Volume 6, No. 11 - November 2017

News You Can Use


- Updating you on what's going on

CFO Patronis Honors the Department of Financial Services’ Veterans

 Thank you for your service

During a recent Cabinet meeting, veterans working for the Department of Financial Services were honored for their service and the sacrifices they have made for Florida and our nation. Governor Scott presented each of the Department’s veterans with the Governor’s Veterans Service Medal. Prior to the Cabinet meeting, CFO Patronis hosted a breakfast reception for the veterans and their families.

CFO Patronis said, “Florida’s veterans made a choice to selflessly serve, and in doing so, they willingly made countless personal sacrifices. As Americans, we owe these dedicated heroes our gratitude, and I am proud to honor those who continue to serve their fellow Floridians by now working in our Department. It was a privilege to spend time with them this morning, and I offer my unending thanks to them and all of Florida’s veterans.”


The Department of Financial Services has taken several steps to assist Florida’s service members and veterans as they transition into civilian careers, including a program called “Operation Dispatch,” which grants comparative skills-based training credit to military firefighters who wish to join Florida’s firefighting community. The Department has also refunded insurance licensing fees for veterans and their spouses and created a series of financial literacy programs aimed at helping military families navigate through unique financial challenges.

An estimated 1.5 million veterans live in Florida, many of whom now work within state and local governments. The Department of Veterans’ Affairs estimates that veterans make up nearly 12 percent of Florida’s population, the third highest population in the nation behind California and Texas.

 

DFS-Veterans-with-CFO-Patronis

 

Miami Homeowner Arrested Following Attempt to Steal $178,200 in Damage Claims

 

Chief Financial Officer (CFO) Jimmy Patronis and the Florida Department of Financial Services (DFS) announced the recent arrest of Renee De La Maza for insurance fraud and grand theft following her attempt to file a damage claim against a new insurance policy after already receiving a $60,000 insurance payout from her former insurance provider for the same damages.

“As Florida continues to recover from an active hurricane season, many homeowners across the state are navigating their way through the claims-filing process and making repairs to their property,” said CFO Jimmy Patronis. “Insurance fraud can drive up insurance rates for our consumers so our message is simple: If you plan to steal from your insurance company or engage in fraudulent activity, be prepared to face swift action from our state investigators.”

Maza’s insurance provider became suspicious of her recent claim-filing activities and referred Maza’s insurance claims to investigators with DFS’ Bureau of Insurance Fraud for an in-depth review.

Investigators confirmed Maza initially filed an insurance claim in 2005 with her previous insurance provider after her home received water damages from Hurricanes Katrina, Rita and Wilma. Shortly after the claim was filed, Maza received more than $60,000 to make the appropriate repairs to her home.

Five years later, Maza filed a supplemental claim for damages that were not previously included in her claim from 2005.However, the 2010 claim of damage was denied based on similarities to the damages already reported in the 2005 claim. The insurance company noted Maza made very few repairs to the home following the 2005 claim.

The investigation went on to show that in 2015, Maza created a new policy with a different insurance provider and she filed an insurance claim for wind and rain damage that allegedly occurred in July 2015. Maza submitted a proof of loss to her insurance company for approximately $43,500 in damages. Maza’s insurance company offered to repair the alleged damages, but Maza chose not to accept the option of repair. Maza’s claim was denied after refusal of repair.

Maza submitted another claim to the new insurance provider in August 2015 for alleged water damages for the same areas listed in Maza’s July 2015 claim. However, this time she filed her claim for an estimated $178,200 in damages. The Bureau’s investigation revealed Maza’s prior claims for damages were never disclosed to her new insurance provider and the claims she made in 2015 were almost identical to the claims she made in 2005 and 2010. This led investigators to believe the 2015 claims were fictitious and filed in an attempt to fraudulently collect an additional insurance payout.

 

Click here to read the press release>>

 

 

CFO Patronis’ Insurance Consumer Helpline Recovers More Than $9 Million for Floridians in Third Quarter of 2017

Florida’s Chief Financial Officer Jimmy Patronis announced that assistance provided to Floridians by insurance specialists working Florida’s insurance consumer helpline (1-877-MY-FL-CFO) led to the recovery of nearly $9.3 million in the third quarter of 2017. Recoveries included insurance claim payments and premium refunds that Helpline specialistconsumers sought the Department of Financial Services’ help collecting.

CFO Patronis said, “Now more than ever, it’s crucial for Floridians to know that they have an unbiased place to turn for insurance information. As many families continue to navigate the post-storm claims process, I encourage them to call us if they reach a roadblock of any kind. Our experts will advocate on their behalf, and quite possibly, secure a positive outcome to a problem that seemed otherwise unsolvable. We’re only one call away, and we’re always ready to help.”

The helpline assists Floridians with financial and insurance-related matters, including disaster preparation and insurance fraud, as well as questions and complaints regarding auto, home, health, life and small business insurance. Between July 1, 2017 and September 30, 2017, the helpline’s insurance specialists answered 70,454 calls and opened nearly 4,500 assistance requests. Nearly $9.3 million was recovered on behalf of 1,307 consumers.

Since January, the helpline has answered more than 211,000 calls, opening nearly 14,000 assistance requested and helping return a total of $25.9 million back to Floridians. Recent examples of how consumers were helped by helpline specialists include:


  • A Bay County consumer asked for the Department’s assistance with an automobile claim after his car was stolen in January 2017. After providing his insurance company with the police report and supporting documentation to validate the theft, he stopped hearing from his insurance company. Following several unsuccessful attempts at reaching his insurance adjuster, who had previously acknowledged receiving the documentation, the consumer called the helpline. The insurance company said that staff turnover had derailed the processing of property damage claims, but quickly processed and paid out the consumer’s $6,100 claim.

  • A Brevard County consumer filed a homeowners’ claim for Hurricane Matthew damages in October 2016, and, after all repairs had been completed, the consumer filed a second claim in Spring 2017 for the recoverable depreciation. The consumer’s second claim went unanswered for months, until she contacted the Helpline for assistance. The insurance company acknowledged receipt of the second claim, but could provide no valid reason why it had not responded to the consumer or paid the claim. Soon after speaking with a DFS insurance expert, the insurance company apologized to the consumer and promptly paid the $1,372 claim.

  • A Citrus County consumer requested the Department’s assistance when, after her sister’s passing, her sibling’s life insurance company continued to demand monthly premium payments rather than paying out the policy benefit. Even after providing a death certificate and beneficiary information, several calls to the life insurance company could not solve the problem. A DFS insurance expert reached out on the consumer’s behalf, and the company acknowledged the miscommunication and delay. The nearly $10,000 policy benefit was promptly paid out to the consumer as her sister’s beneficiary.

  • A Brevard County consumer contacted the helpline to settle an aging but unresolved homeowners’ claim. The consumer’s insurance company offered $10,000 in June 2016 to settle the claim, but the consumer declined and hired a public adjuster to help her. The public adjuster she hired worked alongside the insurance company’s adjuster to submit a second settlement offer, which was rejected by the insurance company. After going to mediation and reaching a settlement amount in April 2017, the claim was still not paid by the company. Upon calling for assistance, helpline experts secured the release of the $61,000 payment to the consumer.

Floridians can contact the insurance consumer helpline toll-free by calling 1-877-MY-FL-CFO (1-877-693-5236).

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$1 Million Work Comp Scam Leads to Arrest of Construction Company Owner

Chief Financial Officer Jimmy Patronis and the Department of Financial Services (DFS) announced the recent arrest of Carlos Contreras, owner of DJC Builders & Construction. Contreras allegedly obtained a fraudulent workers’ compensation policy by underreporting the number of staff he employed, the company’s annual payroll amount and the company’s scope of work. By providing false information on the application, Contreras illegally avoided paying more than $1,000,000 in premium payments for an adequate policy.

CFO Patronis said, “When companies lie to obtain cheaper, inadequate workers’ compensation policies, staff or property owners are left vulnerable to covering sky-high medical costs if a worker gets injured on the job, and free markets are disrupted by scammers who can underbid their legitimate competitors. It’s a lose-lose situation for Florida, and I won’t stand for it.”

Click here to read the press release>>

 

Florida Keys Insurance Agent Charged with Fraud and Grand Theft

CFO Jimmy Patronis and the Florida Department of Financial Services (DFS) announced the recent arrest of Richard Joseph Girard, a licensed insurance agent and owner of A-Rated Insurance Group. Girard allegedly submitted a policy application for property insurance for a Key Largo client but provided fictitious supporting documentation that falsified the age of the roof of the property. As a result, Citizens Insurance accepted the application, initiated a policy and Girard received commission on the successful insurance sale.

Following the acceptance of the insurance application, Citizens Insurance suspected the application submitted by Girard may have been fraudulent and referred the matter to investigators with DFS’ Bureau of Insurance Fraud.

Cuffs

As a result of the investigation, DFS investigators confirmed Girard submitted an inspection report and policy application for a property located in Key Largo, FL October 2016. However, in order for the policy to be accepted and to receive his commission, Girard used older photos and an older inspection report from a previous property on the new application form. By doing so, Girard concealed the actual condition of the property’s roof and structure, allowing him to obtain the insurance policy and receive a commission of $1,528.

Girard was arrested and booked into Plantation Key Detention Center without incident on November 13, 2017, and has been charged with insurance fraud, uttering forged instruments, forgery and grand theft.

This case will be prosecuted by the Monroe County State Attorney’s Office and if convicted, Girard could face up to 20 years in prison.

Once formal charges have been brought forth, DFS’ Division of Insurance Agents and Agency Services will suspend Girard’s insurance license.

 

Click here to read the press release>>

 

Disaster Fraud Action Strike Team Cracks Down on Insurance Fraud After Hurricane Irma

CFO Jimmy Patronis and the Department of Financial Services’ Disaster Fraud Action Strike Team (DFAST) announced the recent arrest of Claude Milhomme after he was caught lying to his insurance company in an attempt to file a false insurance claim on his vehicle for damage allegedly caused by Hurricane Irma.

“Hurricanes bring out the absolute best in our volunteers, donation organizers and first responders, but they also bring out the absolute worst in others and that’s when we see the post-storm fraud,” said CFO Jimmy Patronis. “If you plan to engage in fraudulent activity, no matter how big or how little, we are going to take action.”Hurricane

Milhomme filed a claim September 12, 2017 to his insurance company stating water damage to his vehicle caused by Hurricane Irma in the amount of $225 for a diagnosis, after hours fee and storage fee. The Department’s Disaster Fraud Action Strike Team received a tip October 9, 2017, suspecting fraudulent activity regarding Milhomme’s claim.

As a result, state investigators took a closer look into Milhomme’s claim and it was discovered that Milhomme’s vehicle was inspected at an auto repair shop located in Georgia September 7, 2017. The inspection and diagnostic tests revealed that Milhomme's vehicle was mechanically inoperable due to overheating which resulted in a blown head gasket prior to Hurricane Irma’s landfall September 10, 2017.

Milhomme was arrested November 2, 2017 without incident at the Palm Beach County Jail on one count of fraudulent insurance claim by falsely stating a material misrepresentation of facts.

This case will be prosecuted by the Palm Beach County Office of the State Attorney, 15th Judicial Circuit.

The Department’s anti-fraud strike team consists of three teams that are working in areas heavily impacted by Hurricane Irma including South Florida, Miami-Dade and Monroe counties; Southwest Florida, including Lee and Collier counties; and Central Florida, including Polk and Orange counties. They are trained insurance fraud investigators with specialized knowledge of property & casualty fraud and workers’ compensation fraud and to ensure that law-breakers are prosecuted to the fullest extent of Florida law, CFO Patronis is working directly with dedicated prosecutors housed within each of the respective State Attorney’s Offices.

Click here to read the press release>>

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We highly recommend licensees routinely check their MyProfile accounts for messages from the Department. We send an email notification when a message has been sent to remind you to check your MyProfile account, but on rare occasions you may not receive that email. For this reason, we suggest you add our domains dfs.state.fl.us and MyFloridaCFO.com to your email software's Trusted or Safe Senders List to ensure you are able to receive email notifications from us. Licensees who have a valid email address on file with the Department, as required by law, are sent important email notifications when something affecting their application, license, continuing education, or appointment(s) occurs. Additionally, we will keep you informed with warnings regarding new schemes and scams being marketed to licensees. You can update your contact information through your MyProfile account. We want to keep you informed in a timely manner of pertinent information. You are still required to abide by the Florida Insurance Code regardless of whether you read the information we provide or attempt to provide.