Miamian Arrested for Health Plan Fraud

Enrique Angulo has been arrested in Miami-Dade County, Fla. by Department of Financial Services, Division of Insurance Fraud investigators for defrauding hundreds of South Floridians in a discount health plan fraud scam.

“Criminals who prey on the needy deserve no mercy,” said Tom Gallagher, Florida CFO, who oversees the department. “This suspect stole from people looking for affordable healthcare for their families and people like him are part of the reason insurance costs are rising throughout the state. Getting criminals like this off the street is good news for all Floridians.”

Angulo, presently on four years probation for grand theft in excess of $20,000, was arrested, charged with violation of probation, as well as second-degree grand theft, uttering forged instruments, and organized scheme to defraud. Currently Angulo is being held at the Miami-Dade County Jail without bond. If convicted, Angulo faces a maximum of 25 years in prison.

Gallagher pushed for legislation last year that now requires companies selling discount health plans in Florida be licensed.

“This is an industry where the potential for rampant fraud was great. Too many Floridians were being ripped off by unscrupulous operators, and many were made to think they were buying health insurance when in fact they were signing up for discounts on medical services or prescriptions,” Gallagher said.

According to the DFS, Angulo purchased Americ Health Benefits, a Discount Health Plan in December 2004. Its owner had just been arrested and jailed on separate charges of insurance fraud. In January 2005, Angulo realized the business he purchased was a front for criminal enterprises and had no legitimate use. Rather than close the business, he too began defrauding unwilling consumers.

The scam required consumers that came to Americ Health Benefits to buy a low-cost health discount plan. As part of the registration process, Angulo would request voided or blank checks from the consumer. In addition to charging customers for a discount plan he knew he could not provide, Angulo would create check drafts to withdraw the monthly membership fees from the victims’ accounts.

One victim discovered the health insurance policy she was paying for was worthless after seeking medical attention for her husband and son. The victim was left with more than $15,000 dollars in hospital bills after her calls to Angulo went unanswered. Up until his arrest, Angulo continued to withdraw monthly membership fees in excess of $5,000 from a closed account in the victim’s name.