Category Archives: Insurance Fraud

Miami D & J Rehabilitation Center Target of Another DIF Fraud Arrest

Yalily Clavero Ruiz is the latest to be arrested by the Florida Division of Insurance Fraud (DIF) in connection with deceptive activities at D & J Rehabilitation Center, a Miami clinic that was incorporated in 2009. According to DIF, the 34-year old manager is charged with insurance fraud, grand theft and organized scheme to defraud.

Clavero Ruiz allegedly instructed patients, many of whom were staged accident participants, to sign for treatment that was not provided to them. In one instance, video surveillance conducted on behalf of State Farm showed that Clavero Ruiz paid $1,000 to a patient, who did not receive any treatment, to sign off as if treatment was provided.

DIF has made numerous arrests this year tied to staged accidents and participants who were referred to D & J Rehabilitation.

In October, our FL PIP Guide reported on two recently arrested in the scheme—Victor Manuel Hernandez and Vladimir Caro—whose involvement caused hundreds-of-thousands in fraudulent billings to be submitted to insurance companies.

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Owner of ‘Exclusive Health Systems’ Clinic Arrested on Insurance Fraud Charges

Marlene Lopez del Castillo was arrested in October in connection with an illegal insurance scheme, according to the Division of Insurance Fraud (DIF). She allegedly pretended to be the doctor at Exclusive Health Systems, a Miami clinic she owned. Lopez del Castillo, 44, was charged with insurance fraud, grand theft, and practicing medicine without a license.

According to DIF, two people who participated in a staged vehicle accident in October 2011 visited Exclusive Health Systems for initial evaluations. Lopez del Castillo allegedly behaved as if she were the physician on call and examined both patients during their clinic visits, even though she is not a medical doctor nor does she hold a license with the Department of Health.

Lopez del Castillo also allegedly fabricated follow-up examinations that were later signed off by Dr. Hugo Goldstraj. Dr. Goldstraj gave a statement to investigators indicating that Lopez del Castillo prepared the reports. He said that he did not actually examine the patients nor do the paperwork.

Dr. Goldstraj was arrested in 2013 by DIF in a separate investigation, dubbed ‘Operation No Med Service,’ that involved a massive false billing scheme. Dr. Goldstraj was convicted in May and has since surrendered his license.

Lopez del Castillo opened Exclusive Health Systems in 2000.

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PIP Fraudster/Alligator Whisperer Remains Free but Cannot Cavort with Gators

On our FL PIP Guide on November 10, we told you about how federal prosecutors were trying to get the bond revoked of a Miami Beach PIP scammer who touted himself as an ‘alligator whisperer’-for-hire while waiting to start his jail term. The former chiropractor, 51-year old Hal Mark Kreitman, would swim and frolic with the reptiles and was even photographed kissing them.

However, according to an update in the Sun-Sentinel, prosecutors were overruled as U.S. District Judge Kenneth Marra declared that Kreitman can remain free until January 5, but only if he abides by new conditions set forth by the judge.

The former chiropractor-turned-alligator-whisperer was originally convicted of fraud in October in a staged accident ring case. The scheme revolved around Personal Injury Protection (PIP) payments that were used to defraud insurance companies through mail fraud and money laundering. Kreitman was sentenced to eight years and ordered to pay more than $1.63 million in restitution.

In a strange turn of events, Kreitman was then arrested on October 29 in the Everglades in Monroe County on state charges that he was harassing alligators. Federal prosecutors wanted to use these new charges against him—to have his bond revoked and to move up his surrender date.

While Judge Marra did not revoke bond, he agreed that the evidence showed that Kreitman committed a federal misdemeanor by touching the alligators. Judge Marra set new rules for Kreitman’s release designed to prevent him from posing a danger to the public and the gators.

Kreitman “shall not harass, harm, pursue, hunt, wound, kill, trap, capture, collect, feed, touch, tease, or frighten any wildlife,” the judge wrote in his order.

Prosecutors said Kreitman has also been driving on a suspended license, but according to his attorney, evidence presented showed the license was incorrectly suspended due to a case of stolen identity by Kreitman’s brother.

The judge ordered that Kreitman cannot drive until his license is reinstated; in addition, he could still face state wildlife charges in Monroe County, the Sun-Sentinel article said.

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Panhandle Auto Body Shop Owners Charged with Insurance Fraud

The Wreck-O-Mended auto body shop in Quincy, Fla. was the setting for an insurance fraud scam, according to a report by WTXL TV. Quincy is a small town of approximately 7,000 residents located northwest of Tallahassee in the Panhandle.

Owner Russell D. Owens and his wife Cassandra Owens received almost $2,000 in payment from Progressive Insurance Company for the replacement of a bumper, trunk lid and side panel on an insured’s damaged vehicle. The work was allegedly not done properly, and yet the body shop owners kept the insurance money. The insured must now pursue legal action against the shop in order to collect any money owed to complete the repairs, according to the report.

Russell Owens is accused of overcharging for repairs, a felony, and grand auto theft. Cassandra Owens is charged with criminal conspiracy for her role in the scam. Both parties were arrested this week by the Florida Department of Insurance Fraud.

Click on the link to read the full report.

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Feds Hoping Latest Charges Against PIP Fraudster Turned ‘Alligator Whisperer’ Have Teeth

Hal Mark Kreitman’s role as the ‘Alligator Whisperer’ may land him in even hotter water if federal prosecutors have their way. Authorities were hoping the latest charges against the 51-year old, allegedly for alligator endangerment, were enough to revoke his bond on recent PIP fraud convictions and send him directly to jail.

The former Miami chiropractor was sentenced just a few weeks ago, as we reported on our FL-PIP Guide on October 15, for his role in a larger staged automobile accident fraud ring that involved Personal Injury Protection (PIP) payments to defraud insurance companies through mail fraud and money laundering. Kreitman was sentenced to eight years, ordered to pay more than $1.63 million in restitution, and scheduled to start his prison term on January 5.

According to an article in the Sun Sentinel, Kreitman was hardly out on bond before he was arrested in the Everglades by officers with the Florida Fish and Wildlife Conservation Commission. He was accused of allegedly enticing alligators to offer customers the “Alligator Experience”—face-to-face encounters with the reptiles—if they were willing to pay $250.

Authorities say Kreitman’s interactions with the alligators violate state and federal laws. As a result, the alligators involved may have to be killed because they’ve lost their natural fear of humans, making them dangerous.

After prosecutors argued that Kreitman violated the terms of his release, U.S. District Judge Kenneth Marra decided to delay his ruling, giving him the chance to carefully re-read all relevant laws. For now, the “Alligator Whisperer” remains free.

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Five Arrested, Two Wanted in Organized South Florida PIP Fraud Scheme

Attorneys, chiropractors and clinic employees in Martin, Miami-Dade and Palm Beach Counties were swept up this morning in the culmination of a year-long undercover investigation led by the Florida Department of Financial Services’ Division of Insurance Fraud.

Two Boca Raton attorneys are among the five individuals arrested today:

• Brian Greenspoon (attorney), Boca Raton
• Cory Meltzer (attorney), Boca Raton
• Roger Hughes Bell (chiropractor), Hobe Sound
• Alejandro Marin, Homestead
• Douglas Santiago, Boynton Beach

Lake Worth chiropractor Ray Grand and Stuart resident Christina Savoye have warrants out for their arrest.

A brokering agreement among participants governed the payment of fees to a patient broker who recruited patients illegally for treatment at unnamed South Florida medical clinics. Unbeknownst to the crime ring organizers, the broker was in reality an undercover agent. Other law enforcement personnel, also working under cover, infiltrated the clinics involved to document the allegedly criminal activities.

Principals in the fraud scheme acknowledged on several occasions that it was illegal to pay for patients, so all referrals were paid under the guise of marketing services, according to a press release issued by Florida Chief Financial Officer Jeff Atwater.

Apparently, insurance carriers and others were billed by participating clinics for medical and chiropractic services that were not rendered. Patients were also being taught how to fake injuries, according to the release.

While exact dollar amounts are not available, the crime ring is believed to be responsible for hundreds of thousands of dollars in fraudulent billings.

The defendants will be prosecuted by the 15th and 19th Judicial Circuit State Attorney’s offices, according to the release.

Click on the link to read the full news release.

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South Florida Chiropractor Tied to 2013 PIP Fraud Investigation Surrenders License

On our FL-PIP Guide in September 2013, we reported that chiropractor David Hirschenson was arrested and charged with 19 counts of obtaining illegal crash reports and one count of solicitation.

An update in the case is now being reported. According to the Florida Department of Insurance Fraud (DIF), the 56-year old chiropractor was sentenced in a Miami-Dade County Court this September as a result of the charges made against him a year ago. He received five years probation and also surrendered his chiropractor’s license to the Department of Health.

Details in the case revealed that Hirschenson actually worked with two others in the scheme. The first was a runner who solicited accident victims. In an interesting development in that case, the victims were not referred to Hirschenson’s clinic, but instead to another clinic in North Miami Beach—Advanced Chiropractic and Medical Center.

The second co-conspirator was a local radio station staffer who used the media exception status at the station to request accident reports from a variety of police departments. Hirschenson then used this information illegally to solicit accident victims. DIF arrested both co-conspirators, who cooperated in the investigation against Hirschenson.

Hirschenson, who originally received his chiropractor license in Florida in 1982, also had a prior arrest in the late 1980s as part of an investigation involving solicitation and insurance fraud in Broward County. He was placed on probation for two years by the Board of Chiropractic, but retained his state license for cooperating with the State Attorney’s Office. Hirschenson worked at and operated several clinics, including Pines Total Health Center in Pembroke Pines and Body and Mind Wellness Center in Coral Gables.

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