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OCI Special Agents Bust Insurance Fraud Crime Ring

Amber Miles, Ashley Simmons, Tyria King, and Shermekia Owens

Insurance and Safety Fire Commissioner John F. King announced that agency investigators have busted an insurance fraud crime ring led by a former AFLAC Insurance employee.

Pro Roof GA

In May of 2018, Amber Miles, the 32-year-old ringleader, began submitting multiple claims to AFLAC for various medical treatments at multiple facilities. Between then and April of 2021, Ms. Miles filed 52 different claims and submitted 36 forged documents as evidence. Using her knowledge of the company’s processes, Ms. Miles procured more than $21,000 over the course of three years.

Ms. Miles encouraged and assisted three other suspects, Ashley Simmons, Shermekia Owens, and Tyria King, in following her footsteps. The three women submitted several fraudulent medical invoices to AFLAC for treatment neither they nor their families ever received, procuring nearly $18,000 across 19 individual claims.

“I am extremely proud of the Special Agents from our Criminal Investigations Division that have worked diligently to take this crime ring down,” said Commissioner King. “Insurance fraud hurts all Georgians by raising annual insurance costs and taking away payments from those who need it. Anyone with information on the suspects should call our Warrant Tip Line at 404-463-6363.

Warrants were taken out against each member of the group on May 19th in Muscogee County. They remain wanted at this time.

Suspected acts of criminal insurance fraud can be reported via our new online complaint portal. Alternatively, consumers may call our Fraud Tip Line at 404-463-0953.

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