Category Archives: 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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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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Insurnace Fraud Sweep has resulted in 31 individuals charged

State Attorney Katherine Fernandez Rundle announced today at a press conference the success of “Operation Flames and Flood Two” which charged 31 individuals with insurance fraud.  According to the State Attorney’s Office the operation focused on public adjuster, Jorge Fausto Espinosa, who was hired by policy holders to damage the insured homes for the purpose to collect ill-gotten gains from insurance companies. Jorge Fausto Espinosa, who is already facing charges in a similar fraud case from last year, called “Operation Flames and Flood One”, deliberately staged fire and water damage claims to residential homes in Miami-Dade County, Lehigh Acres, and Naples.

“Operation Flames and Flood Two” focused on the expansion of Espinosa’s fraud activities through his Miami-Dade company, Nationwide Adjusters LLC, into the west coast of Florida into Collier and Lee counties. According to the State Attorney’s Office operation two involved 20 staged fires with loses close to $ 7 million. Several homeowners also face charges for their role in the fraud.

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Century Woman charged with Auto Insurance Fraud

The Florida Department of Financial Services Insurance Fraud Division charged Trisha Michelle Milstead a resident of Century, FL with one felony count of insurance fraud. Assistant State Attorney Greg Marcille stated that on September 8, 2014 Milstead was involved in a vehicle accident, but at the time her vehicle policy had lapsed for non-payment. She then reinstated her insurance policy on September 9, signing a statement that there had been no previous damage during the lapsed time period.  Two days after the policy was reinstated she filed a claim for the accident and damage associated.

Trisha Milstead remains in the Escambia County Jail with bond set at $10,000 and is scheduled for an arraignment hearing next month.

Click here for news article.

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Florida Insurance Fraud Education Committee (FIFEC) Conference

Roig Lawyers attorneys and healthcare policy advisor will speak at 23rd annual Florida Insurance Fraud Education Committee (FIFEC) Conference on June 12, 2015 in Orlando, FL.  Nelson C. Bellido, Dennis La Rosa, Miguel Roura, and Diego Arredondo will present “Mechanisms Available to Adjusters During Review for Regulatory and Compliance Issues”.  The presentation will focus on recent developments in the law, insurance adjuster review process for regulatory compliance issues, administrative regulation and the relationship to PIP under §627.732(11), and PIP amendments and licensing issues.

FIFEC is a non-profit corporation comprised of special investigative unit investigators, law enforcement personnel and dedicated individuals whose purpose is to organize and present an annual statewide educational seminar related to deterring, detecting, investigating and prosecuting insurance fraud. FIFEC is proud of its mission to provide insurance fraud education and training by giving grants to the law enforcement and criminal justice community that attend what is now known as the annual FIFEC Conference.

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.

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Jacksonville PIP Fraud Scheme Involved Staged Auto Accidents

Roxana Suarez La Rosa was arrested for PIP fraud, according to an April 28 release by the Florida Department of Financial Services’ Division of Insurance Fraud.

Suarez La Rosa owned and operated the Saint Jose Injury Center in Jacksonville that was behind a string of staged auto accidents, according to witnesses. Crash participants were asked to sign for medical services they never received, which were then billed to insurance companies. More than 50 insurance claims were generated in the alleged scam. Billing amounts were not disclosed.

If convicted, Suarez La Rosa faces up to 50 years in prison on racketeering and fraud charges. Additional cases against the medical clinic are pending.

The Office of the State Attorney in the 4th Judicial Circuit of Florida, which covers Duval, Clay and Nassau Counties, is handling the case.

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Operator of Unlicensed Orlando PIP Clinics Arrested

Josue Pierrissaint, 30, was arrested by the Florida Division of Insurance Fraud (DIF) for charges related to operating unlicensed Orlando PIP clinics earlier this year.

A string of three PIP clinics were opened by Pierrissaint from 2010 to 2012, as listed below.

  • Edgewater Chiropractic was first opened in 2010. It was based in Lockhart, Fla., located in Orange County northwest of Orlando. Chiropractor Sham Mohammed was named as the straw owner.
  • Dr. Wilson’s Straight Up Chiropractic was opened several months later by Pierrissaint in association with chiropractor Koteuaisa Wilson, who also served as the straw owner. The same Lockhart, Fla. address was used in the AHCA application. Wilson later left the clinic, which reportedly did not stop Pierrissaint from using her name.
  • Dr. Koteuaisa Chiropractic was next launched by Pierrissaint in 2012. The clinic was opened in Orlando without the knowledge or consent of Dr. Wilson, although her name was listed on the AHCA paperwork.

Collectively, the clinics were paid in excess of $425,000 by 16 insurance companies.

Pierrissaint, who is not a doctor, was also arrested early in 2014 on similar charges.

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