PIP fraud is a big-time money crime, as three recent arrests make clear. Perpetrators collected more than $700,000 from insurance companies before investigators shut down their operations.
Those expenses show up in the insurance bills of Florida drivers. In 2008, a 40-year-old driver in Miami with an unblemished driving record was paying $582 in PIP premiums. That figured climbed 80 percent in two years to nearly $1,050 for the same coverage.
Anyone can fight PIP fraud by calling state investigators at 800-378-0445 to report suspected insurance fraud. Individuals who provide tips can remain anonymous and are eligible for a reward of up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme.
The Department of Financial Services to date has awarded almost $250,000 to approximately 40 citizens as part of its Anti-Fraud Reward Program.
Here are three of the latest examples of criminal enterprise:
Case #1: Unlicensed clinic in Orlando area collects $500,000 from insurance companies
Investigators with the Florida Department of Financial Services have arrested Jean Colin, 43, and charged him with operating an unlicensed clinic, fraud, and filing false insurance claims.
Colin and Marc Maxis are accused of staging car accidents after which passengers filed claims for faked injuries and never received treatment. The clinic, Silver Star Health and Rehab in Orange County, pocketed $500,000, according to court records.
Investigators also discovered that chiropractor Judith McKenzie put her name on the clinic’s license, but that Colin and Maxis owned and operated the business. Neither is a physician.
Case #2: Car-crash mastermind in Miramar pockets more than $200,000 in PIP claims
Yasser Vega-Martinez, 34, has been arrested and charged with faking three car crashes that resulted in more than $200,000 in fraudulent insurance claims.
“These staged accidents are at the heart of the PIP fraud epidemic that is casting a shadow over Florida’s roads,” Florida CFO Jeff Atwater said in statement. “Every Florida family is affected by these fake crashes in the form of high auto insurance premiums. My office is determined to work toward policy reforms to curb this costly crime.”
Vega-Martinez set up three accidents between late November 2009 and June 2010, and sent people who had no real injuries to several Miami-Dade clinics: including GMC Rehabilitation Center, AB Diagnostic Center, The Osteomuscular Rehab Center Corp, Y & H Imaging, Grand Canal Rehab, Justin Medical Services, Florida Health Professionals Group Corp, Angels Diagnostic Group and C & C Therapy Center Corp.
Geico and State Farm paid out more than $200,000 in benefits related to the three faked accidents. Vega-Martinez, of Miramar, faces up to 120 years in prison if convicted on all charges.
Case #3: Operator of unlicensed Miami-Dade clinic submits fraudulent PIP claims
Juan M. Dieguez, aka Jorge R. Gonzalez, was arrested and charged with operating a health care clinic without a license, grand theft and insurance fraud, including making fraudulent PIP claims.
The Florida Department of Financial Services’ Division of Insurance Fraud says that Dieguez has owned and operated Venetian Rehab Center in Miami-Dade County since October 2010. He was arrested while working at another clinic, Therapy-Diagnostic, Tech Medical.
Division investigators found that Dieguez absconded from probation following a conviction for Medicaid fraud in 1999. They also discovered that Dieguez’s brother opened Venetian Rehab in 2003 and Dieguez added his false identity as an officer in 2010. Dieguez faces up to 15 years in prison if convicted.
