Category Archives: Florida Division of Insurance Fraud

GEICO Files RICO Suit Alleging Windshield Repair Fraud

A federal lawsuit filed by GEICO on June 9 provides an inside look at an elaborate windshield repair fraud scheme.

The suit, filed in the Middle District of Florida, makes claims of fraud, unjust enrichment and RICO (Racketeer Influenced and Corrupt Organizations Act) violations against at least two companies and their owners.

The complaint explained the scheme as follows:

A company called Cornerstone Mobile paid kickbacks to car dealerships and car wash companies to work off their properties. Cornerstone would offer to fix even the slightest damage to windshields for free. It would obtain the car owner’s insurance information and, more importantly, the owner’s signature to transfer assignment of benefits. Sometimes, GEICO alleges, the Cornerstone owners would steal insurance information from glove boxes of cars and forge the owners’ signature.

Eventually, Cornerstone Network was incorporated. The two entities had separate tax identification numbers but operated in an identical manner. GEICO says the two companies were used in hopes of reducing the number of fraudulent claims from Cornerstone Network alone, and thus avoid detection. Both companies claimed to do windshield repairs, but neither had a physical address—one was just a post office box in Tavernier.

Once Cornerstone got insurance information from automobile owners, the employees used a liquid formula from a window repair kit to coat over cracks and chips. Afterward, Cornerstone charged GEICO and other insurers for a full windshield replacement. The complaint alleges that Cornerstone would wait two to four weeks to file for reimbursement. Florida law allows insurers 30 days to make windshield replacement reimbursements, meaning GEICO was rushed to pay the claims on time and didn’t have a chance to investigate them.

GEICO presented exhibits showing more than 600 fraudulent windshield claims from each Cornerstone company, costing GEICO in excess of $223,000.

The case is Government Employees Insurance Company, et al. v. Jason Fry, et. al.

Click here for full story.

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Filed under Auto Insurance Fraud, Florida, Florida Division of Insurance Fraud, Insurance, Insurance Fraud, Middle District of Florida, Windshield Damage Scam

Five South Floridians Enter Pleas in Insurance Fraud Case

Five defendants arrested on insurance fraud charges as part of the Division of Insurance Fraud’s Operation Cold Call have been sentenced after entering guilty pleas, according to The PIP Source, a newsletter of the Florida Division of Insurance Fraud.

The crimes – which were prosecuted by the 15th Judicial Circuit (Palm Beach County) and the 19th Judicial Circuit (Martin, St. Lucie, Indian River and Okeechobee counties) – took place in 2014 and 2015. A yearlong undercover investigation turned up illegal activity at two healthcare clinics: Accident Recovery Centers and Active Recovery Centers. Patients were illegally recruited and bills were sent for services that were never rendered.

Here are the five pleas and their punishment:

  • Runner Douglas Anthony Santiago was sentenced to three years probation for patient brokering.
  • Runner Alejandro Jose Marin was sentenced to two years probation for patient solicitation and patient brokering.
  • Attorney Brian Greenspoon was sentenced to 18 months probation for patient solicitation.
  • Chiropractor Roger Toby Hughes Bell was convicted of patient brokering and surrendered his license.
  • Attorney Cory Meltzer was convicted of patient solicitation and agreed to disbarment.

Two chiropractors are scheduled for trial later this year, while the final defendant is negotiating a plea.

 

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Filed under Florida Division of Insurance Fraud

Man Charged With Staging Traffic Accidents for Insurance Money

The Florida Division of Insurance Fraud arrested a man in Orlando who was charged with orchestrating automobile accidents for the purpose of defrauding insurance companies.

Alma Germain was accused of buying used junk cars to intentionally cause wrecks. Channel 9 in Orlando said one car was in such bad shape, Germain had to stop several times to add water to the radiator on the way to a staged crash.

Germain was charged with using cash to recruit people to get into crashes with him, then telling them to seek treatment at a local healthcare clinic. The clinic would then bill the insurance company.

In one particular case, Germain had three people in the car with him during a crash. He ran from the wreck site but told the three passengers to go to Family Practice and Rehab in Orlando for treatment. Family Practice billed the insurance company for nearly $25,000.

Click here for full story.

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Filed under Florida, Florida Division of Insurance Fraud, Insurance Fraud, Personal Injury Protection, PIP/No Fault