Kenyan man Oscar Simon Ndereva is now facing over a 20-year jail term after he was arrested for allegedly defrauding Insurance firms in the US up to Ksh111.5 million ($1 million).
As reported by Nation Africa Ndereva is facing multiple charges including impersonation, use of fake driving license as well as wire fraud which saw him run his syndicate since 2015.
In a statement issued by the authorities, Ndereva is believed to have used the identity of another Kenyan identified as JK who fled the country in 2005 to open a pharmacy that would see him run his con business.
The court documents further reveal how Ndereva duped several insurance companies by sending them 780 claims with a demand of over Kh500 million ($5 million).
In a calculated move to draw away suspicion the accused opened several bank accounts and registered companies using a fake driving license.
Ndereva used to send bills of insured clients to the respective insurance companies to cover the medicines issued to them.
Investigations however reveal that the clients in question were non-existent and several agencies fell trap for his scheme since they paid the bills.
“From in or around 2015 to the date of this indictment, in the Eastern District of Texas and elsewhere, Ndereva devised… a scheme and to defraud BlueCross Blueshield and to obtain money by means of materially false and fraudulent pretense, representations and promises.
“Beginning in or around August 2019 and continuing to around January 2020, Mr Ndereva, under the guise of Healogix (the pharmacy), submitted fraudulent claims to commercial health insurance payers requesting payment for services and medication allegedly prescribed by doctors and provided to patients,” stated the prosecution in Texas Courts.
“However, the medication identified on the Healogix claims submitted to the taxpayers were never prescribed by a physician and never delivered to the people listed on the claims,” reads documents from the prosecution.