Victims want justice after insurance scam, 5 suspects indicted

Print
Email
|

by Adrianna Hopkins

WHAS11.com

Posted on March 24, 2010 at 10:40 PM

Updated Wednesday, Mar 24 at 11:56 PM

The Commonwealth Attorney's Office calls it a case of organized crime and insurance fraud. Five people have been indicted for allegedly selling people fake insurance policies.

The commercial touts Health PMO as a "simple low cost solution to get health care right here in Louisville."

The website says "Health PMO has designed a plan to get you the medical care you need."  And it claims to have over 5,000 physicians in the network.

Anna Ruth Seadler saw the commercial, was enticed and called the number.

"I'm out of work... so yes, I lost my insurance through work," said Seadler.

She says an agent with the company met with her and like the website says, he promised free doctors visits and prescriptions, just want Seadler was looking for.

"I thought for $124 a month, and doctors visits and blood work, I'd stay on top of my health," said Seadler.

Health PMO set her first doctor's appointment, as promised. Turned out, Seadler needed surgery and thinking she was insured, she went under the knife.

She says despite paying Health PMO's monthly premiums, she found out her insurer wasn't covering any cost of the surgery and when she called Health PMO, all of the phone numbers were bogus.

"No one would talk to me... I would get no answers from anyone," said Seadler.

Seadler says she's out of nearly $5000 between paying her insurance premiums and paying for the surgery.

Out of frustration she launched a complaint with the Kentucky Department of Insurance which investigated Sheri Datillo, William Jackson, Duane Jorgensen, Marcus Lucas and Stacy Allen Taylor for a year.

Wednesday, a grand jury indicted these five individuals with nearly 70 counts of fraudulent insurance acts, theft by deception and engaging in organized crime.

"There are 11 victims that paid over $300.  23 paid less than $300. They paid what they believed were their insurance premiums," said Stacy Greive, the Asst. Commonwealth Attorney.

We went to the last address listed for Health PMO where Seadler and others sent payments. The building has new ownership.  None of the numbers we called worked either.

"We prosecute a lot of insurance fraud cases. But in my time here, I've not seen a case like this one," said Greive.

Seadler says losing the money was a hard pill to swallow but justice would be just what the doctor ordered.

"I told the detective I am to the point where I don't care about the money, I just want them to spend time in jail."

 

According to state records, Health PMO closed it's doors in 2008. At one point they also had a kiosk at Jefferson Mall. 

WHAS11 News also learned the company allegedly stole over $16,000. We talked to the president of the Better Business Bureau, who says the company had a shady record with them from day one.

Mattingly said if you're looking to buy health insurance, check with the Better Business Bureau or call the Kentucky Department of Insurance to find out if the company is legit.

The individuals allegedly involved with Health PMO are set to be arraigned next week.

Print
Email
|