Category Archives: Insurance

4th DCA Finds AOB Without All Insureds’ and Mortgagees Signatures Unenforceable

On Wednesday, September 5, 2018 the Florida Fourth District Court of Appeals ruled that assignment of benefits (AOB) without all insureds’ and mortgagees signatures are unenforceable. The appellate court found no problems with an insurer requiring consent from all insureds and mortgagees, which is good news at a time when AOB abuse is such a big issue in Florida.

Visit Law360 (subscription required) or Justia for more information on this ruling.

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Filed under Assignment of Benefits, Insurance, Property Insurance

Vero Beach Acupuncturist Charged with Insurance Fraud and Racketeering

Jill Jaynes of Absolute Integrated Medicine in Vero Beach has been arrested and charged with insurance fraud totaling nearly $1.5 million, racketeering and more. If Jaynes is convicted, she could face up to 135 years in prison and millions of dollars in fines.

Click here to read the article.

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Filed under Healthcare Fraud, Insurance, Insurance Fraud

Former NFL Player & Coach arrested for Insurance Fraud

Marlon McCree, former Jacksonville Jaguar football player and assistant coach, has been arrested for an insurance fraud scheme totaling nearly $78,000. McCree allegedly submitted fraudulent invoices from a dental office he’d never been a patient of to his Health Reimbursement Account (HRA) with intentions of defrauding the fund. He could be facing a prison sentence up 30 years and a hefty fine if found guilty.

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Filed under Insurance, Insurance Fraud

Pinellas County Sheriff Going After Unlicensed Contractors

Thirty people were arrested in a three-day sting to “flush-out” unlicensed contractors preying on property owners in Pinellas County. The sting produced at least 60 felony and misdemeanor charges against the violators. Operation Flush Out is Sheriff Bob Gualtieri’s third sting since October 2017.

A Tampa Bay Times’ investigation in 2017 revealed how the Pinellas County Construction Licensing Board preferred to punish unlicensed contractors with fines rather than pursue violations in criminal court. Contracting without a license carries a misdemeanor for first-time offenses and a felony the second time.

Pinellas County government took control of the agency on July 1st. Gualtieri launched the Construction Licensing Investigative Unit and trained deputies to investigate contracting crimes. The department’s previous stings in October and February netted more than 45 arrests and dozens of charges.

Click here to read the article.

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Filed under Insurance, Property Insurance

Global Blockchain Expected to Grow in the Insurance Market

Insurance companies globally lose more than US$80 billion to fraud every year. A growing number of fraudulent insurance claims, increasing need to have transparent and trustworthy systems, and a focus on reducing the total cost of ownership will most likely drive the growth of the market.  A new study from ReportLinker projects global blockchain will have a compound annual growth rate of 84.9% between 2018 and 2023 ($64.5M to $1.393.8M) in the insurance market. The identity management and fraud detection segment are expected to hold the largest market size during that period.

The insurance sector of the Asia-Pacific (APAC) area is increasing its adoption of blockchain technology now and is expected to grow the fastest.

Click here to read the article.

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Filed under Insurance, Insurance Fraud

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.

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

FL Man Poses As NJ Doctor to Submit $1M in Fraud Claims

A Florida man, Yoandi Marrero, has been charged with insurance fraud, theft by deception, attempted theft by deception and identity theft after assuming a New Jersey doctor’s identity to submit more than $1 million in fraudulent medical claims. The services were never rendered and the medical center did not exist.

Marrero was found out when a woman claimed a doctor had billed her insurance for services that were never rendered.

Click here to read the full story.

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Filed under Florida, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud

Florida Public Adjuster Sentenced in $14M Insurance Fraud Plot

Corrupt public adjuster Jorge Fausto Espinosa recruited dozens of homeowners via his firm, Nationwide Adjusters, in an insurance fraud plot where he inflated insurance claims to the tune of $14 million.

Espinosa paid marketers to lure homeowners with free kitchens and remodeling jobs if they allowed him to manufacture damage to their homes. He earned around 30% of the insurance payouts he lined up for the homeowners. Espinosa earned payouts of more than $317,000 at times.

Insurers were pushed to pay overblown insurance payouts from claims resulting from rigged fires to water damaged. Espinosa hit at least 14 insurers with more than 50 inflated claims. He was sentenced to 20 years in state prison for racketeering and insurance fraud among many other charges.

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Filed under AOB, Florida, Florida Division of Insurance Fraud, Fraud, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud, Property Insurance

Florida Man Charged with Theft and Fraud in Property Insurance Scheme

According to investigators, Roderick Clark of Indian Harbour Beach is facing charges after filing a false claim for more than $30,000 in hurricane damages last year.

Clark claimed his home had sustained electrical damage during Hurricane Irma including having to replace 11 outlets and electronic devices that did not belong to him. According to court records, Clark also submitted a forged letter from an electrical company to USAA Insurance Co. stating that they made repairs in the about of $31,350.67.

Clark was arrested and charged with grand theft and insurance fraud.

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Filed under Florida, Florida Division of Insurance Fraud, Fraud, Hurricane Irma, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud, Property Insurance

Florida CFO Advises Homeowners that Insurance Coverage is Vital to Hurricane Preparedness

Florida Chief Financial Officer Jimmy Patronis reminds Florida homeowners that the 2018 Hurricane Season is in full swing and the importance of reviewing their insurance policies to understand the type of coverage it provides.

According to CFO Jimmy Patronis, “Last year, Hurricane Irma alone resulted in more than $8 billion in insured losses. If you haven’t already, now is the time to financially prepare for the 2018 Hurricane Season.” He advises that a vital part of hurricane preparedness is making sure that you understand what is and is not covered under your homeowner’s insurance policy so that you can have adequate coverage.

There are eight insurance coverages homeowners may want to consider for hurricane season:

  • Windstorm Coverage
  • Flood Insurance
  • Food Spoilage
  • Sinkhole Coverage
  • Additional Living Expenses/Loss of Use
  • Inflation Guard Endorsement
  • Replacement Cost Endorsement
  • Law and Ordinance

Once a storm develops, insurance companies may be under binding restrictions and may be unable to obtain a separate policy or add these essential coverages to the current policy. It is imperative that homeowners speak to their insurer to confirm these coverages as soon as possible.

Click here for press release.

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Filed under Florida, Hurricane Andrew, Hurricane Irma, Hurricane Matthew, Insurance, Insurance Claims, Property Insurance, Uninsured