Twenty Convicted This Week for Defrauding Aflac

McALLEN, TX—A total of 20 South Texas residents indicted for their roles in a scheme to defraud the American Family Life Assurance Company (Aflac) of millions of dollars by filing thousands of false injury claims under Aflac’s accident-only insurance plan have been convicted this week, United States Attorney José Angel Moreno 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 false claims. This week a total of 20 have pleaded guilty to wire fraud. Today, at a hearing before U.S. District Judge Randy Crane, three of those charged, Denise Rendon, 39, of Mission, Texas; Norma Sanchez, 40, of Edinburg, Texas; and Eddie Guerra, 34, of Alamo, Texas, pleaded guilty.

Rendon, Sanchez, and Guerra were policy holders under the Aflac accident-only insurance plan. From 2006 to 2010, the defendants routinely 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 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 more than 21,000 false injury claims, accompanied by the physicians’ accident reports, to Aflac’s claims department in Columbus, Georgia, causing Aflac to disburse approximately $3,000,000 in insurance proceeds.

Judge Crane has set sentencing for Sanchez and Guerra for Sept. 28, 2011, while Rendon will be sentenced on Oct. 13, 2011.

The 17 others who pleaded guilty earlier this week to wire fraud and are pending sentencing in the fall for their role in this multi-million-dollar fraud scheme include: Lucila Alcala, 40; Lilly Perez, 32; Desiree Rodriguez, 34; Jose D. Rodriguez, 34; Steven Betancourt, 39; Rachel Betancourt, 42; Maria C. Alaniz, 39; Patricia Cerda-Flores, 44; Dalia Cerda-Delgado, 39; Leonor B. Salinas, 46; Rebecca Castillo, 41; Ninfa Reyes, 38; Noemi Villareal, 60; Idaleen Sanchez, 34; Valerio Ramos, 55; Jose Guerra, Jr. 37; and Rigoberto Ramirez, 30.

All 20 defendants statutorily face a maximum of 20 years in federal prison without parole, a $250,000 fine, and mandatory restitution for the wire fraud conviction.

The investigation leading to the charges against all of the defendants mentioned above was conducted by the McAllen office of the FBI. Assistant United States Attorney Greg Saikin is prosecuting the case.