Author Archives: Michael A. Rosenberg, Esq.

How to Use Data to Combat Florida’s Insurance Litigation Nightmare

Florida has a big insurance litigation problem. Data from the National Association of Insurance Commissioners (NAIC) showed that even though Florida represented just 8% of all homeowner insurance claims in the United States in 2019, the state delivered about 76% of all litigation against homeowner carriers that year.

The problem has been getting worse, according to data mined by Roig Lawyers. There were 68,000 lawsuits filed against insurance carriers in Florida in June 2021 – an all-time high – marking an 11,000 increase from 57,000 in the month before, and more than doubling from about 30,000 in June 2020.

There was no major hurricane event or catalyst for this deluge of litigation, most of which was filed around Miami, Broward County, Palm Beach, Tampa, and Orlando. And it’s not just property claims either. We’ve seen a huge increase in personal injury protection (no-fault) litigation, property, windshield, and worker’s compensation, while health insurance carriers have also been getting sued like we’ve never seen before.

The Insurance Litigation Problem

Why is Florida such a hotbed ­– or hot mess – of insurance litigation? While recent legislative changes are trying to chip away at property litigation, they still lack teeth and do nothing to address claims besides property.

A major problem is Florida’s fee-shifting rules, which create a huge incentive for attorneys to sue insurers. At Roig, we’ve seen carriers sued for tiny amounts, but when plaintiffs win, insurers must pay their attorney’s fees, which can amount to tens of thousands of dollars. In contrast, New York requires attorney’s fees to be proportional to awarded damages.

Technologically speaking, Florida’s court systems are a little behind the times. When carriers get sued, they get a jumbled mess of information, and they have to employ people to extract data manually. It puts carriers on the defensive – how will a company address this problem at the root when it’s spending resources just putting information into a computer? When you’re talking about big insurance carriers, who are seeing thousands of lawsuits in a single month, that’s a lot of wasted time.

We had to deal with this problem at Roig. We tried to transfer information from lawsuits into our system to help our clients strategize. As the mountains of documents grew, we knew we had to find a better solution, so we developed proprietary software that mines, extracts, and organizes all the state’s litigation data to help carriers get on the offensive.

How Data Helps Inform Strategy

This litigation problem in Florida requires serious reform at the legislative level, which means insurance carriers should be trying to communicate with lawmakers. After all, expensive litigation against insurers won’t end well for consumers as insurers pull out of the market and rates increase.

Meanwhile, insurers can use data to get in front of this problem. For instance, they can look at the data and see which plaintiffs’ attorneys are filing massive amounts of lawsuits, and then communicate with them to try to get some of these issues resolved before they become lawsuits.

Another tactic is using the data to see how the plaintiffs’ attorneys are strategizing and adjust policy documents to thwart them. Take a recent example. A plaintiff attorney filed a case in Broward County. The insured lived in Brevard County, which is also where the auto accident occurred and where all the witnesses resided. But the attorney cherry-picked the venue thinking it would be more favorable for the case. With a look at that kind of data, an insurance carrier can easily head off that problem by including a venue selection clause in its policy.

Add Data to the Litigation Defense Arsenal

Data has brought Florida’s insurance litigation problems to light, and it’s also a vital tool that insurance carriers can use to manage the problem until the government puts meaningful structural reform into place.

If you want to learn more about Roig’s insurance litigation data technology solutions, contact us.

Filed under Technology

NICB Launched Online COVID-19 Resource Center Due to Surge in Insurance Fraud Schemes

The National Insurance Crime Bureau (NICB) has created a new page on its website called the “NICB COVID-19 Resource Center.” The page provides the latest information on emerging fraud schemes due to an influx of insurance fraud cases tied to the COVID-19 outbreak.

The Coalition Against Insurance Fraud (CAIF) recently sent out a statement regarding a surge of fake coronavirus health coverage schemes. It warned that robocalls, text messages, and email phishing attacks could fake insurance deals to consumers, asking them to pay for health or travel insurance premiums without delivering coverage.

Click here to read the article.

Filed under Fraud, Healthcare

No Need to Reschedule – Keep Your Claims Moving and GO VIRTUAL!

We Are Able to Facilitate Virtual Examinations Under Oath, Hearings and Depositions!

Don’t cancel! Go virtual!

Recorded statements are not your only choice for presuit investigations and litigation (consent from all parties required). We can facilitate virtual Examinations Under Oath, hearings and depositions.

At this time, the claim investigation deadlines remain under each policy of insurance and under Florida Statutes.

Courthouses have limited operations and are shifting to electronic hearings and suspending jury trials. Our essential services remain uninterrupted. We are handling files via remote technological platforms (videoconference or teleconference) to eliminate the need for people to gather or come in and out of the courthouse.

There may be a small additional cost of $75 – $500.

Please review the Florida Supreme Court Administrative Order for Administering Oaths via Remote Audio-Video Communications Equipment. It orders the following:

  • Notaries and other persons qualified to administer an oath in the State of Florida may swear a witness remotely by audio-video communication technology from a location within the State of Florida, provided they can positively identify the witness; and
  • If a witness is not located within the State of Florida, a witness may consent to being put on oath via audio-video communication technology by a person qualified to administer an oath in the State of Florida; and
  • All rules of procedure, court orders, and opinions applicable to remote testimony, depositions, and other legal testimony, including the attestation of family law forms, that can be read to limit or prohibit the use of audio-video communications equipment to administer oaths remotely or to witness the attestation of family law forms, are hereby suspended, and will remain suspended until the expiration of the provisions of paragraph five in In Re: COVID-19 Emergency Procedures in the Florida State Courts, Fla. Admin. Order No. AOSC20-13 (March 13, 2020), and any orders extending AOSC20-13.

Our vendors can assist in capturing your presuit and litigation needs via smartphone or laptop. Equipment rental services are available as well.

Capabilities of these virtual services include swearing-in, taking testimony, taking screenshots of evidence and documents, the pickup of documents and evidence by the vendor. They can organize exhibits into handy PDF files, hyperlinked, OCR’d and searchable by keyword making them easily accessible from any computer, tablet, or mobile device.

During depositions, files can be synchronized to the transcript, electronic documents can be displayed to witnesses, and mouse movements and keystrokes can be recorded on the computer in realtime.

Please do not hesitate to contact us with any questions or concerns at info@roiglawyers.com.php73-37.phx1-1.websitetestlink.com or call us at 1-855-ROIGLAW (1-855-764-4529).

YOUR LAW FIRM IS HERE FOR YOU!

Filed under Firm News

ROIG LAWYERS REMAINS OPEN AND CAUTIOUS THROUGH THE COVID-19 CRISIS

To our valued clients, partners, & community members:

As COVID-19 continues to affect the global community, we would like to assure you that Roig Lawyers remains fully operational. We are taking preventative measures to ensure the safety of our employees while continuing to provide services without disruption to our clients.

We want to update you on the steps we have taken to ensure business continuity for all our clients as well as the action we are taking to slow the transmission of COVID-19 for the health of our employees, our communities, and society as a whole.

Business Continuity Plan: We have a comprehensive Business Continuity Plan in place to ensure you will continue to have access to the resources and services you require. These plans were developed to cover any contingency that might interrupt day-to-day business, and have been updated to account for new challenges caused by COVID-19.

Remote Workforce: Our attorneys and professional staff are equipped to work remotely, and have been encouraged to do so as a precaution. Effective today, we are ensuring the remainder of our support staff will also be able to work remotely without interruption. This is a normal work practice for Roig Lawyers, and you will see no change in our ability to maintain the level of service you are accustomed to.

Travel Restrictions: We have instructed employees to leverage technology and conduct internal and external meetings virtually as much as possible. We have asked our employees to reschedule all non-essential travel plans and events, and we will continue to update our staff and workspaces with the latest health and wellness practices and tips provided by the United States Center for Disease Control.

Client Guidelines and Expectations: We are continuously updating our Business Continuity Plan according to our clients’ instructions and expectations of their vendors and outside counsel. We are meeting the expectations to minimize business interruption but also protect the health and safety of our employees and our clients.

This is an unprecedented time for everyone, and the situation is changing daily. We are committed to maintaining our business operations and ensuring you continue to receive the highest quality service from us, regardless of our ability to access our offices in this unlikely occurrence.

We are fortunate that we can make these changes with no business disruption. Our hearts and thoughts go out to the people who have been affected by this unprecedented event and we appreciate the healthcare workers, local communities, and governments around the world who are on the front line working to contain this coronavirus. We will continue to actively monitor the situation and share updates as needed. Please stay safe and thank you for your continued trust in us.

Please do not hesitate to contact us with any questions or concerns at info@roiglawyers.com.php73-37.phx1-1.websitetestlink.com or call us at 1-855-ROIGLAW (1-855-764-4529).

Filed under Firm News

Tampa Police Detective Under Fire for Alleged Insurance Fraud Scheme

Sergeant Shane Gadoury of the Tampa Police Department was arrested for allegedly insuring his boat after it had already capsized. Gadoury is charged with filing a false and fraudulent insurance claim for knowingly insuring his capsized boat and submitting a claim. The detective has been placed on administrative leave and faces an internal investigation by the police department as well.

Click here to read the article.

Filed under Fraud

Weston Doctor Sentenced for Conspiring to Illegally Distribute Oxycodone

Dr. Rodolfo Gonzalez Garcia was sentenced to eight years in prison for conspiring to dispense oxycodone, a charge to which he had previously pled guilty. Dr. Gonzalez Garcia and his co-defendants, including his wife Arlene Gonzalez, admitted to using a Hialeah medical office to provide prescriptions for the controlled substance, even though he did not conduct meaningful examinations to prescribe oxycodone appropriately. Dr. Gonzalez Garcia referred to himself as “El Chapo of Oxycodone.”

Co-defendants Arlene Gonzalez and Annie Suarez-Gonzalez pled guilty to conspiracy to pay and receive health care kickbacks. They were sentenced to 4 months in prison and one year of probation each. Co-defendant Fidel Marrero-Castellanos pled guilty to conspiracy to pay and receive health care kickbacks and conspiracy to distribute controlled substances. He was sentenced to 13 months in prison. The co-defendants were ordered to pay a total of $26,306 in restitution.

Click here to read the article.

Filed under Fraud, Healthcare

Florida Doctor Arrested for Allegedly Defrauding Nine Auto Insurers

According to a statement from the Florida Department of Financial Services, Dr. Celestino Santi was arrested for allegedly defrauding nine auto insurance companies our of more than $500,000 in unlicensed medical billing.

Investigators reveal that Santi was allegedly acting as a “straw owner” of Accident Care Center of Boggy Creek to disguise the identity of the unlicensed, true owner of the motor vehicle accident medical treatment center.

Click here to read the article.

Filed under Fraud, Personal Injury Protection (PIP)

Three South Floridians Arrested in Sober Home Health Care Fraud Scheme

Peter Port, 64, of Boca Raton; Brian Dublynn, 62, of Fort Lauderdale; and Jennifer Sanford, 57, Hollywood were arrested for allegedly billing health-insurance companies for services that were not performed or medically necessary. Port, Dublynn and Sanford made about $13 million in the scam through Safe Haven Recovery, a substance abuse treatment facility in Miami.

The trio was charged with conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to commit money laundering and money laundering. They could face at least 20 years in prison if convicted.

Click here to read the article.

Filed under Fraud, Healthcare

Three Miami Arrests in Physical Therapy Clinic PIP Fraud Scheme

Three individuals from the Miami physical therapy clinic Professional Medical Practice have been arrested in an alleged personal injury protection (PIP) fraud scheme. The clinic owner Alean Machado, recruiter Barbarito Leyva-Claro, and physical therapist Yoandra Rodriguez-Pena were charged with Insurance Fraud, Grand Theft, Patient Brokering and Organized Scheme to Defraud.

An undercover investigation uncovered the scheme which paid $2,500 for patients that participated in the fraudulent physical therapy sessions. Two insurance companies were billed over $39,000 in fraudulent claims from the clinic. Machado, Rodriguez-Pena and Leyva-Claro could face up to 45 years in prison if proven guilty.

Click here to read the article.

Filed under Fraud, Personal Injury Protection (PIP)

Unlicensed Contractor Arrested for Defrauding Elderly Man

Cleveland Brantley, an unlicensed contractor with a track record for scamming, was arrested on charges of scheme to defraud, grand theft and elderly exploitation. Brantley scammed a 77-year-old man out of more than $60,000 for repair but did little to no work. The victim contacted Brantley for repairs through HomeAdvisor.com, took his money and promised to do work, but showed up for work on and off for a week but never completed any repairs.

Click here to read the article.

Filed under Fraud