The South Region covers two counties, Miami-Dade and Monroe. Captain Steven Smith, a 24-year veteran with DIF, is also the statewide PIP coordinator and publishes a monthly newsletter called The PIP Source. In the Miami office, there are three squads, each dedicated to investigating PIP fraud. Working closely with the dedicated prosecutors at the Miami-Dade State Attorney’s office, they made 226 presentations and 227 arrests, resulting in a strong impact on PIP fraud in South Florida. There are three PIP squads in this region.

South Region Commander
Captain Steve Smith

Captain Smith has almost 32 years in state government. He graduated from Florida International University in 1979 with a bachelor’s degree in criminal justice and started with the Division of Insurance Fraud in 1988. He was promoted to captain of the south region in 2002 and supervises five squads (four PIP fraud squads and one general fraud squad). He was also appointed PIP fraud coordinator for the state in 2010.

South Region Lieutenants

Lieutenant Violeta Serrano
Lt. Violeta Serrano has been with the Division since 1999, originally hired under the Division’s trainee investigator program. She was the agency’s most productive detective before being promoted to lieutenant in 2004 to lead one of the PIP squads in Miami. Prior to joining DIF, Lt. Serrano was employed for a year by Miami Dade Police Department in uniform patrol. Lt. Serrano obtained her associate’s degree in criminology at Miami Dade College and a Bachelor of Science degree in criminology with a minor in sociology from Florida International University.

Lieutenant Stanley Jean-Felix
Lt. Stanley Jean-Felix began his law enforcement career in 2000 with the New York State Police as a state trooper in Orange and Rockland Counties. He joined the Division of Insurance Fraud in October 2003. At first, he was assigned to the Miami general fraud squad, and later was assigned to a Miami PIP squad. In October 2008, he was promoted to lieutenant of a newly formed Plantation PIP squad. In April 2010, he was transferred and assumed command of a Miami PIP squad.

Lt. Stanley Jean-Felix attained his undergraduate degree from John Jay College in criminology and his master’s degree in criminal justice from Florida International University. Lt. Jean-Felix is a certified fraud examiner under the Association of Certified Fraud Examiners. He is a graduate of Southern Police Institute Command Officers Development Course.

Lieutenant Rafael Delgado
Lieutenant 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.

 

South Region Statistics
During the last fiscal year, the South Region received more than 4,800 referrals resulting in 262 cases opened, 244 presentations to prosecutors and 308 arrests.

South Region Case Highlights

 

Highlight #1
Madelaine Osoria, 41, massage therapist and owner of Well Care Rehab Services, was arrested in January 2013 for insurance fraud for her role in filing false personal injury protection (PIP) insurance claims from staged auto accidents. Eight other clinic employees, or staged accident participants, were also arrested.

DIF detectives discovered that participants from a staged accident in early 2012 were referred to Well Care Rehab Services and Integral Medical Rehab. The patients signed blank forms for treatments they would never receive and were coached on what to tell insurance companies in case they were asked. Arrested were organizers of the staged accident, Gustavo Rodriguez Ruiz and Yunior Montes Mahia, as well as massage therapists Greenly Rodriquez Fernandini and Rosa Gonzalez Cardenas. Also arrested were staged accident participants Elvis Arrondes, Marisella Castellanos, Rayner Couceiro and Luis Jorge Rodriguez. As a result of this staged accident, fraudulent claims in excess of $60 thousand were filed against Allstate and Geico Insurance companies.

DIF was assisted by the Hialeah Police Department and Florida Highway Patrol in the arrest sweep.
All subjects were booked into the Dade County Jail. Prosecuting the charges in this case will be Miami-Dade State Attorney Katherine Fernandez Rundle. Those facing staged accident charges could face a minimum mandatory sentence of two years in prison, if convicted, and as much as 20 years in prison if convicted of grand theft.

Highlight #2
DIF detectives arrested Ismael Govea Morales, 47, on charges of insurance fraud, grand theft, money laundering, organized scheme to defraud and making false entries on books of corporation. Morales was charged with a total of 363 counts.

Morales was involved in an elaborate scheme in which a Florida corporation was hijacked and used to defraud insurance companies of more than $726 thousand in phantom billings.

Morales allegedly used the corporation Prudential Diagnostic Center to submit billings over $700 thousand to 27 different insurance carriers for medical MRI services that never took place. The investigation identified more than 481 false claims, which resulted in nearly $440 thousand in payments to Morales. Prudential Diagnostic Center, a clinic located in Hialeah, was closed down. After that, Morales added his name as an officer to the corporation without knowledge or approval of the true owners. The billings that were submitted in the fraudulent scheme used a mail drop address, opened by Morales, to receive the checks issued by the insurance carriers. Morales initially cashed approximately $44 thousand worth of checks through a bank account he opened under the corporation’s name, but then switched and cashed the vast majority of the checks at a check cashing store in Coral Gables. The case was prosecuted by the Miami-Dade State Attorney’s Office dedicated Insurance Fraud Unit, and Morales pled guilty and was sentenced to 6 months in jail and ten months probation.

Highlight #3
DIF arrested 16 subjects including a medical doctor, two clinic owners, five medical licensees, four staged accident organizers and four other subjects as part of a round-up involving four accident clinics in Miami-Dade County. Two of the massage therapists arrested were previously arrested in 2012 by DIF for fraud in related cases.

Investigation revealed that participants from five staged accidents were referred to clinics for treatment that was not provided, but billed to insurance companies in excess of $408 thousand. The four clinics, Clarke Medical Services, Emoge Medical Services, Magic Hands Medical Services and New Life Rehab Services, are believed to be involved in an organized scheme to defraud involving many more staged accidents and participants than those identified and arrested in the sweep.