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Florida CFO Atwater Announces Five Arrests Tied to $118,000 in Fraudulent PIP Claims

1/28/2011

Contact: Alexis Lambert   (850) 413-2842
                                                                               
TALLAHASSEE
—Florida CFO Jeff Atwater today announced that the Department of Financial Services’ Division of Insurance Fraud (DIF), in partnership with the Tampa Police Department and Hillsborough Sheriff’s Department, has arrested five individuals accused of submitting $118,000 in fraudulent insurance claims through a Tampa clinic.  Two of the suspects, husband and wife Isidoro and Yusimy Martinez, were previously arrested by DIF detectives for a similar scheme involving another Tampa clinic.

Florida currently leads the nation in suspected fraudulent auto insurance claims, particularly fraudulent Personal Injury Protection (PIP) claims.  CFO Atwater has committed to attacking this costly crime.
“This kind of fraud robs hardworking Floridians of the dollars they need to rebuild their businesses and meet the needs of their families,” said CFO Atwater. “I will continue to work aggressively to expose these crimes, and I applaud the fraud detectives who took swift action to notify the insurance companies so that most of the claims were never processed.”
Because of DIF’s quick action, only $4,000 in claims were paid by insurers. DIF investigators used undercover operatives and documented sources to verify all five participants were illegally submitting false medical billing forms. DIF received assistance on this case from Nationwide, Allstate and Hallmark Insurance Companies, along with the National Insurance Crime Bureau.

In addition to Isidoro and Yusimy Martinez, DIF detectives arrested Afranio Rosario, Nadine Diaz, and Lidiana Cabrera on charges of filing false and fraudulent claims through Marbella Medical Center in Tampa.  Isidoro Martinez is still on probation for the previous arrest and was also charged with violation of probation.

Three years ago, Isidoro and Yusimy Martinez were arrested for similar activities at the former Bella Mar Medical Center in Tampa.  Yusimy pleaded guilty to insurance fraud, patent brokering and staging an accident.  She received one year of community control and three years of probation, was court ordered to pay restitution and investigative fees and was banned from owning a clinic in Florida.  Isidoro pleaded guilty to insurance fraud and patient brokering, was ordered to jointly pay restitution with his wife, investigative fees and received five years of probation.

Yusimy could not legally operate her own clinic; therefore, she allegedly paid a “straw owner” to open the Marbella Medical Center under his name through the Agency for Health Care Administration by arranging for a false license exemption application.  As soon as the clinic opened, 19 patients were immediately obtained from automobile accidents to further their fraud scheme. 

Chief Financial Officer Jeff Atwater, a statewide elected official and officer of the Florida Cabinet, oversees the Department of Financial Services including the Division of Insurance Fraud.  CFO Atwater’s priorities include fighting financial fraud, abuse and waste in government, reducing government spending and regulatory burdens that chase away businesses, and providing transparency and accountability in spending.