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.

Woman Sentenced To Prison For Defrauding The IRS

Press Release

US Attorney's Office - San Juan

SAN JUAN, P.R. – Today, March 16, 2016, defendant Mariely
Malavet-Rivera was sentenced by United States District Court
Judge Francisco A. Besosa to serve a term of imprisonment of
34 months and was ordered to pay restitution in the amount of
$103,632.10 for defrauding the Internal Revenue Service (IRS),
announced Rosa Emilia Rodríguez-Vélez, United States.

Malavet-Rivera pled guilty on October 2, 2015, to twenty-four
counts of wire fraud, one count of theft of public money, and one
count of aggravated identity theft. These charges stemmed from a
scheme utilized by Malavet-Rivera from 2010 until 2013 to submit
false Federal tax returns seeking the additional child tax credit (AC
TC) in order to obtain fraudulent tax refunds from the IRS via check
and direct deposit. Personal identification information including in-
dividuals’ names, dates of birth, and social security numbers were
utilized without the knowledge or consent of the individual in order
to request and obtain the fraudulent tax refunds.

The false Federal tax returns contained defendant’s own postal address
and bank account information so that the fraudulent refunds would be
deposited via wire transfer to bank accounts Malavet-Rivera controlled
and the physical checks would be mailed to her postal address. The de-
fendant then used a fraudulent driver’s license or voter registration iden-
tification to cash the fraudulent refund checks through an intermediary
company.

The fraudulent tax refund scheme had a total value of approximately
$227,653.22.

The case was prosecuted by Assistant United States Attorney Seth A.
Erbe and investigated by the Internal Revenue Service, Criminal In-
vestigation (IRS-CI).