Fraud of the Month – April 2021

Father destroys family for insurance payout

BY ARINZE IFEKAUCHE | April 6, 2021

Ali F. Elmezayen was sentenced to 212 years in prison after driving himself, his ex-wife, and his two severely autistic sons off of a pier in Los Angeles. Elmezayen’s kids drowned to death in the backseat of the car. His ex-wife–– who couldn’t swim–– barely escaped with her life after a nearby fisherman threw her a flotation device.

Why would a 45-year-old father of three (his third son was away at camp) intentionally murder his family? Greed.

According to prosecutors, Elmezayen had just exited chapter 11 bankruptcy in 2012 when he began shopping for expensive life insurance policies for his wife and children. Between 2012 and 2013 Elmezayen bought eight policies totalling more than $3 million in accidental death and life insurance policies on himself and his family. Elmezayen was playing the long game.

He was willing to pay as much as $6,000 per year to maintain the policies. This was a significant investment for a man who reported a $30K annual income. Elmezayen wanted to be sure his scheme would pay off. So he made multiple calls to his insurers, sometimes posing as his ex-wife, to quiz them about the terms of the policies and inquire as to whether or not they would investigate accidental deaths two years after the policies went into effect. Those calls were recorded and were later used against him in court.

Elmezayen patiently waited for his murderous opportunity. Exactly two years and 12 days after enrolling in his most recent policy, he struck. Elmezayen was three years removed from bankruptcy and ready for a new life–– one that did not include his wife and children. He loaded up the car and headed to the Port of Los Angeles. Once he arrived at the port he drove the car into the ocean with the driver side window down. He swam to safety but made no effort to save his family.

After the “accident” two of his insurers paid him $260K. Elmezayen used the money to buy a boat and property in Egypt. By 2018 the FBI had arrested Elmezayen. He’s been incarcerated ever since. After his sentencing in March, he will spend the rest of his life behind bars.

Wolfe ran Regency Inc., a medical billing company she used to set up a series of fraudulent medical supply companies. She used Regency to falsify the documents necessary for her and her co-conspirators to use straw owners to procure and operate as many as 50 fly-by-night medical supply companies in the Tampa Bay-area. A local TV station investigated Wolfe’s activities, and found that DME offices tied to her criminal enterprise were routinely staffed with just a few employees and the office spaces were filled with hip, wrist, and knee braces. The recipients would then receive notification that the equipment had been billed to their Medicare or CHAMPVA plan.

According to court documents, Wolfe and her conspirators bribed doctors to approve unneeded equipment. Once the network was established, they billed more than $400M worth of claims to taxpayer funded plans –– justifying the enormous volume of claims as “telehealth visits.” Local seniors, unaware that they had been conscripted into the scheme, reported receiving medical braces in the mail that they never ordered from companies they’d never heard. The equipment was almost always from doctors to whom they’d never spoken. Wolfe’s DME companies were among the businesses raided in a nationwide fraud investigation entitled “Operation Brace Yourself.” Many of them shut down after the FBI raids. Wolfe’s tax charge stems from her admission to using Regency’s funds for personal items that did not qualify as legitimate business expenditures.

A former Regency employee turned whistleblower is entitled to 23% of the $20.3M False Claims Act lawsuit brought against Wolfe and her company. The suit resolves a number of claims that Regency violated the False Claims Act in a number of ways: including falsifying documentation in order to fraudulently establish DME corporations to bill for medically unnecessary DME equipment, and engaging in improper marketing practices that violated the Anti-Kickback Statute.

Wolfe faces a maximum penalty of 13 years in prison for her crimes. She is currently awaiting sentencing. 

Arinze Ifekauche is the Communications Director of the Coalition Against Insurance Fraud. He can be reached at arinze@insurancefraud.org.