The mafia's hold on NYC, while not as strong as it used to be, still exists. They have been moving to white collar crime in the last few decades. I would not be surprised if they played a major part in manipulating case and death numbers for insurance payouts.

from 2018 but still interesting

I'm from Philly and my cousin and I hung out w him in the mid 80s in Clubs in Philly and A.C. when we were underage. I knew his father also but not until he was already in jail! He was good friends w my Aunt and Uncle when they were growing up. He would call her from jail in Alabama and i would get on phone and ask him questions about jail life! (I was a criminal justice major and a dem at the time) I knew it would all catch up to Joey someday!