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Wednesday, March 23, 2016

10 Year Sentence For Doctor Who Defrauded AFLAC

Press Release

US Attorney's Office - San Juan

SAN JUAN, P.R. – On Monday, March 21, 2016, the Hon. Gustavo
Gelpí sentenced Aníbal Pagan-Romero, a general practitioner with a
clinic in Quebradillas, Puerto Rico, to a term of imprisonment of 120
months and a term of supervised release of five (5) years in the crimi-
nal case for mail fraud prosecuted against Pagan-Romero in federal
court. Pagan-Romero was also ordered to pay $2,056,503.32 in resti-
tution to the American Life Assurance Company (“AFLAC”) of Co-
lumbus, Georgia. This sentence is the result of a lengthy investigation
undertaken by the Federal Bureau of Investigations into multiple insu-
rance fraud schemes in the Western region of Puerto Rico which resul-
ted in the arrest and prosecution of hundreds of individuals.

On October 5, 2015, Aníbal Pagan-Romero had been found guilty by
a jury of his peers on all counts of an 82 count indictment charging 21
conspiracies and 61 individual counts of mail fraud.   Pagan-Romero
was charged with 35 patients for orchestrating a large-scale fraudulent
scheme where he fraudulently signed AFLAC accidental insurance claim
forms without examining the patients. The evidence presented at trial sho-
wed that Pagan-Romero caused a loss to AFLAC in excess of $6,000,000.
The 35 patients who were charged alongside Pagan-Romero pled guilty to
the charges prior to the trial.

The three-week trial before the Hon. Gustavo Gelpi included the testimo-
ny of three of the doctor’s employees and four patients who indicated that
Pagan-Romero personally instructed them to submit the documents for his
signature without examination. The evidence also showed that the scheme
had grown so large and lucrative that Pagan-Romero had to hire two emplo-
yees to do data entry full time in order to generate the thousands of AFLAC
claim forms submitted for reimbursement under his signature.

The case was prosecuted by Assistant United States Attorneys Dennise N.
Longo and Julia Díaz-Rex.

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