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Florida Division of Insurance Fraud Announces Multiple Miami PIP Fraud Arrests

6/1/2015

Contact: Ashley Carr
(850) 413 – 2842
 
Miami, Fla. – Today, the Florida Department of Financial Services’ Division of Insurance Fraud announced two insurance fraud arrests. Ariel Rivero Santana, Jr. and Raul Antonio Perez Payes, both of Miami, were arrested for their roles in separate personal injury protection or PIP fraud scams.
 
Ariel Santana, 42, was taken into custody after he was revealed to be the true owner of A & J Rehabilitation Center, a PIP clinic located in Miami that illegally submitted more than $350,000 in fraudulent claims to various insurance companies.
 
In an effort to circumvent licensure requirements, Santana hired chiropractor Peter Maffetone to operate as the clinic’s straw owner. As a licensed health care professional, Maffetone fraudulently obtained a licensure exemption from the Agency for Health Care Administration, allowing the clinic to operate without a license for more than three years. Santana and Maffetone went on to submit fraudulent claims totaling nearly $367,000 to four insurance carriers: Esurance, Geico, Progressive and United Auto.
Six additional participants and organizers tied to Santana have been arrested by DIF detectives within the last year. All of them are connected to two staged accidents that accounted for fraudulent billings of more than $180,000 to multiple clinics, including A & J Rehabilitation Center.
 
In a separate case, DIF detectives arrested Raul Antonio Perez Payes, 31, after detectives learned that he organized a staged car accident in August 2012. In addition to planning the staged accident, Payes recruited and paid accomplices to participate in the scam.
 
Investigators determined that Payes offered one individual at least $500 to be a passenger, and, after reporting the staged crash to the Florida Highway Patrol to create a crash report, Payes paid another participant $2,500 to visit various PIP clinics for the treatment of fake injuries. The resulting fraudulent insurance claims totaled more than $86,000. Since late 2014, four additional participants tied to this staged accident have been arrested.
 
With more than 20 felony counts filed against him, Raul Payes faces to up to 120 years if convicted. Arial Santana faces up to 25 years in prison if convicted. Both cases will be prosecuted by the office of Miami-Dade County State Attorney Katherine Fernandez Rundle, and both were booked into Turner Guilford Knight Correctional Center in Miami.
 
Anyone with information about suspected insurance fraud is asked to call 1-800-378-0445. Citizens who provide tips can remain anonymous. The Department of Financial Services has awarded $350,000 to 60 citizens as part of its Anti-Fraud Reward Program. The program rewards individuals up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme.
 
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Chief Financial Officer Jeff Atwater, a statewide elected official, oversees the Department of Financial Services. 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. Follow the activities of the Department on Facebook (FLDFS) and Twitter (@FLDFS).