DOI Division of Insurance Fraud investigation works to keep Kentucky consumer costs low

FRANKFORT, Ky. — The Division of Insurance Fraud Investigation of the Kentucky Department of Insurance (DOI) completed a 19-month investigation resulting in the fraud conviction of two Jefferson County women on Oct. 8 by the Jefferson Circuit Court. Former insurance agent Adley Riley, 27, and roommate Kharis Montgomery, 28, pled guilty to multiple felony and misdemeanor counts of insurance fraud, totaling $50,939.99.

DOI fraud investigators began investigating Riley and Montgomery in July of 2017 after AFLAC reported the suspected fraud. Riley used her position as an AFLAC agent to submit false claims by creating dozens of fake accounts and paying for polices from her personal bank account. Riley’s fraudulent claims totaled $32,276.99. Riley also helped Montgomery file several fraudulent insurance claims and split the proceeds with Montgomery. Montgomery received $18,660 in fraudulent claim payouts.

“Insurance fraud increases costs for providers which ultimately raises consumer insurance rates” said DOI Commissioner Nancy Atkins. “Kentucky Department of Insurance investigators work diligently to investigate suspected fraud to protect the interests of Kentuckians in the insurance market.”

Riley pled guilty to three felony counts of Theft by Deception Over $500, 11 felony counts of Fraudulent Insurance Acts Over $500, and two misdemeanor counts of Fraudulent Insurance Acts Under $500. She was sentenced to five years’ probation, 180 days of home incarceration, and ordered to pay back a total of $41,609.99 in restitution.

Montgomery also pled guilty to one felony count of Theft by Deception Over $500, three felony counts of Fraudulent Insurance Acts Over $500, and one misdemeanor count of Fraudulent Insurance Acts Under $500. She was sentenced to two years’ probation, 30 days in jail, and 60 days home incarceration. She also must pay $9,330 in restitution.

DOI investigates an average of 300 fraud cases each year, and encourages consumers and insurance companies to report suspected insurance fraud by completing DOI’s complaint form, http://insurance.ky.gov/ppc/static_info.aspx?static_id=1.

The Department also recommends that Kentucky consumers utilize the Department’s licensee search function to confirm the license status of agents and agencies, http://insurance.ky.gov/ppc/Agent/Default.aspx.