The insurance industry is faced with fraud cases of all types.  Costs associated with paying fraudulent insurance claims ultimately affect insurance rates.  In order to combat fraud of all types, insurance companies employ highly trained investigators to examine possible cases of insurance fraud.

 

Recently,  a Texas family pleaded guity in a large supplemental insurance fraud scheme.  According to the U.S. Attorney’s Office and the Associated Press,  seven family members including one probation officer have been convicted as co-conspirators in a $3 Million insurance fraud scheme.

The Texas family was among a group of 27 defendants that attempted to defraud AFLAC by filing thousands of false claims under the company’s Accident-Only Supplemental Insurance Plan.

According to a news release from the U.S. attorney’s office for the Southern District of Texas, U.S. Attorney Kenneth Magidson, a former probation officer along with his mother, two aunts, and three cousins, pleaded guilty on november 14 in McAllen in the insurance and wire fraud scheme.

According to the Insurance Journal, “the six others who pleaded guilty were Mary Cedillo of Edinburgh, Martha Ortega, Yolanda Segovia, Candida Chavez, Lori Chavez and Anissa Chavez of McAllen, Texas.”

U.S. attorneys stated that the defendents used the same two Reynoso, Mexico doctors to prepare and file approximately 21,000 false injury claims with Aflac.

The investigation into this insurance fraud ring, was conducted by the FBI.  Assistance was given by Aflac’s special investigations unit in Georgia.

Ten people pleaded guilty in the case in early November and 20 others pleaded guilty in early August.

 

Source: U.S. Attorney’s Office, Associated Press, Insurance Journal