Doctor And 532 Others Indicted For Mail And Social Security Fraud Conspiracy

A federal grand jury has issued a 709-count indictment, charging 533 defendants with mail fraud conspiracy, mail fraud, Social Security fraud and one forfeiture count, according to Rosa Emilia Rodríguez-Vélez, U.S. Attorney for the District of Puerto Rico. 

Dr. Ubaldo Planell-Pabon, of Lares, Puerto Rico, is the lead defendant in the indictment.
 
According to the federal government, the victim of the offenses charged in the indictment was American Family Life Assurance Company (AFLAC), which paid out nearly $7 million to its policyholders as a result of the fraudulent scheme.
 
The indictment alleged that: 
 
Between 2004 to 2008, Planell-Pabon falsely completed and signed the physician statement section of AFLAC's Accidental Injury Claim Form and/or prescription form, falsely certifying injuries for AFLAC claimants and/or policyholders. He falsely represented that the claimants had suffered injuries, when in fact they had not sustained any such injuries, and Planell-Pabon never conducted a physical examination of any of the claimants. Planell-Pabon was paid between $10 and $20 by the AFLAC claimants for each false claim form that he completed and signed, and caused a total disbursement by AFLAC of at least $6,926,374, by way of checks, that were sent to the policyholders through the U.S. Postal Service.
 
Counts 625 to 709 charged the defendants with Social Security fraud for the misuse of dependent Social Security numbers. Defendants used Social Security numbers belonging to their children/dependents on AFLAC claim forms in furtherance of the conspiracy to commit mail fraud.
 
"The submission of false injury claim forms on behalf of insured individuals caused AFLAC to disburse close to seven million dollars for injuries which were non-existent. The price of this illegal scheme is ultimately paid by the consumers, whose insurance premiums will increase to cover the loss sustained by the company as a result of these fraudulent claims," stated U.S. Attorney Rodriguez-Velez.