Insurance Fraud NEWS
Five people indicted in life insurance fraud scheme
March 28, 2019, San Juan, PR
On Tuesday, a federal grand jury returned a 35-count indictment charging five individuals with conspiracy to commit wire and mail fraud, 10 counts of mail fraud, 11 counts of wire fraud, six counts of aggravated identity theft, and seven counts of money laundering, related to a scheme to defraud life insurance companies, announced Rosa Emilia Rodríguez-Vélez, U.S. Attorney for the District of Puerto Rico.
The indictment alleges that from November 2006 through the return of the indictment, defendants Luz M. Santiago-Torres, Jimmy E. Santiago-Burgos, Félix Rosa-Rosa, José Rivera-Esparra, and Ulises Feliciano-Caraballo “conspired, devised, and engaged in a scheme to defraud life insurance companies by applying for, paying for, and receiving life insurance policies for insureds without the insured’s knowledge and consent,” Justice’s release reads.
Participants in the scheme submitted life insurance applications “containing materially false information, misrepresentations, and forged signatures that were sent to insurers, including Triple-S, Multinational, Occidental, Americo Financial, Universal, National, Great American, and Metlife, all without the knowledge and consent of the insured listed on the life insurance application.”
The total of the fraudulent insurance policies exceeds $5 million, with more than $1.5 million paid by life insurance companies as a result of policyholders’ deaths.
The FBI handled the investigation with the assistance of the U.S. Postal Inspection Service, and the Puerto Rico Police Department, pursuant to a referral from the Office of the Insurance Commissioner of Puerto Rico.
As a part of the conspiracy, insurance agents, including Félix Rosa-Rosa, José Rivera-Esparra, and Ulises Feliciano-Caraballo, prepared and submitted the fraudulent life insurance applications to the insurance companies. Upon the death of the policyholders, payments were then made to the listed beneficiaries, including Santigo-Torres and Santiago-Burgos.
More than 30 fraudulent insurance policy applications were identified involving more than 20 policyholders, who include five people who are still alive, “four whom died of natural causes, and four whom suffered violent deaths in Juana Díaz, Puerto Rico, including murder.”
The violent deaths include the “shooting deaths of Daniel Santiago Ramos and Reinaldo Santiago Torres on July 1, 2011 and August 28, 2012 respectively, as well as the deaths of brothers Jose A. Torres-Cruz and Margarito Torres Cruz, who died on October 31, 2009 and June 2, 2018 respectively, when each was struck by a vehicle and killed on Road 552 in Juana Diaz,” Justice noted.
The agency explained as follows:
“The co-conspirators listed the personal identification information of insureds on life insurance applications, including their name, social security number, and date of birth; listed false contact information including false residential addresses, false mailing addresses, and false telephone numbers. The false contact information provided corresponded to the addresses and contact information for individuals involved in the conspiracy and scheme to defraud. By doing so, the defendants would receive communications made via telephone and mail rather than the actual named insured.
“Multiple insureds, for whom life insurance policies were obtained without their knowledge and consent, resided at and were provided elderly care at Hogar Sustituto Luz Santiago y Fernando Santiago also known as Sueño Felíz, a home for the elderly operated by defendant Santiago-Torres in Juana Diaz, Puerto Rico. Sueño Felíz was licensed to operate with the Puerto Rico Department of Family until the license was revoked on or about April 5, 2011.
“In addition to the mail and wire fraud charges, defendants Luz M. Santiago-Torres, Félix Rosa-Rosa, and José Rivera-Esparra were charged with aggravated identity theft of insureds’ names, social security numbers, and signatures. Santiago-Torres is also facing seven counts of money laundering for making monetary transactions in excess of $10,000 with proceeds of the conspiracy and scheme to defraud, including the $30,000 purchase of a 2018 Jeep Wrangler Unlimited. All defendants are facing the forfeiture of the criminally derived proceeds, including $1,543,974.22.
If found guilty, the defendants face a maximum penalty of 20 years of imprisonment for each conspiracy, mail fraud, and wire fraud count as well as a maximum two-year term of imprisonment for each aggravated identity count, and a maximum 10 years of imprisonment for each money laundering count.
Source: Caribbean Business