Thread: 10 Texans sentenced for defrauding Aflac

Ten South Texas Residents Sentenced to Prison for Defrauding Aflac

U.S. Attorney’s Office October 28, 2011
Southern District of Texas(713) 567-9000

McALLEN, TX—Ten south Texas residents have been sentenced to federal prison for their roles in a scheme to defraud the American Family Life Assurance Company (Aflac) by filing false injury claims under Aflac’s Accident-Only Insurance Plan, United States Attorney Kenneth Magidson announced today.

A total of 36 persons were charged in mid-June 2011 in a number of indictments for their roles in a scheme to defraud Aflac of millions of dollars by filing thousands of false injury claims.

This morning, U.S. District Judge Micaela Alvarez sentenced 10 of these defendants to terms of imprisonment without parole each to be followed by a three-year-term of supervised release and ordered that they make full restitution to Aflac. The sentences imposed were as follows:
â–*Rachel Betancourt, 42, of Edinburg, Texas—27 months in prison and $96,955 in restitution
â–*Dalia Cerda-Delgado, of Palmview, Texas—24 months in prison and $38,925 in restitution
â–*Lilly Perez, 32, of La Villa, Texas—24 months in prison and $139,120 in restitution
â–*Patricia Cerda-Flores, 44, of Palmview, Texas—18 months in prison and $86,395 in restitution
â–* Desiree Rodriguez, 34, of Edinburg, Texas—17 months in prison and $109,450 in restitution
â–*Maria C. Alaniz, 39, of Elsa, Texas—15 months in prison and $88,340 in restitution
â–*Jose Rodriguez, 34, of Edinburg, Texas—15 months in prison and $102,335 in restitution
â–*Ninfa Reyes, 38, of Edcouch, Texas—12 months and one day in prison and $38,925 in restitution
â–*Noemi Villareal, 60, of Edcouch, Texas—12 months and one day in prison and $63,450 in restitution
â–*Rebecca Castillo, 41, of Edinburg, Texas—eight months in prison and $17,510 in restitution

The 10 defendants above pleaded guilty in August 2011 to one count of wire fraud, admitting that they engaged in a fraud as a policyholder under Aflac’s Accident-Only Insurance Plan. Specifically, from 2005 through 2010, the defendants routinely delivered lists of fake accidents and injuries to two physicians in Reynosa, Tamaulipas, Mexico. The physicians prepared an “accident reportâ€

All defendants were allowed to continue on bond and voluntarily surrender to a Bureau of Prisons facility to be designated in the near future.

Ya really think they are going to show up??????????

McAllen Woman Convicted for Role in Aflac Insurance Fraud Scam

Guilty Plea Marks the 36th Conviction in Multi-Million-Dollar Conspiracy

U.S. Attorney’s Office
March 26, 2012 Southern District of Texas
(713) 567-9000

MCALLEN, TX—Another south Texas resident has been convicted in relation to a multi-million-dollar conspiracy to defraud the American Family Life Assurance Company (Aflac), United States Attorney Kenneth Magidson announced today.

A total of 36 persons were charged in mid-June 2011 in a number of indictments for their roles in a conspiracy to defraud Aflac of millions of dollars by filing false injury claims. Prior to today’s hearing, 35 of the defendants had been convicted for their roles in the scheme. Today, the final defendant, Maria Guzman, 42, of Edinburg, Texas, pleaded guilty to making false statements relating to health care matters before U.S. District Judge Micaela Alvarez. With this conviction, all 36 defendants have been convicted of felony offenses for their respective roles in the conspiracy.

According to information presented by the United States in court, Guzman was a policyholder under Aflac’s Accident-Only Insurance Plan and, from 2005 to 2010, delivered lists of fake accidents and injuries to two licensed physicians who worked together in Reynosa, Tamaulipas, Mexico. The physicians allegedly prepared an “accident report” for each fake injury in exchange for a cash kickback of approximately $15 per report. In these accident reports, the physicians falsely claimed they had provided treatment and prescribed medicine to Guzman for her purported injuries. Over time, Guzman and other policyholders participating in the conspiracy with the physicians faxed more than 22,000 false injury claims, accompanied by the physicians’ fraudulent accident reports, to Aflac’s claims department in Columbus, Georgia, causing Aflac to disburse more than $3 million in insurance proceeds. The physicians and policyholders attempted to conceal their scheme in numerous ways, such as agreeing to use minor injuries—including lacerations and burns—as opposed to more serious injuries that paid higher cash benefits but could potentially attract a greater level of scrutiny by Aflac’s claims department.

Guzman has been permitted to remain on bond pending her sentencing hearing, which has been scheduled for June 29, 2012 at 9:00 a.m. At that time, Guzman faces up to five years in federal prison without parole, a $250,000 fine, and mandatory restitution for her false statements conviction.

The ongoing investigation leading to the charges was conducted by the FBI, with valuable assistance from Aflac’s Special Investigations Unit. Assistant United States Attorney Gregory S. Saikin is prosecuting the case.

FBI.gov is an official site of the U.S. Federal Government, U.S. Department of Justice

FBI — McAllen Woman Convicted for Role in Aflac Insurance Fraud Scam