Tag Archives: Staged accidents

Rise In Searches For ‘How To Set Fire’ As Economy Crashes

Internet search queries for “how to set fire” are spiking amid the downturn from the coronavirus pandemic, which experts say is a sign that some people may be planning to commit insurance fraud. Search term data compiled by Google shows that the number of users looking for information on how to start a fire grew by 125% in the last week of March.

Insurance companies are highly attuned to the potential for fraud, but risk experts believe it’s too soon to tell. There was a similar kind of anticipation around 2007 to 2009, “that we were going to see just ungodly amounts of insurance fraud triggered by an economic downturn,” said Frank Scafidi of the National Insurance Crime Bureau, but this never occurred to the scale some projected. They saw an increase in arson activity related to cars, however, where a vehicle would be reported stolen to an insurance company when the owner had a hand in the car’s disappearance.

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Filed under Fraud, Property (Homeowners)

Florida CFO Jimmy Patronis says a Quarter of Pedestrian Accidents in 2018 are Faked

According to Florida Chief Financial Officer Patronis, “In 2018, there were 9,300 pedestrian crashes and of those, an estimated 25 percent were staged.”

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Filed under Fraud, Personal Injury Protection (PIP)

Kissimmee School Teacher Arrested for Staged Accident Scheme

Kissimmee elementary school teacher, Lanfranco Palman, is facing three felony charges for allegedly faking being hit by a car to defraud his insurance company. The staged accident occurred at a grocery store in 2016 where Palman claimed he was hit by a vehicle, but witnesses say he fell onto the hood after the car had stopped.

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Filed under 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 Fraud

Pending PIP Litigation on the East and West Coasts Could Impact States In Between

PropertyCasualty360 published a report about pending automobile personal-injury litigation in California and New York that could have a lasting impact if the decisions spread to other jurisdictions. Courts will determine allowable evidence for suits involving these insurance claims.

East Coast

In New York, insurers investigated radiologist Andrew Carothers, a suspected illegal straw owner after he filed 20,000 lawsuits against auto-insurance carriers. After insurers refused to pay Carothers, he flooded the state’s courts with more than 20,000 lawsuits seeking collection for unpaid “services.” The civil cases were consolidated, and the jury agreed Carothers was fraudulently engaged in the corporate practice of medicine. The Appellate Division affirmed, so Carothers went to the New York Court of Appeals, where the case awaits a decision.

A favorable decision can deter scams like Carothers’ in other states that forbid the corporate practice of medicine. Fraudsters who often quickly expand operations to line their pockets in other states could be deterred. A decision is expected in 2019.

West Coast

Dave Pebley was involved in a serious vehicle accident, sought medical care and filed suit. He had health coverage but decided not to submit his bills for payment. That is because, under California law, the jury would only hear about the amount paid by his health insurer as the measure of his medical expense while Pebley was billed at the top rate for medical services by refusing to use his health insurance.

The insurer cried foul, asserting that such actions mislead the jury, and are fraudulent because medical providers never expect to receive such high payments. They argued the plaintiff may present the higher medical bills but must provide expert testimony to prove the charges are fair and reasonable. Similarly, the defendant or their insurer may present counter-evidence as to what the health providers normally accept for payment of those services.

The California Second District Court of Appeal reasoned that juries should be allowed to ultimately decide the appropriate charge for the medical services. Parties are lining up to support an appeal of the case to the state Supreme Court. If Pebley succeeds in California, potentially winning the $3.6 million he seeks, the strategy of refusing to use health insurance can be expected to spread rapidly to other states.

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Filed under Fraud, Personal Injury Protection (PIP)

Two GEICO Adjusters Charged in Miami Insurance Fraud Ring

On Monday, July 10th, 14 people were charged in “Investigation Vehicle Roulette” conducted by Florida’s Bureau of Insurance Fraud and the State Attorney’s Office. Two GEICO insurance adjusters, Juan Carlos Diaz and Cesar Santiago Tapanes, prosecutors say got cash kickbacks for helping defraud their own company were among those arrested.

In September 2016, a Lexus GS350 was involved in a fender bender with a Chrysler 320 in North Miami-Dade. The rogue insurance adjusters reported inspecting the Lexus and authorized a series of payments totaling over $16,000. However, investigators say the accident never actually happened.

In fact, the same Lexus had been the subjection of 10 previous claims involving crashes that never occurred, all signed off by Diaz and Tapanes. The scam ended up costing GEICO more than a million dollars.

According to an arrest warrant by detectives, at least 45 bogus claims were made. The group faces charges including grand theft, insurance fraud, and racketeering.

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Filed under Fraud

Two Miami Medical Clinics Raided for Staged Accidents & Insurance Fraud

Florida’s Department of Investigative and Forensic Services Bureau of Insurance Fraud and the Miami Police Department raided two South Florida medical clinics accused of paying for patients and fraudulent billing. Both clinics have been under investigation since early 2017 for recruiting people for staged accidents and billing insurance companies for thousands of dollars in treatments that they were not providing.

According to Captain Emissael Díaz of Florida’s Bureau of Insurance Fraud “Just in South Florida alone, most of your rates are going to go up 20 to 25 percent just because of the insurance fraud.” The captain stated that schemes of this kind are the reason insurance rates are going in South Florida.

The suspects taken into custody are facing several charges, including patient brokering, insurance fraud and grand theft.

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Filed under Uncategorized

Florida Man Caught Staging Crash on Dashcam

According to the Sun Sentinel, a Florida man was arrested on Friday, October 6th in connection with an alleged staged crash that occurred in December of 2016. 65-year-old Mauril Aldophe of Delray Beach plotted to force a tow truck to rear-end him. Unfortunately for Mr. Aldophe, the tow truck was equipped with a dashcam capturing footage of him abruptly stopping for no apparent reason and then driving forward for several feet, throwing his car into reverse, and then slamming back into the tow truck.

According to investigators, Mr. Aldophe went to a medical clinic three days after the incident and filed a personal injury claim stating a truck had rear-ended him while he was stopped at a red light.

Mr. Aldophe now faces charges for insurance fraud and participation in an intentional crash.

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Filed under Personal Injury Protection (PIP)

Florida Insurance Rates Rise Thanks to Windshield-Replacement Schemes

According to Insurance Business America, your auto insurance premiums are going up, all because of ongoing windshield-replacement schemes.  As reported by Ryan Smith of Insurance Business America, these windshield schemes involve drivers with cracked windshields signing over insurance benefits to windshield repair and replacement shops.  These shops, through an “assignment of benefits”, will then submit an inflated invoice for the work allegedly rendered.

The Tampa Bay area has become the hub of the fraud and abuse involving these schemes.  More often then not, the fraudulent schemes are no fault of the insureds.   Florida law states that a deductible cannot be applied to windshield replacement and repair services.  This allows these shops to advertise that the work being done is “free” to the insureds.  The result of these “free” services has led to over 1900 windshield-claim lawsuits in Florida in 2016 alone; increasing litigation costs and ultimately hitting everyone’s pocket.

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Filed under Uncategorized

Auto Insurance Fraud Comes in All Shapes and Sizes

A recent study by the auto insurance industry reveals that fraud costs the industry $50 billion each year. And with that much money at stake, the criminals can get pretty creative.

South Florida law enforcement used “Operation Cold Call” last year to bust up a personal insurance protection (PIP) fraud ring that used chiropractors, lawyers and clinic employees. Undercover agents infiltrated the ring over a year’s time, uncovering a network of con artists who recruited and paid people to lie about injuries and the healthcare they received after crashes. But fake injuries are pretty tame compared to two other schemes mentioned in the report:

  • The Montana License Plate Scam: Montana has no sales tax or use taxes on vehicles. In this scheme, an unscrupulous attorney in Montana helps out-of-staters create a limited liability company in Montana. Then that LLC is used to buy an expensive sports car or recreational vehicle. The vehicle is taken back to the LLC owner’s home state, and technically, the owner is driving a “company car” with Montana plates. But if there is a wreck, theft or weather damage, the auto insurance company may cancel the policy or deny the claim due to violation of insurance and registration laws within the driver’s home state.
  • The Hot Wheels Ruse: One insurance company had a customer make a claim for parts stolen from the customer’s vehicle. Everything appeared legit at first, until investigators took a closer look at the photos submitted with the claim. The photos were actually extreme close-ups of a toy car, but at least the toy car was the same make and model as the customer’s real car.

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Filed under Uncategorized