Volume 1 Number 42
October 18, 2004










TEXT VERSION

 



 

 

 

MIAMI MAN ARRESTED FOR SELLING BOGUS DISCOUNT PLAN

Investigators suspect hundreds of residents in South Florida were victimized

Florida’s Chief Financial Officer Tom Gallagher has announced the arrest of a man, formerly banned from the insurance industry, who allegedly sold a fraudulent medical discount plan to several hundred customers throughout South Florida. Americ Health Plan, which cost almost $200 a month, included a supplemental insurance policy that consumers said confused them into thinking they were buying health insurance.

Reynaldo Gonzalez-Duenas, 48, surrendered today to investigators with the Department of Financial Services, Division of Insurance Fraud, and was arrested on one count of organized fraud and seven counts of third-degree grand theft. He was booked into the Miami-Dade County Jail. If convicted, he could face a maximum statutory penalty of 40 years in prison.

“Before purchasing these discount plans, consumers should know that these plans are not health insurance,” said Gallagher, who oversees the Department of Financial Services. “Some discount card sellers are careful to say their plans are not insurance, but others are not so clear. Some intentionally give the impression that they are offering benefits usually associated with insurance.”

The Office of Insurance Regulation is currently working on rules to enforce a law that Gallagher proposed requiring medical discount plans to be registered. The law goes into effect in January. The department has responded to more than 1,100 complaints about medical discount plans.

Investigators with the department’s Division of Insurance Fraud, operating on a tip from the Division of Agent and Agency Services, found that Gonzalez-Duenas orchestrated several unlicensed individuals in the selling of the discount health care plan and the supplemental insurance portion of it. They told customers the plan included a network of physicians and hospitals, but no provider network existed and Gonzalez-Duenas pocketed the profits.

The investigation is continuing, and anyone with information is asked to call the department’s Fraud Buster hotline at 1-800-378-0445.

Gonzalez-Duenas lost his agent license and was issued a lifetime ban from the insurance industry after his arrest for grand theft in April 2000. At the time, he was the director and owner of Durey Insurance Group, Inc., formerly located at 7575 W. Flagler St. in Miami.

From September 1998 through April 1999, Gonzalez-Duenas accepted enrollment forms for Humana health coverage for approximately 132 consumers. After having sold the coverage by saying he could get pre-existing conditions covered, he submitted falsified enrollment forms to Humana.

Investigators said Gonzalez-Duenas began operating Americ Health Plan approximately six months after his 2000 arrest.

Gallagher reminds customers to “verify before you buy. If it sounds too good to be true, it probably is.”
 

The skyline for October is Daytona Beach, photo courtesy of the Daytona Beach Area Convention & Visitors Bureau.