Author Archives: Mark J. Rose, Esq.

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.

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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.

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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

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Filed under Fla. Stat. 627.736 (2008)

PIP Fraud Featured on A&E American Takedown

The newest series on A&E, American Takedown, goes behind-the-scenes of a year-long undercover investigation into an accused insurance fraud ring in Palm Beach, Martin, and Miami-Dade counties.  The show aired on A&E on Thursday, July 9, 2015, at 10 pm EST.

The episode followed the breakdown of the investigation of attorneys, chiropractors and clinic employees involved in recruiting, paying, and treating “patients” for injuries that did not exist following staged car accidents.  The investigation was known as “Operation Cold Call” which targeted a network of attorneys, doctors, and clinic employees in Boca Raton, Boynton Beach, Lake Worth, Hobe Sound, Stuart, and Homestead. Investigators from the state’s Department of Financial Services worked undercover and were embedded into the clinics that were accepting patients who were illegally solicited.

Click here to read the Department of Financial Services newsletter

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Filed under Insurance Fraud

Orlando PIP Clinic Owner Arrested for Defrauding Insurance Companies

Dr. Troy Godsey and Renata Berriel Deazevedo were arrested in connection with an illegal insurance scheme involving multiple insurance companies and totaling more than $100,000. Godsey, a licensed chiropractor, served as an owner of the clinic, and Deazevedo managed the day-to-day activities of the business.

According to the Florida Department of Financial Services, Godsey and Deazevedo ran Spine Health Solutions PA in Orlando, and provided medical treatments to people who were injured in car accidents. The pair billed insurance companies for reimbursements for “patients” under their Personal Injury Protection coverage. Three insurance companies were billed nearly $300,000 for the alleged treatment of 20 injured individuals.

They both face more than 50 years in prison if convicted under the felony charges, including operating an unlicensed health care clinic, and filing false and fraudulent insurance claims.

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Filed under Insurance Fraud

Jacksonville Clinic Owner Arrested for Racketeering and Insurance Fraud

Sandy Morales, who owned and operated Gate Parkway Diagnostic Center, has been arrested for racketeering and insurance fraud charges, as reported in a June 18, 2015 article by the Jacksonville Business Journal.

According to the Florida Department of Financial Services, Sandy Morales organized a complex Personal Injury Protection (PIP) fraud scam that resulted in over $100,000 in fraudulent filing claims for injuries in accidents which did not occur.

Investigators stated that Morales’ arrest is one of 180 arrests since September 2012 that are tied to the fraud network. According to the Division of Insurance Fraud, Morales elaborately staged multiple car accidents, paid people to pose as passengers, and then paid those individuals to seek treatment in his clinic for bogus injuries. Morales is also accused of recruiting other clinic owners to participate in the fraud, and sending patients to those clinics in order to increase the fraud network.

The clinics involved in the PIP scam, now closed, include:

  • Arlington Rehabilitation Services Inc.
  • Baymeadows Injury Center LLC
  • Health Point Injury Center LLC
  • One Touch Therapy Center Inc.
  • Saint Jose Injury Center LLC
  • Therapy Diagnostics Tech Medical Inc.
  • Wellness Rehab Services Inc.
  • Atlas Massage Therapy Corp.

Morales could face a maximum of 45 years in prison, and is currently being held in Duval County Jail with a bond of over $600,000.

Click here to read article.

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Filed under Insurance Fraud

Tampa Chiropractor arrested on Insurance Fraud Charges

Douglas Price was arrested for insurance fraud and three counts of patient brokering, according to a June 15, 2015 news story by ABC Action News. Investigators stated that Price had been under investigation for 8 months under suspicion of insurance fraud and patient brokering. Investigators focused on Price’s South Tampa and Auburndale clinics.

Price is accused of paying patients to seek unnecessary treatments at his clinics. According to investigators, Price would pay patients up to $1,000 each to seek unnecessary medical treatment at both clinics.

Investigators also arrested, Sonya Rivera, an employee of Price who is accused of recruiting patients, and assisting in the fraud.

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Filed under Fla. Stat. 627.736 (2008)