View this article online: https://www.insurancejournal.com/news/southcentral/2011/11/03/222740.htm

10 South Texas Residents Sentenced to Prison for Insurance Fraud

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, U. S. Attorney Kenneth Magidson announced.

In June 2011, 36 persons were charged in various indictments for their roles in a scheme to defraud Aflac of millions of dollars by filing thousands of false injury claims.

U.S. District Judge Micaela Alvarez sentenced 10 of the 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:

• Rachel Betancourt, 42, of Edinburg, Texas — 27 months in prison and $96,955 in restitution
• Dalia Cerda-Delgado, , of Palmview, Texas — 24 months in prison and $38,925 in restitution
• Lilly Perez, 32, of La Villa, Texas — 24 months in prison and $139,120 in restitution
• Patricia Cerda-Flores, 44, of Palmview, Texas — 18 months in prison and $86,395 in restitution
• Desiree Rodriguez, 34, of Edinburg, Texas — 17 months in prison and $109,450 in restitution
• Maria C. Alaniz, 39, of Elsa, Texas — 15 months in prison and $88,340 in restitution
• Jose Rodriguez, 34, of Edinburg, Texas — 15 months in prison and $102,335 in restitution
• Ninfa Reyes, 38, of Edcouch, Texas — 12 months and one day in prison and $38,925 in restitution
• Noemi Villareal, 60, of Edcouch, Texas — 12 months and one day in prison and $63,450 in restitution
• 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 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 above faxed approximately 6,944 false injury claims and accident reports (purportedly certifying the fake injuries) to Aflac in Columbus, Ga. The 10 defendants received various amounts of money from Aflac totaling $778, 470.

In early October, six of the defendants charged in this case were sentenced to prison and ordered to pay restitution by U.S. District Judge Randy Crane for periods ranging from six months to 12 months and one day. They include: Idaleen Sanchez, 34; Valerio Ramos, 55; Rigoberto Ramirez, 30; Eddie Guerra, 35; Jose Guerra, 47; and Norma Sanchez, 40.

An additional 11 defendants — Lucila Alcala, 40; Leonor Salinas, 46; Norma Flores, 54; Nora L. Palacios, 53; Georgina Flores, 43; Jessica Herrera, 30;, Nancy Rodriguez, 32; Maria Cantu, 56; Denise Rendon, 38; Beatriz Carreon, 44; and Minerva Murgia, 43, pleaded guilty to wire fraud and are awaiting sentencing.

Seven other defendants are awaiting trial and are presumed innocent until proven guilty.

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

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

Source: U.S. Attorney’s Office for the Southern District of Texas