Tag Archives: Florida

Palmetto Bay Man Arrested for Insurance Fraud and Grand Theft

Carlos Guillermo Aponte of Palmetto Bay was arrested in September for three counts of insurance fraud and grand theft for allegedly defrauding Citizens Property Insurance Corp. The Department of Financial Services’ Disaster Fraud Action Strike Team (DFAST) investigated Aponte after receiving a tip about fraudulent invoices and false rental agreements with letters claiming lost of rent for more than $30,000.

Aponte could face prison time of up to 45 years and fines up to $45,000.

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Filed under Insurance Fraud

Lake Mary Man Arrested for Posing As Insurance Agent

Michael Hensley of Lake Mary has been arrested for falsely presenting himself as an insurance agent and providing general liability insurance for two Seminole County businesses. This isn’t the first time Hensley’s been accused of posing as an insurance agent and stealing money from local business owners.

While Hensley’s license expired in 2015, he’s pocketed $72,000 in insurance premiums over the years. The business owners would discover that they were not covered when attempting to file a claim.

Claims for damage due to Hurricane Irma uncovered Hensley’s alleged scheme causing one business over to pay $18,000 out of pocket to fix the roof of his business due to the storm.

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Filed under Insurance Fraud

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

Owner of Medical Billing Company Pleads Guilty to Healthcare Fraud Scheme

According to the report, Billings USA received or created fabricated bills for its clinic customers. The clinics would then bill insurance companies for allowable amounts and create records to back up the charges.  Billings USA collected a 6% fee on the reimbursement from insurers. Palma’s company filed $5.7 million in fraudulent claims to Blue Cross Blue Shield with one clinic and then an additional $5.9 million in fraudulent claims to Blue Cross and Cigna with another clinic.

Mauricio Palma, the owner of medical billing office Billing USA in Miami, pleaded guilty to conspiracy to commit healthcare fraud and was sentenced to eight years in prison. Palma faces $2.1 million in restitution lost $1.8 million in forfeiture.

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Filed under Fraud, Healthcare Fraud, Healthcare Fraud

New Statute To Help Deflect Frivolous ADA Lawsuits

As reported in the Miami Herald, Florida lawmakers have implemented a new law aimed at ADA public accommodation compliance lawsuits often pressuring small businesses and property owners into quick settlements in order to avoid lengthy and costly court battles. In an analysis published in March by The News-Press (Fort Myers), of all the lawsuits filed under the ADA’s public accommodations law in Florida during the past five years, more than half of the approximately 6,000 suits were filed by just 12 plaintiffs. In addition, many of the plaintiffs are represented by the same law firms. The bill, receiving unanimous approval in both the Florida House and Senate during the 2017 legislative session, was recently signed into law by Gov. Rick Scott and is now in effect.

The new statute enables businesses and property owners to take substantive, preventative measures to help insulate themselves from the most frivolous claims. Under the law, a business or property owner may retain a qualified expert to conduct an inspection of their property to ensure compliance with building codes satisfying the ADA’s requirements. If the property is found to be in compliance with the ADA, the expert may issue a certificate of conformity that includes the date of inspection, proof of the expert’s qualifications, and a statement confirming that the property is in conformity. For properties that are not found to be in compliance, the owner may develop and submit a remediation plan approved by a qualified expert indicating that the property will be brought into conformity within a specified time period.

The compliance certifications or remediation plans may be filed with the state’s Department of Business and Professional Regulation, which will now maintain a publicly accessible website to serve as a registry for all of the certifications and remediation plans that it receives. Importantly, a remediation plan in existence before an ADA lawsuit is filed could serve to moot such a lawsuit.

The new law does not prohibit disabled plaintiffs from filing ADA public accommodations lawsuits, nor does it prohibit plaintiffs’ attorneys from seeking fees. It does, however, provide Florida businesses and property owners with a means to potentially defeat or limit frivolous ADA barrier-to-access lawsuits and greatly minimize their exposure to related attorney fees and costs.

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Filed under ADA, FL Legislation, Florida, Lawsuits