Tag Archives: Insurance Fraud

Florida Couple Accused of Allegedly Lying About Sinkhole to Homebuyer

On July 16, 2015, a Spring Hill couple was accused of lying about a sinkhole to a homebuyer, according to a news article by ABC news. Glenn Jasen, 64, and Katheryn Jasen, 63, were indicted on a charge of wire fraud, which is a federal felony. If convicted, they each could face a maximum of 20 years in prison, according to U.S. Attorney A. Lee Bentley III.

According to the indictment, the Jasens found a sinkhole on their property and made a claim to Citizens Insurance. Instead of repairing the sinkhole the Jasens deposited the insurance check for an undisclosed amount into a bank account, as stated by the U.S. attorney’s office.

The Jasens then put the home up for sale, and in the real estate disclosures given to the purchaser of the house, they failed to disclose the sinkhole and the claim on the property, according to the indictment.

Please click here to read news article.

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Filed under Insurance Fraud

PIP Fraud Featured on A&E American Takedown

The newest series on A&E, American Takedown, goes behind-the-scenes of a year-long undercover investigation into an accused insurance fraud ring in Palm Beach, Martin, and Miami-Dade counties.  The show aired on A&E on Thursday, July 9, 2015, at 10 pm EST.

The episode followed the breakdown of the investigation of attorneys, chiropractors and clinic employees involved in recruiting, paying, and treating “patients” for injuries that did not exist following staged car accidents.  The investigation was known as “Operation Cold Call” which targeted a network of attorneys, doctors, and clinic employees in Boca Raton, Boynton Beach, Lake Worth, Hobe Sound, Stuart, and Homestead. Investigators from the state’s Department of Financial Services worked undercover and were embedded into the clinics that were accepting patients who were illegally solicited.

Click here to read the Department of Financial Services newsletter

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Filed under Insurance Fraud

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.

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Filed under Insurance Fraud

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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Filed under Insurance Fraud

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.

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Filed under Insurance Fraud

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)

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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Filed under Insurance Fraud