Two former employees of Aetna in Jacksonville, Rochell Green, 40, and Breana Ferguson, 34, have been arrested for orchestrating an elaborate insurance fraud scheme that defrauded the company of more than $1.1 million. The fraud, which spanned from 2019 to 2023, involved submitting at least 42 false insurance claims, along with fabricated supporting documents, according to the Florida Department of Financial Services.
Green and Ferguson, both of whom worked for the health care insurer, were arrested after warrants were issued on October 22. Green was apprehended on October 25, while Ferguson was taken into custody on November 8. The fraudulent activities were discovered following a months-long investigation, which began in February 2023.
During the course of the scheme, Green collected over $408,000, while Ferguson received more than $736,000. The pair reportedly submitted fake medical invoices and bogus explanations of benefits for non-existent procedures. These forged documents helped to support their fraudulent claims, which involved insurance plans that had no basis in reality, as the supposed treatments never took place, nor did the patients ever receive care.
According to the Florida Chief Financial Officer, Jimmy Patronis, Green initially started the fraud in 2019 and later recruited Ferguson in 2021, offering her a share of the illicit profits in exchange for her involvement. Both were charged with multiple counts of insurance fraud, which could result in severe legal consequences.
This case underscores the ongoing efforts by Florida’s Department of Financial Services to combat insurance fraud and protect consumers from deceitful practices.
