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Fraud case files
Marquette woman keeps ex-husband on insurance after divorce
An anonymous caller contacted the Blue Cross Blue Shield of Michigan Anti-Fraud Hotline in 2007 reporting that a woman had kept her ex-husband on her health care benefits after the couple divorced in 1992.
The Blues investigated and discovered that it had paid claims totaling $849,868.94 for the ex-husband after the divorce. The Blues turned the case over to the Marquette Police Department for further investigation. During the investigation, the woman claimed she and her ex-husband had remarried, but no court records of a second marriage existed. It was also discovered that the woman had embezzled between $50,000 and $100,000 from her employer.
The information on both the health care fraud and embezzlement cases was submitted to the county prosecutor's office, and the woman was charged with embezzlement. However, she was not charged with health care fraud. In August 2009, the woman received 12 months probation, was ordered to reimburse her former employer and forfeited the rights to her pension.
The Blues is pursuing a civil suit against the woman since she was not charged with health care fraud.
Blues members who suspect health care fraud are urged to call the Blues Anti-Fraud Hotline at 1-800-482-3787, or report fraud through this website.
