The South Region is responsible for the enforcement of insurance related crimes committed in Broward, Dade and Palm Beach Counties. The region is divided into two Personal Injury Protection (PIP) squads and two general fraud squad, directed by one captain and four lieutenants.
Captain Rafael Delgado has been a sworn law enforcement officer since January 1982, in which he served with the NYPD for 21 years before retiring and coming to work for the Department of Financial Services, Division of Insurance Fraud. Within the NYPD he was assigned to Uniformed Patrol, Organize Crime Control Bureau, Detective Bureau and an FBI Task Force Unit. He held the position of police office, detective and retired with the rank sergeant-supervisor of detective squad (SDS).
In 2005 he moved to South Florida and began a law enforcement career as a detective with the Department of Financial Services, Division of Insurance Fraud and was assigned to the Miami Field Office. While assigned to the Miami Field Office, he worked in a general fraud squad and personal injury protection squad. In August 2011, he was promoted to lead detective within the PIP squad. He is a certified Field Training Officer, and has been an active training officer for new law enforcement detectives assigned to the Miami Field Office.
In March of 2012, Rafael Delgado was promoted to Lieutenant and assigned as the supervisor of the Miami worker compensation squad. In September 2012, Lieutenant Delgado was assigned to manage a third PIP squad in Miami.
In April of 2014, Rafael was promoted to Captain and assigned over the South Central Region.
Lt. William Lee began his law enforcement career in Connecticut in 1979. Upon moving to Florida in 1982, Lt. Lee was employed by the Sunrise Police Department. He served there for 18 years, the last 13 as a Sergeant. Lt. Lee started his employment with the Division of Insurance Fraud in 2000. In 2010, he was promoted to lieutenant and now supervises the Plantation PIP squad. Lt. Lee holds a Bachelor of Science degree from the University of New Haven and a master’s degree from Florida International University. He is also a certified fraud examiner.
Lt. Spirn began her career in law enforcement in 1990 after receiving my Bachelors Degree in Criminal Justice from Pepperdine University and Florida Atlantic University (FAU). She was then hired by the Jupiter Police Department and was immediately enrolled in the police academy in Lake Worth, Florida. Lt. Spirn worked as a Road Patrol Officer for the Jupiter Police Department from 1990 until 1993 when she was recruited by the Lake Clarke Shores Police Department. While working for Lake Clarke Shores PD, Lt. Spirn received training and certifications in Crime Prevention and Investigations and was eventually promoted to the position of Investigator, Office of the Chief. As the Investigator, Lt. Spirn was responsible for all criminal and internal investigations. In 2004 Lt. Spirn was hired as a detective by the Department of Financial Services (DIF) and was assigned to General Fraud. Since then she has also been assigned to PIP, Mortgage Fraud and Workers' Compensation Fraud. Lt. Spirn was selected to participate on a DEA Taskforce after attending their training academy. In September 2012, Stacey was promoted to Lieutenant in the Broward Office for the General Fraud Squad and am very excited to begin my career as a supervisor.
Evangelina Brooks began her law enforcement career in 2002 with the Vero Beach Police Department. She joined the Florida Division of Insurance Fraud in May 2006 and was assigned to the Miami Region PIP Squad. In 2007, she transferred as a detective to the West Palm Beach Workers’ Compensation Squad. In January 2009, she was promoted to Lieutenant of the newly formed West Palm Beach PIP Squad.
Lt. Brooks attained her undergraduate degree from Bethune-Cookman College and her Master’s Degree from The University of Louisville. Lt. Brooks is active member of the DIF training section. She is also a FDLE/CJSTC certified instructor, specializing in the areas of high liability: firearms, defensive tactics, ASP Baton, CPR/ First Aid and vehicle operations. Lt. Brooks is also an adjunct instructor at the Indian River State College.
Bill Santner is a lieutenant with the Division of Insurance Fraud, and had been employed here since 1989. During that time he has worked on most aspects of insurance fraud, and continues to serve in the Miami Field Office. He has 33 years law enforcement experience.
Operation El Martillo (Sledgehammer-Phase 2) (Arrests made within both federal and state judicial systems).
This criminal investigation targeted an organized group conducting insurance fraud (staged crashes) in Palm Beach County. The subjects of the investigation were soliciting staged crash participants, paying participants and billing insurance companies fraudulently for services not rendered. This investigation included a minimum of five clinics in the West Palm Beach area. The subjects paid for individuals to stage fake crashes and then farmed out the “crash victims” to their controlled clinics for treatment. The clinics billed the auto insurance companies under Florida’s Personal Injury Protection (PIP), usually up to $10,000 per crash victim for treatments that were not needed or given.
After Phase 2 was implemented, multiple cases were presented to the Palm Beach State Attorney’s Office for prosecution. While few of them are still pending court action, many of them have resulted in conviction of those involved.
To date the total restitution ordered from Operation Sledgehammer (both phases) and its associated cases is just over $36 million dollars. Currently several cases are still pending court action.
The Florida Department of Financial Services/Fraud Division had learned insurance claims were filed on behalf of six different individuals’ insurance policies pertaining to Thibault Auto Glass during the course of an unrelated investigation. The insurance companies received insurance claims through a third party administrator (Safelite Solutions/SGC Network) from Thibault Auto Glass for replacing the windshields on six vehicles. The insurance companies paid Safelite Solutions/SGC Network (third party administrator) as a result of these claims approximately $1,800. Subsequently, Thibault Auto Glass received payment for services never rendered.
After Mr. Thibault was convicted in Broward County and placed on probation, he violated his probation in Hernando County when he resumed these fraudulent practices. He was charged with violation of probation, along with new charges of theft and insurance fraud. This case in Hernando County is currently pending prosecution.
The Department of Financial Services, Division of Insurance Fraud received information from Progressive Insurance Company alleging that David Glincher of Auto Loss Claims Consultants, LLC (ALCC) had filed diminished value (the value your vehicle has been reduced by after an accident occurs) claims with Progressive Insurance Company as a result of car crashes on behalf of policy holders. Progressive Insurance had paid the claims and sent drafts to ALCC. The drafts were deposited into the business account of ALCC. ALCC never forwarded the victims their portion of the settlement money. The investigation revealed that there were as many as 274 victims that were not paid by ALCC and David Glincher for insurance claims he filed on their behalf with multiple insurance companies.
The victims were claimants in traffic crashes where they were not at fault. Glincher identified his victims through the use of Florida Public Records, i.e., Florida Crash Reports. Glincher, through his company ALCC would send mailings with his brochures explaining the diminished value claims. Some victims would return the completed claim forms while others never received them or simply discarded them. The claims were filed by ALCC and were paid by the insurance companies to ALCC and the victims' name. Many victims never received their percentage from Glincher.
A review of bank records and victim interviews determined the total theft reached more than $294 thousand dollars.
Twelve of the victims interviewed acknowledged Glincher's representation, but never received compensation; 13 other victims stated they were not represented by Glincher, he was not given permission to use their identification and no compensation was received.
He was booked into the Broward County Jail on March 13, 2014, and is pending trial.
An investigation was conducted and it was determined that Ines Ezeta committed health care fraud. Ezeta filed a claim for an emergency room visit from February 5, through February 12, 2013 on her Colonial Life Disability Insurance. Ezeta completed a claim form which she signed and sent along with a copy of her medical bills in support of her claim which describe various procedures and treatments performed by Jackson Health Systems with a total amount of $84,116.50. Investigation revealed Ezeta submitted a fraudulent medical statement which was altered. The document was obtained from a relative who was an actual patient at Jackson Health. Ezeta was interviewed when she confessed and was charged with insurance fraud, and grand theft. Ezeta was convicted in Miami-Dade County Court and ordered to pay investigative costs; since the fraud was determined quickly, no claims were paid.
An investigation was conducted in Miami Dade County where Sky Imaging was operating as an unlicensed clinic. The clinic was owned by Nazih Chamoun. Also involved in the operation of the clinic was his son, Robbie Chamoun. The clinic was run without a valid license and was conducting business daily. Services were provided and billed to various insurance companies in excess of $1 million dollars during a 13-month period of time.
Nazih Chamoun was convicted in Dade County Court of 19 counts of operating an unlicensed clinic. Nazih Chamoun received one year probation and was ordered to pay over $7,000 in investigative costs to DIF, $1000to the Miami-Dade State Attorney’s Office and $250,000 in restitution to various insurance companies affected by the unlicensed clinic activity.
Robbie Chamoun was convicted in Dade County Court on numerous counts of operating an unlicensed clinic, and theft. The agreement included that the defendant serve one year on a pretrial diversion program (PTI) and pay $1000 to the Miami-Dade State Attorney’s Office.
Investigation found that a vehicle crash occurring on March 16, 2012 in Miami-Dade County was in fact a staged crash. Through interviews and follow-up investigation it was determined Morales was the planner and organizer. Witnesses indicated Morales offered $2000each to individuals recruited to participate, and attend a clinic for treatment based on this crash.
One participant was driven to the clinic for alleged treatment, and in fact, signed approximately eight blank treatment forms for submission to the insurance company.
As a result of Morales’ actions, StateFarm Insurance Company paid $10,271 in fraudulent claims. Case is pending trial.
The Division of Insurance Fraud received information from the insurance company that several individuals organized a plan to stage a crash in Miami-Dade County. The organizer (Inerarity) and his sister agreed to pay participants of the crash subsequent to treating at a Miami-Dade clinic. The clinic billed the insurance companies for treatment that never took place.
Two organizers and four participants were arrested and later convicted. The clinic involved was subsequently closed. Restitution to the insurance companies was ordered in the amount of over $11,000. Several of the defendants in this case were involved in a staged crash in Broward County, which resulted in four additional arrests.