Author Archives: Jessica Z. Martin, Esq.

Taxi Companies Sue Miami-Dade For $1 Billion In Wake Of Uber Law

A class action lawsuit on behalf of three taxi cab operators is seeking up to $1 billion from Miami-Dade County, claiming a new county ordinance has severely decreased the value of the medallions required of cab owners.

The suit was filed one day after the Miami-Dade County Commission legalized ride-hailing providers such as Uber and Lyft.

“The effect of ‘regulating’ (Uber and Lyft) is to legalize, upon information and belief, upwards of ten thousand for-hire transportation providers in Miami-Dade County, and to thereby remove any and all disincentives or barriers to the increasing dilution of the for-hire transportation market in same,” the complaint states.

Lead plaintiff Miadeco Corp. brought the lawsuit along with B&S Taxi Corp. and Checker Cab Operations Inc.

“Give us equal protections under the law,” Coral Gables attorney Ralph Patino, who is representing the taxi companies, said at a news conference. “You cannot take away a property right without paying market value.”

The medallions, which were worth an average of $340,000 each in 2014, are necessary for the cab companies to operate. Taxi companies now say the medallions may only be worth $50,000. Patino said damages to the medallions would total $600 million to $700 million. He added that total is likely to reach $1 billion by the time a jury would hear the suit. Since county law treats the medallions as property, Patino is suing under the principal of inverse condemnation.

Taxi companies say Uber gets to play by different rules because the company’s fleet of part-time drivers, which number 10,000 in Miami-Dade alone, don’t need medallions. But Uber says the medallions allow cabs to park outside Miami International Airport and the area’s many hotels, whereas Uber drivers must be summoned first via the company’s phone app.

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Filed under Miami-Dade County, Transportation Network Companies

DEATH BY DISTRACTION: 214 People Died In 2015 From Distracted Driving Crashes In Florida

More than 39,000 people were injured in Florida wrecks last year caused by distracted driving, including 214 who died.

According to AdCouncil.org, more than nine in 10 Americans believe sending and reading texts while driving is dangerous.  There have been many efforts to educate and convey the potential consequences of texting and driving using scare tactics or preachy messaging. And, while research shows that people are convinced that the behavior is dangerous, they are still doing it.

Data recently released by the Florida Department of Highway Safety and Motor Vehicles reveal 45,740 accidents in 2015 were caused by distracted driving, resulting in 39,396 injuries. To curb such statistics, the state Legislature passed the “Florida Ban on Texting While Driving Law” in 2015.

Miami-Dade ranked second in Florida for distracted driving crashes with 4,445 and topped the state with 16 fatalities in those accidents. Orange County topped the state in crashes (5,506) and injuries (5,040). Thirteen deaths in Orange were the result of distracted driving.

Hillsborough County (3,896) and Broward County (3,762) were third and fourth, respectively, in the number of wrecks from distracted driving. Here are the statistics for counties with ROIG Lawyers offices:

County                 Crashes          Injuries            Deaths

Hillsborough       3,896                  3,496                   11

Broward               3,762                  2,967                   8

Palm Beach          2,194                  1,656                   7

Leon                      791                      600                      0

Click here for the full story.

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Filed under Florida

Cell Phone Video Shows Potential Insurance Fraud

With the number of cyclists and cars sharing the roads, collisions are a common fear and an unfortunate reality for many South Florida drivers. However, collisions where both parties emerge without a scratch can be more than just “lucky.” It could be too good to be true as discovered by this one Fort Myers couple.

According to Fox 4 news, on March 1, 2016, a couple collided with a bicyclist in Southwest Florida leaving him completely unscathed. However, once he stood up and began complaining about the value of the sunglasses that were ruined in the accident, a passing woman told him to get back on the ground, advising him that it would be worth a lot more than his sunglasses. Luckily, her husband, the passenger in the car involved in the collision, just happened to be recording on his cell phone.

“Stay right there! Stay right there! Then you got 72 to 76 hours to go to the hospital,” she tells him. The cyclist does not reply to the woman but you can see him sitting on the ground as he’s being coached on what to do. To this, the cyclist does not reply but rather continues to complain about his damaged “pair of $180 sunglasses,” which you can hear on the recording. “You can sue their insurance fund” yells the passing woman to the cyclist, trying to convince him that the sunglasses are not worth much in comparison to what he can make from a lawsuit.

The recording was taken to Mr. Auto insurance, a Fort Myers area insurance agency, where the video was shown to agents who have dealt with cases like this before. “Like these people here, they took a minute, record it, report it, that’s the most important thing,” says insurance agent Dave Lindback.

Video recordings can prevent individuals from paying more money in the long run. Most people think the insurance company is the one that has to cover the extra expenses, but that is not as true as some people believe it to be. Eventually, rates increase on renewals and in the end, customers pay for it.

Recording and reporting incidents like this do not only help your insurance rates but may also affect your case in court. “If I was on the jury and I saw that video, it would blow my socks off. I would absolutely find zero damages. I think maybe the state attorney needs to take a look at that,” says Fort Myers attorney Mike Chionopolous.

Click here to read article.

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Filed under Florida, Insurance, Insurance Fraud, PIP/No Fault

Eleventh Circuit Declines 7th GEICO Car Crash Trial

On Tuesday September 22, 2015, the Eleventh Circuit declined to allow a seventh trial in a GEICO General Insurance Co. coverage dispute, rejecting an argument by the estate of a car crash victim that the insurer wasn’t prejudiced by the exclusion of decisions reached after it denied coverage, according to a Law360 article.

The court refused to rehear the decision vacating a Florida federal court judgment in favor of Esperanza Garcia, who represents the estate of a women killed in a car accident with a GEICO-insured driver in a car rented by someone else. The court found that GEICO should have been able to tell the jury that the coverage decision preceding Garcia’s bad faith suit was overturned because of changes in Florida case law impacting whether the driver has the rental agency’s consent to drive the car.

The court stated that “the exclusion substantially prejudiced GEICO,” and “a jury would no doubt find it exceedingly relevant that Florida law on implied consent was in a state of flux, or that a panel of Florida’s First District Court of Appeal and a United States District Judge for the Southern District of Florida supported GEICO’s conclusion regarding implied consent.”

Garcia petitioned the court for a panel rehearing in early September, asking the Eleventh Circuit that GEICO could not have been hindered by the judge’s order excluding legal rulings reached after the company denied coverage, arguing that those rulings were based on previous, cumulative decisions, making their exclusion harmless.

The Eleventh Circuit rejected all of Garcia’s requests in an order on September 22, 2015.

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Filed under Fla. Stat. 627.736 (2008)

Crash Victims Lose Bad Faith Claim at Eleventh Circuit Court

According to an August 28, 2015, Law360 article, The Eleventh Circuit Court determined that Clarendon National Insurance Company did not act in bad faith when protecting two of its insureds from a $750,000 excess judgment arising from a car accident in 2006. The court found no evidence to suggest such a claim. Carlos Mesa filed claims against the owner, Jary A. Martinez, and driver of the vehicle, Cesar A. Vega Zalaya.

Mesa stated that Clarendon passed up an opportunity to settle with him as well as failed to advise him on ways to avoid an excess judgment. However, the court found that Clarendon National Insurance Company did act in good faith since the company identified the claimants and reached a settlement of $20,000 per accident policy limit soon after realizing that the $10,000 per person limit was not enough to cover the claimant’s damages.

The court sided with the insurance company and not Carlos Mesa, stating that Clarendon may have not been as proactive in advising its insureds of settlement opportunities but not to the level of bad faith.

“Clarendon’s duty of good faith requires that it investigate the facts and give fair consideration to the prospect of a settlement offer that is reasonable under the circumstances, which it did here”, the court said.

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Filed under Eleventh Circuit Court

Undercover Agents Arrest Bradenton Clinic Operators for Insurance Fraud

On August 12, 2015, an undercover operation led to the arrest of three Bradenton clinic operators and a search for another suspect for insurance fraud charges, according to the Bradenton Herald. The Florida Division of Insurance Fraud (DIF) began investigating the First Medical & Rehab clinic in an undercover operation in March.

Investigators found evidence of the clinic paying people involved in automobile accidents to report that they had specific procedures done that were later billed to the insurance company.

DFS collaborated with Farmers Insurance to purchase a fictitious policy and expose the insurance fraud at the clinic. These three arrests were part of a greater scheme of arrests that took place statewide, resulting in a total of six arrests in Fort Myers and two in Orlando.

Click here for the full story.

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Filed under Insurance Fraud

Miami Couple Sentenced For Operating Clinic to Defraud Medicare

On June 29, 2015, U.S. District Judge Susan C. Bucklew sentenced Gladys Fuertes, 41, and Mario Fuertes, 41, of Miami for operating a sham clinic. Gladys Fuertes was sentenced to 19 years and 6 months in federal prison for conspiracy to commit healthcare fraud, healthcare fraud, aggravated identity theft, and obstruction of healthcare fraud investigation. Mario Fuertes was sentenced to 11 years and 3 months in federal prison for conspiracy to commit healthcare fraud, healthcare fraud, and obstruction of a healthcare fraud investigation. The couple was ordered to forfeit $1,036,759.72. A federal jury convicted the Fuerteses on March 24, 2015.

According to a Department of Justice release, the couple established and operated Gables Medical and Therapy Center for the purpose of committing healthcare fraud by employing unlicensed medical professionals. The Fuerteses misused the Medicare billing numbers of other medical professionals, without their knowledge, in order to claim medical treatments.

Prosecutors say Gladys and Mario Fuertes paid a co-conspirator to recruit Medicare beneficiaries and to drive patients to the Gables Medical for basic and sham medical services. The couple fraudulently billed Universal Medicare in excess of $900,000 for treatments not rendered and for treatments requiring a physician’s presence.

Gladys and Mario Fuertes also facilitated the provision of fraudulent prescriptions for controlled substances to Gables patients and allowed a co-conspirator to assist patients in filling prescriptions for controlled substances such as oxycodone, according to the Department of Justice. The co-conspirator also purchased the controlled substances from Gables patients and sold them on the street.

Gladys and Mario Fuertes also obstructed the federal investigation by instructing Gables Medical patients to lie to law enforcement agents. The couple provided federal agents with altered Medicare documentation.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 2,300 defendants who collectively billed the Medicare program for over $7 billion, according to a Department of Justice report.

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Filed under Insurance Fraud

11th Circuit Court Grants State Farm’s Request to Depose Imaging Center Owner

Petitioner State Farm sought to depose Respondent YH Imaging’s owner, Yamir Hernandez, as well as other individuals who allegedly performed portable x-rays in this case.  Respondent YH sought to have State Farm’s motion for discovery dismissed.

State Farm made their Motion for Discovery pursuant to Florida’s PIP Statute.  That statute provides, in  relevant part, that in “the event of a dispute regarding an insurer’s right to discovery of facts under this section, the insurer may petition a court of competent jurisdiction to enter an order permitting such discovery. The order may be made only on motion for good cause shown  . . . .”  §627.736(6)(c) Fla. Stat. (2013) (emphasis added).

In this case, the Court concluded that State Farm had established, through its motion and supporting affidavit, the necessary good cause to bring the discovery action.  The Court cited favorably two cases  holding that PIP insurers should be able to obtain informal discovery upon simple request and that court-ordered discovery is available upon a showing of good cause.  See Kaminester v. State Farm, 775 So. 2d 981 (Fla. 4th DCA 2000); State Farm v. Goldstein, 798 So. 2d 807 (Fla. 4th DCA 2001).  The Court also found persuasive orders granting similar actions for discovery entered by other judges in the 11th Judicial Circuit.

The Court granted petitioner’s Motion for Discovery and denied Respondent’s Motion to Dismiss.  State Farm was thereby granted leave to conduct the depositions at issue.

The case is State Farm Mutual Automobile Insurance Company, et al. v. YH Imaging, Inc., In Re OM, MM, et al., Circuit Court, 11th Judicial Circuit in and for Miami-Dade County. Case No. 11 28263 CA 05 (24).  December, 3, 2013. Click on the link to read the court order.

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Filed under Case Law, Fla. Stat. 627.736 (2012)

Mobile X-Rays Lead to Summary Judgment in Milo v. State Farm

Plaintiff Milo Diagnostic Center filed suit against Defendant State Farm to recover PIP benefits for mobile x-rays provided to Pedro Barreto, a State Farm insured. According to Florida PIP Statute Section 627.732(2) (2006), only medically necessary services are covered.  “Medical necessity” is defined as those services that a prudent physician would provide in a manner that is in accordance with generally accepted standards, clinically appropriate, and not primarily for the convenience of the patient or medical provider.

In a motion for summary judgment, State Farm argued against the medical necessity of such mobile x-rays in this case. State Farm presented evidence in the form of a deposition of a Department of Health expert that, pursuant to the Florida Administrative Code, mobile x-ray equipment is only to be used where it is impractical to transfer the patient to a stationary radiographic location. The reason for this caution is that the use of mobile machines results in increased radiation to the patient and inferior quality films. State Farm also relied upon an affidavit of a chiropractic doctor attesting that the use of mobile x-rays on Barreto was not medically necessary.

On November 12, 2013, Judge Jason E. Dimitris granted Defendant State Farm’s Motion for Summary Judgment regarding Medical Necessity. Judge Dimitris expressed the Court’s concern about the increased radiation exposure and poor quality films. Milo did not file a written response, but did appear at oral argument. Judge Dimitris held that since Milo did not produce counter-evidence sufficient to create a genuine issue of fact concerning the medical necessity for the use of mobile x-rays in this case, State Farm’s motion for summary judgment was granted and final judgment in the case was entered.

Click on the link to read the Judge’s order in Milo Diagnostic Center, Inc. vs. State Farm Fire & Casualty Co., No. 07-30146 SP 23 (4) (Fla. Miami-Dade Cty. Ct. 2013).

Contact partner Jessica Z. Martin via email or at 954-462-0330 to discuss any questions about the case.

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Filed under Case Law