The operators of an Indiana-based insurance company that left 7,200 people with unpaid medical claims in one of the costliest, most extensive fraud schemes in Florida were sentenced to prison Wednesday, Florida officials said.
Circuit Court Judge Julie H. O’Kane sentenced William Paul Crouse to four years and Carmelo Zanfei to two years. They were ordered to report to jailers on Oct. 12.
A restitution hearing is scheduled for Dec. 9.
Both were also sentenced to 20 years supervised probation, said Tom Gallagher, who as Florida’s Chief Financial Officer is also head of the Division of Insurance Fraud, which investigated the fraud claims.
Zanfei and Crouse, who operated TRG Marketing LLC, were charged because they marketed the health plan to Florida residents and 43 other states without a certificate of authority to sell the plan. They also claimed the plan was exempt from certificate and licensing requirements of state law. The plan was also not funded properly and did not pay millions of dollars of claims by people who thought they had valid health insurance, the statement said.
Florida was the only state seeking criminal charges.
Zanfei pleaded guilty to four counts of unlawful transaction of insurance.
“Many Floridians suffered physical and mental anguish because of these two individuals,” Gallagher said. “I am relieved to see these scam operators will serve time behind bars and that restitution is pending.”
In one of the fraud cases, Teresa Orr of Monteverde said she was left with $250,000 in unpaid claims from her husband’s cancer treatment. He was NASCAR-circuit driver Pete Orr.
Orr maintains that her husband died because he could not get access to medical care he needed in time, the statement said.
Cindy Baker of Okeechobee said her husband committed suicide because he was upset over unpaid claims and damage to his credit.
Copyright 2005 by The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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