Category Archives: auto insurance

IIHS Confirmed Tesla’s Claims About Reducing Injury Liability Claims with Autopilot

The Insurance Institute for Highway Safety (IIHS) has confirmed Tesla’s claim that its Autopilot and active safety features result in ‘fewer physical damage, injury liability claims.’ However, IIHS also found that the introduction of these features could increase other kinds of claims.

The combined driver assistance features on the 2014–16 Model S lowered the frequency of claims filed under property damage liability (PDL) and bodily injury (BI) liability coverage with the 2012–14 Model S without the technology. However, IIHS didn’t find that they lowered the frequency of collision claims. They also saw increases in MedPay and PIP claims.

Highway Loss Data Institute’s senior vice president, Matt Moore, admits that they would need more data to really understand the effect of Autopilot.

Click here to read the article.

Comments Off on IIHS Confirmed Tesla’s Claims About Reducing Injury Liability Claims with Autopilot

Filed under auto insurance, Personal Injury Protection, PIP, PIP/No Fault

Travelers Advocates Current Auto Insurance System for Autonomous Vehicles

Travelers Institute released a white paper expressing their view on autonomous vehicles (AVs) and the role the auto insurance industry should play in addressing the significant policy questions and challenges that will inevitably arise in the future. An insurer that has been around for more than 160 years, Travelers applauds the safety advances of AVs and believes that the current auto system can accommodate AVs and non-AVs.

Click here for the white paper.

Comments Off on Travelers Advocates Current Auto Insurance System for Autonomous Vehicles

Filed under auto insurance, Autonomous Technology

Deltona Man Charged With Arson in Insurance Fraud Scheme

Brian Lee Caswell of Deltona was arrested and charged with second-degree arson, arson resulting in injury, burning to defraud an insurer, giving false information to a law enforcement officer and making a false police report.

According to Caswell’s arrest warrant, he had hatched a plan with Alex Spivey of Orlando and Melinda Philbrook of Lady Lake to destroy their truck and collect an insurance payout. Caswell initially claimed the vehicle had been stolen, but later admitted planning the scheme after co-conspirator Spivey caught fire during the arson.

Click here to read the full article.

Comments Off on Deltona Man Charged With Arson in Insurance Fraud Scheme

Filed under auto insurance, Auto Insurance Fraud, Florida, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud

Pending PIP Litigation on the East and West Coasts Could Impact States In Between

PropertyCasualty360 published a report about pending automobile personal-injury litigation in California and New York that could have a lasting impact if the decisions spread to other jurisdictions. Courts will determine allowable evidence for suits involving these insurance claims.

East Coast

In New York, insurers investigated radiologist Andrew Carothers, a suspected illegal straw owner after he filed 20,000 lawsuits against auto-insurance carriers. After insurers refused to pay Carothers, he flooded the state’s courts with more than 20,000 lawsuits seeking collection for unpaid “services.” The civil cases were consolidated, and the jury agreed Carothers was fraudulently engaged in the corporate practice of medicine. The Appellate Division affirmed, so Carothers went to the New York Court of Appeals, where the case awaits a decision.

A favorable decision can deter scams like Carothers’ in other states that forbid the corporate practice of medicine. Fraudsters who often quickly expand operations to line their pockets in other states could be deterred. A decision is expected in 2019.

West Coast

Dave Pebley was involved in a serious vehicle accident, sought medical care and filed suit. He had health coverage but decided not to submit his bills for payment. That is because, under California law, the jury would only hear about the amount paid by his health insurer as the measure of his medical expense while Pebley was billed at the top rate for medical services by refusing to use his health insurance.

The insurer cried foul, asserting that such actions mislead the jury, and are fraudulent because medical providers never expect to receive such high payments. They argued the plaintiff may present the higher medical bills but must provide expert testimony to prove the charges are fair and reasonable. Similarly, the defendant or their insurer may present counter-evidence as to what the health providers normally accept for payment of those services.

The California Second District Court of Appeal reasoned that juries should be allowed to ultimately decide the appropriate charge for the medical services. Parties are lining up to support an appeal of the case to the state Supreme Court. If Pebley succeeds in California, potentially winning the $3.6 million he seeks, the strategy of refusing to use health insurance can be expected to spread rapidly to other states.

Click here for full article.

Comments Off on Pending PIP Litigation on the East and West Coasts Could Impact States In Between

Filed under auto insurance, Auto Insurance Fraud, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud, PIP, PIP/No Fault, Uncategorized

Two GEICO Adjusters Charged in Miami Insurance Fraud Ring

On Monday, July 10th, 14 people were charged in “Investigation Vehicle Roulette” conducted by Florida’s Bureau of Insurance Fraud and the State Attorney’s Office. Two GEICO insurance adjusters, Juan Carlos Diaz and Cesar Santiago Tapanes, prosecutors say got cash kickbacks for helping defraud their own company were among those arrested.

In September 2016, a Lexus GS350 was involved in a fender bender with a Chrysler 320 in North Miami-Dade. The rogue insurance adjusters reported inspecting the Lexus and authorized a series of payments totaling over $16,000. However, investigators say the accident never actually happened.

In fact, the same Lexus had been the subjection of 10 previous claims involving crashes that never occurred, all signed off by Diaz and Tapanes. The scam ended up costing GEICO more than a million dollars.

According to an arrest warrant by detectives, at least 45 bogus claims were made. The group faces charges including grand theft, insurance fraud, and racketeering.

Click here for full article.

Comments Off on Two GEICO Adjusters Charged in Miami Insurance Fraud Ring

Filed under auto insurance, Auto Insurance Fraud, Florida, Florida Division of Insurance Fraud, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud

Appeal Court Backed Air Ambulance Firm in PIP Dispute

The 11th U.S. Circuit Court of Appeals backed air-ambulance firm Air Methods Corp. in a dispute stemming from a traffic accident that resulted in the death of accident victim Lemar Bailey about whether the amount paid for helicopter services should be limited by Florida’s no-fault auto insurance law. The federal appeals court ruled that the air-ambulance firm is considered an air carrier under federal law and should be able to bill the child’s father, Lenworth Bailey, for costs that exceeded the limits in the state’s no-fault system.

Following the March 2013 accident, Air Methods Corp. billed $27,975 for its services. Bailey’s auto insurer, State Farm Mutual Automobile Insurance Co., paid $6,911 under the fee schedule. His health insurer, Aetna Life Insurance Co. paid another $3,681. However, Bailey did not pay the remaining balance of nearly $17,400. He filed a potential class-action lawsuit alleging that the air ambulance company was trying to improperly collect amounts in excess of the fee schedule. However, the judge ruled in favor of the Air Method, which led Bailey to the appeals court that also rejected such arguments.

Click here to view the full article.

Comments Off on Appeal Court Backed Air Ambulance Firm in PIP Dispute

Filed under auto insurance, FL Legislation, Florida, Insurance, Insurance Claims, Insurance Defense, Lawsuits, Personal Injury Protection, PIP, PIP/No Fault

Roig Lawyers Partner Keith Hernandez Publishes Article in CLM Magazine on Autonomous Vehicle Technologies and its Impact on Insurance

ROIG Lawyers Deerfield Partner Keith Hernandez has published an article in CLM Magazine entitled “Keep Your Eyes Off the Road.” In the article, Keith discusses the emergence of autonomous vehicle technologies and its impact on traditional insurance.

Click here to read the entire article.

CLM Magazine is the premier source for content that addresses trends, topics of interest, and industry challenges for those in the claims and litigation management industry.

Comments Off on Roig Lawyers Partner Keith Hernandez Publishes Article in CLM Magazine on Autonomous Vehicle Technologies and its Impact on Insurance

Filed under auto insurance, Autonomous Technology, Claims Handling, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud, PIP/No Fault, Uncategorized

Ringleader Pleads Guilty To His Role In $23 Million Auto Insurance Fraud Crime Ring

According to the Sun Sentinel, Felix Filenger of Sunny Isles, pleaded guilty this week to his role in an elaborate crime ring that operated at several South Florida chiropractor clinics. The fraud totaled at least $23 million from 10 auto insurance companies over the last seven years, per court records.

Federal prosecutors say Filenger and Andrew Rubinstein took over troubled clinics and hid their ownership by having chiropractors and other people register the practices in their names. The men told chiropractors what treatments they wanted to be performed, based on the potential revenue from the services, prosecutors said. Medical staff who refused to “play ball” were fired, they said.

Filenger admitted he, and other group leaders, paid kickbacks of $1,500 to $2,000 – per patient – to tow truck drivers and body shop workers who agreed to illegally steer accident victims to chiropractic clinics that were secretly owned by Filenger and his allies.

Filenger plead guilty to one count of racketeering conspiracy on Monday in federal court in Miami and is scheduled to go to trial on January 8.  Two co-defendants, who are still scheduled for trial that day, may plead guilty to related charges on Wednesday, court records show.

Andrew Rubinstein, 48, of Miami, is jailed on charges of racketeering and mail fraud conspiracies, wire fraud, health care fraud, and making false statements.

Olga Spivak, 59, a chiropractor from Hollywood, is free on bond. She faces the same charges.

Click here for full article.

Comments Off on Ringleader Pleads Guilty To His Role In $23 Million Auto Insurance Fraud Crime Ring

Filed under auto insurance, Auto Insurance Fraud, Broward County, Florida, Florida Division of Insurance Fraud, Insurance Fraud, Miami-Dade County, Palm Beach County, Personal Injury Protection, PIP, PIP/No Fault

Florida Man Arrested for False Insurance Claim

Insurance Journal has reported that a Florida man, Claude Milhomme, was arrested for attempting to file a false insurance claim for his vehicle. According to the Department of Financial Services’ Disaster Fraud Action Strike Team (DFAST), Milhomme filed a claim in September stating water damage to his vehicle caused by Hurricane Irma in the amount of $225 for a diagnosis, after hours fee and storage fee.

DFAST received a suspected fraud tip about one month later. After an inspection by state investigators, it was revealed that Milhomme’s vehicle was mechanically inoperable prior to Hurricane Irma’s landfall in September of 2017.

Click here to view the full story.

Comments Off on Florida Man Arrested for False Insurance Claim

Filed under auto insurance, Auto Insurance Fraud, Florida, Insurance, Insurance Claims, Insurance Fraud

Judge Dismisses Lawsuit of Injured NJ Driver Who Maintained FL Insurance Policy

A New Jersey judge has ruled that Jeffrey Scholes, a man living in New Jersey but driving a car registered and insured in Florida, may not sue another New Jersey driver for injuries he sustained in a car accident. Judge Patrick Bartels of Essex County Superior Court dismissed Scholes’ personal injury lawsuit against defendant Stephen Hausmann on Oct. 24 citing that it would be a violation of the state’s automobile insurance statutes as Scholes fraudulently maintained a Florida automobile insurance policy while living in New Jersey.

Bartels noted that Scholes had been living and working in New Jersey since 2009 but maintained a Florida insurance policy issued by GEICO, registered his car there and had a Florida driver’s license because it was more cost-effective.

According to the ruling, Scholes was “severely injured” when he was struck head-on by Haumann’s car on Oct. 23, 2014, in South Orange. Although Scholes sustained back injuries that required epidural injections and surgery, Hausmann moved to have Scholes’ lawsuit dismissed on the grounds that New Jersey law requires that people who live in the state and who have a car here must maintain New Jersey car insurance.

Bartels agreed. “[W]e agree that plaintiff’s automobile is not considered insured pursuant to New Jersey law,” he said.

Click here for full article.

Comments Off on Judge Dismisses Lawsuit of Injured NJ Driver Who Maintained FL Insurance Policy

Filed under auto insurance, Auto Insurance Fraud, Florida, Insurance, Insurance Fraud, New Jersey, PIP