Health Care Insurance Fraud
| U.S. Attorney’s Office April 21, 2011 |
Michael J. Moore, United States Attorney for the Middle District of Georgia, announced that on April 19, 2011, eight defendants were sentenced after entering pleas of guilty to one count of health care insurance fraud against American Family Life Assurance Company, also known as AFLAC, in violation of Title 18 United States Code, Section 1347(2) and 18 United States Code Section 2, before the Honorable Clay Land, United States District Court, Columbus, Georgia. The sentences are as follows:
| Defendant | Sentence |
| Shawnea De La Torre | Six months to serve; restitution $62,901.25; $100 mandatory assessment; three years’ supervised release |
| Jesus De la Torre | Twelve months and one day to serve; restitution $183,053.25 (joint and several liability); $100 mandatory assessment; three years’ supervised release |
| Adraine Moore | Six months to serve; restitution $60,426.25; $100 Mandatory Assessment; three years’ Supervised Release |
| Castoreo Milsap | Six months to serve, Restitution $33,045.00; $100 mandatory assessment; three years’ supervised release |
| Quandra Jones | six months to serve, Restitution $53,126.25; $100 Mandatory Assessment; three years’ Supervisory Release |
| Maurice Hinkle | Six months to serve; restitution $15,120.00; $100 mandatory assessment; three years’ supervised release |
| Candace Garcia | seven months to serve, Restitution $93,951.25; $100 Mandatory Assessment; three years’ Supervisory Release |
| Stephanie Ervin | Six months to serve as follows: two months in custody of the Bureau of Prisons followed by four months of home confinement; restitution $28,570.00; $100 mandatory assessment; three years’ supervised release |
AFLAC is engaged in business both within and outside the state of Georgia. While AFLAC engages in various types of businesses, its primary function is to provide supplemental insurance (health care benefit program) to policyholders who are ill or injured, or both, and are unable to work. Each defendant submitted fraudulent claims against their supplemental insurance policies with AFLAC to fraudulently obtain funds ranging in various amounts from $243.75 to $67,105.00. AFLAC’s actual loss was more than $500,000.00. Each defendant faces a possible maximum sentence of 10 years’ imprisonment, a $250,000.00 fine, or both, and three years of supervised release. “These types of cases have a far-reaching effect and are a priority of the Department of Justice,” Moore said.
The case was investigated by Special Agent David Whitlow, Federal Bureau of Investigation, and prosecuted by Assistant United States Attorney Verda Colvin.
For additional information please contact Sue McKinney, Public Affairs Specialist at (478) 621-2602.