Camden County has been charged with orchestrating a scheme to defraud his employer of nearly $200,000, according to an announcement by Attorney General Matthew J. Platkin, the Division of Criminal Justice (DCJ), and the Office of the Insurance Fraud Prosecutor (OIFP).

John Philbin, 48, has been charged by complaint with insurance fraud and theft by deception, both second-degree crimes. The charges allege that while working for Assurant Insurance Company between October 3, 2022, and May 22, 2023, Philbin fabricated insurance claims, created false identities and vendor invoices, and used his authority to approve and direct approximately $191,163 in fraudulent claim payments to bank accounts under his control.

“The cost of insurance is something all families must be concerned with,” said Attorney General Platkin. “Insurance fraud only adds to that cost. In this case, the defendant is someone who worked in the industry. We need to be able to trust the people who are working for insurers to do their jobs fairly and honestly.”

“The defendant in this case knew the system from the inside, and he is charged with exploiting that knowledge and access for illicit financial gain,” said DCJ Director Theresa L. Hilton.

Alleged Scheme and Execution

According to court documents, Philbin used his access as a claims adjuster to submit and approve 11 fictitious claims, complete with fake vendor estimates and invoices for emergency or restoration work purportedly performed by non-existent companies. Searches of New Jersey’s business registry confirmed that the named vendors did not exist.

Philbin allegedly:

• Assigned each false claim to himself

• Approved the claims using his internal authority

• Used Post Office boxes in Clementon and Blackwood to facilitate and obscure the transactions

• Directed payments to himself for services never rendered

Digital evidence, including audit logs and metadata linked to Philbin’s unique identifier, allegedly ties him to the creation and approval of the false documents.

Legal Proceedings and Potential Penalties

The case is being prosecuted by Deputy Attorney General Alan Babbitt under the supervision of Assistant Bureau Chief Evgeniya Sitnikova and Bureau Chief Crystal Callahan of the OIFP. The investigation was conducted by OIFP detectives with assistance from analysts and the Gloucester Township Police Department, as well as cooperation from Assurant Insurance Company.

If convicted, Philbin faces five to 10 years in state prison and a fine of up to $150,000 for each second-degree charge.

Public Reporting and Fraud Prevention

The Office of the Insurance Fraud Prosecutor continues to encourage the public to report suspected insurance fraud. Anonymous tips can be submitted by calling 1-877-55-FRAUD or visiting www.NJInsurancefraud.org. State regulations allow for rewards to be issued to individuals whose information leads to an arrest, prosecution, and conviction.

The charges against Philbin remain allegations, and he is presumed innocent until proven guilty in a court of law.