Tag Archives: DIF

Lee County Man Convicted in Staged Accident PIP Fraud

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.

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Filed under Fla. Stat. 627.736 (2012), Insurance Fraud

Fort Myers Chiropractor Arrested, Caught Paying Confidential Informant to Fake Injuries

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.

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud

Broward County Chiropractor Pleads Guilty to Insurance Fraud Involving Accident Staging Ring

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.

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Filed under Fla. Stat. 627.736 (2008), Fla. Stat. 627.736 (2012), Insurance Fraud, Licensing

Nerber A. Iglesias, 40, and Michael Borkowski, 42 Arrested in Undercover PIP Fraud Sting

Two more arrests were made as a result of a personal injury protection (PIP) fraud scheme in Manatee County involving patient brokering. The arrests of Nerber A. Iglesias, 40, and Michael Borkowski, 42, were the result of an undercover sting, according to an announcement made by Florida Chief Financial Officer Jeff Atwater.

According to the Claims Journal report:

An investigation by the Florida Department of Financial Services’ Division of Insurance Fraud revealed that Iglesias approached a Sarasota chiropractor about becoming the straw owner of Garden Relief Center, LLC. The chiropractor contacted law enforcement and, under the direction of the department, applied for a clinic exemption certificate to begin operating the facility. The chiropractor, working undercover, was also contacted by a local body shop owner named Michael Borkowski, who made arrangements to provide accident patients to the clinic for a fee. During the course of the investigation, Garden Relief Center submitted almost $40,000 in fraudulent insurance claims to six different insurance companies.

The full article is available here.

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Filed under Fla. Stat. 627.736 (2008), Fla. Stat. 627.736 (2012), Insurance Fraud, Licensing

Eight Arrested for Staging Accidents in Miami-Dade County, Connections to Six Different PIP Fraud Rings

Florida’s Chief Financial Officer, Jeff Atwater, announced Tuesday that eight individuals involved in multiple staged accidents in Miami-Dade County were connected to six different PIP fraud rings.  The press release from the the CFO states:

An investigation by the Florida Department of Financial Services’ Division of Insurance Fraud revealed that Alexander Cid, 47; Luis Rivero Dominguez, 35; Franklyn Chaviano, 38; Robert E Bayona, 55; Carlos Padron Fernandez, 38; Yosmel Ramos Peraza, 24; Andres Vega Fleites, 61; and Jorge Fernandez Rodriguez, 52, participated in staged accidents in coordination with six fraud rings as organizers or drivers between May 2009 to May 2011.

The staged auto accidents resulted in more than $340,000 in fraudulent auto insurance claims.  If convicted, the eight individuals involved could serve a total of 455 years in prison.

The Division of Insurance Fraud (DIF) recently entered into a partnership with the Florida Highway Patrol (FHP), which will include the assignment of FHP Troopers to the Miami and Tampa DIF offices to work in the investigation of staged accident ring activity.

The full press release is available here.

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Filed under Fla. Stat. 627.736 (2008), Fla. Stat. 627.736 (2012), Insurance Fraud

Three Charged With Insurance Fraud in Naples, Florida

Johnson Safaite, 24; Li Franc Safaite, 55; and Ronald Samedifede, 41, each face two counts of making a false insurance claim as a result of an alleged January motor vehicle accident in which a vehicle swerved to avoid Li Franc Safaite’s vehicle and eventually struck a utility pole.  When authorities arrived, Li Franc and his three passengers reported that they were rear ended in the alleged accident.

All four occupants then sought treatment at a clinic and billed Geico more than $11,000.00.  The claims were denied and the four involved in the false claims were referred to Florida’s Division of Insurance Fraud (DIF).

The full article is available here.

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud

PIP Fraud Brings 5.5 year Sentence to Oscar Luis Franco Padron

On Friday, May 25, 2012, Oscar Luis Franco Padro was sentenced to five and half years in prison for PIP fraud involving staged accidents.

Padro, who managed several clinics and recruited patients to perpetrate the fraud, was ordered to pay $4.35 million in restitution.  U.S. Attorney Wifredo A. Ferrer said,

This massive ring orchestrated phony automobile accidents and made a living by defrauding insurance companies of millions of dollars. … Not only were the insurance companies defrauded, but this scheme also hurt consumers as our insurance costs continue to soar because of fraud.

The press release from the State Attorney’s Office details how Padron and others perpetrated the fraud:

In their guilty pleas, the defendants admitted they and others would find individuals who owned automobiles and had car insurance from insurance companies that scheme participants preferred in order to participate in staged automobile accidents. In recorded conversations, the recruiters, used the term Spanish word perro (dog) for the person who causee the staged accident and a pejorative Spanish slang for women to describe the purported victims.

To execute the scheme, the recruiters sought drivers and their friends/family members to participate because, under Florida’s “No Fault” insurance law, insurers must provide PIP coverage of $10,000 per person.

Once the recruiters found the participants, they coached the participants on how to perform the staged accident, what to say to the police officer who responded to the scene and how to claim they were injured.

The accident participants were then directed by the recruiters to chiropractic clinics that were controlled by co-defendants. The staged accident participants were instructed to sign numerous blank treatment forms that would later be submitted indicating that they had visited the clinic on a number of occasions for treatment, although they may have visited the clinic only once or twice.

During their visits, some staged accident participants received no treatment at all, or may have received only a short exam or treatment, but paperwork indicated that a full and lengthy exam and treatment was given. Co-defendants Leon, Diaz, Bello, and Gonzalez are all licensed massage therapists who will lose their licenses.

Co-defendants Padron and Ross also admitted that, when converting the deposits of the mail fraud proceeds to cash, it was done in a way to avoid the $10,000 currency transaction reporting requirement. Two of the co-defendants would write a series of checks, typically for $9,000 each, made payable to different individuals, including Padron and Ross, that would be cashed on the same day, or made payable to the same individual that would be cashed on successive days, even though there were sufficient funds available in the account to allow for a single check to be cashed. Oftentimes co-defendants would go to the bank together to cash checks simultaneously, but each check would be written for less than the $10,000 currency transaction reporting amount.

The clinics involved in this scheme included Chiropractic Office of South Florida, located in Palm Springs, New York Medical and Rehab Center, located in Lake Clarke Shores and Healthcare ’R Us in Palm Springs.

The 15 individuals involved include:

Vladimir Lopez, Lazaro Vigoa Mauri, aka Lazaro Vigoa, Joaquin Ross, aka Joaquin Ross Vasquez or Quinito, Lisbet Leon, aka Lisbet Leon Machado,Aureliano Diaz, Carmen Venegas, Yida Bello, aka La Gorda, Gloria Patricia Cintron, aka Patty, and Veronica Riofrio, aka Vero, Ketty Gonzalez, Ernesto Miralles, Julio Fernandez Delgado, Alex Anoldo Flores, and Zachary Keith Stuhler.  Lopez and Vigoa Mauri are fugitives.

 

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Filed under Fla. Stat. 627.736 (2008), Insurance Fraud