CLINIC OWNER, ‘PATIENTS’
FACE INSURANCE FRAUD
These individuals were charged under a new law that took effect October 1, 2003, that made organizing or participating in a staged crash punishable by a statutory minimum sentence of two years and as many as 15 years in prison. In a staged crash, organizers and unscrupulous clinic owners target the personal injury protection (PIP) insurance of drivers, and bill on average up to the maximum $10,000 benefit per insured.
“PIP fraud dramatically drives up the cost of automobile insurance, making it harder for Floridians to afford the coverage Florida law requires them to carry,” said Florida’s Chief Financial Officer Tom Gallagher, who oversees the Department of Financial Services. “The law targeting staged crash organizers has helped our investigators and prosecutors successfully pursue these scam artists.”
So far, 25 arrests have been made under the new law. In addition, in March the department partnered with the Automobile Joint Underwriting Association and the Miami-Dade State Attorney’s office to hire a dedicated PIP fraud prosecutor. Just this year, the department has made193 arrests, up from 155 in 2003, and dedicated prosecutor Nina Vivenzio has overseen more than 160 of this year’s arrests.
“We intend to file racketeering charges in some of these organized fraud clinic cases in the future,” Vivenzio said. “It is a tremendous problem, and we need to take tougher action against these criminals.”
Investigators with the department’s Division of Insurance Fraud said most of those arrested today were patients at Miami Health & Life Medical Management, Corp, a clinic located at 300 SW 107 Ave., Suite 206, Miami.
Clinic owner Rolando Martinez, 35, has been charged with 51 counts of insurance fraud, 51 counts of grand theft and one count of organized scheme to defraud in the first degree, for false claims filed by the clinic in a 10-month period totaling over $450,000. Martinez opened the clinic in late 2003.
Other arrests today included participants from two staged crashes accused of filing more than $65,000 in fraudulent claims filed against two insurance companies.
Fausto Guerra, the alleged recruiter, Alina Mecias and Kenia Lopez are accused of filing more than $38,000 in fraudulent claims stemming from an alleged staged crash on May 12.
Guerra was previously arrested on October 21, 2004, for organizing another staged crash on June 13. Carlos Ilarraza and Daryelis Olivares were arrested on charges stemming from filing more than $27,000 in fraudulent claims in that staged crash. Investigators said clinic owner Martinez knew the crash was staged and instructed at least one of the patients on what to tell the doctor.
Division investigators also arrested several “patients” who allegedly signed for treatment they never received. Investigators determined that fraudulent claims were filed with their insurance companies in excess of $65,500. Those charged are Alexander Arencibia, Juan Garcia, Esterlina Reyes, Magaly Rodriguez, Zoraida Rosado, and Jose Tamayo.
The Department of Financial Services, Division of Insurance Fraud, investigates various forms of fraud in insurance, including health, life, auto, property and workers' compensation insurance. Anyone with information about this case or another possible fraud scheme should call the department's Fraud Busters Hotline at 1-800-378-0445. A reward of up to $25,000 may be offered for information leading to an arrest and conviction.
The skyline for November is the beautiful city of Lakeland in Polk County.