December 2015
Volume 6 - Issue 6
“If consumers aren’t
going to get the relief
the legislation
intended, then the time
to repeal has arrived.”
- CFO Atwater spokeswoman Ashley Carr
HEADER HERE
Florida Legislature Set to
Review Ending PIP / No-Fault
The state's personal-injury protection auto insurance system, known as "no-fault," would
end in 2019 under a set of proposals currently in the Florida Legislature.
Rep. Bill Hager, R-Delray Beach, filed a proposal (HB 997) last week, two months after
Insurance Commissioner Kevin McCarty tossed out the idea of, "Let's just repeal PIP
and do nothing," as a way to further reduce fraud in the personal-injury protection
system.
The repeal idea also appears to have backing from state Chief Financial Officer Jeff
Atwater.
Atwater, who along with Gov. Rick Scott championed 2012 changes intended to fight
fraud in the no-fault system, maintained as recently as October that time was needed to
see the impact of the legislative changes.
On Monday, a spokeswoman for Atwater said that the "time has now passed."
INSIDE THIS ISSUE
1
PIP Under Review
2
Most Wanted
3
PIP Fraud News
4
Statewide Arrests
5
Statewide Contacts
"Ultimately, it's a policy decision for the Legislature to make, but two years after the
passage of the PIP legislation, it's time for the insurance industry to bring forward
evidence that shows whether or not rates are going to come down," Atwater
spokeswoman Ashley Carr said in an email. "If consumers aren't going to get the relief
the legislation intended, then the time to repeal has arrived."
Sen. Jeff Brandes, R-St. Petersburg, filed the Senate version (SB 1112) of Hager's
proposal on Dec. 11. The identical measures would require motorists to have a minimum
of property-damage and bodily-injury liability coverage.
With lawmakers estimating that the average Florida motorist was paying $180 a year for
the personal-injury protection portion of their auto coverage, a 2012 law set benchmarks
for insurers to lower rates on the coverage. The law also required people involved in
crashes to seek treatment within 14 days and allowed up to $10,000 in benefits for
emergency medical conditions, while putting a $2,500 cap on non-emergency conditions.
State officials maintained the changes were showing signs of success.
See the full article by Jim Turner at http://www.tampabay.com/news/business/banking/
florida-lawmakers-look-at-pulling-the-plug-on-no-fault-auto-insurance/2258663.
The PIP Source
Page 2
City of Miami PD Arrests 7 in PIP Fraud Sweep
The City of Miami Police Department Staged Crash Unit, working in conjunction with the Federal
Bureau of Investigation (FBI), Miami-Dade State Attorney’s Office, Florida Department of Health
(DOH) and National Insurance Crime Bureau (NICB), announced the arrest of seven individuals at
three PIP clinics in Miami. The undercover investigation started in April 2015 after authorities learned
individuals in the clinics were allegedly involved in staged car crashes and PIP fraud.
“Insurance fraud is an attack on every individual who pays an insurance premium,” commented
Miami-Dade State Attorney Katherine Fernandez Rundle. “Insurance fraud scams utilizing staged
accidents and fake medical treatments depend on an entire crew of criminals who put our money into
their own pockets. The message to such swindlers is that this effective law enforcement team of
police and prosecutors is still out there working to shut you down.”
Included in the charges against the seven defendants were staged accident, insurance fraud, grand theft, organized
scheme to defraud and patient brokering.
Arrested from Excellent Health Services were clinic owner Marisel Chaviano, receptionist Yuleidy Fonseca and
massage therapist Carlos Garmendia Ferrer. The clinic first opened in 2006, and Garmendia Ferrer was first licensed in
2010.
Arrested from AQ Medical & Rehab was massage therapist Yusniel Aguero. The clinic first opened in 2014 and Aguero
was first licensed in 2014.
Arrested from RFG Medical Clinic were clinic owner Alberto Lopez, receptionist Yexenia Cantillo and massage therapist
Miuriz Diaz De Villegas. The clinic first opened in 2000 and Diaz de Villegas was first licensed in 2011.
The insurance companies involved included Allstate, Infinity, Nationwide, State Farm, United Automobile and
Windhaven.
Elvis Homen
aka Elvis Mario Homen Chaviano
White Hispanic Male, 28 years old
5’6”, 170 lbs, Brown Eyes, Brown Hair
Warrant Information:
Warrant/Case #: W612945049
Felony Charges: Staged Accident, Grand Theft, Insurance Fraud
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud (DIF) is attempting to locate Elvis Homen in reference to the
outstanding warrant.
Homen is wanted for his role in organizing a staged accident and the
filing of fraudulent insurance claims.
Homen has yet to be found since his warrant was issued in February
2015. His warrant is full extradition. Homen was last known to be in the
Tampa area.
If you know where Homen can be located, please contact the Division
of Insurance Fraud at 1-800-378-0445.
Check out the DFS Most Wanted at http://www.myfloridacfo.com/PressOffice/MostWanted/
December 2015
Page 3
PIP FRAUD – In The News
Family-Run Healthcare Fraud Ring Dismantled by Feds
Hendris Castillo Morales, one of the leaders of a family-run ring that tried to rip off more than $100 million in healthcare
insurance payments by the city of Miami, Miami-Dade County Public Schools and numerous major companies was
sentenced to 10 years in prison last month.
More than $15 million was paid to the healthcare network which operated about 35 clinics in Hialeah, Doral and Miami
between 2012 and 2015, according to the indictments. Among the bilked entities: Pepsi Co., Macy's, RadioShack, BJ's
Wholesale Club, Lincoln Property Company, Nextera Energy and Southeast Frozen Foods Company.
Prosecutors charged a total of 18 defendants, including Danny Jacomino Bordon, with trying to steal $130 million from
the public entities, private companies and major insurers, namely Blue Cross Blue Shield, United Healthcare and Cigna.
Jacomino Bordon also ran a Miami rehab clinic. Three defendants, Reynaldo Castillo, Ezequiel Servero Casas and Jose
Gerardo Gonzalez, fled to Cuba.
See the full article by the Miami Herald’s Jay Weaver at http://www.miamiherald.com/news/local/community/miami-dade/
article41857827.html.
30 Arrested by Feds in Massive Indiana Staged Crash Fraud Ring
Thirty-six people were indicted on federal charges after a two-year investigation of an apparently well-known Evansville
"crime family," who were the ringleaders of an alleged "massive" fraud operation that involved staging at least 12 car
crashes to collect insurance money. The illegal scheme netted the group at least $600,000.
Federal prosecutor Josh Minkler, who called the investigation the largest white collar crime investigation in Evansville's
recent history, stated "Over a six-year period from 2008 to 2014, the Burris family recruited individuals to participate in a
series of staged car crashes, the filing of false police reports, (and) the filing of false insurance claims for injuries that
were either faked or self-inflicted."
See the full article by the Courier and Press’ Richard Gootee at http://www.courierpress.com/news/crime/federalindictments-in-massive-crash-fraud-case-to-be-announced-2430a69a-b45e-64fb-e053-0100007f0dc8-344815932.html.
Louisiana Arrests 9 in New Orleans For Staged and Jump-In Crashes
Louisiana State Troopers arrested nine suspects and were looking for nine more involved in staged and/or “jump-in”
crashes as a means to defraud insurance companies. The warrant roundup resulted from nearly a dozen independent
investigations conducted by the Louisiana State Police Insurance Fraud/Auto Theft Unit New Orleans field office.
Detectives worked closely with numerous insurance companies including Repwest, Progressive, State Farm, Imperial
Fire and Geico.
Total financial exposure as a result of the fraudulent claims is estimated to be more than $165,000.
More information on this story is available at http://www.wwl.com/Troopers-Obtain-18-Arrest-Warrants-in-New-Orleans/22139937.
Farmers and Geico Donate Undercover Vehicles to Division of Insurance Fraud
In November 2015, Farmers and Geico each donated a surveillance vehicle to the Division of Insurance Fraud (DIF) to
assist in their efforts in the fight against insurance fraud. These donations were made with the assistance of Special
Agent Terra Rush, National Insurance Crime Bureau (NICB). Thank you to Farmers and Geico for their continued efforts.
Pictured below at left: Ian Oliver, Farmers Insurance SIU Manager, SA Terra Rush, NICB and DIF Major Mike Byrne.
Pictured at right: DIF Major Mike
Byrne; SA Terra Rush, NICB;
Gary Hodge, Geico SIU
Supervisor and Michael Zuhars,
Geico Auto Damage Field
Supervisor.
.
The PIP Source
Page 4
Statewide PIP Arrests – November 2015
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.
Erica Renee Burks, 28 - lost wages - $4,000 (Esurance) J
Terrell Leenard Sharp, 27 - fake ins card (Progressive) TL
Terrell Leenard Sharp, 27 - ID theft / fraudulent claim (Progressive / Zurich) TL
Brian Allen Ford, 29 - jump-in 04/05/15 - $2,500 (Direct General / Progressive) T
Brandee Lee Smith, 33 - false vehicle theft - $2,052 (United Auto) B
Braulio Valenzuela, 74 - false claim pedestrian - $14,789 (United Auto) M
Silvia Vanessa Diaz-Lemus, 40 - staged acct 12/15/11 (driver) $55,561 - Gate Parkway Diagnostic Center / Wellness Rehab
Services (Farmers) J
Wuilmar Dony Escalante Velasquez, 29 - fake ins card (MGA) W
Pedro Miguel Rodriguez, 35 - staged acct 12/15/11 (recruiter) $55,561 - Gate Parkway Diagnostic Center / Wellness Rehab
Services (Farmers) J
Yeritza Ramos, 34 - staged acct 02/22/11 (passenger) $8,837 - Baymeadows Injury Center (Progressive) J
Jose Joaquin Palma, 56 - staged acct 03/14/12 (recruiter) $50,765 - Sunshine Medical Services (United Auto) M
Ashley Nicole Agenat aka Ashley Ulysse, 30 - operating unlicensed clinic - $116,026 - Palmetto Chiropractic, LLC (Allstate /
Assurance America / Direct General / Farmers / First Acceptance / Geico / Infinity / Ocean Harbor / Peachtree / Progressive / Sentry /
State Farm / Travelers / Windhaven) T
Nixon Lordeus, 46 - operating unlicensed clinic - $116,026 - Palmetto Chiropractic, LLC (Allstate / Assurance America / Direct
General / Farmers / First Acceptance / Geico / Infinity / Ocean Harbor / Peachtree / Progressive / Sentry / State Farm / Travelers /
Windhaven) T
Catalina Velez aka Ana Neira, 32 - staged acct 02/22/11 (driver) $2,639 (State Farm) J
Djoodmy Elie, 45 - operating unlicensed clinic - $116,026 - Palmetto Chiropractic, LLC (Allstate / Assurance America / Direct
General / Farmers / First Acceptance / Geico / Infinity / Ocean Harbor / Peachtree / Progressive / Sentry / State Farm / Travelers /
Windhaven) T
Herlen Luis Guerra Gonzalez, 21 - false statement in support of vehicle theft - $18,850 (Allstate) M
Elvie Smith, 61 - false receipts - $13,537 (Allstate) O
Eilyn Morera, 18 - false statement in support of claim (Allstate) M
Vivian Lucia Monzon, 48 - application fraud (21st Century) M
Leandro Fernandez, 22 - staged acct 03/22/11 (driver) $39,474 - Baymeadows Injury Center (Allstate) J
Miguel Lojano, 36 - staged acct 03/22/11 (driver) $21404 (Sentry) J
Shayawntae Ashante Lambert, 33 - unlicensed agent / application fraud (Geico) B
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
December 2015
Page 5
Statewide PIP Contacts
DISTRICT I
Major Michael BYRNE
DISTRICT II
Major Rafael DELGAGO
PANHANDLE REGION
Counties: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf,
Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty,
Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton,
Washington
SOUTH CENTRAL REGION
Counties: Broward, Charlotte, Collier, Glades, Hendry,
Highlands, Indian River, Lee, Martin, Okeechobee,
Palm Beach, St. Lucie
Pensacola Field Office - 850.453.7802
Capt. David LINDSAY
Lt. Sandra FITZSIMONS
Tallahassee Field Office - 850.413.3115
Acting Lt. Michael SMITH
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
NORTH CENTRAL REGION
Counties: Brevard, Hillsborough, Lake, Orange, Osceola,
Seminole, Volusia
Orlando Field Office - 407.835.4402
Capt. Evangelina BROOKS
Lt. Laquanda GREEN
Lt. John SAVINO
WEST CENTRAL REGION
Counties: DeSoto, Hardee, Hernando, Manatee, Pasco, Pinellas, Polk, Sarasota
Tampa Field Office - 813.972.8602
Capt. Darrell WILSON
Lt. Carlos ROSARIO
St Petersburg Field Office - 727.563.1142
Lt. Carl LANE
Copy goes her.
Editor’s
Corner
On page 1, we report that the Legislature is set
to review ending PIP / No-Fault in Florida.
On page 2, we feature another fugitive in
Insurance Fraud’s Most Wanted.
As always, we report on PIP Fraud in the News
and the latest PIP-related arrests.
West Palm Beach Field Office - 561.837.5601
Capt. Ted PADICH
Lt. James FEENEY
Ft. Lauderdale Field Office - 954.958.5402
Lt. Bill LEE
Ft. Myers Field Office - 239.278.7527
Lt. Glen CLASEN
SOUTH REGION
Counties: Dade, Monroe
Miami Field Office - 305.536.0302
Capt. Steven SMITH
Lt. Violeta SERRANO
Lt. Stanley JEAN-FELIX
Lt. Missael DIAZ
South Florida Major Medical Fraud Task Force
Supervisory Special Agent Fred Burkhardt 847.544.7141
Central Florida Major Medical Fraud Task Force
Supervisory Special Agent Jose Olivier 847.282.7404