32 South Texans accused of defrauding insurer

June 18, 2011 12:06:47 PM PDT
Federal prosecutors said Friday that they have charged 32 South Texas residents with bilking insurer Aflac out of $3 million over a decade by faking a variety of minor injuries -- including burning an arm while making tortillas and injuring a leg while feeding a dog.

The 32 include a police officer, teachers and county employees. They face fraud and conspiracy charges for making the fake minor injury claims.

Those charged bought accident insurance and with the help of two Reynosa, Mexico, doctors filed minor injury claims thought too small to draw suspicion. In return, the border-city doctors received small kickbacks, according to the indictments.

"Greed, simple and pure, has allegedly driven a police officer, teachers, county government employees and others to participate in a multi-million dollar insurance fraud," said U.S. Attorney Jose Angel Moreno in a prepared statement.

Federal investigators dubbed the case "Operation Sitting Duck," a play on the insurer's feathered mascot.

The accused submitted about 21,600 fraudulent claims between July 2001 and April 2010, according to the indictment. The doctors coached those filing claims to keep the injuries minor to avoid requests from the insurer for X-rays or medical tests, according to the indictment.

If convicted, each could face up to 20 years in prison for each count of conspiracy and wire fraud. Some indictments remain partially sealed, so more arrests are possible.

"The indictments stemming from the alleged fraud ring in Texas followed lengthy investigations and cooperation with law enforcement to maximize results," said Jon Sullivan, spokesman for the Columbus, Ga.-based insurer. "We would like to thank the FBI and the U.S. Attorney's office for their diligence in protecting the best interest our policyholders."

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