Mass. Businessman Sentenced in Insurance Scam

A Williamstown, Massachusetts man was sentenced this week in federal court for fraud and obstruction of justice in connection with seven group health insurance plans in Western Massachusetts.

United States Attorney Michael Sullivan; James Benages, regional director of the Employee Benefits Security Administration; and Kenneth Kaiser, special agent in charge of the Federal Bureau of Investigation in New England, announced that David Michael Leja, 51, was sentenced by U.S. District Judge Michael Ponsor to 2 years and 6 months’ imprisonment, to be followed by 3 years of supervised release, and a $15,000 fine.

LEJA was convicted on Dec. 15, 2004 following a 13-day bench trial of 42 counts of mail fraud, 7 counts of false statements in relation to a health care benefits, and 1 count of obstruction of justice. He was acquitted of 1 count of witness tampering.

Evidence presented during the trial reportedly proved that Leja, a licensed insurance broker, who owns Berkshire Group Health Services at 85 Main Street in North Adams, Massachusetts, falsified claims information for seven self-funded group health insurance plans in an effort to obtain artificially low stop loss insurance quotes for his clients. The Court also found that LEJA illegally used the mails in furtherance of his fraudulent scheme.

In addition to the mail fraud and false statement convictions, the Court reportedly found that Leja obstructed justice by fabricating additional bogus documents, including an e-mail that he sent to himself after surreptitiously accessing a key government witness’s email account, that he planned to use at trial to impeach the witness and undermine the government’s case against him.