Insurance Fraud NEWS

Coalition Against Insurance Fraud

5 individuals indicted in life insurance fraud scheme to obtain policies without insureds' knowledge

March 28, 2019, San Juan, PR — On March 26, 2019, 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, announced Rosa Emilia Rodríguez-Vélez, United States Attorney for the District of Puerto Rico. The FBI handled the investigation with the assistance of the United States Postal Inspection Service, and the Puerto Rico Police Department, pursuant to a referral from the Office of the Insurance Commissioner 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. Participants in the conspiracy and scheme to defraud 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.

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 various insurance companies. Upon the death of the insureds, payments were then made to the listed beneficiaries, including Santigo-Torres and Santiago-Burgos.

More than 30 fraudulent insurance policy applications were identified involving over 20 different insureds. Those insureds include five individuals who are still alive with active policies in their name as of the date of the indictment, four whom died of natural causes, and four whom suffered violent deaths in Juana Diaz, Puerto Rico, including murder.

The four 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.

The total of the fraudulent insurance policies involved in the conspiracy exceeds five millions dollars. In excess of one million five hundred thousand dollars was actually paid by life insurance companies as a result of insureds’ deaths.

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.

“Luz M. Santiago-Torres and her coconspirators deliberately targeted senior citizens as part of a life insurance fraud scheme that affected more than 20 victims, some of whom lost their lives violently, and yet they didn’t care and collected fraudulent insurance payouts,” said Rosa Emilia Rodríguez-Vélez, United States Attorney for the District of Puerto Rico. “These charges demonstrate our firm commitment to stopping those who exploit senior citizens and other vulnerable populations.”

“The FBI appreciates the outstanding work of the U.S. Attorney’s Office, U.S. Postal Inspection Service, and the Office of Social Security, and remains confident that we and our partners have the capacity to address any large scale fraud scheme that threatens the public,” said Douglas A. Leff, Special Agent in Charge of the FBI-San Juan Field Office. “As always, the sooner these frauds get reported to us, the faster we can respond and apprehend those responsible. We are available 24 hours a day at 787-754-6000 and www.tips.fbi.gov.”

“Postal Inspectors, federal prosecutors and our law enforcement & regulatory partners have diligently worked to identify and disrupt the activities of a criminal group who stole the identities of individuals, and obtained fraudulent life insurance policies in the names of their victims,” said Raimundo Marrero, Assistant Inspector in Charge, Newark Division, U.S. Postal Inspection Service. “Postal Inspectors will continue to tirelessly investigate these types of financial crimes that utilize the U.S. Mail to target businesses and consumers alike.”

The case is being prosecuted by First Assistant United States Attorney Timothy Henwood and Assistant United States Attorney Seth A. Erbe. If found guilty, defendants are facing a maximum penalty of 20 years of imprisonment for each conspiracy, mail fraud, and wire fraud count as well as a maximum 2 year term of imprisonment for each aggravated identity count and a maximum 10 years of imprisonment for each money laundering count. Indictments contain only charges and are not evidence of guilt. Defendants are presumed to be innocent unless and until proven guilty.

Source: United States Department of Justice

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