Category Archives: Fla. Stat. 627.736 (2008)

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)

GEICO and the Florida Department of Transportation Announce Partnership Against Distracted Driving

On June 1, 2015, the Florida Department of Transportation (FDOT) announced a partnership with GEICO Insurance to help curb the issue of distracted driving on Florida’s roadways. According to the announcement, sixty-four different “Safe Zones” are being created at different rest areas, welcome centers, and turnpike service plazas. “Safe Zones” are to be used by drivers for calling, texting, and accessing mobile apps.

“Motorist safety is our top priority and we are committed to reducing distracted driving on our roads,” stated Brian Blanchard, FDOT Assistant Secretary for Engineering and Operations. According to the Florida Highway Patrol, distracted driving accidents in Florida have increased 25 percent since 2012.

GEICO is sponsoring the addition of new signage along highways directing drivers to rest areas, welcome centers, and turnpike service plazas in order to remind drivers to use the “Safe Zones.”

“Distracted driving is a major concern for motorists in Florida and across the country. Each year, there are a growing number of injuries and fatal accidents directly related to this issue,” said George Rogers, GEICO Regional Vice President.

Click here to read news release.

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Filed under Fla. Stat. 627.736 (2008)

Separate PIP Fraud Cases Lead to Two Miami Arrests

Two individuals from Miami who have allegedly been involved in personal injury protection (PIP) fraud schemes have recently been arrested by the Division of Insurance Fraud (DIF) in separate cases.

Ariel Santana was arrested after he was revealed to be the owner of A & J Rehabilitation Center, a PIP clinic located in Miami, that illegally submitted more than $350,000 in fraudulent claims to various insurance companies, according to a press release issued by the Florida Department of Financial Services’ Division of Insurance Fraud.

DIF’s investigation found that Santana hired chiropractor Peter Maffetone to operate as the clinic’s straw owner and fraudulently obtained a licensure exemption from the Agency for Health Care Administration which resulted in the clinic operating without a license for more than three years. Santana and Maffetone submitted fraudulent claims totaling nearly $367,000 to four insurance carriers: Esurance, Geico, Progressive and United Auto.

Raul Antonio Perez Payes was apprehended, in an unrelated case, after DIF detectives discovered that he organized a staged car accident in August 2012. According to investigators, Payes recruited and paid accomplices to participate in the scam, which resulted in fraudulent insurance claims totaling more than $86,000.

Both cases will be prosecuted by the office of Miami-Dade County State Attorney Katherine Fernandez Rundle.

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Filed under Fla. Stat. 627.736 (2008)

Pilot program of self-driving cars comes underfire

It has come to light through an investigation conducted by the Associated Press that four of the 48 self-driving cars on California’s roads have been involved in four accidents since September 2014. In a recent article published on Quartz.com, two of the accidents occurred while the self-driving vehicle was driving, and the other two accidents occurred while the human safety driver was in control.  The two companies responsible for the self-driving vehicles were Google and Delphi. Google’s Director of self-driving program, Chris Urmson, revealed that the tech giant’s fleet has experienced 11 minor accidents in 1.7 million miles in six years since the driverless car program began.

The AP reported that the national rate for reported “property damage only crashes” is about 0.3 per 100,000 miles driven, according to data from the National Highway Traffic Administration.  If one uses this statistic and compares Google’s crashes in about 140,000 miles the crash rate seems high.

The self-driving car program is required to submit data to the California Department of Motor Vehicles; however this information has not been readily released to the public based on the state’s Vehicle Code which requires accident reports concerning traffic injuries or fatalities to remain confidential.

Many believe that as a matter of public policy the government does not want to reveal to much information since they do not want these tech companies to be put under a microscope while this program is still in its testing phase.

The self-driving car program has yet too prove to be as flexible and responsive as humans on the road in dealing with unpredictable situations on the road.

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Filed under Fla. Stat. 627.736 (2008)

Insurance agent sentenced for 8 years for racketeering

On May 12, State Attorney Bill Eddins announced the arrest of Randall Peterson. Peterson was a Cantonment insurance agent who conducted a fraudulent insurance scheme while operating under multiple business names which involved the theft of several hundred thousand dollars of commissions and bonuses from American National Insurance Company and Liberty National Insurance Company.

Peterson’s scheme began with him advertising job opportunities on the Internet for his fictitious company, College Consultants of the Gulf Coast. He then had hundreds of applicants provide information for life insurance which  he and his associates expressed to the job applicants as a free job benefit. The prosecutor’s office showed that Peterson used the information from the job applicants to complete life insurance applications that he submitted to the insurance companies in order to receive advanced commissions, which were as much as 130 percent of the first year premiums and bonuses.

Randall Peterson was found guilty of racketeering and money laundering by Circuit Court Judge Ross Goodman.  The state will request at a future hearing that restitution be set at an amount over $500,000.

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Filed under Fla. Stat. 627.736 (2008)

Three Arrested in Lauderdale-by-the Sea PIP Scam

On May 6, 2015, the Florida Department of Financial Services’ Division of Insurance Fraud announced the arrest of three Broward County men on charges of insurance fraud. The men reportedly collected more than $77,000 in insurance payments after staging a Lauderdale-by-the-Sea car crash, recruiting and paying people to feign injuries and undergo unnecessary therapy.

Ronie Petidos, 34, of Coral Springs, Patrick Logene, 39, of Fort Lauderdale, and Marc la Pierre, 27, of Coconut Creek, each face a single count of insurance fraud. Each of these felony charges carries a maximum penalty of 15 years in prison.

The arrested individuals staged an automobile accident using a hotel van filled with passengers who participated in the scam and sent the participants to clinics that they controlled.  The arrested van passengers include Shaeronda Jackson, Kennsly Giles and Jeffrey Louis of Fort Lauderdale, Jean Regisma of Lauderhill, Stephen Blanc of Lauderdale Lakes.

Ronie Petidos and Marc La Pierre were previously arrested in 2014 for their role in another staged accident that occurred in 2012. The criminal case is still pending in Broward County Court.

Clink on the link for the Florida Department of Financial Services announcement.

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Filed under Fla. Stat. 627.736 (2008)

Allstate battles in Appellate courts

Allstate is under fire in various courts addressing the language of its policy following the Florida Supreme Court’s ruling in Geico Gen. Ins. Co. v. Virtual Imaging Services, Inc., 141 So.3d 147 (Fla.2013). In Virtual Imaging, the Court ruled in favor of Virtual Imaging finding that GEICO had not made the election in the policy that they would use the Medicare fee schedules of Florida’s PIP statute to reimburse the medical providers.

Multiple appellate courts have been asked to address the issue of the language in Allstate Insurance Co.’s policy regarding its election to use the Medicare fee schedules to limit benefit reimbursements. The various Appellate courts are addressing the following question: “Did Allstate provide the requisite notice that it would use the fee schedule payment limitations authorized by Subsection 5(a)(2)?”

The following cases are under review throughout Florida’s Appellate courts:

Allstate v. Stand-Up MRI

Case No. 1D-14-1213

First District Court of Appeal

This case includes several consolidated county court appeals. Allstate is the Appellant, and former Judge Gary Farmer represents the Plaintiffs. The First DCA ruled in favor of Allstate in March (see earlier post titled, 1st DCA Upholds Allstate Use of Medical Fee Schedules). On April 24, the First DCA denied Appellee’s April 2nd motion for rehearing, rehearing en banc and certification.

Allstate v. Markley Chiro.

Case No. 2D-14-3818 in the Second District Court of Appeal on cert. question of great public importance

Allstate is Appellant

The case was fully briefed in February, 2015 and argument is requested.

Fla. Wellness v. Allstate

Case No. 3D-15-0151

Third District Court of Appeal

There are five consolidated county court appeals. Allstate is the Appellee. Marlene Reiss represents the Plaintiffs/Appellants. The briefing has not yet begun.

Ortho. Specialists v. Allstate

Case No. 4D-14-0287

Fourth District Court of Appeal

There are several consolidated county court appeals. Allstate is the Appellee. Former Judge Gary Farmer represents the Plaintiffs. The appeal was argued on April 14th.

Florida Wellness v. Allstate

Case No. 15-11590

The U.S. Court of Appeals for the Eleventh Circuit

The federal district court’s summary judgment order is being appealed by Plaintiff South Florida Wellness. Allstate is the Appellee. The briefing has not yet begun.

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Filed under Case Law, Fla. Stat. 627.736 (2008)