McALLEN, TEXAS
Two Mexican doctors — Dr. Mayolo Melchor, 59, and Dr. Bertha Hernandez-Melchor, 61, both of Reynosa, Tamaulipas, Mexico, plead guilty Wednesday to conspiring with policyholders of the American Family Life Insurance Company to fax fraudulent claim forms and accident reports to the insurance company for accidents and injuries that never occurred.
Both plea agreements were entered before U.S. District Judge Micaela Alvarez.
Judge Alvarez has set sentencing for Aug. 18. Both defendants face up to 20 years in federal prison and a possible $250,000 fine. They will remain in custody pending that hearing.
The defendants admitted American Family Life policyholders paid them to prepare and sign fictitious reports for accidents and injuries that never occurred.
American Family Life policyholders filled out the fictitious claim forms in the McAllen area and delivered them to the defendants’ family medicine clinic in Mexico where Melchor and Hernandez-Melchor prepared and signed corresponding accident reports for each fake accident and injury, according to federal officials.
The policyholders then faxed the fictitious claim and accident forms to American Family Life headquarters in Columbus, Georgia, officials said.
The defendants admitted the fraudulent claim forms and accident reports that were faxed to AFLAC from September 2001 to August 2010 resulted in the disbursement of approximately $2.5 million in fraudulent benefit checks to the policyholders.
The FBI investigated.