No jail for insurance fraudster

Law doesn't provide for prison sentence

Courthouse building in downtown George Town

A woman who took out health insurance for her workers, only to cancel the policies after their permits were granted, was sentenced to community service, much to the dismay of the judge who wanted to jail her.

In handing down the sentence, Magistrate Angelyn Hernandez expressed her frustration that the Health Insurance Act did not allow for a prison sentence in the case.

Appearing before the Summary Court on Monday, 8 Aug., Krishelle Edwards, 27, listened in silence as prosecutor Kenneth Ferguson detailed the fraudulent scheme.

“In order to secure work permits for her employees, the defendant needed a certificate of insurance that would last the duration of the work permit for each employee,” said Ferguson. “So, prior to submitting the application she went to an insurance company, paid for the first month and got policies put in place for each employee. She then submitted the certificates to WORC. However, as soon as the permits were granted, she either didn’t make the remaining payments or she cancelled the policies.”

Ferguson told the court that when it was time to renew the work permit Edwards would move to a different insurance provider, and did so for the past six years, “until the system caught up to her”.

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He added, “This was a relatively sophisticated system that went undetected for several years.”

Edwards was charged with four counts of failing to effect a standard health insurance contract, each of which she pled guilty to at a prior court appearance.

Section 5 (2) of the Health Insurance Act (2018 Revision), under which Edwards was charged, states “every employer shall effect and continue on behalf of (c) each of his employees; and (d) the dependants of each of his employees, a standard health insurance contract”.

Judge: Defendant should have gone to prison

When passing sentence, Hernandez told Edwards she was “frustrated at not being able to send her to prison”.

“We need to stop this taking advantage of vulnerable persons,” said Hernandez. “This was a case of deliberate offending over a period of 61 months and is a breach of our laws in a way no employer should behave.”

She added, “The persons most affected by this are the vulnerable foreign workers, who come here to make an honest living only to be taken advantage of by persons like you.”

Edwards told the court that, despite her guilty pleas, she had in fact not done anything wrong, that she had given the insurance money to the employees, who in turn failed to make additional monthly payments.

Hernandez told Edwards it was her responsibility to make the payments and that ultimately her actions were a poor reflection of the wider society.

“The only way to deter other like-minded individuals is to properly criminalise such behaviour,” said Hernandez.

Although the Health Insurance Act does set out imprisonment as a potential sentence, this is only in cases where an unauthorised person or company issues health insurance contracts. All other breaches of the law attract penalties of a fine of $30,000 for Summary Court convictions and a fine of $40,000 for Grand Court cases.

“This is very frustrating for me as a sentencing judge to not be able to send you to prison for such a significant breach of the law,” said Hernandez. “You knew that what you were doing was socially, morally, and economically wrong, yet you still did it. What’s more, I cannot fine you, because you do not have the money to pay a fine, yet you are still allowed to get a trade and business licence.”

She added, “You should not be allowed to have a business, and for the life of me I do not understand how it is possible that you have been granted one.”

The only sentence available to Hernandez was that of community service, of which the maximum sentence is 240 hours to be completed in two years.

“The judgment of this court is that you are to serve the maximum term of community service, but it is to be completed in 12 months,” said the judge.