Miami Man Diagnosed With Medical Fraud Charges

November 22, 2004

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

Reynaldo Gonzalez-Duenas, 48, surrendered 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. If convicted, he could face a maximum statutory penalty of 40 years in prison.

Investigators, 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 reportedly pocketed the profits.

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 in Miami at 7575 W. Flagler St. Investigators said Gonzalez-Duenas began operating Americ Health Plan approximately six months after his 2000 arrest.

Topics Fraud

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Insurance Journal Magazine November 22, 2004
November 22, 2004
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Agency Management