Author Archives: Mark J. Rose, Esq.

Insurance Companies Are Using Drones Instead of Insurance Adjusters

According to a July 24, 2015 article in the Boston Business Journal, the Federal Aviation Administration (FAA) granted Liberty Mutual Insurance permission to use four types of drones of varying sizes with several conditions regarding the use of the drones. The drones cannot ascend more than 400 feet off the ground and travel no more than 100 miles per hour. The FAA stated that the drones are small and do not weigh more than 55 pounds.

Liberty Mutual Insurance plans to use these drones to photograph houses and businesses damaged by fires or natural disasters for some claims, in place of manned planes or adjusters on ladders.  According to spokesman Glenn Greenberg, Liberty Mutual plans to begin using the drones later this year “on a limited basis.” The drones will initially be used to inspect sites damaged in hurricanes and other large-scale natural disasters, which will help adjusters assess a wide area of damage in a relatively short amount of time.

According to Liberty Mutual, the drones will help protect and keep their claims adjusters and contractors safer since they will not have to risk piloting planes or falling off ladders during roof inspections. Greenberg stated that “they are very excited by this technology that helps our claims professionals more safely help our customers after a loss.” The drones will also provide the insurer with higher-quality photos.

State Farm and AIG have recently received FAA approval to use drones as well. The FAA is asking that the insurance companies have both a visual observer and a pilot with a commercial, private, or other flying certificate to monitor the drone’s flight.

Click here for article.

http://www.roiglawyers.com

Comments Off on Insurance Companies Are Using Drones Instead of Insurance Adjusters

Filed under Technology

South Florida Men Arrested For Insurance-Billing Fraud

On August 5, 2015, four South Florida men were arrested for their alleged involvement in insurance- billing fraud cases. According to The Florida Department of Financial Service’s Division of Insurance Fraud (DIF), they have been accused of orchestrating crashes and processing phony claims roughly totaling $145,000.

The first individual arrested was Nayef Casas Diaz, the owner of M&N Rehabilitation Center in Miami. According to DIF, Casas was charged for conspiring with bystanders to crash cars, call the police, and collect insurance money. There are suspicions that he paid the participants $1,000 each to receive treatment at M&N Rehab and another rehab facility.  The insurance company paid a total of $63,000.

The second and third individuals arrested Alexis A. Gonzalez and Erik A. Perez, directed an undercover state insurance-fraud agent to pose as a patient and sign documents for treatment that was never carried out. The undercover agent was given $1,000 compensation while the total arrangement produced over $11,000 in claims.

According to the State of Florida, the last offender, Vicente Ortiz Alpizar, was arrested for staging an accident resulting in over $70,000 in false claims. He is accused of receiving $1,500 from A&J Rehabilitation Center and D&J Rehabilitation Center in Miami, FL and received unnecessary treatments following these staged accidents.

Click here to read press release from the Florida Department of Financial Services.

Comments Off on South Florida Men Arrested For Insurance-Billing Fraud

Filed under auto insurance fraud, Insurance Fraud

Roig Lawyers Attorneys Present on Regulatory Compliance

Roig Lawyers, a minority-owned, multi-practice litigation law firm dedicated to serving clients across six offices throughout Florida, is pleased to announce that Jessica Z. Martin, Partner (Deerfield Beach), and Dennis LaRosa, Healthcare Policy Advisor (Tallahassee), will present a program on August 11, 2015 to a national insurance carrier’s SIU Team in Orlando covering regulatory compliance as it relates to insurance defense.

“At Roig Lawyers we believe that continually updating and educating our lawyers is one of the most important aspects of a comprehensive PIP defense.  It is even more important that SIU’s stay on the cutting edge of new and innovative issues so that cases that come to defense counsel utilize the most current thought in the industry,” said Martin.

The presentation will cover specific topics such as medical director responsibilities and the implications of clinic licensing, and exemptions under current and newly enacted legislation together with innovative ideas in defending insurance law suits.  In recent years, regulatory compliance has become a significant tool for auto insurers in fighting personal injury protection fraud and abuse. It will also cover recent case law regarding Section 627.736(6)(b) requests for pre-suit discovery, and other investigative tools to obtain information regarding whether a clinic is operating lawfully.

Martin has been practicing since 2006 defending Personal Injury Protection (PIP)/No-Fault, bodily injury and uninsured/underinsured litigation and aiding insurance carriers with fraud (SIU) investigations, through Examinations Under Oath (EUO), Section 627.736(6)(c) Petitions/Motions for Discovery, and leading affirmative litigation against fraudulent medical providers. Martin is a skilled trial attorney and is also experienced in the use of alternative dispute resolution techniques, including mediation and arbitration, as a means of litigation avoidance. Martin joined the firm in 2002, became a licensed attorney in 2006, and the first female partner in the firm in 2009.

LaRosa has over 40 years experience in state licensing, including 10 years as a supervisor at the Agency for Health Care Administration implementing and overseeing health care clinic licensure and exemptions. LaRosa is a sought after speaker in discussing the relationship between state licensing and automobile insurance having made presentations to the Florida Bar, National Insurance Crime Bureau, the International Association of Special Investigative Units, attorneys and judges and has been a witness in numerous federal criminal and civil cases dealing with this subject.  While a practicing attorney, he prosecuted scores of administrative law cases, appeals, and represented the State of Florida in both state and federal courts on diverse issues ranging from taxation, state licensing, and environmental law to admiralty.  He has been a healthcare policy advisor with Roig Lawyers for the past two years.

About Roig Lawyers

Roig Lawyers is a multi-practice Florida Litigation firm with an unfaltering growing presence in the legal market celebrating 15 years of service, with more than 100 attorneys in 6 offices in Deerfield Beach, Miami, Orlando, West Palm Beach, Tampa, and Tallahassee. Roig Lawyers offers unparalleled legal representation in the areas of commercial litigation, construction, community association law, corporate law, real estate, banking and finance, immigration, labor and employment, and all phases of insurance defense litigation.

For more information about Roig Lawyers, visit www.roiglawyers.com.

Comments Off on Roig Lawyers Attorneys Present on Regulatory Compliance

Filed under Health care, insurance defense, PIP/No Fault

Roig Lawyers Tampa Attorney to Present “Emerging Trends in PIP SIU”

Roig Lawyers attorney Miguel R. Roura will present “Emerging Trends in PIP SIU” to a national insurance carrier in Tampa on August 5, 2015.

The presentation will educate adjusters on recent SIU trends, help identify fraud, and discuss various investigative tools used to fight fraud. Also, the presentation will review caselaw which will aid adjusters in determining what issues and facts create a solid or weak defense.

Miguel concentrates his practice in the areas of Personal Injury Protection (PIP)/No-Fault litigation and fraud (SIU) investigations. He also defends clients in cases involving bodily injury, uninsured motorist, property damage, and general liability litigation. The identification and investigation of fraudulent claims represents a significant portion of Miguel’s practice.

Miguel is a graduate of Stetson University College of Law (J.D., 2008) and the University of Florida (B.A., 2004).

About Roig Lawyers

Roig Lawyers is a multi-practice Florida Litigation firm with an unfaltering growing presence in the legal market celebrating 15 years of service, with more than 100 attorneys in 6 offices in Deerfield Beach, Miami, Orlando, West Palm Beach, Tampa, and Tallahassee. Roig Lawyers offers unparalleled legal representation in the areas of commercial litigation, construction, corporate law, real estate, banking and finance, labor and employment, and all phases of insurance defense litigation.

For more information about Roig Lawyers, visit www.roiglawyers.com.

Comments Off on Roig Lawyers Tampa Attorney to Present “Emerging Trends in PIP SIU”

Filed under Insurance Fraud, Personal Injury Protection, PIP/No Fault

U.S. Court of Appeals Agrees to Hear Florida PIP Case

The U.S Court of Appeals for the 11th Circuit in Atlanta has agreed to consider an appeal of a lower-court decision in Florida on whether drivers in Palm Beach County and across Florida should be granted class-action status in their claim against Hospital Corporation of America (HCA) Hospitals who are allegedly grossly overcharging for services under the state’s PIP/No-Fault insurance system.

According to a recent blog post on PalmBeachPost.com, the lower court decision in Florida stated the drivers could pursue cases individually against HCA Hospitals but not as a group. The plaintiffs in the case allege that the hospitals are draining Personal Injury Protection (PIP) benefits by charging up to 65 times what Medicare pays.

Click here to read the blog post.

www.roiglawyers.com

Comments Off on U.S. Court of Appeals Agrees to Hear Florida PIP Case

Filed under Personal Injury Protection, PIP/No Fault

Florida Couple Accused of Allegedly Lying About Sinkhole to Homebuyer

On July 16, 2015, a Spring Hill couple was accused of lying about a sinkhole to a homebuyer, according to a news article by ABC news. Glenn Jasen, 64, and Katheryn Jasen, 63, were indicted on a charge of wire fraud, which is a federal felony. If convicted, they each could face a maximum of 20 years in prison, according to U.S. Attorney A. Lee Bentley III.

According to the indictment, the Jasens found a sinkhole on their property and made a claim to Citizens Insurance. Instead of repairing the sinkhole the Jasens deposited the insurance check for an undisclosed amount into a bank account, as stated by the U.S. attorney’s office.

The Jasens then put the home up for sale, and in the real estate disclosures given to the purchaser of the house, they failed to disclose the sinkhole and the claim on the property, according to the indictment.

Please click here to read news article.

Comments Off on Florida Couple Accused of Allegedly Lying About Sinkhole to Homebuyer

Filed under Insurance Fraud

Uber Leases Office Headquarters in Miami

Uber has chosen to open its Miami headquarters at Brickell City Tower. According to the South Florida Business Journal, Uber has signed a 9,333-square-foot lease in the 33-story tower at 80 S.W. 8th Street, which is located near Mary Brickell Village.

The ride-sharing service is currently operating in Miami-Dade County. Miami-Dade County Mayor Carlos Gimenez has expressed support for Uber and has stated that it should be specifically addressed by county regulations that do not hinder the business. However, Uber has announced that it will halt service in Broward County on July 31st because it said new regulations there imposed great difficulties on its business.

Uber’s new Miami headquarters reveals the companies’ plans to remain a key player in the Miami market.

Click here to read news article.

www.roiglawyers.com

Comments Off on Uber Leases Office Headquarters in Miami

Filed under Fla. Stat. 627.736 (2008)