An insurance claims adjuster in Camden County allegedly fabricated filings for work to be done on properties and used his position to approve payouts of nearly $200,000 he kept for himself, the New Jersey Office of Attorney General said Thursday.
John Philbin, 48, of Clementon, worked for Assurant — an international insurance company based in Atlanta — when he allegedly began submitting bogus claims for properties in New Jersey, prosecutors said.
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The role of an adjuster is to investigate claims, submit findings to insurers and calculate their liability to policyholders before settlements are paid.
Between October 2022 and May 2023, Philbin filed 11 claims for property restoration and emergency mitigation at various locations, prosecutors said. He allegedly used false identities, fake vendor estimates and invoices from non-existent companies among the documents submitted.
Once the claims were sent to Assurant, Philbin had the cases assigned to himself for approval, according to investigators. Insurers issued payouts for work that never occurred and the money allegedly was directed to bank accounts Philbin controlled. He hid his involvement by using P.O. boxes in Clementon and Blackwood.
“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,” Theresa L. Hilton, director of the attorney general's office's Division of Criminal Justice, said in a statement. “Cases like these are why we have attorneys and investigators who are also familiar with the inner workings of the insurance industry."
Philbin was identified after fraud investigators checked internal audit logs at his company and found documents that contained unique metadata linking him to the fabricated filings.
Insurers paid out a total of $191,163 on the fake claims Philbin allegedly submitted.
He faces second-degree charges of insurance fraud and theft by deception. If convicted, he could be sentenced to five to 10 years in state prison and fined of up to $150,000.