Four Florida residents were arrested on April 1 for participating in a Broward County scheme to defraud insurance companies by filing false PIP claims.
The defendants filed eight claims concerning a Mercedes that belonged to one of them, according to a statement from the Florida Department of Financial Services, Division of Insurance Fraud.
Claims alleged that the Mercedes had been run off the road. It was ultimately determined that only one of the eight claims was lawfully made and that the other seven were filed in furtherance of the defendants’ scam.
According to the statement, the four individuals arrested are:
- Ermes Falero, Boca Raton
- Gary Lee, Boca Raton
- Javier Navarro, Miami
- Michael Rumain, Point Pleasant
Falero, with Lee’s help, is alleged to have organized a scheme by which he and Lee would falsify documentation and use that false documentation to file fraudulent insurance claims. The remaining two defendants are accused of making fraudulent statements supporting Falero’s and Lee’s false insurance claims.
Falero, the scam’s main organizer, faces 150 years in prison. Lee faces up to 90 years, and the defendants who made the false statements each face 15 years in prison.
A 41-year old from Orlando, who was at the center of an alleged staged vehicle accident which occurred in 2013, was recently apprehended by the Florida Division of Insurance Fraud (DIF).
Jean Severe was arrested in November for organizing the fake crash. According to DIF, participants were sent to Florida Chiro & Rehab Center for unnecessary medical treatment of their bogus injuries. The scheme resulted in more than $6,000 in false claims filed with insurers Allstate and GEICO.
A post on our December 1st FL-PIP Guide reported that five individuals were arrested for their roles in an alleged staged accident scam in 2012 that resulted in fraudulent Personal Injury Protection (PIP) claims costing three insurance carriers almost $40,000. The five cases will be prosecuted by the Broward State Attorney’s Office.
A sixth individual wanted in connection with this crime—Mario Rene Ruiz—has yet to be apprehended and is now considered a “Most Wanted Fugitive” for insurance fraud, the Division of Insurance Fraud (DIF) announced.
According to DIF, Ruiz has lived in Fort Lauderdale but may have returned to Honduras, his native country. The 32-year old reportedly measures 5’6” in height, weighs 152 lbs., and has brown eyes and hair.
Anyone with information regarding Mario Ruiz’s whereabouts is asked to contact DIF at 1-800-378-0445 or the Broward County Sheriff’s Office. Tipsters can remain anonymous and may be eligible for a reward as part of the Florida Department of Financial Services’ Anti-Fraud Reward Program.
To date, the department has awarded almost $349,000 to nearly 60 citizens as part of its Anti-Fraud Reward Program, which rewards individuals up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme.
September was a busy month for the Florida Division of Insurance Fraud (DIF). The agency arrested a massage therapist for fabricating medical forms, as well as four other individuals who organized and recruited participants to be involved in staged accidents.
According to DIF, one arrest occurred in Orlando while the remainder took place in Miami. Those arrested in the five unrelated cases include:
Madelein Marin Aroche. The 41-year old massage therapist worked at New Life Medical Center in Miami. She was charged with insurance fraud after submitting false therapy forms for treatment she never provided to two patients who participated in staged accidents. Her scheme resulted in almost $30,000 in fraudulent billing to GEICO Insurance Co.
Renfroe Lorenz Tyson. The 46-year old recruiter and participant was arrested in Orlando for his role in a 2013 staged accident that resulted in more than $6,600 in fraudulent billings to Allstate and GEICO.
Victor Manuel Hernandez. The 32-year old from Miami conspired with William Tejeda Mayobanex, who was arrested by DIF in August. Hernandez helped recruit participants for a staged accident in 2011. The participants were then referred to A & J Rehabilitation Center and D & J Rehabilitation Center, where more than $64,000 in fraudulent billings were submitted to United Auto and York Services.
Vladimir Caro. The 38-year old organizer staged an accident in 2011. The six participants in the crash were also referred to A & J Rehabilitation Center and D & J Rehabilitation Center. More than $117,000 in fraudulent billings were submitted to Allstate, State Farm, United Auto and Windhaven.
Sandy Morales Castro, 33, was identified as a recruiter and the eighth subject arrested in a staged accident that occurred in 2010. This fake crash resulted in more than $46,000 in fraudulent billings submitted to GEICO, MGA and Progressive.
The first successful conviction in Lee County for a staged motor vehicle accident was recently announced by Florida Chief Financial Officer Jeff Atwater. Alain Guevara, 29, of Lehigh Acres, pleaded guilty in the 20th Judicial Circuit Court to staging an August 2012 motor vehicle accident and knowingly presenting false information in support of a PIP claim. He faces a two year mandatory minimum sentence.
The initial accident report stated that a rented truck, driven by Guevara’s accomplice, failed to obey a stop sign and collided with Guevara’s vehicle. Property damage ensued. Following the collision, Guevara knowingly presented a false, incomplete and misleading accident report to the insurance company. Allstate Insurance Company and REPWEST Insurance Company received the fraudulent PIP claims.
One of the insurance companies, suspecting fraud, reported the accident to the Department of Financial Services’ Division of Insurance Fraud (DIF). DIF commenced its investigation and concluded that the damage sustained by the vehicles was inconsistent with the accident account provided. In fact, a vehicle damage consistency report revealed that the car was not even in motion at the time of impact.
In addition to vehicular damage inspection and review of the facts, DIF subpoenaed phone records for the parties involved. Phone company logs revealed that the two drivers knew each other prior to the incident, as evidenced by numerous calls between them prior to, and immediately following, the collision.
Fort Myers, FL chiropractor, Dr. David Greydinger, was arrested last week after investigators caught Greydinger submitting fraudulent insurance claims for non-existent auto accidents. Reports indicate Greydinger, of MYO Health Clinic, paid informants kickbacks to submit claims totaling $6,000 arising out of non-existent accidents. Reports indicate that MYO Health Clinic remains open for business at this time.
Detective William Quick of the Florida Division of Insurance Fraud stated, “Greed is the primary force behind everything with insurance fraud. It all comes down to money.”
The full report is available here.
On Tuesday, Broward county chiropractor Jennifer Adams, 39, of Boca Raton, admitted to one count of conspiring to commit mail fraud and agreed to pay more than $1.92 million in restitution to 10 insurance companies.
Adams permitted her name to be used to create two chiropractic clinics: Ovy Rehabilitation Medical Center, Inc. in West Palm Beach, and Chiropractic Office of South Florida, LLC in Palm Springs. Both clinics submitted fraudulent PIP claims on behalf of individuals involved in staged accidents.
Adams, a chiropractor in Florida since 1999, agreed to relinquish her medical licenses. According to the Sun-Sentinel report:
The maximum punishment is 20 years in prison and a fine of $250,000 though she will likely face a much lesser penalty when she is sentenced by U.S. District Judge Daniel T. K. Hurley in federal court in West Palm Beach in the next several weeks.
The full story is available here.