Tag Archives: Miami-Dade County

Owner of ‘Exclusive Health Systems’ Clinic Arrested on Insurance Fraud Charges

Marlene Lopez del Castillo was arrested in October in connection with an illegal insurance scheme, according to the Division of Insurance Fraud (DIF). She allegedly pretended to be the doctor at Exclusive Health Systems, a Miami clinic she owned. Lopez del Castillo, 44, was charged with insurance fraud, grand theft, and practicing medicine without a license.

According to DIF, two people who participated in a staged vehicle accident in October 2011 visited Exclusive Health Systems for initial evaluations. Lopez del Castillo allegedly behaved as if she were the physician on call and examined both patients during their clinic visits, even though she is not a medical doctor nor does she hold a license with the Department of Health.

Lopez del Castillo also allegedly fabricated follow-up examinations that were later signed off by Dr. Hugo Goldstraj. Dr. Goldstraj gave a statement to investigators indicating that Lopez del Castillo prepared the reports. He said that he did not actually examine the patients nor do the paperwork.

Dr. Goldstraj was arrested in 2013 by DIF in a separate investigation, dubbed ‘Operation No Med Service,’ that involved a massive false billing scheme. Dr. Goldstraj was convicted in May and has since surrendered his license.

Lopez del Castillo opened Exclusive Health Systems in 2000.

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Filed under Insurance Fraud

Insurance Coverage Questions Put the Brakes on Miami Rideshare Programs

Plans to introduce Uber and other rideshare programs utilizing technology-based apps in Miami are on hold for now, according to a recent article in the Miami Herald.

Two key members of the Miami-Dade Board of County Commissioner’s transportation and aviation committee blocked a ride-sharing proposal that would have then gone before the full committee for a vote.

Popular rideshare services, like Uber X, Lyft and Sidecar, have seen accelerated growth in major U.S. cities. Using technology that the taxi industry finds highly disruptive, people with regular driver’s licenses can use their personal vehicles to transport riders for a fee. These drivers register for dispatch services. Accepted drivers are then able to connect to customers and collect fares via credit cards by using smartphone apps.

Critics, however, have accused these providers of working outside the constraints set for taxi and other commercial transit services, for questionable business practices, and for having inadequate insurance coverage for drivers and their vehicles.

San Francisco-based Uber recently announced that it has new insurance to cover the gap “during the time that ridesharing drivers are not providing transportation services for hire, but have the Uber app open and are available to receive a trip request,” according to an article in Insurance Journal.

Uber appears to be the first company, the article notes, to have a policy that extends insurance of ridesharing drivers to cover the potential insurance gap. This liability coverage kicks in only if a driver’s personal insurance fails to cover an incident and provides up to $50,000/individual/incident for bodily injury; $100,000 total/incident for bodily injury; and $25,000/incident for property damage.

A tragic accident over New Year’s Eve in which an Uber driver struck and killed a 6-year old girl when he was logged on to Uber’s app brought national attention to the nascent rideshare industry. Uber has been hit with a wrongful death lawsuit as a result, according to a March 14 Verge article.

Chicago’s City Council has also stepped up efforts to further investigate the insurance gap of the three companies operating in the city and recently subpoenaed their insurance records. The Council is still working to get the necessary evidence of still-undisclosed policies, according to a March 14 article in the Chicago Tribune.

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Filed under Fla. Stat. 627.736 (2008)

Miami-Dade County Passes PIP Ordinance

On February 21, 2012 the Miami-Dade Board of County Comisioners voted on and passed a County ordinance setting forth registration requirements for medical providers who provide treatment to PIP patients. According to the County Commissioners the intent behind the ordinance is to

Prevent fraudulent automobile insurance claims which negatively affect both consumers and insurers within Miami-Dade County through the implementation of registration requirements for certain Personal Injury Protection Medical Providers, as defined below, operating in Miami-Dade County, which treat patients allegedly injured in automobile accidents and receive a major portion of the Personal Injury Protection Medical Provider’s income from personal injury protection insurance claims.

To read the ordinance click here

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Filed under Insurance Fraud