Kauai dentist ordered to pay more than $20K in restitution for insurance fraud

Kauai dentist ordered to pay more than $20K in restitution for insurance fraud

HONOLULU (HawaiiNewsNow) - A Kauai dentist has been ordered to pay more than $20,000 in restitution for committing insurance fraud, a judge ruled earlier this week.

The Department of Commerce and Consumer Affairs Insurance Division said Dr. Terry Allen, the former owner of the Kalaheo Dental Group, manipulated names while billing insurance providers for patient services, resulting in a higher payment than what was earned.

The state says Allen, along with his officer manager Diane Maldonado, pulled of various types of fraud.

In their schemes, insurance companies for patients with dual coverage were each billed as the primary insurer for services. This resulted in over payment with Allen failing to issue refunds.

In another fraudulent plan, Maldonado used her niece's dental plan to pay for services rendered to her niece's boyfriend.

Allen, who was a non-HMSA participating member, used the names and numbers of HMSA dental associates to charge the insurance company for work. This also led to payment higher than what he would have received as a non-HMSA member.

"Insurance fraud is not a victimless crime and offenders come from all walks of life. Insurance companies suffer the loss but ultimately the consumers are affected with the rise of premiums," the state said in a news release.

State Circuit Judge Kathleen Watanabe sentenced Allen to a four-year term of deferral and ordered him to pay $20,878.86 in restitution to HMSA. He was also ordered to pay a $2,500 fee to the Crime Victims Compensation Fund along with other court fees.

Maldonado, who was sentenced in July, was also placed on a four-year deferral status and ordered to pay more than $3,400 in restitution and other fees.

Allen has since sold Kalaheo Dental Group.

To report suspicious activity or for more information on insurance fraud, call the Insurance Fraud hotline at (808) 587-7416.

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