Category Archives: Fraud

Orlando Woman Arrested for Arson and Burning to Defraud

Tondra Shenika Roberts was arrested for allegedly setting her car on fire on Christmas Eve. According to police reports, Roberts said the vehicle was supposed to be repossessed and she left the keys inside in case someone showed up to take it.

Investigators found the key in the ignition of the abandoned car as well as a box of matches on the driver’s seat and an empty Heineken bottle with a paper towel inside of it. Lab reports from the car came back positive for gasoline. Roberts said she filed an insurance claim for the damage.

Roberts is facing felony charges of arson and burning to defraud an insurer.

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Filed under Fraud

Boynton Beach Man Accused of Selling Fake License Plates and Insurance Cards

Fedelin Pericles also known as “The Tag Man” was arrested by undercover officers after selling them fake temporary tags and a false insurance card. An anonymous tipster gave detectives Pericles’ phone number and told them that he was providing fraudulent temporary tags for $60 and insurance cards for $100.

On three occasions “The Tag Man” sold three undercover officers two temporary licenses and one fake insurance card. Pericles’ charges include counterfeiting a motor vehicle registration, falsifying records, uttering a forged instrument, organized fraud and driving with a suspended license.

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Two Arrested in Patient-Brokering and Insurance Fraud Scheme

Licensed pharmacist Richard Vallette and a “middleman” Todd Mulvaney were arrested in patient-brokering and insurance fraud scheme. Vallette and Mulvaney conspired to split thousands of dollars in insurance reimbursements from fraudulent prescriptions with who they thought was a drug-treatment center owner, but turned out to be an undercover cop.

Both men are facing six counts of patient brokering and six counts of insurance fraud. According to the Palm Beach County State Attorney’s Office, this is an active investigation and there will likely be additional arrests.

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Pinellas County Detectives Arrest 35 Unlicensed Contractors in Undercover Sting

Pinellas County Detectives arrested 35 unlicensed contractors in an undercover sting operation coined “Operation Cast Out.” The suspects’ charges include unlicensed specialty contracting violations, workers compensation fraud, and various other criminal charges unrelated to unlicensed contracting.

The sting operation was conducted from November 3-5 at a vacant storefront in Madeira Beach. The unlicensed contractors were found advertising on social media platforms and came to the business agreeing to engage in illegal contracting work without a license or permit.

Citizens in Pinellas County can search for licensed contractors or report unlicensed construction activity by visiting the PCCLB website.

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Filed under Fraud

Three Unlicensed Contractors Banned for Post-Storm Fraud

According to the Florida CFO Jimmy Patronis, three unlicensed contractors in Leon, Gadsden and Gulf counties have been banned from soliciting and conducting any work in Florida pending a full investigation. The Disaster Fraud Action Strike Team is investigating additional reports of potential fraud in Bay, Gulf, Washington and Leon counties. CFO Patronis is stressing the importance of verifying professional license information and whether the company has workers’ comp insurance before you hire a contractor.

Here’s a list of Tips to Stop Post-Storm Fraud:

  • Beware of Crooked Contractors.
  • Don’t Sign Anything.
  • Too Good to Be True? It Probably Is.
  • Beware of Door-to-Door.
  • Check a License.

Click here to read the press release.

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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

Florida Medical Professionals Charged in Largest Healthcare Fraud Crackdown In US History

Over 600 medical professionals in 35 states across the U.S. are on the hook for submitting more than $2B in fraudulent claims in what the U.S. attorney’s office is calling the largest healthcare fraud crackdown in the history of the Department of Justice. Of the 601 charged in this crackdown, almost 150 of the accused are from Florida.

Many of the crimes committed in this crackdown are linked to the opioid crisis, but also includes money laundering, check cashing and billings to Medicare.

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Filed under Fraud, 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.

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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.

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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