FOR IMMEDIATE RELEASE WEDNESDAY, APRIL 30, 2003 WWW.USDOJ.GOV CRM (202) 514-2008 TDD (202) 514-1888 WASHINGTON, D.C. - Assistant Attorney General Michael Chertoff of the Criminal Division and U.S. Attorney Maxwell Wood of the Middle District of Georgia announced today that criminal charges have been filed against eight residents of the U.S. Territory of American Samoa in connection with an alleged scheme to defraud the American Family Life Assurance Company (AFLAC).
A 25-count indictment, returned by a federal grand jury in the Middle District of Georgia in February and unsealed today, charges Tausiga Ofoia, Ateliana Teo, Tagiilima Shimasaki Fruean, Anevili Semeatu, Iosefo Filipo Toilolo, Kilepoa Tuitama, and Ivan Faofetai Tuliau with conspiracy and various counts of mail fraud in connection with a $200,000 scheme to defraud AFLAC, a company headquartered in Columbus, Georgia.
A second, nine-count indictment charges Irata Finuaga, a resident of American Samoa, with mail fraud in an $80,000 scheme to defraud AFLAC.
Agents of the Federal Bureau of Investigation arrested the eight defendants in American Samoa yesterday, and transported them to Honolulu, Hawaii. The eight defendants will be presented for an initial appearance before a magistrate judge in the federal judicial district of Hawaii.
As charged in the first indictment, the defendants entered into a conspiracy and a scheme to defraud AFLAC under a supplemental health insurance policy that AFLAC sold in American Samoa which paid beneficiaries a fixed-dollar amount for each day they were hospitalized. Ofoia and Teo allegedly used their positions as record clerks at the Lyndon B. Johnson Tropical Medical Center, the only hospital in American Samoa, to alter hospital records by whiting out names and other identifying information on real patient records and substituting their names and those of their co-conspirators or their dependents who were covered by their AFLAC policies. According to the indictment, the defendants would then submit claims for benefits supported by the altered medical records certified by Ofoia and Teo, when neither the co-conspirators nor their dependants had been hospitalized. When AFLAC paid on the false claims, the co-conspirators allegedly shared the fraud proceeds with Ofoia and Teo, often paying them as much as 50 percent of the proceeds.
As charged in the second indictment, Finuaga used her position as an employee of an insurance brokerage selling and servicing AFLAC policies, to intercept legitimate insurance claims, copy the medical records attached to those claims, and then alter the records by whiting out the real patients names and substituting her own name or the names of her dependents. Finuaga would then allegedly submit the claims to AFLAC and receive benefits.
The cases are being prosecuted by Senior Litigation Counsel William T. Clabault and Trial Attorney Nancy E. Potts of the Fraud Section, Criminal Division of the U.S. Department of Justice, in conjunction with the United States Attorneys Office for the Middle District of Georgia. The investigation was conducted by the Honolulu office of the Federal Bureau of Investigation. 03-261
Source: US Department of Justice
