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Feb. 29, 2012

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Five More South Texas Residents Sentenced to Prison This Week For Insurance Fraud
27 defendants sentenced to prison to date in connection with multi-million dollar conspiracy to defraud Aflac

McALLEN, Texas – Five more 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 designed to defraud Aflac of millions of dollars by filing thousands of false injury claims.  To date, 35 of those defendants have pleaded guilty and 27 have been sentenced to for their participation in the scheme to prison terms ranging from six to 30 months without parole.  

Today, Chief U.S. District Judge Ricardo Hinojosa imposed the following sentences:

Yesterday, U.S. District Judge Micaela Alvarez imposed the following sentence:

Each of the defendants listed above pleaded guilty in 2011 to one count of wire fraud, admitting that they engaged in a multi-year scheme as a policyholder of Aflac. Specifically, the defendants routinely delivered lists of fake accidents and injuries to two physicians who practiced together in Reynosa, Tamaulipas, Mexico. The physicians prepared an “accident report” for each fake injury in exchange for a cash kickback of approximately $15 per accident report. In each report, the physicians falsely claimed they had provided treatment and prescribed medicine to the defendants for their purported injuries. Over time, the defendants and their co-conspirators faxed thousands of false injury claims and accident reports (purportedly certifying the fake injuries) to Aflac in Columbus, Ga. Aflac disbursed more than $3 million as a result of the false claims submissions.

The investigation leading to the charges was conducted by the FBI. Assistant United States Attorney Greg Saikin is prosecuting the case.