John Philbin, 48, of Clementon, New Jersey, is charged by complaint with insurance fraud and theft by deception (both 2nd degree).

“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. “Cases like these are why we have attorneys and investigators who are also familiar with the inner workings of the insurance industry, and who work to bring charges against those who seek to steal from it.”

“Insurance claims adjusters are entrusted to safeguard the claims process, not exploit it,” said Interim Insurance Fraud Prosecutor Al Garcia. “When someone with inside access allegedly creates fake claims and funnels payouts to themselves, it betrays policyholders and undermines confidence in the system. OIFP will hold all offenders accountable—especially those in the insurance industry who abuse that trust.”

According to documents filed in this case, Philbin was employed as a property claims adjuster by Assurant Insurance Company and held authority to approve insurance claims. From October 3, 2022, to May 22, 2023, Philbin allegedly knowingly created or caused to be created 11 fictitious claim files under false identities. He also allegedly fabricated vendor estimates and invoices purporting to reflect emergency mitigation or restoration work by non-existent companies. Searches of New Jersey business records revealed no filings or registrations for those entities.

Philbin allegedly assigned the claims to himself and approved the claims under his individual authority. He allegedly caused insurer funds to be issued for work that never occurred, directing the proceeds to himself for his benefit. To facilitate and conceal the scheme, Philbin allegedly used Post Office boxes in Clementon and Blackwood. Internal audit logs and document metadata bearing Philbin’s unique identifier allegedly linked him to the creation and approval of the fabricated documents. The insurer paid out approximately $191,163 on these fictitious claims.

This case is being prosecuted by OIFP Deputy Attorney General Alan Babbitt under the supervision of Assistant Bureau Chief Evgeniya Sitnikova and Bureau Chief Crystal Callahan. The investigation was conducted by OIFP Detective Shawn McDonald, Detective Joseph Wilsbach, and Detective Briana Rafferty, under the supervision of Sergeant Brian Bunn, Lieutenant Joseph Waters, Lieutenant Natalie Brotherston, and Deputy Chief Kelly Howard, with assistance from analysts Terry Worthington and Marwa Kashef. Interim Insurance Fraud Prosecutor Garcia thanked his staff for their work on this case, as well as the Gloucester Township Police Department and Assurant Insurance Company.

The charges and allegations contained in the complaint are merely accusations, and the defendant is presumed innocent unless and until proven guilty in a court of law.

Second-degree charges carry a sentence of five to 10 years in state prison and a fine of up to $150,000.

OIFP’s mission includes coordination of all anti-insurance fraud activities statewide, and many successful prosecutions are a result of initial anonymous tips. If you suspect insurance fraud or have information about a potential case, OIFP wants to hear from you. You can report fraud anonymously by calling the toll-free hotline at 1-877-55-FRAUD or visiting www.NJInsurancefraud.org. State regulations permit a reward to be paid to eligible persons who provide information that leads to an arrest, prosecution, and conviction for insurance fraud.