U.S. Attorney for the Southern District of California: Former U.S. Navy Service Member Sentenced for $2M Insurance Fraud Scheme
Toups' sentence followed his guilty plea to conspiracy to commit wire fraud. According to his plea agreement, participants in the scheme obtained approximately
Toups admitted that from 2012 to at least
"Lying and stealing funds meant for injured service members is appalling," said
"Fraudulently filing claims for unearned benefits diverts compensation from deserving service members who suffered serious and debilitating injuries while on active duty," said Special Agent in Charge Rebeccalynn Staples with the
"
"Stealing from a program set in place to aid injured and disabled servicemembers diverts compensation from deserving individuals," said
According to the plea agreement, in addition to submitting his own TSGLI claims based on fake injuries and disabilities, Toups encouraged numerous current or former Navy service members to submit claims and sometimes told them to provide medical records to McGrath. McGrath, a nurse, falsified or doctored medical records to exaggerate or fake injuries. Villarroel certified that he reviewed the records and determined activities of daily living were lost or impaired and consistent with the claimed injuries as required for claims to be processed and qualify, at times supporting the determination by falsely stating he interviewed the claimant. Villarroel also, at times, provided others' medical records for McGrath to use in fabricating claims.
Toups admitted that he encouraged recipients of claim payments to give him part of the money, sometimes characterizing it as a "processing fee." McGrath and Villarroel received part of the kickback depending on their involvement in the claim. Toups paid Villarroel in cash and by cashier's check. At times, Toups and others conducted financial transactions in amounts under
According to court records, Toups and his co-defendants were part of the Explosive Ordinance Disposal Expeditionary Support Unit One ("EOD ESU One"), based in
DEFENDANT ... 18CR1674-JLS
RELATED CASES
Dr.
SUMMARY OF CHARGES
Toups:
18 U.S.C. Sec. 1349, Conspiracy to Commit Wire Fraud
Maximum Penalty: Twenty years in prison,
Others:
18 U.S.C. Sec. 1349, Conspiracy to Commit Wire Fraud
Maximum Penalty: Twenty years in prison,
18 U.S.C. Sec. 1343, Wire Fraud
Maximum Penalty: Twenty years in prison,
18 U.S.C. Sec. 287, Making a False Claim
Maximum Penalty: Five years in prison,
AGENCIES
Naval Criminal Investigative Service
*The charges and allegations contained in an indictment or complaint are merely accusations, and the defendants are considered innocent unless and until proven guilty.
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Original text here: https://www.justice.gov/usao-sdca/pr/former-us-navy-service-member-sentenced-2-million-insurance-fraud-scheme
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