The Bureau of Workers’ Compensation (WC) Fraud has five dedicated squads located throughout the State. The Bureau received over 1,300 Workers Compensation referrals this past fiscal year. These referrals include working without Workers’ Compensation Coverage, Claimant Fraud, Premium Fraud and Money Service Business Fraud. The Bureau squads are located in Tampa, Orlando, West Palm Beach, Miami and the MSB squad which is comprised of Division Detectives from the West Palm Beach and Broward Field Offices, as well as two Broward County Sheriff’s Office and one Palm Beach County Sheriff’s Office Detectives.
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Captain John Dygon has 36 years of law enforcement experience, beginning as a deputy sheriff in Ohio. John moved to Florida, and joined the Miami Police Department. After several years, he moved to the Florida Department of Law Enforcement attaining the rank of special agent supervisor. Since joining the Division, John was promoted to lieutenant in 2003, and has supervised a general fraud squad, and currently supervises a PIP squad in the Miami Field Office. In September, 2012, John was promoted to Captain over the newly-formed South Central Region. In April, 2014, John transferred to the Captain's position over the Bureau of Workers' Compensation Fraud. John is a graduate of the Southern Police Institute Command Officers Development Course.
Ruthell J. Harris holds a bachelor’s degree in Criminal Justice from Florida State University. In 1985, the Department of Corrections hired Lt. Harris as a correctional probation officer, and she worked supervising both felony and sexual offenders.
After 15 years with probation, Lt. Harris entered the police academy and, in 2000, received her State of Florida police certification. In that same year, she continued her law enforcement career by becoming an investigator with the Division of Insurance Fraud. In July 2008, Lt. Harris was promoted to her current position as supervisor of the Orlando Field Office workers’ compensation squad where she continues to develop her anti-fraud and management skills while supervising a squad of detectives.
Lt. Harris is a 2009 graduate of the Southern Police Institute (University of Louisville) Command Officers Development Course (SPI-Class 51).
Lt. Rapp began her diverse career with the Florida Division of Insurance Fraud in May 2002, when she was hired as a detective assigned to the Tampa Field Office. During her first three years as a detective, Lt. Rapp worked primarily on personal injury protection (PIP) fraud cases. Lt. Rapp was one of four detectives who worked on a protracted PIP investigation that led to the arrests of 14 individuals and resulted in the first set of patient brokering convictions in Hillsborough County, in 2005. Prior to being promoted in 2008, Lt. Rapp worked a variety of general fraud cases, and she specialized in the investigation of licensee fraud. In June 2008, Lt. Rapp won a Davis Productivity Award for her work on a case that she worked jointly with the Division of Agent and Agency Services and the Statewide Prosecutor’s Office. The investigation resulted in the arrest and conviction of an insurance agent who misappropriated homeowner’s insurance premiums from over 40 victims, in multiple counties, during an active hurricane season. Lt. Rapp currently serves as a lieutenant for the Bureau of Worker’s Compensation Fraud, Tampa West Central Field Office, where she oversees a squad of five detectives who work closely with the Division of Worker’s Compensation Compliance and members of the insurance industry to combat worker’s compensation insurance fraud.
Lt. Rapp has an associate’s degree from Nassau Community College in New York, and bachelor’s and master’s degrees from the University of South Florida, Tampa. In December 2010, Lt. Rapp obtained a Ph.D. from the University of South Florida in adult education and research and measurement.
Lieutenant Gina Narcisse has over 10 years of law enforcement experience. Prior to joining DIF, Narcisse served four years as a state trooper with the Florida Highway Patrol where she worked in the patrol and criminal investigation sections. Narcisse joined the Division in 2008, as a detective at the Miami Field Office. Since then, she has actively assisted Miami DIF team members with investigations, utilizing surveillance and covert electronic video and audio recording devices leading to the take down of several significant cases resulting in numerous arrests. Narcisse has earned a Bachelor of Arts in Criminal Justice from Johnson & Wales University.
The Florida Division of Insurance Fraud completed an investigation concerning Smart Touch Services Inc. Smart Touch Services Inc., and related subsidiaries avoided paying full workers’ compensation premiums by misrepresenting the wages and the number of employees. The investigation revealed that Smart Touch was paid approximately $20.6 million dollars in wages from West Gate Resorts for janitorial services from 2009-2011, but reported only $6,860,000 in wages.
Through the investigation, it was revealed that Ada Schoenbohm and her mother Ada Urdaneta were owners of Smart Touch Services, Inc and related shell corporations. They used the shell corporations to hide wages and avoid paying full premiums. Also during the investigation, it was discovered that a person associated with owners of Smart Touch Service, Inc., Sergio Jose Villalobos opened several business checking accounts for several shell corporations in the name of an individual who was deported in 2008. The investigation additionally revealed that Andreina Urdaneta wife of Villalobos assumed the managerial duties of one of the major shell company used to hide wages.
The investigation determined Smart Touch Services Inc. deprived the insurance company of collecting premiums totaling $822,000.
On January 28, 2014, Ada Schoenbohm, Ada Urdaneta, Sergio Villalobos and Andreina Urdaneta were arrested and charged with racketeer influenced & corrupt organization, workers’ compensation fraud and scheme to defraud.
Case is currently pending prosecution.
Angela C. Kleckner was a former correctional officer with the Brevard County Sheriff’s Office. Kleckner filed a workers’ compensation claim on October 15, 2007. Kleckner while employed allegedly acquired external Methicillin-Resistant Staphylococcus Aureus (MRSA). According to documentation, she began coughing and it was determined that the infection had transferred to her lungs. As a result in 2009, per court order, the insurance claim administrator was required to pay full disability benefits to Kleckner which included paying for multiple medications, including oxygen for home use, as well as a carry/travel oxygen pack.
During a deposition Kleckner stated she could not perform such tasks as personal care and had shortness of breath. However, surveillance video was conducted on various days from March of 2012 to July of 2012 contradicting those statements. She was observed on multiple occasions without the oxygen tank.
Investigation by the Division of Insurance Fraud determined that Kleckner gave false and/or misleading statements of fact in support of the claim.
On February 26, 2014, Kleckner pled guilty. Kleckner was sentenced as follows: 10 years supervised probation, adjudication withheld and restitution in the amount of $33,212.17 to Insurance Victim and Court Costs in the amount of $491.
Otto Biltres is the owner of a temporary staffing agency called Preferred Staffing of America, Inc. Mr. Biltres obtained an insurance policy via Lumbermen’s Underwriting Alliance (LUA) and misrepresented the nature of his business to LUA by claiming that he was operating as a temporary staffing agency only. Investigation revealed that Biltres was actually operating the agency as a Professional Employee Organization (PEO) that was not licensed. In addition, Mr. Biltres knowingly misled consumers into believing that his company, Biltres Staffing of Tampa Bay and later, Preferred Staffing of America, Inc. was a licensed PEO that could legally perform PEO services, such as processing employee payroll, handling payroll taxes, and providing workers’ compensation insurance coverage to outside client companies. Biltres was charging these client companies for PEO services, without ever providing the client companies with workers’ compensation insurance, which put all the client companies at risk by operating without it. Biltres formed a partnership with Insurance Agent Charles “Charlie” Brown, where he paid Mr. Brown a 45 percent commission for each client company that Charlie Brown & Associates referred to Preferred Staffing of America, Inc. for PEO services.
In an effort to mislead his client companies into thinking that they had workers’ compensation insurance coverage, Biltres falsified all of the certificates of insurance that he was sending out to each client company of Preferred Staffing of America. During several interviews Biltres admitted that he falsified the certificates of insurance he provided his client companies by performing a Google search and finding a blank template for a Certificate of Insurance. He then proceeded to type in all the required information, including the workers’ compensation insurance policy number. Insurance Agent Charlie Brown assisted Biltres in creating the false certificates of insurance and was instrumental in perpetrating this scheme. Charlie Brown’s wife, Kelly Walter-Brown along with two unlicensed insurance agents, Joseph “Joe” Jordan and Johnny “John” Lewis, who were working under Charlie Brown, were also instrumental in facilitating this organized scheme to defraud by steering client companies to Preferred Staffing of America, Inc. for a commission fee. The client companies who were the victims in this case are located across the nation: in Florida, Indiana, Mississippi, and California. The total amount of the alleged theft is $130,089.08. Case is pending trial.
This matter was predicated based on multiple complaints received by the Division of Insurance Fraud. It was alleged that Mr. Smalbach during the course of conducting business, misrepresented the factual details of investment products to senior citizens in order to make the sale. Some of the alleged activity consistsed of “twisting” annuities.
During the time frame of the following complaints, Mr. Smalbach worked for Gunn Allen Financial until June 2008, and Summit Financial Group/Summit Brokerage Services, Inc. After June 9, 2008, Mr. Smalbach was no longer registered to sell securities in Florida and obtained employment with Transfer Technologies International, Inc.
During the course of this investigation, 36 complainants/couples were interviewed. The majority of the complainants were senior citizens. In all of these interviews, there were several common factors in their complaints against Smalbach. In sum, Mr. Smalbach concealed the true facts and risks to the investors with the various investment products. A majority of the investments required the investors to meet the suitability requirements of an “accredited investor” in order to qualify to participate in the investment. However, the majority of complainants did not meet the investor suitability requirements. The majority of the complaints involved high risk investments such as Provident Shale Royalties, Royale Energy, AXA Equitable-Variable Annunity, Jackson National-Variable Annuity, and Transfer Technologies International- Stock Certificates and Promissory Notes.
Mr. Smalbach fraudulently induced the victims to sign blank documents, which he completed himself, for the purpose of qualifying the victims for investments that were unsuitable for them. He intentionally failed to provide them with a prospectus knowing that if he did, the information contained therein would directly contradict the representations he had already falsely made about these investments.
On April 9, 2013, Smalbach was sentenced to seven years in prison, followed by 10 years of probation. He was be ordered to pay $2,074,846.19 in restitution and $10,551.18 in investigative costs.
On June 29, 2013, the Florida Department of Financial Services Division of Workers’ Compensation observed what appeared to be a lawn maintenance crew of four or more men working within the city limits of Okeechobee. The men were engaged in the trimming of trees and collecting the debris. Investigation revealed the equipment belonged to TML Enterprises Inc. or Thomas Mark Lightbody of Coral Springs, Florida.
The crew leader advised all the workers on site were employees of Mark Lightbody, the owner of TML Lawns.
It was learned that each employee was paid by Mr. Lightbody, in cash, approximately $80per day. During the investigation, Lightbody produced two documents concerning TML Enterprises Inc; the documents were a certificate of insurance and a certificate of exemption. The certificate of insurance was a general liability policy. The second certificate, non-construction industry exemption, was issued to Thomas M. Lightbody. Neither document indicated workers’ compensation coverage for Mr. Lightbody's workers.
Mr. Lightbody failed to provide a workers’ compensation policy. To confirm the documents, the producer of the certificate of insurance was contacted and it was confirmed there was no active policy in place.
A comprehensive search of the State of Florida’s databases found no proof of workers’ compensation coverage insurance for TM Lawns d/b/a/ TML Enterprises Inc. or Thomas M. Lightbody.
During the course of the investigation it was learned the original company contracted with the client property was another landscape company. This company had sub-contracted to another landscaping company who in turn sub-contracted the job to TML Lawns d/b/a TML Enterprises, Inc.
Based on the aforementioned facts the Division of Insurance Fraud arrested Mr. Thomas M. Lightbody, owner of TM Lawns d/b/a/ TML Enterprises Inc. for failure to secure workers’ compensation coverage.
Mr. Lightbody was convicted in Okeechobee County.
While working a joint effort with the State of Florida Department of Financial Services Bureau of Workers’ Compensation Compliance, the West Palm Beach Division of Insurance Fraud discovered Salon Suites, Inc. (Delfino’s Hair Salon) located in Martin County, Florida, was operating without having workers’ compensation insurance for its employees. The company is a non-construction business and therefore required to have coverage for four or more employees. At the time of the coverage lapse, Salon Suites had ten employees in addition to the two owners for a total of twelve employees.
The business was issued two stop work orders after failing to comply with the insurance laws of the State of Florida.
The Salon Suites, Inc. owner, Carol Francis Cattania, was charged and convicted in Martin County for failing to provide workers’ compensation coverage for her employees.
The Money Service Bureau Taskforce is a collaborative effort comprising detectives from the Broward Sheriff’s Office, the Palm Beach County Sheriff’s Office and the Division of Insurance Fraud.
This investigation found Beverli Garcia Simisterra and his company, Bever Construction Incorporated, in conjunction with Jose Irata Ramos, Adalid Exequiel Ramos Rodriguez and uninsured subcontractors, engaged in a scheme to violate the worker’s compensation statutes. The investigation determined that Simisterra obtained a minimal policy, falsely claiming Bever was a relatively small construction company. Fraudulent certificates of insurance were issued, for a fee, which were in turn used by unlicensed subcontractors operating in the construction trade throughout south Florida.
General contractors using these unlicensed subcontractors were led to believe they were related to Bever Construction, which was in fact, not true.
Upon completion of the jobs, the uninsured subcontractors were paid by business-to-business checks from the GC’s account payable to a “shell company.” The checks were subsequently cashed at local check cashing stores, and workers paid in cash, circumventing workers’ compensation laws.
By these factual misrepresentations, Simisterra was able to avoid properly paying approximately $1,524,058.00 in premiums.