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Insurance claims manager facing prison sentence for fraud

On Behalf of | Jul 25, 2022 | Federal Offenses

Financial crimes and criminal activities related to health care, financial misappropriation and other related crimes are serious, and those convicted of these types of charges could face grave penalties. One man is facing a prison sentence after he was convicted for his role in an insurance fraud scheme related to COVID-19 unemployment claims. The defendant worked for the Michigan Unemployment Insurance Agency during the time the operation was taking place.

Details of an insurance fraud scheme

According to the prosecution’s case, the unemployment insurance fraud scheme involved the use of wire fraud to approve false claims and secure money. The defendant would use his position within the government agency to approve fraudulent Pandemic Unemployment Assistance claims. He would then accept kickbacks from the others involved with the scheme. Estimates suggest this operation resulted in a loss of approximately $1.5 million.

At the time when the insurance fraud scheme was underway, the defendant was a leads claim examiner. This role gave him access to a database where he could see unemployment claims. Investigators say that he was paid between $50 and $150 for his role in the scheme. The defendant acknowledged his actions in the insurance fraud scheme.

Seeking the best sentence

In a case involving federal-level charges, the stakes are extremely high. A Michigan defendant may find it best for his or her specific situation to seek lesser penalties in a plea agreement with the prosecution. In this specific case, the defendant will serve two years in a federal prison after he pleaded guilty to conspiracy to commit wire fraud.