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Life Health > Health Insurance

Michigan Officials Say 14 Hit Aflac With Fake Injury Claims

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What You Need to Know

  • Aflac reported concerns about the claims to Michigan insurance regulators.
  • State insurance regulators investigated the allegations together with Ogemaw County officials.
  • Local media reports about the charges attracted about 200 Facebook shares and 17 Twitter likes within 36 hours after the news appeared.

Fourteen residents of Ogemaw County, Michigan, submitted a wave of fraudulent claims for injury benefits to Aflac, according to officials with the Michigan Department of Insurance and Financial Services.

The residents received a total of $3 million in benefits payments for injury-related chiropractic treatment that never occurred, officials said earlier this week.

For insurance agents, the news could represent an opportunity to educate clients about the fact that the money for insurance benefits payments come from premium payments and, in some cases, investment earnings, not from thin air.

The Investigation

Aflac filed a complaint alleging insurance fraud with the Michigan insurance department.

The department’s fraud investigation unit conducted an investigation of the allegations with the Ogemaw County Sheriff’s Office.

Investigators found enough evidence for the county prosecutor’s office to file charges against 14 people, according to officials with the Michigan insurance department.

“The investigation is ongoing and additional charges may be filed in the future,” officials said.

All 14 people charged were charged with a felony, insurance — fraudulent acts, and two were charged with identity theft.

Both insurance fraud and identity theft come with a maximum penalty of four years in prison, a fine of up to $50,000 and payment of restitution.

The prosecutor’s office has filed the charges with the 34th Circuit Court in Ogemaw County.

Representatives for the individuals charged could not immediately be reached for comment.

Aflac said in a statement that insurance fraud impacts everyone.

“Aflac fully cooperated with authorities in Michigan to ensure that these allegations were investigated and that the alleged perpetrators are brought to justice,” the company said. “Aflac has zero tolerance for fraud committed against our company, our policyholders, shareholders and stakeholders.”

An Insurance Regulator’s View

Anita Fox, the director of the Michigan insurance department, said in a comment, included in an announcement of the filing of charges, that the case began because someone suspected foul play and filed a complaint.

“These fraudulent claims make insurance more expensive for all of us,” Fox said.

She asked Michigan residents to reported suspected fraud online, through the state insurance fraud reporting website, or by calling the Michigan insurance department at 877-999-6442.

Social Media Impact

Reports of the charges that appeared on the websites of two local TV stations, WWTV and WJRT-TV, were shared about 200 times on Facebook within 36 hours after the news was released.

The Facebook users who shared the reports reacted with comments such as “Holy moly,” “Wow!” and “Wow… don’t know what to say…”

A Twitter post by Dana Smith Dutra, who has about 12,000 followers. attracted six retweets, 17 likes and three comments.

(Photo: Kiyoshi Ota/Bloomberg)


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