Top insurance firm falls victim to scam

By DateLine Philippines

The National Bureau of Investigation (NBI) has asked the Department of Justice (DOJ)-Task Force on Business Scam to investigate a multi-million scam allegedly perpetrated by a municipal registrar, a sales agent, and several plan holder beneficiaries of Prudential Life Plans, Inc., one of the country’s top insurance firms.

In a 13-page complaint, the NBI’s Anti-Fraud and Action Division through its supervising agent, Ronald Aguto Jr., sought the prosecution of 13 individuals that reportedly benefited from spurious insurance claims filed with Prudential Life Plans, Inc.

They included Lourdes Bayangan, municipal civil registrar of Tabuk, Kalinga; Juliet Kotoken, sales associate of Prudentialife; and Genevieve Guerrero, Victoria Dy, June Dy, Margaret Batane, Lito Pagadeo, Roberto Bayangan, Felicitas Belandres, Fredalyn Buliyat, Irene Buliyat, Janet Olat, and Andrew Olat, all beneficiaries of life insurance policy holders.

Based on the bureau’s investigation the said beneficiaries filed insurance claims with Prudentialife from January 2003 to May 2004.

The accused submitted the required documents needed in filing an insurance claim including the plan holder’s death certificate, physician’s statement, plan contract, birth certificates of both the plan holder and the claimant.

Grepalife, the insuring company of Prudentialife, subsequently approved the claims on the basis of the death certificates and other documents and released the insurance benefits of the plans in the total amount of P18.58 million

However, Prudentiallife noticed in 2004 the unusually large number of insurance claims being filed by designated beneficiaries from a singular geographical area, particularly Tabuk, Kalinga.

This prompted the insurance firm to conduct a re-evaluation of the approved insurance claims and discovered a number of anomalies.

Further investigation conducted by Prudentialife in Tabuk, Kalinga showed that the death certificates and other documents submitted by the claimants were fabricated.

Prudentialife also discovered that Kotoken and Bayangan conspired in the fabrication of the death certificates, birth certificates, and marriage certificates to support the life insurance claims of the accused.

“The designated beneficiaries, with the complicity of Kotoken and Bayangan, employed deceit by making it appear that the plan holders are deceased… [They] fabricated the submitted death certificates to make it appear that the plan holders died beyond the contestability periods of the plans,” the NBI said.

Since the insurance claims should not have been approved, Prudentialife sent letters to the beneficiaries informing them that the full payment guarantee should not have been applied to the plans and that consequently, the plans are considered cancelled.

Prudentialife also demanded the return to the company of the amounts wrongfully released to the beneficiaries as insurance benefits.

Despite the demand, the accused failed to return the amount released to them. This prompted the insurance firm, through its supervisors Edgardo Reyes from the Plan Benefits Department-Insurance and Claims Section and Marlyn Alinio, Grepalife-Life Claims Section, to seek the help of the NBI.

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