Crooked Insurance Agent Stays in Jail

It’s Not Nice to Sell Fake Policies and Tamper with Witnesses

Patricia Sledge created fake AFLAC policies and claims and profited, as an agent of AFLAC, in amounts exceeding four million dollars. She was caught, tried before a jury, convicted and sentenced.

ImUnited States of America v. Patricia Diane Smith Sledge, No. 17-50363, United States Court of Appeals for the Ninth Circuit (March 11, 2019) Sledge appealed from her jury conviction and sentence for mail fraud, in violation of 18 U.S.C. § 1341, and witness tampering, in violation of 18 U.S.C. § 1512(b)(3). Sledge, a sales associate for American Family Life Assurance Company (“AFLAC”), orchestrated a large-scale insurance fraud scheme.

FINDINGS

There was sufficient evidence to support Sledge’s two witness tampering convictions. The statute prohibits, among other things, attempting to “corruptly persuade” a witness to lie to investigators. This language encompasses non-coercive attempts to persuade witnesses to lie to investigators. Viewing the evidence in the light most favorable to the prosecution, a rational trier of fact could have found that Sledge attempted to corruptly persuade the two witnesses to lie to investigators.

The district court did not abuse its discretion by admitting Exhibit 1, a spreadsheet summarizing the insurance policies and claims generated by Sledge that AFLAC identified as fraudulent. AFLAC analyst Susan Gonzales testified that she created the spreadsheet, which pulled data from an AFLAC database of policy and claims information, at the request of an AFLAC investigator as part of the company’s internal investigation. Contrary to Sledge’s contention, Gonzales had personal knowledge of the spreadsheet as its creator. Gonzales’s lack of personal knowledge about whether the summarized policies and claims were in fact fraudulent affects the weight of Exhibit 1, not its admissibility.

Further, admission of Exhibit 1 did not violate Sledge’s Confrontation Clause rights because the spreadsheet was not based on any hearsay from the AFLAC investigator. Gonzales only mentioned the investigator to explain why she prepared the spreadsheet (i.e., its effect on the listener), not for the truth of any statement by the investigator.

The prosecutor did not engage in misconduct by referring to Exhibit 1 in closing argument. The record shows that the prosecutor correctly described Exhibit 1 as summarizing the policies and claims that AFLAC had identified as fraudulent. Moreover, aside from AFLAC’s identification, there was independent evidence in the record supporting the notion that the policies and claims listed in Exhibit 1 were in fact fraudulent.

Finally, during sentencing, the district court did not clearly err in finding that the amount of loss attributable to Sledge’s fraudulent scheme was over $4.1 million, resulting in an 18-level enhancement under. Likewise, the court did not clearly err in ordering restitution of over $4.1 million under the Mandatory Victims Restitution Act of 1996.

ZALMA OPINION

Sledge defined, by her actions, breach of the covenant of good faith and fair dealing, by cheating her employer, AFLAC, as an agent and claimant. Her jail sentence and restitution order should give her much to think about as she sits in her room at the gray bar hotel.


© 2019 – Barry Zalma

This article, and all of the blog posts on this site, digest and summarize cases published by courts of the various states and the United States.  The court decisions have been modified from the actual language of the court decisions, were condensed for ease of reading, and convey the opinions of the author regarding each case.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant  specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 50 years in the insurance business. He is available at http://www.zalma.com and zalma@zalma.com.

Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.

Over the last 51 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals.

Passover Seder for Americans

Passover is one of the many holidays Jewish people celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the Passover Seder for Americans: An All English - Easy to Perform - Passover Seder by [Zalma, Thea, Zalma, Barry]mountains, the rain, sun, the planets, the stars, and the people and wonder how did all these wonderful things come into being?

All Jewish fathers are required to teach their children, at least once a year at the Passover holiday, about the exodus from slavery in Egypt. For American Jews who have difficulty understanding Hebrew and complicated books describing the Exodus, my wife and I wrote this book to use for our own Seder where each member of the family reads part of the book.

Available as a Kindle book or a paperback at here.

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About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.
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