Tag Archives: Jeff Atwater

Tampa PIP Fraud Investigation Results in Seven Arrests

An office manager who acted as a patient broker as well as her six patient recruits were recently arrested on insurance fraud charges by the Florida Department of Financial Services’ Division of Insurance Fraud (DIF) after a two-year investigation uncovered suspicious insurance claims made by the individuals.

According to a story in the Tampa Tribune, Minette St. Fleur, 50, paid individuals to pose as patients injured in car accidents. The complex scheme, which was centered at Integrated Healing Clinic in Tampa, involved these patients filing fraudulent claims to multiple insurance agencies for their bogus injuries. Prices paid for treatments, some of which never occurred, greatly exceeded actual costs and totaled more than $150,000 in fraudulent claims, DIF found.

The scam was directed at GEICO Insurance Company, 21st Century Insurance, Progressive, Safeco Insurance, State Farm Insurance and Liberty Mutual Insurance. GEICO initially noted some patients repeatedly visited the clinic for many different treatments and that some dates on clinic paperwork did not match the dates on the filing of claims. The company brought the suspicious activity to the attention of DIF who began their investigation.

St. Fleur has been charged with insurance fraud and patient brokering, and was released on $2,000 bond

The others who were arrested for their involvement in the scheme included:

  • Sonthonax Ferdinand, 57
  • Marie Jean Gilles Valcin, 42
  • Marie Celestin, 38
  • Josue Auguste, 42
  • Elisena Louissaint, 48
  • Joseph D Pierre, 39

Hillsborough County State Attorney Mark Ober’s office will prosecute the case.

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Sales of Fraudulent Life Insurance Policies Leads to Pompano Beach Arrest

A Pompano Beach woman who sold fraudulent life insurance policies to elderly military veterans and their families has been arrested and charged with insurance fraud, according to an April 1 announcement by Florida’s Chief Financial Officer, Jeff Atwater.

Patrice Sands sold the policies to members of Make-A-Wish Veterans, Inc., a Miami company providing assistance to veterans. According to investigators, Sands sold the policies, collected premiums, and deposited those premiums into a bank account tied to her business, Universal Research Group Insurance Agency. She never actually procured the policies, however.

When her husband died, one 84-year-old victim attempted to collect the death benefits due her under the policy she had purchased from Sands. No benefits were received, however, and Sands told the widow that the insurance company had “gone under.” Sands then sought return of the life insurance certificate and allegedly destroyed it. A check written by Sands to refund the woman’s premiums bounced due to insufficient funds.

If convicted, Sands faces up to 25 years in prison and the suspension of her insurance agent license.

Since July 2014, the Division of Insurance Fraud has arrested 59 insurance agents, bail bond agents, and public adjusters for fraud that has totaled almost $4.5 million dollars.

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Florida CFO Stresses Insurance Fraud Prevention Efforts

As Fraud Prevention Month came to a close, Florida Chief Financial Officer Jeff Atwater announced that the Florida Department of Financial Services remains focused on raising awareness of insurance fraud and its impact on the lives of Floridians. He also reassured citizens that his office will continue to combat this unlawful activity.

Throughout the country, the overall price tag for fraud is more than just a dollar amount in a budget report. The estimated $80 billion annual cost of fraud poses potential fiscal drains not only to insurance companies but to law-abiding insurance customers who in turn have to pay higher premiums.

According to the National Insurance Crime Bureau (NICB), auto insurance fraud, homeowners’ insurance fraud, and workers’ compensation fraud make up the three most prevalent types of insurance fraud. In addition, personal injury protection, or PIP, fraud accounts for nearly 50 percent of all fraud referrals in Florida.

The Florida Legislature passed HB119 in 2012 to reduce PIP fraud and yield savings for consumers. Florida auto policyholders have saved $65 since passage, according to the Atwater release, resulting from a statewide decrease in PIP fraud of 13.6 percent.

Also, the Department of Financial Services’ Division of Insurance Fraud (DIF) has helped bring fraudulent offenders to justice by actively pursuing these criminals through their investigations. Since 2011, when CFO Atwater first took office, DIF personnel have made a significant impact in the fight against fraud:

  • 5,708 insurance fraud arrests made
  • 4,485 fraud convictions stemming from these arrests
  • 96% conviction rate in partnership with local law enforcement and the State Attorney’s Offices

The Department’s Division of Consumer Services also conducts a consumer educational program, notes Atwater, to help Floridians from becoming fraud victims. Consumers who become aware of potential fraud can report it using an Insurance Fraud Hotline at 1-800-378-0445, or on the webpage www.MyFloridaCFO.com/Fraud. An Anti-Fraud Reward Program is in place to award individuals up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme.

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Broward Staged Accident Results in Five PIP Fraud Arrests

Five individuals were recently arrested for their involvement in an alleged staged accident that took place in Broward in July 2012, according to an announcement by Florida Chief Financial Officer Jeff Atwater.

The five, who were arrested on grand theft and insurance fraud charges, carried out the alleged scam which resulted in fraudulent Personal Injury Protection (PIP) claims costing almost $40,000. Officials say a sixth individual is associated with the crime as well but has yet to be apprehended.

Investigators with the Department of Financial Services’ Division of Insurance Fraud (DIF) said that the five participated in the alleged crash as vehicle passengers. Shortly after the accident, they sought medical treatment at several South Florida clinics for bogus injuries. GEICO, Ocean Harbor and Gainsco insurance companies received fraudulent PIP claims as a result of the scam.

Those arrested include: Alfredo Romero, 66, of Hollywood; Alice Martinez, 27, of Pembroke Pines; and Jose Rodas, 33, Whitney Lopez, 25, and Mirna Madrid, 37, all of Fort Lauderdale. Alfredo Romero was also arrested in July 2014 for his role in another Broward County staged accident.

The cases will be prosecuted by the Broward State Attorney’s Office.

Mario Ruiz, 32, of Fort Lauderdale is the sixth individual currently wanted in connection with this crime. Anyone with information regarding his whereabouts is asked to contact DIF at 1-800-378-0445 or the Broward County Sheriff’s Office. Citizens may remain anonymous.

The Department of Financial Services to date has awarded almost $349,000 to nearly 60 citizens as part of its Anti-Fraud Reward Program. The program rewards individuals up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme.

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Five Arrested, Two Wanted in Organized South Florida PIP Fraud Scheme

Attorneys, chiropractors and clinic employees in Martin, Miami-Dade and Palm Beach Counties were swept up this morning in the culmination of a year-long undercover investigation led by the Florida Department of Financial Services’ Division of Insurance Fraud.

Two Boca Raton attorneys are among the five individuals arrested today:

• Brian Greenspoon (attorney), Boca Raton
• Cory Meltzer (attorney), Boca Raton
• Roger Hughes Bell (chiropractor), Hobe Sound
• Alejandro Marin, Homestead
• Douglas Santiago, Boynton Beach

Lake Worth chiropractor Ray Grand and Stuart resident Christina Savoye have warrants out for their arrest.

A brokering agreement among participants governed the payment of fees to a patient broker who recruited patients illegally for treatment at unnamed South Florida medical clinics. Unbeknownst to the crime ring organizers, the broker was in reality an undercover agent. Other law enforcement personnel, also working under cover, infiltrated the clinics involved to document the allegedly criminal activities.

Principals in the fraud scheme acknowledged on several occasions that it was illegal to pay for patients, so all referrals were paid under the guise of marketing services, according to a press release issued by Florida Chief Financial Officer Jeff Atwater.

Apparently, insurance carriers and others were billed by participating clinics for medical and chiropractic services that were not rendered. Patients were also being taught how to fake injuries, according to the release.

While exact dollar amounts are not available, the crime ring is believed to be responsible for hundreds of thousands of dollars in fraudulent billings.

The defendants will be prosecuted by the 15th and 19th Judicial Circuit State Attorney’s offices, according to the release.

Click on the link to read the full news release.

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Jeff Atwater, Facing Re-Election, Notes Success in Shutting PIP Clinics

Jeff Atwater has served as Florida’s Chief Financial Officer since January 4, 2011, and is up for re-election in November. He recently spoke with the editorial board at The News-Press in Naples about his accomplishments and priorities.

In a wide-ranging interview, Mr. Atwater emphasized Florida’s fight against fraud as an area of success. Some highlights from the interview follow.

“We have worked with sheriffs, the state attorney’s office, the FBI and locally with law enforcement, under the umbrella of financial literacy,” notes Mr. Atwater. “We are beginning to neutralize this. We are shutting PIP clinics and under-the-table transactions.”

Key accomplishments in the state’s continuing battle against fraud over the past three years include:

  • 5,000 insurance fraud arrests
  • 2,000 arrests in PIP fraud cases
  • $129 million in public assistance fraud uncovered

Atwater may run for governor or the U.S. Senate in four years, according to the article. He has served in public office since 1993, when he was elected Vice Mayor of North Palm Beach. He was elected to the House of Representatives in 2000 and the Florida Senate in 2002. In 2008 he was selected to serve as Senate President.

Click on the link to read the full article.

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Three Jacksonville Residents Charged with PIP fraud

Florida Chief Financial Officer Jeff Atwater recently announced that three Jacksonville residents have been arrested for personal injury protection fraud. The suspects—Yolanda Vargas, Christian Vargas, and Willdelyn Rodgriguez—have each been charged with one count of committing a staged motor vehicle accident and one count of insurance fraud.

A fourth suspect by the name of Felix Vargas, who has not yet been located, is alleged to have recruited the three individuals to participate in the fraud scheme. He is believed to be connected to a New York identity theft ring, as well as to an IRS scam in which he directed payment of others’ tax refunds to himself.

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Miami-Dade Clinic Owner Arrested for PIP Fraud in ‘Operation No-Med Services’

Aurora Hernandez, who owned and operated Magic Hands Medical Services, has been arrested on PIP fraud charges for allegedly organizing and billing a staged accident.

According to an announcement by Florida Chief Financial Officer Jeff Atwater, her arrest is the latest in an aggressive crackdown called “Operation No-Med Services.” This investigation, which began in May 2013 and involves four accident clinics in Miami-Dade County, has led to the arrests of a medical doctor, two clinic owners, five medical licensees, six staged accident organizers and six other co-conspirators.

The Division of Insurance Fraud (DIF) said that its investigation revealed participants from five staged accidents were referred to clinics, including Magic Hands, for treatment that was not provided but still billed to insurance companies in excess of $408,000.

“I am proud of our investigators for their commitment to keeping fraudsters off the streets and out of the pockets of hard-working Floridians,” said CFO Atwater. “Every act of fraud drives up the cost of insurance and we refuse to allow those selfish acts to continue.”

For her role in the scheme, the 32-year old Hernandez faces a maximum of 235 years in prison.

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Florida Insurance Premiums May Reflect $100 per Policy in Fraud Costs

Insurance fraud costs U.S. consumers $80 billion annually, according to a recent news report by News4Jax.com. For Florida residents, insurance fraud takes $100 out of consumers’ pockets each year in the form of higher auto and other insurance premiums.

“Staged accidents have been a problem around Florida, especially in urban areas,” reports James Quiggle of the Coalition Against Insurance Fraud. “Sometimes you can arrest the lower level recruiters or fake patients and convince them that they need to rat out the ring members or leaders in order for liens.”

Arson is another common form of auto fraud, according to claims executives from Main Street America who were interviewed for the News4 story. The use of an accelerant in an auto fire, for example, is usually a good sign that fraud is involved.

Social media posts that indicate signs of potential fraud are also coming under close scrutiny by insurance adjusters and claims executives. In one instance, a “bedridden” claimant posted a social media update showing a recent whitewater rafting expedition.

The good news is that many criminals involved in auto insurance fraud and related forms of fraud are caught and brought to justice.

Click on the link to read the full article “Insurance fraud costing all of us $80 billion a year.”

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Owner of Tampa Accident Clinic Sentenced for Insurance Fraud

Dailin Rojas Perez, who was charged in September with racketeering and money laundering, has entered into a plea agreement and will serve 24 months house arrest for her connection to a major insurance fraud scheme at a Tampa accident clinic, Florida Chief Financial Officer Jeff Atwater announced.

The 30-year old Rojas Perez is also required to pay $350,000 in restitution to the insurance carriers who were deceptively billed, as well as almost $40,000 in investigative costs. Fraudulent proceeds involved more than $340,000, according to her indictment last fall.

Through an investigation by the Department of Financial Services’ Division of Insurance Fraud, Rojas Perez’s company—Today’s Medical Marketing, LLC—conspired with Medical Therapy Practitioners to fraudulently bill insurance carriers. The deceptive charges included billing for: services not rendered, services procured as a result of staged automobile crashes, services for patients who had no injuries, and services not compensable because the business license was obtained fraudulently.

“I am proud of our investigators for bringing this fraudster to justice,” CFO Atwater said. “We will not tolerate anyone who commits insurance fraud and causes the rates of hard-working Floridians to increase.”

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