Chiropractor, 2 Others Charged in Unlicensed Clinic Fraud in Orlando

March 2012
Volume 2 - Issue 9
HERE
Chiropractor,HEADER
2 Others
Charged in
Unlicensed Clinic Fraud in Orlando
Florida Chief Financial Officer Jeff Atwater announced that charges have been filed
against an Orlando chiropractor and two clinic operators for allegedly conspiring to
create a “straw” ownership arrangement to thwart Florida’s clinic licensing laws.
Charges have been
filed against an
Orlando chiropractor
and
two clinic operators for
allegedly conspiring
to create a
“straw” ownership
arrangement...
Judith Christina McKenzie, a chiropractic physician, allegedly fronted ownership of Silver
Star Health and Rehab, an accident clinic in Orlando. However, an investigation by the
Department of Financial Services’ Division of Insurance Fraud (DIF) determined that
Silver Star was really owned, operated and managed by non-physicians Jean Ely Colin
and Marc Arthur Maxis. Arrest warrants were issued for all three. McKenzie and Colin
surrendered and were booked into the Orange County Jail. Maxis was located and
arrested in Palm Beach County.
“This kind of fraud costs every honest Floridian with a car in the driveway, and we can’t
throw the crooks in jail fast enough,” Atwater said. “My department is committed to
finding the perpetrators and bringing them to justice, but we also must put more barriers
in place to stop this fraud and the skyrocketing cost of auto insurance in Florida.”
McKenzie purported to be the sole owner of Silver Star, so the clinic operated with a selfproclaimed exemption since its inception in May 2008. Because McKenzie held a
license with the Department of Health (DOH), she was automatically exempt from clinic
licensing requirements regulated by the Agency for Health Care Administration under the
Health Care Clinic Act.
INSIDE THIS ISSUE
1
Chiropractor Arrest
2
Tampa Takedown
3
PIP Fraud News
5
FIFEC - 20 Years
6
PIP’s Dark Side
8
Statewide Arrests
10
Statewide Contacts
Florida Statute 400.9935 (3) states, “All charges or reimbursement claims made by or on
behalf of a clinic that is required to be licensed under this part, but that is not so licensed,
or that is otherwise operating in violation of this part, are unlawful charges, and therefore
are noncompensable and unenforceable.”
As a result of the clinic’s fraudulent business arrangement, insurance claims filed by the
clinic were fraudulent. The DIF found more than $525,000 in fraudulent PIP claims filed
with five different insurance companies.
Detectives said Silver Star’s banking records proved the “straw ownership” arrangement.
Furthermore, McKenzie admitted she did not run the clinic and had no financial
obligations to the operation.
The three co-conspirators are charged with organized scheme to defraud, operating an
unlicensed health care clinic, filing false and fraudulent insurance claims and grand
theft. If convicted on all charges, each could face up to 125 years in prison in addition to
fines and restitution.
The case is being prosecuted by the Orange County State Attorney’s Office.
March 2012
Page 2
Ten Arrested in Tampa Clinic Takedown
Florida Chief Financial Officer Jeff Atwater announced the arrests last month of ten accident clinic employees
for soliciting undercover agents posing as accident victims.
A long-term investigation by the Florida Department of Financial Services’ Division of Insurance Fraud and
the Tampa Police Department revealed that employees at multiple accident clinics, including Tampa Rehab
Center, Auto Injury Doctors of Tampa and PVC Medical Center, paid fraud investigators posing as accident
victims to sign fraudulent treatment forms attesting to medical services they never received. The clinics
subsequently submitted fraudulent claims to insurance companies including Nationwide, Farmers,
Progressive and 21st Century Insurance.
“Florida’s auto insurance system has become a feeding frenzy for those who are looking to make money off
the backs of consumers,” CFO Atwater said. “My office will continue to partner with state and local law
enforcement agencies to dismantle these organized crime rings and put the crooks behind bars.”
The individuals arrested during the sweep include Tavares Castillo, 37; Jose Luis Avila Robles, 30; Jorge Luis
Gutierrez, 33; Jose Miguel Alvarado Jr., 29; Yankiel Cordero, 21; Yankiel Borrego, 31; Blanca M. Acosta, 53;
Evelisse Acosta, 42; Alfredo Rodriguez, 41, and Aileen Lynn Cazanas, 18. The individuals were arrested on
third-degree felony charges for patient brokering and filing fraudulent insurance claims. If convicted, they
could face up to 15 years in prison.
This case is part of a continuing crackdown by CFO Atwater’s Division of Insurance Fraud in the fight against
auto insurance fraud in Florida.
How You Can Help Fight Insurance Fraud in Florida
This year, the Florida Legislature created a fund to which anyone can contribute to the fight against insurance fraud by
making a donation, gift or grant to the Insurance Regulatory Trust Fund. The proceeds will be used by the Division of
Insurance Fraud to hire additional dedicated prosecutors and insurance fraud detectives, as well as fund anti-fraud
programs around the state. This is an exciting program that we believe will have a substantial impact on insurance fraud
in Florida.
Payments should be made payable to: The Department of Financial Services
(Please write “Code 1201F” on the memo line of your check.)
The mailing address is:
Department of Financial Services
Revenue Processing Section
P.O. Box 6100
Tallahassee FL, 32314-6100
The donor should include correspondence with the check indicating it is a grant or donation for the Division of Insurance
Fraud. The letter should include his / her intent that the grant or donation be deposited to the Insurance Regulatory Trust
Fund and used for anti-fraud efforts. Also include a statement that if the donation is to be used for any other purpose,
the funding should be withdrawn.
If you have any questions, you can contact us at the PIP Source and we will get an answer. Thank you for your help.
Join the Fight. Be a part of the Solution. Make a Difference.
The PIP Source
Page 3
PIP FRAUD – In The News
Massage Therapist Arrested in WPB Fraud Case
Massage therapist Diosniley Acanda Crespo, 38, was arrested for insurance fraud and grand theft for allegedly
fabricating records for treatment he did not provide to three patients. Crespo worked at Coral Therapy and Medical
Center, a clinic in West Palm Beach. The clinic, allegedly owned by chiropractor Laz Rodriguez, opened in 2010.
Crespo, who was first licensed as a massage therapist in November 2009, was charged with more than $2,330 in
fraudulent billings that were discovered by Allstate after conducting surveillance of the patients. A total of $41,520 was
billed by Coral Therapy and Medical Center for the three patients in this case. One of the patients told detectives she
was offered $3,000 to be treated at the clinic, but never got paid.
Coral Therapy and Medical Center was issued an exemption with the Agency for Health Care Administration (AHCA).
Investigation of the clinic continues and additional arrests are anticipated.
Clinic Owner Arrested Again for More Staged Accidents
Clinic owner Daysi Puigros, 43, was arrested again last month and charged with allegedly organizing two more staged
accidents. Puigros, owner of Better Life Medical Center, was first arrested in August 2011 after an investigation by the
Division of Insurance Fraud found that she had operated an unlicensed clinic and used the name and license of a
deceased doctor to fraudulently bill insurance companies. Subsequent to the original charges, it was discovered that
Puigros organized multiple staged accidents to obtain patients to be treated at her clinic, and she was arrested again in
October 2011.
The latest charges involve a staged accident in 2009 where participants were sent to Better Life Medical Center and a
staged accident in 2010 where some participants were sent to one of Puigros’ clinics, Quality Life Rehabilitation Center,
LLC, while others were sent to Centinel Medical Center. As a result of these two staged accidents, more than $110,000
in fraudulent claims were submitted to Affirmative, Allstate, Progressive, RAC, State Farm, and United Auto. The
National Insurance Crime Bureau (NICB) assisted in this case.
Five Arrested in Miami Staged Accident Case
Five subjects were arrested for a staged accident that occurred in May 2011. Rafael La-Rosa, 32, allegedly organized
the staged accident, offering participants up to $2,000 to go to a clinic afterwards. Participants were sent to accident
clinics in Miami, including Benefica Health Center and La Maison Medical Practice. More than $88,000 in fraudulent bills
were submitted to Allstate and Ocean Harbor.
Four participants, including Jose Angel Abreu Hernandez, 25, Odalys Olomo Hernandez, 42, Leslie Simo, 19, and Arturo
Varela, Jr, 22, were each charged with staged accident, insurance fraud and grand theft. The National Insurance Crime
Bureau (NICB) assisted in this case.
Dennis Russo Named to Lead NICB in Florida
Dennis Russo was named as Director of Operations for the Southeast Region, replacing the retired Ron Poindexter, and
will lead the National Insurance Crime Bureau’s (NICB) fight against fraud in Florida. Russo had been supervising
NICB’s Central Florida Major Medical Fraud Task Force since May 2011.
Russo started his law enforcement career with the Polk County Sheriff’s Office in 1978, rising to the rank of detective
before moving to the Florida Department of Law Enforcement (FDLE) as a Special Agent in 1988. There Russo was
responsible for investigating major multiple jurisdictional crimes, including narcotics, homicides and fraud and was a
member of the Special Operations Team and a high liability instructor.
Russo joined NICB in April 2008, assigned to the greater Orlando area to investigate medical fraud, auto fraud and
run the Orlando Mini Medical Fraud Task Force. In July 2010, Russo was assigned to the Central Florida Major Medical
Fraud Task Force.
We congratulate Director Russo in his new position and look forward to continuing our working relationship with NICB.
March 2012
Page 4
PIP FRAUD – In The News
Staged Accident Demonstration Held for Florida Government Leaders
Cars collided in full view of Florida’s highest ranking officials today at the Pat Thomas Law Enforcement Academy,
showcasing the dangerous crimes of insurance fraud through staged accidents. Florida continues to lead the nation in
staged accidents and abuse of the Personal Injury Protection (PIP) system.
“Viewing how easy it is to fake an auto accident is sickening,” Gov. Rick Scott said at a news conference after the
demonstrations. “If there was any shred of doubt left in any legislator’s mind, this exercise has surely demonstrated
beyond a doubt that PIP reform is critical to protect Florida drivers from these dangerous staged car accidents and from
rate increases caused by fraud.”
The Florida Highway Patrol and the Coalition to Put the Brakes on Accident Fraud hosted the event.
“It defies logic that as automobile accidents have decreased by eight percent over the past five years, auto insurance
rates have skyrocketed for Florida families from 80 percent in Tampa and Miami to nearly 50 percent in Jacksonville and
Destin,” Chief Financial Officer Jeff Atwater said. “One thing is clear: Florida’s personal injury protection system is
surrounded by sharks looking to make their money off the backs of consumers, and by taking decisive action this
session to drive down costs, we can protect Florida insurance consumers from being preyed upon.”
Florida Highway Patrol Colonel David Brierton also vowed to provide training to his troopers across the state in an effort
to reduce or eliminate traffic crash fraud.
“This is a new generation of organized crime and we need to work together to develop a solution,” Col. Brierton said.
“Every day that passes is another day law enforcement officers across the state will have to handle fraudulent accident
reports and another day the wallets of Floridians are hit with the ever-increasing costs of abuse from accident fraud.”
Visit the Coalition to Put the Brakes on Accident Fraud website at www.putthebrakesonaccidentfraud.com.
Read this article at http://www.prnewswire.com/news-releases/governor-rick-scott-witnesses-examples-of-insurance-fraud-139461253.html.
Miami Police Department Leads Crackdown on Fake Insurance Cards
On Wednesday, February 29, 2012, the Miami Police Department conducted a county-wide Fraudulent Proof of Motor
Vehicle Insurance Operation, which was the largest of its kind in Florida’s law enforcement history. A total of 17 arrests
were made, including four for fake insurance cards and a total of 542 citations were issued.
Drivers that were stopped by police officers for traffic violations or involved in motor vehicle crashes were asked to show
proof of insurance. The goal of this operation was to identify and apprehend any drivers with fake insurance
cards. Drivers caught with forged paperwork were charged with a third-degree felony for carrying fraudulent proof of
motor vehicle insurance. The Miami Police Department, the National Insurance Crime Bureau (NICB), 19 insurance
companies and 22 law enforcement agencies cooperated in this joint effort. During the operation, officers were able to
radio in the driver’s insurance card information to a command center where the insurance representatives were standing
by to verify the insurance coverage.
Drivers with fake insurance cards affect all drivers on the road because in the event of a crash with an uninsured
motorist, the cost acquired can eventually be passed on to those with valid insurance. Insurance rates keep escalating
every year to recover losses due to uninsured drivers. It is illegal to drive in the state of Florida without insurance or with
a fake insurance card.
The law enforcement agencies that participated in this operation included Aventura, Bal Harbour, Bay Harbor, Biscayne
Park, Coral Gables, Florida Highway Patrol, Hialeah, Homestead, Key Biscayne, Medley, Miami, Miami Beach, MiamiDade, Miami-Dade School Police, Miami Gardens, Miccosukee, North Bay Village, North Miami, Opa-Locka, Sunny Isles
Beach, Surfside, and West Miami.
The insurance companies that participated included 21st Century, Allstate, Direct General, Farmers, Gainsco, Geico,
GMAC, Infinity, Kingsway Amigo, Mercury, MetLife, Nationwide, Sentry, Star Casualty, State Farm, Travelers, United
Auto, USAA and Windhaven.
The PIP Source
Page 5
FIFEC Set to Celebrate 20 Years
This year the Florida Insurance Fraud Education Committee (FIFEC) will celebrate the 20th anniversary of their Annual
Conference, which will take place June 13-15, 2012, in Orlando. The conference is attended by law enforcement,
insurance investigators and professionals, members of IASIU (International Association of Special Investigative Units)
and NSPII (National Society of Professional Insurance Investigators).
The Florida Insurance Fraud Education Committee began as the DIF/SIU Annual Training Seminar representing the
Florida Department of Insurance’s Division of Insurance Fraud and the Special Investigations Unit (SIU) community in
1992. DIF hosted this first seminar, which was actually a one-day, open forum-type workshop held in Altamonte Springs,
with no agenda other than to foster a favorable working environment between the public and private sectors involved in
the fight against insurance fraud. To register or for more info, go to www.fifec.org.
Expected to return this year is Florida’s Chief Financial Officer Jeff Atwater, and new Division of Insurance Fraud
Director Dan Anderson will make his first appearance at the conference.
This year's conference will again be held at the Caribe Royale Orlando All-Suites Hotel and Convention Center, located
at 8101 World Center Drive in Orlando, where it has been since 2004.
Scheduled among this year’s offerings are the following PIP-related courses:
Clinic Capers
Chiropractic Trends
Covert Clinic Operations
Lawyer Referral Services
The State of Fraud in the State of Florida
Forget the Treatment - Just Send the Bill!
Handling EUOs: A “Literally” Hands On Approach
Anatomy of a Clinic - Organized Crime in SW Florida
The Web: Fee Splits, Kickbacks and Clinic Ownership Issues
Vehicle Accident Reconstruction for Adjusters and Attorneys
Staged Accident Investigations: Deputy, Detective & SIU Perspectives
Fraud Referrals to DIF: The Road to Prosecution Begins With DIF & NICB
Basic Automobile Accident Reconstruction for the Insurance Investigator
Out of the M.I.S.T. - Some New Trends & Some Old Trends in Soft Tissue Claims
Hot Topics & Trends in Personal Injury Protection (PIP): Case Law & Legislative Update
Fraud Cases and EUOs in a Post-Custer World: Real Time Examples and Audience Participation
Discussion of Recent Florida Case Law Developments Regarding EUO Methodology and Limitations
March 2012
Page 6
The Dark Side of PIP Fraud
The Division of Insurance Fraud (DIF) arrested seven defendants in January and February 2012 for a staged
accident that occurred on May 18, 2011, in Miami that resulted in more than $78,000 in fraudulent claims.
Typical story, right?
But there is an interesting twist to this story, and it reveals a dark side to this widespread crime.
Organizer Roberto Martinez, 28, has staged many fake accidents in his young life. The Division has
previously arrested him for three other staged accidents. Martinez was first arrested in April 2011 for a
staged accident and $17,950 in fraudulent claims. While out on bond in that case, Martinez staged an
accident in June 2011 resulting in $77,438 in fraudulent claims. Martinez was arrested and his bond was
revoked. While Martinez sat in jail awaiting trial, he was charged with a paper accident that he arranged in
August 2010, resulting in $18,671 in fraudulent charges.
For these four staged accidents, Martinez is responsible for more than $192,000 in fraudulent claims filed
against three different insurance companies.
Most staged accident organizers like Martinez have a relationship with the clinics to which they provide
patients; many of the clinics know the “patients” are participants from fake crashes. Martinez operated his
ring with the purpose of optimizing his profit; he would “sell” his participants to as many clinics as he could,
collecting multiple payoffs. This causes a problem for the clinics when the insurance companies receive
multiple claims for the same patient treating at different providers, and the clinics are often not paid for their
claims, causing them to be upset with the runner. In this case, Martinez.
One of the participants in an accident staged by Martinez decided to end his involvement and refused to go to
any more clinics. Someone believed to be associated with one of the clinics allegedly attempted to take this
participant to the clinic by force, and when the participant resisted, he was pepper-sprayed.
But what happened in this new case is even more alarming. In this case, one of the participants in the May
18, 2011, staged accident was taken to a clinic where he was allegedly threatened and accosted about
money owed to the clinic by Martinez. When the participant was unable to help the clinic get its money, he
was removed from the clinic, put into a car and was under the belief that the driver and accomplice were
going to kill him. Instead, the participant pulled out his own handgun and shot the two other people in the car
and escaped. Miami-Dade Police Department charged them both with kidnapping, and they face trial in
March.
Among the clinics that billed insurance companies for treating patients from staged accidents organized by
Martinez were: Absolute Health Center Corp, Ache Free Body, Active Wellness Center, Atlantic Mobile
Services, B & A Diagnostic, C & C Rehabilitation Center, Dade Wellness Center, First Care Solution, J & C
Imaging, Lianet Rehab Center, Lorena de Jesus Rehabilitation, Matanzas System Corp, MCJ Medical Center
Corp, MG Therapeutic Rehabilitation Corp, Ocean Medical & Diagnostic Services, Omega Medical
Diagnostic, ORD Medical Center and Viva X-Ray Medical Diagnostic Center.
Under arrest in this case are the organizer Martinez, recruiters Raul Torres Oliva, 29, and Juan Torres
Garcia, 54. Also under arrest are participants Aida Artiles Rodriguez, 51, Manuel Madrigal Perez, 49, Juan
Manuel Diez, 26, and Julio Gutierrez, 55. One suspect remains at large.
This case will be prosecuted by the dedicated prosecutors in the Insurance Fraud Unit in the 11th Judicial
Circuit, under the direction of Miami-Dade State Attorney Katherine Fernandez Rundle.
The insurance companies defrauded by Martinez in these staged accidents include 21St Century, Geico and
State Farm. This case is part of a continuing crackdown by CFO Atwater’s Division of Insurance Fraud and
the National Insurance Crime Bureau in the fight against auto insurance fraud in Florida.
The PIP Source
Page 7
PIP Clinic Closings
At least 47 clinics have closed as a result of law enforcement investigations by the Division of Insurance Fraud and other
state, local and federal agencies over the last year. These clinics include the following:
1st Open MRI, LLC - Miami
AB Diagnostic Center - Opa Locka
Aesthetic & Rehabilitation Center - Tampa
Alhambra Health & Rehab - Orlando
American Relax Center - Tampa
Auto Injury Doctors of Tampa, LLC - Tampa
Bayshore Chiropractic Center - Naples
Best Care Medical Center - Tampa
Coral Therapy and Medical Center - West Palm Beach
Coral Way Rehabilitation Services - Miami
D & A Rehabilitation Center Corp - West Palm Beach
Elite Rehabilitation Services Center - Lake Worth
Family Chiropractic Center - North Miami Beach
Family Health Care Solutions - Miami
Florida Rehabilitation Practice - Tampa
Ft Myers Chiropractic Center - Ft Myers
Hallandale Medical Associates - Hallandale
Health Park Chiropractic (aka Fils Chiropractic and Rehab Center, LLC) - Naples
Injury Mid-Florida Rehab LLC dba Physical Medicine Group - Orlando
La-Salle Comprehensive - Miami
MAA Diagnostic Solution - Coral Gables
Marbella Medical Center - Tampa
Medical Therapy Practitioners - Tampa
Medico de la Familia Corp - Hialeah
Mendez Rehab Center, LLC - Tampa
New Horizon Practice - Miami
New Oasis Practice - Miami
Oasis Medical and Rehabilitation Center - Miami
Pain Solution, LLC - Tampa
Personal Outreach Rehabilitation - Tampa
Physical Rehab Center - Tampa
Preferred Diagnostic Solution - Tampa
Progressive Rehab Treatments Corp - Lake Worth
PVC Medical Center - Tampa
Relief All Pain Rehab Center - Tampa
Relief Pain Rehab Center - Tampa
Tampa Rehab Center, LLC - Tampa
Therapeutic Health Center - Tamarac
Therapium Health Corporation - Miami
Therapy Diagnostic Tech Medical - Miami, Jacksonville and Tampa
Universal Rehab Med Group - Lake Worth
Venetian Rehab Center - Miami
Wagner Chiropractic & Acupuncture - Daytona Beach
Wellness Center of Tampa - Winter Haven
West Coast Chiropractic & Medical Center - Tampa
Westchester Professional Health Services - Miami
Whitfield Chiropractic and Massage Clinic, PLLC - Winter Haven
March 2012
Page 8
Statewide PIP Arrests – February 2012
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Jose Manuel Diez, 26 – staged acct 05/18/10 (driver) $78,941 - J & C Imaging / Active Wellness Center / Ocean Medical & Diagnostic Services / Omega Medical Diagnostic / Lianet Rehab Center / Viva X-Ray Diagnostic Center / Atlantic
Mobile Services / Absolute Health Center Corp / Ache Free Body / B & A Diagnostic (21st Century / State Farm) M
Jean Ely Colin, 43 - clinic owner / unlicensed clinic - $523,590 – Silver Star Health and Rehab (Allstate / Farmers /
Liberty Mutual / Safeco / State Farm) O
Judith McKenzie, 68 - chiropractor / unlicensed clinic - $523,590 - Silver Star Health and Rehab (Allstate / Farmers /
Liberty Mutual / Safeco / State Farm) O
Julio Gutierrez, 55 – staged acct 05/18/10 (driver) $78,941 - J & C Imaging / Active Wellness Center / Ocean Medical &
Diagnostic Services / Omega Medical Diagnostic / Lianet Rehab Center / Viva X-Ray Diagnostic Center / Atlantic Mobile
Services / Absolute Health Center Corp / Ache Free Body / B & A Diagnostic (21st Century / State Farm) M
Luis Sergio Pileta Echeverria, 38 – staged acct 06/21/10 (passenger) $69,608 – Quality Life Medical Center / Centinel
Medical Center (Allstate / Progressive / RAC / United Auto) M
Kelvin Enrique Escalante, 23 – false statement in support of jump-in 01/17/11 - $3,977 (Direct General) F
Amalia Soto Escalante, 43 – jump-in 01/17/11 - $3.977 – Dr Russell Turner (Direct General) F
Sherley Lussage, 23 – staged acct 10/29/09 (passenger) $30,000 - R & H Clinic (Liberty Mutual) O
Vanessa St Marc, 24 – staged acct 10/29/09 (passenger) $30,000 - R & H Clinic (Liberty Mutual) O
Marc Maxis, 42 – staged acct 10/29/09 (recruiter) $30,000 - R & H Clinic (Liberty Mutual) O
Marc Maxis, 42 – clinic owner / unlicensed clinic - $523,590 – Silver Star Health and Rehab (Allstate / Farmers / Liberty
Mutual / Safeco / State Farm) O
Luis Mendez Rubalcaba, 55 – PIP patient false injury - $14,624 (Sentry) T
Mladen Antolic, 56 – doctor – insurance fraud / patient brokering / racketeering - Physical Medicine Group dba Injury
Mid Florida Rehab () O
Terry Thackeray, 45 – false claim - $10,898 (State Farm) W
Fernando Taveras Castillo, 37 – clinic employee - $8,362 – Tampa Rehab Center (Farmers / Nationwide) T
Blanca Rojas, 44 – staged acct 06/09/10 (jump-in) $44,900 – Advance Quality Medical Center / GA Therapy Service
(Allstate / Progressive) M
Alfredo Rodriguez, 40 – clinic manager – $7,812 - PVC Medical Center (21st Century / Nationwide) T
Blanca M Acosta, 53 – clinic employee – $7,812 - PVC Medical Center (21st Century / Nationwide) T
Jose Miguel Alvarado Jr, 28 – runner - $8,362 – Tampa Rehab Center (Farmers / Nationwide) T
Kenzi Sanchez, 17 – staged acct 06/09/10 (jump-in) $44,900 – Advance Quality Medical Center / GA Therapy Service
(Allstate / Progressive) M
Michael John Santos, 24 – staged acct 06/09/10 (driver) $44,900 – Advance Quality Medical Center / GA Therapy
Service (Allstate / Progressive) M
Orisel Guerra, 39 – staged acct 11/11/10 (jump-in) $30,200 – Selem Medical Center Corp (State Farm) M
Mariset Orihuela Guerra, 19 – staged acct 11/11/10 (jump-in) $30,200 – Selem Medical Center Corp (State Farm) M
Evelisse Acosta, 41 – massage therapist – $7,812 - PVC Medical Center (21st Century / Nationwide) T
Dorotea Mirella Perez Almeyda, 62 – staged acct 11/11/10 (jump-in) $30,200 - Selem Medical Center Corp (State Farm) M
Kenia Peres, 33 - staged acct 03/20/09 (passenger) $40,792 - Better Life Medical Center, LLC (Affirmative / RAC / State Farm) M
Office Code –B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
The PIP Source
Page 9
Statewide PIP Arrests – February 2012
Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name
and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company
name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.
Giobel Moreira Navarro, 47 – staged acct 07/08/10 (recruiter) $45,002 - CAC Medical Center / Centinel Medical Center
(Allstate / Progressive) M
Rolando Soto, 37 - staged acct 03/20/09 (driver) $40,792 - Better Life Medical Center, LLC (Affirmative / RAC / State Farm) M
Giobel Moreira Navarro, 47 – staged acct 06/19/10 (recruiter) $87,765 - Centinel Medical Center / The Hope
Rehabilitation (Progressive / State Farm) M
Giobel Moreira Navarro, 47 – staged acct 02/02/10 (recruiter) $101,805 - Brilliant Medical Center / L & A Majestic
Medical Center, LLC / ORD Medical Center (Progressive / State Farm / United) M
Yankiel Cordero, 20 – massage therapist – $22,662 - Auto Injury Doctors of Tampa (Farmers / Progressive) T
Ivan Zamora, 38 – staged acct 06/19/10 (driver) $87,765 - Centinel Medical Center / The Hope Rehabilitation
(Progressive / State Farm) M
Suramy Hernandez, 42 – PIP patient - $370 - Better Life Medical Center (Mercury) W
Nelson Reinaldo Hernandez, 47 – PIP patient - $720 - Better Life Medical Center (Mercury) W
Jesus Iluminado Guerrero, 29 – staged acct 06/07/09 (recruiter) $19,414 (Allstate) M
Yankiel Borrego, 30 – clinic manager – $22,662 - Auto Injury Doctors of Tampa (Farmers / Progressive) T
Jose Luis Avila Robles, 30 – runner – $22,662 - Auto Injury Doctors of Tampa (Farmers / Progressive) T
Jorge Luis Gutierrez, 33 – runner, office manager – $7,812 - PVC Medical Center (21st Century / Nationwide) T
Leslie Simo, 19 – staged acct 05/22/11 (passenger) $88,647 – All X-Ray Diagnostic / Benefica Health Center /
La Maison Medical Practice / Diagnostic & Radiology (Allstate / Ocean Harbor) M
Kriter Oliver Gutierrez, 35 – staged acct 04/03/09 (driver) $28,375 - E & B Rehabilitation Center / Francos Medical
Center (Progressive / State Farm) M
Jose Angel Abreu, 25 - staged acct 05/22/11 (driver) $88,647 – All X-Ray Diagnostic / Benefica Health Center /
La Maison Medical Practice / Diagnostic & Radiology (Allstate / Ocean Harbor) M
Arturo Varela, Jr, 22 - staged acct 05/22/11 (passenger) $88,647 – All X-Ray Diagnostic / Benefica Health Center /
La Maison Medical Practice / Diagnostic & Radiology (Allstate / Ocean Harbor) M
Aillen Lynn Cazanas, 18 – clinic employee $22,662 - Auto Injury Doctors of Tampa (Farmers / Progressive) T
Odalys Oloma Hernandez, 42 - staged acct 05/22/11 (driver) $88,647 – All X-Ray Diagnostic / Benefica Health Center /
La Maison Medical Practice / Diagnostic & Radiology (Allstate / Ocean Harbor) M
Rafael La-Rosa, 32 - staged acct 05/22/11 (recruiter) $88,647 – All X-Ray Diagnostic / Benefica Health Center /
La Maison Medical Practice / Diagnostic & Radiology (Allstate / Ocean Harbor) M
Diosniley Acanda Crespo, 38 – massage therapist - $2,330 - Coral Therapy and Medical Center (Allstate) W
Daysi Puigros, 43 - staged acct 03/20/09 (recruiter) $40,792 – Better Life Medical Center, LLC (Affirmative / RAC / State Farm) M
Daysi Puigros, 43 - staged acct 06/21/10 (recruiter) $69,608 – Centinel Medical / Quality Life (Allstate / Progressive /
RAC / United Auto) M
Zaily Morera, 39 – staged acct 04/03/09 (passenger) $28,375 - E & B Rehabilitation Center / Francos Medical Center
(Progressive / State Farm) M
Guillermo Alberto Chavez, 56 – staged acct 02/23/10 (passenger) $101,805 – Brilliant Medical Center / L & A Majestic
Medical Center / Ord Medical Center (Progressive / State Farm / United) M
Kenneth Wayne Beasley, 52 - staged acct 02/23/10 (driver) $101,805 - Brilliant Medical Center / L & A Majestic Medical
Center / Ord Medical Center (Progressive / State Farm / United) M
Office Code –B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
March 2012
Page 10
Statewide PIP Contacts
PANHANDLE REGION
Counties: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf,
Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty,
Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton,
Washington
Pensacola Field Office - 850.453.7802
Capt. Buddy HAND
Lt. Joseph HOLOKAN
NORTH REGION
Counties: Alachua, Baker, Bradford, Citrus, Clay, Columbia,
Dixie, Duval, Flagler, Gilchrist, Hamilton, Levy, Marion,
Nassau, Putnam, St. Johns, Sumter, Suwannee, Union
Jacksonville Field Office - 904.798.5802
Capt. Brian McCOY
Lt. Kevin JONES
WEST CENTRAL REGION
Counties: Charlotte, Collier, DeSoto, Glades, Hardee, Hendry,
Hernando, Highlands, Hillsborough, Lee, Manatee, Pasco,
Pinellas, Polk, Sarasota
Tampa Field Office - 813.972.8602
Capt. Michael BYRNE
Lt. Carlos ROSARIO
Lt. Darrell WILSON
Fort Myers Field Office - 239.278.7527
Lt. Mark FRITZ
Copy goes her.
Editor’s
Corner
On page one, we spotlight the major arrest of two
clinic owners and the chiropractor who helped
them operate their accident clinic without a license.
On page two, we cover a major bust conducted by
the Division of Insurance Fraud in Tampa involving
three clinics.
On page six in “The Dark Side of PIP Fraud,” we
expose a disturbing new trend of violence in what
has traditionally been a paper crime.
FIFEC celebrates its 20th anniversary this year.
As always, we cover PIP-related news from around
the state and report on those arrested for PIPrelated crimes.
EAST CENTRAL REGION
Counties: Brevard, Indian River, Lake, Martin, Okeechobee,
Orange, Osceola, Palm Beach, Seminole, St. Lucie, Volusia
West Palm Beach Field Office - 561.837.5601
Major Simon BLANK
Capt. Glen HUGHES
Lt. Evangelina BROOKS
Orlando Field Office - 407.835.4402
Lt. Jewel CAMERON
SOUTH REGION
Counties: Broward, Dade, Monroe
Miami Field Office - 305.536.0302
Capt. Steven SMITH
Lt. Violeta SERRANO
Lt. John DYGON
Lt. Stanley JEAN-FELIX
Plantation Field Office - 954.321.2902
Lt. Bill LEE
South Florida Major Medical Fraud Task Force
Supervisory Special Agent Fred Burkhardt 954.329.7427
Central Florida Major Medical Fraud Task Force
Supervisory Special Agent Dennis Russo 863.967.6904