Posts Tagged ‘insurance claim’

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Investigations manager at UAIC to participate in PIP roundtable

Tuesday, August 3rd, 2010

Blanca Aparicio, manager of the special investigation unit at United Automobile Insurance Corporation, will be featured in a roundtable discussion on personal injury protection (PIP) fraud on Aug. 4, 2010. Florida insurance companies and drivers lose millions of dollars each year from fraudulent claims submitted by drivers, passengers and medical centers. State regulators and local police have devoted task forces to uncovering the fraud and breaking up criminal rings.

Florida Insurance Consumer Advocate Sean Shaw will host the discussion on ways to curb fraudulent activities, improve the claims process, and ensure that the licensure of health care clinics is adequate. The goal is to ensure that PIP coverage remains a cost-effective means for Floridians to receive medical treatment for minor injuries and to help control automobile insurance rates.

The roundtable on Aug. 4 will be held from 9 a.m. to noon and again from 1 p.m. to approximately 4 p.m.  The event will be held in the Florida House of Representatives’ Committee Room 404, House Office Building. A copy of the agenda is posted on the Insurance Consumer Advocate’s website.

Those unable to attend can watch the round table at the Florida Channel’s website or by listening via conference at (888) 808-6959, Conference Code: 4132880.

Also participating in the roundtable are:

  • Rep. Bryan Nelson, Apopka, Insurance, Business & Financial Affairs Policy Committee
  • Dr. Barry Burak, Affiliated Healthcare Centers Inc.
  • Deborah J. Cunningham, Manager, Florida Special Investigations Unit, Nationwide, Allied, Titan, & Victoria Insurance Companies
  • Attorney Kenneth J. Dorchak of Buchalter, Hoffman & Dorchak, North Miami
  • Kim Driggers, Esq., Assistant General Counsel, Florida Chiropractic Association
  • Attorney Scott W. Dutton of Dutton Law Group, Tampa
  • Wade Fairchild, PIP Claim Process Specialist, Allstate
  • Ralph Glatfelter, Florida Hospital Association
  • Howard Goldblatt, Director of Government Affairs, Coalition Against Insurance Fraud
  • Dr. Gary Kompothecras, Physicians Group LLC, Sarasota
  • Belinda Miller, Deputy Insurance Commissioner Property & Casualty Insurance, Office of Insurance Regulation
  • Tracy T. Pickard, Director of Special Investigations, Direct General Insurance
  • Chris Shakib, Terrell Hogan Law Firm, Jacksonville
  • Dr. Todd Sussman, C.D., Total Healthcare of Florida, Weston
  • Capt. Steven Smith, Department of Financial Services, Division of Insurance Fraud, Operations and Investigations, Miami-Dade Region
  • Jessica Turner, Special Investigations Manager, Farmers Insurance Group
  • Attorney Johnny Moore, Deputy Insurance Consumer Advocate, Office of the Insurance Consumer Advocate
  • R. Terry Butler, Senior Attorney, Office of the Insurance Consumer Advocate
  • Reamonn Soto, FAMU Intern, Academy of Leadership and Excellence Program, Office of the Insurance Consumer Advocate

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Courts take heed of important ruling on small-dollar PIP lawsuits

Wednesday, July 21st, 2010

A judge wanted to hand over $0.17 or $9.63 in interest (depending on whether the judge found the interest fluctuated or was a flat rate) to the plaintiff and big fees to its attorney, but the recent appellate court ruling on “de minimis” lawsuits put a stop to the nonsense.

Miami-Dade County Court Judge Lawrence D. King granted a motion for summary judgment by United Automobile Insurance Company (UAIC) after a higher court ruled that the courts should be cleared of small-dollar lawsuits.

Let’s hope that other county court judges fall in line and put an end to the abuse of the law by plaintiff attorneys. This ridiculous game of suing for pennies and pocketing tens of thousands of dollars in fees should have come to an end a long time ago.

George A. David had sued UAIC in 2008 on behalf of Stand-Up MRI, Inc., claiming that UAIC had underpaid the interest owed on a PIP treatment claim. As with other lawsuits, Stand-Up MRI had cashed the payment check before hiring an attorney who sent a letter demanding more money. The letter didn’t say how much.

Nor did the lawsuit. It wasn’t until David, of George A. David, P.A., got before Judge King that it became known his client was owed just $.17 or $9.63.

Judge King had denied UAIC’s motion to dismiss the lawsuit, in which the company argued that the complaint failed to state the amount due and ordered UAIC to file an answer. Subsequently, UAIC filed a motion for summary judgment regarding Stand-UP MRI’s defective demand letter, which Judge King also denied.

UAIC argued that when it responded to the initial demand letter (which did not state the amount of interest owed), it requested that Stand-Up MRI contact UAIC immediately there was a discrepancy in the payment made. But instead of contacting UAIC and advising the interest was short by $0.17 or $9.63, Stand-Up MRI filed suit less than a week later.

UAIC then filed a motion for summary judgment based on the doctrine of “de minimis non curat lex” which was set for hearing on July 17, 2010.  Based upon the recent ruling by the appellate circuit court which found that a similar lawsuit must be dismissed based upon the same doctrine, Judge King granted UAIC’s motion for summary judgment.

UAIC has been sued countless times for amounts from a few cents to a few dollars. Now that plaintiff attorneys cannot collect five- and six-figure fees for these needless lawsuits, the courts and taxpayers should see some relief.

There’s more to be done – stamping out PIP fraud, for instance – but taking away the economic incentive to sue first and let the insurance company know what you are suing for later has started to level the playing field in the courtroom.

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No ‘PIP time machine’ for auto insurance claim, says Miami-Dade court

Saturday, July 17th, 2010

Been in a car accident? No insurance policy? No problem. At least that is one driver’s thought when she bought insurance from United Automobile Insurance Company (UAIC) after her daughter was injured in a collision.

Now, more than four years and seven months later, a Miami-Dade County circuit court, sitting in its appellate capacity, says that county court judge Teretha Thomas erred when she found a UAIC adjuster could promise coverage despite there being no insurance policy in effect.

A driver was involved in an accident on Dec. 7, 2005, at 7:55 a.m., in which her daughter was a passenger, according to court records. At 10:23 a.m., the driver purchased an insurance policy with UAIC. The next day, the daughter began receiving treatment for injuries allegedly received in the accident, and made a claim for payment through UAIC.

When the medical provider submitted the bill, UAIC did not pay and was sued. When the provider’s attorney, Todd A. Landau, took the deposition of UAIC’s claims adjuster, that person erroneously said the company had no issue with regard to coverage.

Landau argued to Judge Thomas that the adjuster’s testimony meant UAIC had no objection to paying the claim. The judge agreed and ordered a judgment before the lawsuit went to trial.

UAIC appealed and three circuit court judges sitting in their appellate capacity agreed that UAIC never promised to pay the medical bills. The judges unanimously ruled that while insurance coverage cannot be forfeited, it also cannot be created where it doesn’t exist. And any agreement to change the effective date – or time – of coverage cannot come after a lawsuit is filed.

It’s obvious to us that any responsible driver that you should have insurance before you get behind the wheel. You cannot force an insurance company to pay for an accident when no insurance policy was purchased or in effect. That’s plain common sense.

The appellate court agreed with our reasoning and granted UAIC’s motion for attorney fees. The court found the appeal was frivolous as there was no reasonable basis in fact or law to uphold Landau’s argument that coverage should exist despite no insurance policy being in effect. Landau wrote a check to UAIC for $15,250.

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Appeals court overturns verdict that gave big payoff to plaintiff attorney

Tuesday, July 13th, 2010

The fee faucet from which so many plaintiff attorneys drink has been reduced to a potential trickle by the appellate division of Miami-Dade County circuit court. Before attorneys sue auto insurance companies over Personal Injury Protection (PIP) claims, they must make clear beforehand what their client wants, said the court in a July 1, 2010, opinion authored by Judge Mark King Leban.

The court showed excellent common and financial sense. There is no reason that an attorney should pocket $13,000 when suing for two bucks.

In handing down a unanimous decision, the court said the only motivation for the lawsuit was attorney fees. The court told the county court judge to look at the lawsuit again, deny the plaintiff attorney her fees, and dismiss the complaint.

The case began after a United Automobile Insurance Co. (UAIC) policyholder was injured in a car accident in 2004. Fourteen months after UAIC paid her medical bills, her attorney, Maria Corredor, sent a letter saying that additional money was owed, but did not state how much.  Four months later Corredor filed suit, and only then did she explain that her client was seeking $2.53 in alleged overdue interest.

Corredor is a regular player in the plaintiff PIP bar.  When UAIC surveyed PIP plaintiff attorneys who sought the highest legal fees, the company found that she charged and was regularly awarded $400 an hour. She had every incentive to sue rather than write UAIC and ask for the tiny amount owed.

Without a trial, Miami-Dade county court judge Robin Faber awarded the plaintiff a total of $2.53 and gave Corredor $13,370.25 in fees and costs, plus interest.

The amounts made no sense – legally or economically – so UAIC appealed. Ridiculous fee awards like this one just encourage more plaintiff attorneys to bring frivolous suits in hopes of a big payday.

A panel of three Miami-Dade circuit judges acting in their appellate capacity agreed with UAIC in a 15-page opinion.  Had the plaintiff and her lawyer sent a letter specifying exactly how much was owed, “no lawsuit would have been filed, nor any judgment entered for such a paltry amount, nor any award for attorney’s fees for such a conscience-of-the-court shockingly large amount,” the court wrote in its opinion.

The judges then absolved UAIC of any wrongdoing.

“In the case at bar, there was no wrongful conduct by United,” they wrote in their opinion. The company paid the medical providers 14 months before Corredor sent her vague letter demanding more money. And her client waited 18 months after the medical providers cashed their checks to sue.

The court also said that county courtrooms should not entertain lawsuits for trivial dollar amounts. The court cited a Florida Supreme Court decision from 1858 in which a case was dismissed because the amount involved was a small (“de minimis”) amount between $9 and $11.  In the UAIC case, the judges wrote, “One wonders how ‘de minimis’ an amount for which an insured/provider will repair to the court for redress: $1.23? $0.25? A nickel?”

The answer is 17 cents, as reported in this blog. The good news is that the courts are running out of patience with plaintiff lawyers who waste the time and money of taxpayers and insured drivers. One can only hope that judges in Miami-Dade county courts and beyond heed the wise words in this court decision.

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Suspicious accidents, PIP claims soar in Florida, National Insurance Crime Bureau says

Tuesday, June 29th, 2010

The number of suspicious auto accidents that were staged or deliberately caused by criminals in Florida has increased dramatically in the past year, according to the National Insurance Crime Bureau (NICB). The independent organization said on June 29, 2010, the number of questionable claims submitted to its insurance company members shows a 58 percent jump from 2008 to 2009.

This comes to no surprise to those of us at United Automobile Insurance Co. (UAIC) who fight insurance fraud every day. We see fake accidents and fake injuries all the time.

The report, shows the following trends in Florida:

  • Tampa had 487 questionable claims related to staged or caused accidents in 2009, a 290 percent increase over the previous year.
  • Miami had 258 questionable claims, an 11 percent increase year to year.
  • Orlando had 240 questionable claims, a 24 percent increase.

South Florida was the hotbed of staged crashes, according to the bureau. While the Miami and Hialeah areas continue to show increased activity, criminals have moved north and Tampa Bay is now the center of this crime trend.

The number of questionable claims for all insurance fraud increased 15 percent from 2008 to 2009 in Florida. But the 58 percent jump in the staged accident category shows that criminals are taking advantage of the state’s no-fault auto accident coverage, the bureau said. Florida had the highest rates of fraud in both bodily injury and personal injury protection among states with no-fault insurance.

We have been telling legislators, regulators and law enforcement officials for years that Florida is the epicenter of PIP fraud. Now we have the numbers to back that up.

To combat the problem, the bureau created a task force in South Florida in 2002. The success of the program pushed criminals to Tampa and Orlando areas. Staying in pursuit, the bureau will soon open another major medical fraud task force in Tampa.

The bureau has launched a public awareness campaign in the Tampa Bay area, using billboard and bus shelter ads, as well as radio spots to urge people who suspect a staged accident scheme to call 1-800-TEL-NICB or text their information to TIP411, keyword “fraud.”

We urge every driver in the Tampa Bay area and around the state to report fraud when you see it. You will be bringing criminals to justice and could see your insurance premiums drop if we all do enough to stamp out fake claims.

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Attorney tries to dodge fees when PIP lawsuit goes bad

Tuesday, June 29th, 2010

When it comes to money that plaintiffs or their attorneys have to pay out of their pockets, some lawsuits never come to an end. And that’s what happened with a claim that started seven years ago.

Plaintiff attorneys are paid as much as $500 an hour for filing paperwork at the courthouse and filling in forms, United Automobile Insurance Co. (UAIC) uncovered in its research of court records.

But when those attorneys lose, they want the other side to receive less than $100 an hour. How surprising.

UAIC fought a 2003 accident claim in Broward County, Florida. The claimant, who was not insured by UAIC, sought Personal Injury Protection (PIP) coverage relating to an alleged accident. UAIC denied payment of PIP benefits after discovering the claimant herself owned two vehicles for which insurance was required. That led to a lawsuit in Broward County Court.

During litigation, plaintiff attorney William C. Ruggiero argued that one of the vehicles the claimant owned had been stolen and the other was inoperable, and as such, United was responsible for PIP coverage. Ruggeiro, whose law offices are in Fort Lauderdale,  even filed an affidavit of the claimant’s daughter alleging the vehicle was inoperable.

UAIC discovered from the claimant herself that she did in fact own two vehicles, that neither had ever been stolen, and that both vehicles were in fine working condition. In fact, one of the vehicles was actively driven by her daughter, the person who signed the affidavit alleging the vehicle was inoperable.

After two long hearings on UAIC’s motion to dismiss the case, Broward County Court Judge Martin Dishowitz finally ruled in our favor.

UAIC then asked for payment of the attorney’s fees incurred while litigating the bogus claim. Ruggiero and his client once again made every argument possible to deny UAIC’s request. Judge Dishowitz ultimately dismissed the plaintiff’s arguments and granted entitlement to fees but challenged just how much UAIC’s defense attorney should be paid per hour.

A fee expert hired by Ruggeiro said that insurance defense attorneys usually get paid $85 to $150 per hour, with the average being $100 to $135 per hour.

UAIC argued that because its defense attorney had five years of experience defending PIP cases, the rate should be $250 to $350 per hour. Judge Dishowitz regularly awards plaintiff PIP attorneys with similar experience $250 to $350 per hour.

Judge Dishowitz made UAIC argue twice for why it should be paid and in the end only awarded $145 per hour. Was that a reasonable amount? It would be if the plaintiff attorneys were not asking for and being awarded $300 to $500 an hour. Somehow, those lawyers believe their time is more valuable than ours and the judges seem to believe that too. It is such a biased system.

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UAIC to LaBovick: Let’s get to truth on PIP lawsuits

Wednesday, May 12th, 2010

Our report on April 13 that LaBovick & LaBovick was filing hundreds of small-dollar lawsuits in Broward County apparently got the attention of the law firm and its managing shareholder, Brian F. LaBovick. Don’t think he caught United Automobile Insurance Company (UAIC) in the act of something devious, as the headline of his blog post would suggest. We were the ones who lifted the veil on his operations. Now, he is howling about “bringing the insurance giant to justice” in an April 27 blog post.

Thanks to our enterprising work, Mr. LaBovick now admits in his blog post that his firm has flooded the Broward courts with at least 1,000 lawsuits that are Personal Injury Protection (PIP) related. He also acknowledges that the plaintiff in every case is a company he controls, Gulfstream Medigroup. And Mr. LaBovick also admits that many of the lawsuits are for small sums of money.

Mr. LaBovick has a lot to say in his post about how he thinks his firm is undertaking a noble effort. He says his firm stands up for the rights of doctors and medical providers. There is a big problem with his argument: the doctors and medical providers he claims he is standing up for are not the ones filing suit and claiming they have been underpaid.

Mr. LaBovick also raises the question, “How much is the ‘right amount’ to be ripped off before a doctor sues?” Sadly, he has no numbers or statistics to back up the claim that anyone has been cheated. In reality, Mr. Labovick is filing lawsuits for bills that were previously paid in full, or were paid at an amount that the medical clinic accepted as full and final payment.  In one case, UAIC erroneously paid the medical clinic twice for the same services, with both checks cashed by the provider, and the LaBovick firm still filed a lawsuit claiming UAIC underpaid!  These are the numbers and statistics that will come out in court.

If you want to talk about rip-offs, cite numbers, such as the fact that the Florida Department of Insurance Fraud gets as many tips about PIP fraud as all other types of insurance fraud combined. Or read about the busts of medical clinics that excessively overcharge, submit bills for services never rendered, or treat people who stage accidents. Those people are the criminals who Mr. LaBovick should be criticizing.

So, Mr. LaBovick, let’s get down to what this is really about: your legal fees. In every case, LaBovick & LaBovick is seeking the same thing: attorney’s fees from insurance companies like UAIC.  If it weren’t about the attorney’s fees, then the lawsuits would have never been filed.  Why else would Mr. Labovick file a lawsuit for an alleged underpayment of $3.89 when it costs a minimum of $55 to file the suit?

Gulfstream Medigroup and LaBovick & LaBovick (which, of course, are one and the same) are just another group in a long line of attorneys that are out to milk Florida’s no-fault PIP system for exorbitant attorney’s fees.  This is a game to them, and the ones who ultimately pay are taxpayers and honest Florida drivers. The game needs to end.

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Latest PIP fraud crackdown leads to arrests in Tampa, Miami

Thursday, April 22nd, 2010

The Florida Division of Insurance Fraud is fighting rampant Personal Injury Protection (PIP) fraud in the state with investigations of diagnostic and treatment clinics. The latest effort resulted in eight arrests on April 20, 2010, of owners and workers at clinics in the Tampa Bay area and Miami.

PIP fraud continues to be a widespread problem in Florida. Reports say that many PIP insurance claims are padded and some are totally fraudulent. Those unjustified overcharges are a large reason that Florida drivers pay some of the highest auto insurance premiums in the country.

PIP-related lawsuits cost taxpayers and drivers money, as plaintiff attorneys file court claims seeking as little as $1.19 for their clients and tens of thousands of dollars for themselves in legal fees. Abuses of the court system have been reported in this blog.

As a public service, we are reprinting below the news release from the office of Florida Chief Financial Officer Alex Sink, who initiated the sweeps in January.

CFO Sink Announces Arrest of Eight PIP Scammers in Continued PIP Sweep Arrests

TALLAHASSEE — Florida CFO Alex Sink’s Division of Insurance Fraud (DIF) today joined the Hillsborough County Sheriff’s Office and the National Insurance Crime Bureau (NICB) to announce a staged vehicle accident Personal Injury Protection (PIP) sweep, including clinic owners and workers involved in PIP fraud scams around the state.

“Staged accidents put every Floridian at risk, both physically and financially,” said CFO Alex Sink. “I am taking aggressive action every day to get these scammers off our streets and behind bars where they belong.”

CFO Sink investigators arrested Miguel Costillo Rivero, 47, outside of his Tampa residence this morning after an investigation showed that Rivero was soliciting people to be part of staged accidents, offering money in return for participation. Superior Injury Care, Inc., a Tampa, clinic received false PIP claims that provided the clinic with reimbursement funds from insurance companies on services never rendered. Rivero is being charged with patient brokering and false fraudulent insurance claims, both third-degree felonies.

Superior Injury Care clinic therapist Courtney Braden and receptionist Blanca Luz Villalobos were also arrested in the Rivero case, charged with Patient Brokering and False/Fraudulent Insurance Claims, both 3rd degree felonies.

CFO Sink’s detectives were initially introduced to Miguel Castillo Rivero by David Vazquez Perez. Perez was interviewed in Pasco County with assistance by the Pasco County Sheriff’s office, regarding a staged accident. Perez admitted taking participants to Rivero’s house, where they received payments and reminders to return to the clinic once a week to fill out insurance paperwork. Perez has been booked into the Pasco County Jail. Perez was charged with one count of false/fraudulent insurance claim.

Tampa Pain Rehab, LLC Director Livan Diaz Acosta, 34, and therapist Jonathan Alfonso Rosero, 23, were also arrested this morning on the same PIP-related charges — patient brokering and false/fraudulent insurance claims which are both third-degree felonies. Acosta and Rosero have been booked into the Hillsborough County Jail.

CFO Sink’s investigators arrested Joel Bauta Lopez, 37, and Claudia Valdes Diaz, 21, owners of Ganesha Medical Center Corporation in Miami, yesterday [April 20] on charges of insurance fraud, grand theft and operating an unlicensed clinic while attempting to collect more than $40,000.00 in fraudulent insurance claims.

The charges stem from a previous arrest of both suspects in May 2009 for participating in a staged accident ring under a former business name, E&B Rehabilitation Center. After their first arrest, they posted bond and reopened a clinic under a new name, Ganesha Medical Center Corp., continuing to work without a business license.

Since Lopez and Diaz committed this new crime while out on bond for their 2009 arrest, they could be held without bond until their trial. Both suspects were booked into the Miami-Dade County Jail yesterday afternoon and each charged with one count of operating without a license, eight counts of Insurance Fraud and eight counts of Grand Theft.

These arrests are part of an ongoing PIP sweep by DIF that began earlier this year through partnership with the New Port Richey Police Department, Pasco County Sheriff’s Office, Hillsborough County Sheriff’s Office, Direct Insurance., Met Life Insurance and NICB. Further arrests are pending around the State.

For more information on PIP fraud in Florida, visit DIF’s website at http://www.myfloridacfo.com/fraud/.

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It’s time to fight back against PIP fraud

Monday, April 19th, 2010

“You know all our cases are phony and we bribe the judges.”

This may sound like a quote from a television crime drama, but it’s not.  It’s a direct quote from plaintiff Personal Injury Protection (PIP) attorney and longstanding member of the Florida Bar, Michael Ira Libman.  Mr. Libman is regularly awarded $450 an hour to pursue PIP cases.

Plaintiff PIP attorney Carlos Lopez-Albear once bragged that the plaintiff PIP attorneys in Miami-Dade County are named “The Dirty Thirty.”  Lopez-Albear is regularly awarded $400 an hour for PIP cases.

“These are perfect examples of what insurers encounter in Dade and Broward County,” responds Richard Parrillo, Sr., founder and CEO of United Automobile Insurance Company (UAIC).  “Plaintiff PIP attorneys are so arrogant, they flaunt the fraud they engage in.

“I’m confident we are not the only carrier that faces this type of arrogance and it is time for us to speak out,” Parrillo says. ” Insurance fraud comes at a heavy cost to Florida residents and it’s time we fight back.”

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Lawsuit-happy firm in Palm Beach files PIP court claim for $3.89

Tuesday, April 13th, 2010

Little lawsuits. Littler lawsuits.

It’s just another day at the Broward County courthouse for Gulfstream MediGroup. The Palm Beach-based firm has become a litigation machine, filing more than 300 lawsuits in Broward County’s courts in both January and February 2010, according to public records. That’s equivalent to one every half-hour the main courthouse was open.

In the last three months of 2009, Gulfstream MediGroup filed 435 lawsuits against companies that insure drivers, according to public records. Among them, a claim for $3.89, plus legal bills for its exclusive law firm, LaBovick & LaBovick. The CEO of Gulfstream MediGroup, Brian F. LaBovick, is also the managing shareholder at LaBovick & LaBovick, which specializes in PIP litigation. The law firm and its automobile claims collection firm operate at the same address on Hood Road in Palm Beach Gardens, Fla.

The plaintiff lawyers who supposedly represent insured drivers are now getting into the litigation business just for themselves. In all of these cases, the driver and his or her medical provider were bought off a long time ago. Now it’s just the plaintiff lawyers and their captive billing agency down the hall.

Gulfstream MediGroup sued UAIC in December 2009 for an accident that the UAIC-insured driver said took place three years earlier. Since that time, the driver has signed over her claim to Hallandale Open MRI in Hallandale, Fla. That company, in turn, has signed over all its insurance claims from 2004 to 2007 to Gulfstream MediGroup in an undated document.

The lawsuit claims that UAIC underpaid a PIP-related claim by $3.89 and seeks to recover that amount for Gulfstream MediGroup, plus attorneys’ fees for LaBovick & LaBovick. A recent survey of attorneys’ fees in PIP cases found that many attorneys charge between $300 and $400 an hour for filing legal paperwork in Broward County courts.

From our point of view, it just doesn’t make sense to tie up the courts for a measly $3.89 so that an attorney can take home tens of thousands of dollars in fees. This is an abuse of the justice system. Gulfstream MediGroup is just dumping hundreds of lawsuits at the Broward courthouse. The firm is demanding that taxpayers and, ultimately, insured drivers pay for them.

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