Category Archives: Fla. Stat. 627.736 (2008)

South Carolina Couple Sues Uber for Miami Beach Crash Aftermath

The Miami Herald reported on March 14, 2016, that Dr. Richard Day and wife Jean Day filed a lawsuit against Uber after being involved in a car accident.  Back in December, the couple traveled to Miami from South Carolina for a medical conference when they ordered an Uber. According to a police report and the lawsuit, the driver, Ingrid Parra, crashed when leaving the Eden Roc hotel in South Beach after failing to yield to oncoming traffic. While Dr. Day’s injuries included a broken leg, his wife received massive brain injuries that will require multiple surgeries.

This is the latest lawsuit against ride- sharing services involved in Miami Dade that points to drivers paying more attention to their smartphones than the road. This comes at a time when the county commission is considering legislation to regulate businesses such as Uber and Lyft.

The popularity of these ride-sharing services has skyrocketed in South Florida and across the country in recent years, but not without controversy. Back in November, Lyft was hit with a lawsuit by a family of a 29 year old woman after being thrown off her motorcycle when colliding with a ride share driver in Wynwood. Also, in January, Uber was sued by the relatives of a Miami Dade College student who was killed in a fiery crash in Kendall. The Uber driver was not faulted in this incident.

The predominance of ride- sharing services such as Uber and Lyft have given rise to fierce resistance from taxi drivers as well as local governments who struggle to legalize their procedures. Opposition to ride sharing services, claim Uber drivers violate vehicle for-hire rules, but the popularity has put enormous pressure on the commissioners. Broward County initially required fingerprinting the drivers but backed down when Uber threatened to leave the market last summer. After a Michigan Uber driver was arrested and charged with fatally shooting six people, Miami Dade commissioners have threatened to impose the fingerprinting requirement, which they will be voting on in May.

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Filed under Fla. Stat. 627.736 (2008), Transportation Network Companies

Georgia Insurance Agent Arrested for Stealing Thousands From Seniors

On February 18, 2016, the Department of Insurance Fraud (DIF) announced the arrest of William David Rodeffer III of Folkston, Georgia. According to DIF, Rodeffer allegedly accepted insurance premium payments totaling nearly $40,000 for two clients for insurance policies that were never purchased. One of the consumers believed he had purchased a workers’ compensation policy which covered him if one of his workers were injured on the job. Unfortunately, he had an employee who was injured and, as his employer, he was left to cover an additional $30,000 in medical bills and lost wages.  In total, nearly $70,000 in financial losses were caused by Rodeffer.

Rodeffer was a licensed insurance agent in Georgia and was working as an agent in Georgia, but moved to Yulee, Florida when his company opened a second office in Florida. Rodeffer then applied for a license in Florida, which was denied due to his criminal history, resulting in a lack of qualification to transact insurance business in Florida.

According to DIF’s three year investigation, Rodeffer continued to illegally sell insurance policies in Florida despite his denied application for licensure. During this time he repeatedly accepted premium payments from two clients for policies he never purchased, meaning that his clients never had coverage.

One of Rodeffer’s clients, a 91 year old Floridian, thought he had purchased a workers’ compensation policy from him until one of the workers’ under his policy was injured and filed a claim against the policy sold by Rodeffer. Once the worker filed the claim against the policy it was revealed that the policy never existed. Rodeffer’s client made at least 10 premium payments for the policy, which Rodeffer fraudulently kept.

A second client, American Legion Post 283, was led to believe they held general liability property insurance coverage after providing numerous premium payments to Rodeffer. The investigation revealed that Rodeffer failed to obtain insurance coverage for them as well.

Rodeffer is currently awaiting trial in Georgia for similar charges where had previously been charged in 2014 by Nassau County Sheriff’s Office for a separate offense.

 

 

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

Additional Grand Theft Charges Filed Against Orange County Insurance Agent

The Florida Division of Insurance Fraud (DIF) announced on February 10, 2016 that additional charges have been filed against Orange County insurance agent Mario Ferreri, owner of Orlando-based Financial Management Resources.

According to DIF, Ferreri was arrested in 2015 for allegedly stealing more than $1 million from his clients. Recently, another victim has come forward alleging that a $95,000 check intended for an annuity payment may have also been stolen by Ferreri.

According to the press release from DIF, the Department’s Division of Agent and Agency Services received a complaint from Lincoln Life Insurance Company stating their suspicions that Ferreri had stolen two of his client’s insurance premium payments and used the money for his personal benefit. Due to the criminal nature of the allegations the case was referred to colleagues in the Division of Insurance Fraud.

The investigation revealed that Ferreri had gained the trust of two of his clients and convinced them to make their premium payment checks payable to one or more of his companies instead of their respective insurance companies. The clients individually contacted their insurance carriers and realized their payments had not been received.

On December 5, 2014, Ferreri was arrested and booked into Orange County Jail on two counts of a scheme to defraud more than $50,000 where he is still being held on a bond of $250,250. According to DIF, an additional second degree grand theft count has been added along with an added bond amount of $200,000. If convicted, Ferreri faces up to 30 years in prison.

Click here to read press release.

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Filed under Fla. Stat. 627.736 (2008)

‘Uber Bill’ Cruises in Florida House

According to a Law360 article, on January 27, 2016, House Bill 509 passed through the state House of Representatives.

The bill, sponsored by Representative Matt Gaetz, R-Fort Walton Beach, requires drivers for transportation network companies (TNC’s) to pass background checks, obtain permits and meet insurance coverage minimums. The creation of H.B. 509 comes in response to concern from critics and supporters over TNC services being provided in compliance with state and local laws and making sure sufficient safety measures are in place.

“By cutting red tape for TNCs and other disruptive technologies, we are making Florida a state were innovation is welcomed and entrepreneurs are able to make their dreams a reality,” said Florida House Speaker Steve Crisafulli, R-Merritt Island.

The passage of the bill gained support from leading service providers Uber Technologies Inc. and Lyft Inc. as well as business groups such as the Florida Chamber of Commerce and Associated Industries of Florida, and Governor Rick Scott.

Recently, the Florida Senate passed a similar bill, regarding insurance issues and TNC’s. Senate Bill (S.B.) 1118, sponsored by Senator David Simmons, R-Altamonte Springs, did not address permitting or background checks and notably did not include a provision in H.B. 509, which preempts local regulation on these services.

The two bills differ in their insurance requirements. H.B. 509 requires drivers or TNCs to provide at least $50,000 for death and bodily injury per incident, $100,000 for death and bodily injury per incident, and $25,000 for property damage when the driver has the transportation network company’s app on but no passengers.  This is contrary to S.B. 1118 that calls for levels of $125,000, $250,000 and $50,000, respectively, any time they have their ride-hailing app turned on.

Matt Gore, general manager for Uber in Florida, said “We hope the Senate works quickly to take up this issue, and for Florida to join more than 20 states across the country that have permanently secured the benefits of expanded access to safe transportation options and flexible work opportunities.”

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Filed under Fla. Stat. 627.736 (2008), Transportation Network Companies

Rose Radiology to pay almost $9 million to settle false billing allegations

According to the Tampa Bay Times, Rose Radiology Centers Inc. a Tampa Bay based diagnostic center, will pay the government $8.71 million to settle allegations that it violated the federal False Claims Act by billing federal health care programs for unnecessary radiology procedures.

Rose Radiology Centers Inc. operated approximately a dozen offices in the Tampa Bay area and is the official radiology practice for the Tampa Bay Rays and Tampa Bay Lightning.
The settlement deals with a lawsuit filed by two whistle-blowers under the federal False Claims Act, which allows private parties to bring suit on behalf of the government and to share in any recovery. The lawsuit stated that Rose Radiology Centers Inc. improperly billed for radiology procedures referred by chiropractors, which are not covered by Medicare. Rose Radiology bypassed this constraint when they accepted orders from chiropractors and billed for them as if the tests were actually ordered by a Rose Radiology-employed physician. The whistle-blowers will receive a combined $1.7 million as their share of the recovery from the case.

The radiology center is accused of performing and billing for radiology procedures that were never ordered by the patients’ treatment providers and of sending claims to Medicare for radiology services that were not performed at facilities authorized as Medicare providers, according to the article. In addition to the other allegations, the center is accused of giving kickbacks to referring physicians.

Shimon Richmond, special agent in charge for the Health and Human Service office of the Inspector General stated, “Not only do the kinds of frauds that were alleged in this case rob Medicare of needed funds, they threatened the health of elderly and disabled Americans.”

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

Bradenton Insurance Agent Arrested After Defrauding Client of More than $200,000

In a January 5, 2016 press release, The Florida Division of Insurance Fraud (DIF) announced the arrest of Timothy T. Rush, 38 year-old, Bradenton-based insurance agent. Rush was arrested for allegedly stealing $224,600 from an unsuspecting Port Charlotte resident.

“In early 2015, the Manatee County Sheriff’s Office received a complaint regarding Timothy R. Rush after one of his clients suspected that the money he had been paid was not being used for the insurance annuities that Rush and his client had agreed upon,” according to DIF. After the complaint, DIF and Florida’s Division of Agents and Agency Services launched an investigation into the practices of Rush.

The investigation revealed that Rush was a licensed insurance agent in Florida and was authorized to sell Bankers Life annuities. Rush worked with a Port Charlotte resident to secure a Medicare insurance supplement and the client agreed to make payments on a Bankers Life annuity which Rush sold her. According to the investigators, Rush opened a fictitious corporation through Florida’s Division of Corporations that was used to open a separate bank account.  Rush then illegally deposited the diverted annuity payments from the Port Charlotte resident totaling$224,600.

On December 30, 2015, Rush was arrested and booked into the Manatee County Jail with a bond of $100,000 and was charged with one count of an organized scheme to defraud, a felony of the first degree. This case will be prosecuted by the Office of Manatee State Attorney Ed Brodsky and if convicted, Rush will face up to 30 years in prison.

Click here to read press release.

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Filed under Fla. Stat. 627.736 (2008)

Allstate Wants High Court to Enter PIP Dispute

Allstate Insurance Co. has asked the Florida Supreme Court to address the issue of reimbursement for medical services under the state’s No-Fault auto insurance system as a result of conflicting opinions in the lower courts. Allstate is looking to overturn a ruling in August 2015 by the 4th District Court of Appeal in favor of medical providers.

The 4th District Court of Appeal ruling addressed whether policies were clear that Allstate would reimburse the providers under a statutory fee schedule. The providers argued that the policies were “ambiguous” on the issue of whether such an election to pay at the fee schedule was made and the 4th District Court of Appeal agreed.

In the brief filed by Allstate to the Florida Supreme Court, Allstate argues that the August ruling conflicted with a decision by the 1st District Court of Appeal and that similar cases are currently pending in two other appellate courts. “Given that every Florida driver must carry PIP insurance, and the vast numbers of claims processed under such coverage, this conflict (between appeals courts) creates confusion and instability in the lower courts and impacts thousands of insureds and many other citizens and business in Florida”, according to the brief filed by Allstate.

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Filed under Fla. Stat. 627.736 (2008)

Man arrested/accused of running unlicensed medical clinic

A Central Florida man has been arrested by State investigators for running an unlicensed medical clinic to rip off insurance companies for tens of thousands of dollars, according to a WFTC article.

State insurance fraud investigators stated that the clinic on Pine Hills road was a front for Yves Joseph’s lavish lifestyle. He was running an unlicensed medical clinic in Orange County and had millions of dollars moving through his accounts. As a result of his bank records, the Florida Division of Insurance Fraud was able to detect the fraud.

Investigator stated that Joseph’s office first opened in 2006, and that he would hire medical doctors and chiropractors to pose as the owners of the clinic in order to make the medical clinic appear legitimate. Joseph however, was the real owner of the clinic and managed the clinic. According to investigators, Joseph billed more than $158,000 to several insurance companies that they currently know of.  During the investigation, investigators found that from 2011 to 2014 there was more than $1.7 million in credits and $1.2 million was withdrawn from bank accounts in cash.

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Filed under Fla. Stat. 627.736 (2008)

Florida Decision States That Uber Drivers Are Independent Contractors

On December 3, 2015, the Florida Department of Economic Opportunity (DEO) determined that Uber drivers in Florida will be considered independent contractors rather than employees. This reverses an earlier state decision and shows the State’s position in a countrywide debate regarding the classification of Uber drivers.

Executive Director of the DEO, Jesse Panuccio, stated in his decision that “Technology is allowing hundreds of thousands of people to go into business for themselves. Those in business for themselves may not have the same guarantees and benefits of those in the employ of others, but there are many other benefits of being your own boss. …Technological advances are opening up that dream to many more people, and we should not malign (or perhaps misclassify) that trend as worker misclassification.” This decision means that the San Francisco-based company can avoid paying drivers’ unemployment benefits, workers’ compensation and other employee-related costs.

This decision follows Uber’s appeal of a prior state revenue department decision in May, which dealt with the classification of former Uber drivers Darrin McGillis and Melissa Ewers as company employees, entitling them to unemployment benefits after Uber dismissed them from the service. Darrin McGillis states that he is planning to appeal the decision to the District Court of Appeals.

Click here to Daily Business Review article. (Subscription required)

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Filed under Fla. Stat. 627.736 (2008)

Lyft Sued for Wrongful Death Over Miami Crash

On November 18,2015, a Miami widow of a car crash victim sued Lyft for alleged negligence leading to the wrongful death of a motorcyclist. The widow is alleging that the ride-hailing company failed to properly train the driver that caused the fatal accident.

Poliana Perez, whose husband Loinier Perez was killed while riding his motorcycle on October 31, believes that Lyft Florida Inc. is liable for the crash caused by driver Pirooz Pakdel. Pakdel was carrying a pair of Lyft passengers when he allegedly made an improper left-hand turn and rammed into Loinier Perez.

Perez’s attorney, Ervin Gonzalez of Colson Hicks Eidson, stated that “Lyft, which isn’t even authorized to operate in Miami-Dade County, fell far short of its obligation to act in the best interests of public safety and an innocent life was taken.” The suit alleges that Lyft knew or should have known that Pakdel was not properly trained or suited for the job. The San Franciso-based Lyft allows passengers to use a smartphone app to hail rides from drivers in their personal cars.

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Filed under Fla. Stat. 627.736 (2008)