It was an inside job, one that cost an insurance company in Florida more than $1.1 million, authorities said.
Investigators with Florida’s Department of Financial Services on Friday charged Rochell Green and Breana Ferguson, of the Jacksonville area, with orchestrating a scheme that sent 42 false insurance claims to the health insurer Aetna, DFS said in a statement.
The women, both employees of Aetna, became familiar with the claims process for hospital coverage, accident insurance and voluntary supplemental plans, the agency said. Each enrolled in the insurance plans and uploaded fake documents in support of their claims for procedures that did not happen and for patients that did not exist, Florida CFO Jimmy Patronis explained.
“It’s amazing the lengths bad actors will go to commit fraud and scam the system to make a quick buck. Kudos to my insurance fraud detectives for arresting these fraudsters and placing them behind bars where they belong,” Patronis said in a bulletin.
Green, 40, reportedly began the scheme in 2019 and later asked Ferguson to help, splitting the proceeds on her claims payments, DFS noted. Green collected more than $408,000 in the scheme and Ferguson’s false claims produced some $736,000 in insurance payments, the agency said.
Green was arrested Oct. 25. Ferguson, age 34, was arrested Nov. 8. Both were booked into the Duval County Jail and released on bond. Duval County Sheriff’s Office records show Green was charged in 2012 with attempting to cash a worthless check.
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