October 2015
Volume 6 - Issue 4
Dating back to May
2011, DIF has
investigated a series of
staged car accidents
that occurred in the
Jacksonville area.
INSIDE THIS ISSUE
1
Jacksonville Arrest
2
Most Wanted
3
PIP Fraud News
4
Statewide Arrests
6
Statewide Contacts
HEADER HERE
Jacksonville Massage
Therapist Charged
in Fraud Scheme
The Division of Insurance Fraud (DIF) announced the arrest of massage
therapist John Alexander Fraga (aka Juan Alejandro Fraga), 57, for his
involvement in the billing of more than $40,000 to multiple insurance
companies for the treatment of fake injuries following a series of staged
car accidents in an attempt to fraudulently collect personal injury
protection (PIP) insurance payments for profit.
Dating back to May 2011, DIF has investigated a series of staged car
accidents that occurred in the Jacksonville area. During a five month
period in 2012, DIF investigated three separate staged accidents that
involved fraudulent rehabilitative practices at Jacksonville’s Gate Parkway
Diagnostics Center (GPDC).
DIF investigators discovered that the occupants of the vehicles involved in
the staged accidents were allegedly recruited by GDPC employees to
seek treatment for fake injuries following each accident. John Fraga, a
licensed massage therapist at GDPC, authorized 127 documents that
were used to bill multiple insurance companies for PIP insurance payouts
totaling more than $40,000. The forms signed were for services that never
occurred as treatment for injuries that failed to exist.
During the course of this ongoing investigation, several other arrests tied
to this operation have been made, including: Sandy Morales, the owner of
GDPC, and the four individuals who were occupying the vehicles involved
in these staged accidents; Michael Huerta, Olegario Hernandez Perez,
Danay Torres-Gomez, and Salvador Torres.
John Fraga was arrested and booked into the Miami-Dade County Jail.
He faces five felony charges, and if convicted, he faces up to 35 years in
prison. This case will be prosecuted by ASA Joe Licandro in the Office of
State Attorney Angela B. Corey.
Read this related article from the Florida Times-Union at http://
jacksonville.com/news/crime/2015-10-05/story/jacksonville-therapistjoins-list-arrestees-fake-crash-insurance-scam.
October 2015
Page 2
Floridians Receive Top Honors At 2015 IASIU Awards
Direct General Insurance Company’s Jessica Turner (pictured at left), MBA, FFE, CIFI, was chosen
as the International Association of Special Investigation Units (IASIU) 2015 Investigator of the Year.
Turner’s investigation led to the successful execution of the National Insurance Crime Bureau’s
(NICB) “Operation I Crash You” in 2014. The identification of this organized fraud ring fraud based
in Hialeah, Florida was a result of Jessica Turner’s ability and diligence in obtaining confidential
information from a key witness. Turner’s initial investigation uncovered a spider web of staged
accidents, clinics and financial fraud, which involved 271 claims (an estimated $2.7 million dollars in
claim exposure) to the auto insurance industry in Miami. Turner is an SIU Regional Manager at
Direct General Insurance and is from Miami, Florida.
Kimberly Meguiar (pictured at right), FCLS, CIFA, of Esurance was selected
for the Analyst of the Year award. On June 18, 2015, the US Attorney’s office announced the
arrests of five defendants for fraudulently billing insurance companies $5 million for services that
were never performed. Esurance SIU Senior Analyst Kimberly (Kim) Meguiar was an integral part
of the investigation and analysis that lead to these arrests which in turn saved Esurance
thousands of dollars in fraudulent payments. Meguiar began her insurance career at Esurance in
2007, starting as a Claims Assistant and eventually working her way up to a Senior PIP (Personal
Injury Protection) adjuster. Meguiar is from Tampa, Florida.
Turner and Meguiar received their awards at IASIU’s 30th Annual Seminar held September 13-16
in Orlando, Florida. Over 720 insurance fraud experts attended IASIU’s Annual Seminar. IASIU is
a non-profit organization dedicated to promoting a coordinated effort within the industry to combat
insurance fraud. Membership is made up of more than 3,800 individuals from more than 600 insurance and self-insured
companies worldwide. IASIU also provides education and training, develops a greater awareness of the insurance fraud
problem, encourages high professional standards of conduct and supports legislation to deter insurance fraud. For
more information about IASIU and the annual seminar, visit www.iasiu.org.
Emilio Ortega
aka Emilio Corso Ortega
White Hispanic Male, 53 years old
5’8”, 165 lbs, Brown Eyes, Brown Hair
Warrant Information:
Warrant/Case #: W191957171
Felony Warrant Charge: Patient Brokering, Solicitation
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud (DIF) is attempting to locate Emilio Ortega in reference to the
outstanding warrant.
Ortega is wanted for his role in soliciting accident victims for treatment
at an injury and rehab clinic with the promise of payment for treatment.
Ortega has yet to be found since his warrant was issued in September
2014. His warrant is full extradition.
If you know where Ortega 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/
The PIP Source
Page 3
PIP FRAUD – In The News
Attorney in Operation Cold Call Case Enters Plea
On October 5, 2015, Palm Beach attorney Brian Greenspoon, 42, entered a no contest plea to charges of unlawful
solicitation, a third degree felony, in Palm Beach County Circuit Court. Greenspoon was arrested on October 30, 2014
as part of a takedown that included several attorneys and chiropractors who were involved in an organized scheme of
soliciting auto crash victims. Eight subjects have been arrested in the case and Greenspoon is the third to enter into a
plea agreement. Greenspoon was sentenced to 18 months probation and 150 hours of community service.
NICB Analyst Honored With Award by Broward County Sheriff’s Office
On September 29, 2015, NICB Senior
Field Information Analyst Kathy Novak,
among others, was awarded with the
Broward Sheriff's Office (BSO) Special
Recognition Award for serving with the
Calvary Chapel Ft. Lauderdale Women's
Prison Ministry Lifestyle Program. The
program was established 21 years ago in
partnership with BSO to reduce the
likelihood of an inmate being
reincarcerated by equipping them with the
proper tools and resources to become
contributing members of our community.
Five days a week, volunteers conduct classes, lead small groups and focus groups (such as for victims of abuse), and
provide one-on-one mentoring with the inmates.
Novak, a 13 year employee with NICB, is pictured fifth from the left, in the above group photo with the other Special
Recognition Award winners and BSO Sheriff Scott Israel. Congratulations Kathy!
MetLife and Direct Donate Undercover Vehicles to Division of Insurance Fraud
In September of 2015, MetLife donated a
surveillance vehicle to the Division of Insurance
Fraud (DIF) to assist in their efforts in the fight
against insurance fraud. This donation was
made with the assistance of Special Agent Terra
Rush, National Insurance Crime Bureau (NICB).
Thank you to MetLife for their donation.
Pictured at right: Victor Uribe, Metlife SIU
Investigator, Dennis Russo, NICB Regional
Director, John Sargent, National SIU Manager,
Nancy Jensen Regional Supervisor, DIF Major
Mike Byrne and Kelvin Gomez, SIU Investigator.
In October of 2015, Direct Insurance donated a
surveillance vehicle to the Florida Division of Insurance
Fraud (DIF) to assist in their efforts in the fight against
insurance fraud. This donation was made with the
assistance of Special Agent Terra Rush, National
Insurance Crime Bureau (NICB). Thank you to Direct for
their donation.
Pictured at left: Tracy Pickard, SIU National Director, Sara
Solomon, SIU analyst, Rusty Gray SIU Analyst, Holly Roe,
PIP Manager, Jennifer Liotti, SIU Team Leader, DIF Major
Mike Byrne, Terra Rush, NICB SA; Peter Hansen, Chief
Claims Officer, Senior Vice President, Direct Insurance.
October 2015
Page 4
Statewide PIP Arrests – September 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.
Bridget Meyer Boyarovsky, 38 - application fraud / false claim - $72,484 (Esurance) J
Osselyn Oreste, 33 - unlicensed clinic owner - $188,763 - Total Health Medical Group (Allstate / Geico / Liberty Mutual / Travelers) O
Osselyn Oreste, 33 - unlicensed clinic owner - $21,423 - Elite Wellness (Direct General / Farmers / Liberty Mutual) O
Marquis Devon Streater, 31 - false vandalism claim - $1,500 (Geico) O
Jose Miguel Maldonado, 33 - staged acct 05/21/12 (passenger) $13,830 - Gate Parkway Diagnostic Center (Geico) J
Karla Michelle Prado Torres, 30 - staged acct 05/21/12 (passenger) $18,086 - Gate Parkway Diagnostic Center (Geico) J
Yalily Clavero Ruiz, 35 - clinic manager / false claims - $34,735 - D & J Rehabilitation Center (State Farm) M
Adan Avila, 42 - application fraud / false claim - $6,826 (Windhaven) M
Wilson Ramos Vieira, 41 - staged acct 10/25/11 (passenger) $16,879 - Back 2 Life Rehabilitation Center (Geico) B
Elva P Jean, 42 - unlicensed clinic owner - $116,468 - Kirkman Family Chiropractic () O
Andre de Paula Barbosa, 26 - staged acct 10/25/11 (passenger) $18,399 - Back 2 Life Rehabilitation Center (Geico) B
Saul Guzman, 39 - false vehicle theft - $11,700 (Infinity) T
Pedro Roberto Lessa Alves, 33 - staged acct 10/25/11 (recruiter) $78,996 - Back 2 Life Rehabilitation Center (Geico / Kingsway
Amigo / Security National) B
Angel Damien Reyes, 34 - fake ins card (Windhaven) B
Daniel Ramirez, 44 - staged acct 12/05/12 (recruiter) $55,282 - 86 Medical Rehab Center / B & A Diagnostic / Blue Village Medical
Center Corporation / Florida Superior Imaging / Intermas Medical Center Corporation / Karow Chiropractic Center / National
Orthopedics and Neurosurgery (Kingsway Amigo / Liberty Mutual / Ocean Harbor) M
Roxana Suarez la Rosa, 31 - organized scheme to defraud () J
Anouce Toussaint, 32 - unlicensed clinic owner / money laundering - $110,721 - First Choice Pain and Rehab / Tamiami Pain and
Rehab, LLC () F
John Antolino, 45 - application fraud (State Farm) B
John Antolino, 45 - application fraud (Infinity) B
Vandral Dwain Myers, 49 - solicitation (Westway Towing) (Geico) B
Victor Manuel Mieses, 33 - staged acct 06/06/12 (recruiter) $70,615 - Beyond Care Corp / Union Medical Center (Geico / Kingsway
Amigo / Progressive / State Farm / United Auto) M
Shannon Martin Klamert, 29 - staged acct 06/06/12 (driver) $70,615 - Beyond Care Corp / Union Medical Center (Geico / Kingsway
Amigo / Progressive / State Farm / United Auto) M
Pablo Nodal Denis, 41 - false claim - $1,148 (Infinity) M
Charles Thomas Schneider II, 30 - staged acct 04/14/12 (passenger) $38,997 – Total Rehab and Wellness (Infinity / RepWest) B
Crescencio Velazquez Regalado, 60 - staged acct 05/13/13 (recruiter) $89,040 - D & J Rehabilitation Center / Health and Wellness
Services / Kendall Regional Radiology / Sheridan ER Physicians (Direct General / State Farm) M
Brittany Monee Kelly, 29 - sale of fake ins card (Infinity) O
Terrance Abraham Moore, 32 - fake ins card (Infinity) O
Jorge Hernandez Santiago, 42 - fake ins card (Gainsco) W
Milagros Legra Lafita, 53 - staged acct 04/22/12 (driver) $13,354 - One Touch Therapy Center (Progressive) J
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
The PIP Source
Page 5
Statewide PIP Arrests – September 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.
Mariela N Quintana, 46 - massage therapist / fraudulent claims - $66,549 - D & J Rehabilitation Center (Gainsco) M
Eduardo O Chinea Martinez, 40 - staged acct 09/19/12 (vehicle owner) $69,625 - B & A Diagnostics / Doctors Professional Medical
Group / Gentle Care Rehab Services / Psychologist Technology / South Florida Medical Health Corp / YH Imaging (Geico / United
Auto) M
Juan J Santana, 36 - massage therapist / clinic owner / false claims - $51,288 - Atlas Massage Therapy Corp / Health Point Injury
Center / San Jose Injury Center (Geico) J
Crescencio Velazquez Regalado, 60 - staged acct 09/18/12 (recruiter) $84,214 - D & J Rehabilitation Center / Health and Wellness
Services / Med Rehab of Florida / YH Imaging (Direct General / Esurance / Geico) M
Mailin de la Cari Soto Martin, 26 - staged acct 04/22/12 (passenger) $9,295 - One Touch Therapy Center (Progressive) J
Leidian Jorge Roman Diaz, 25 - staged acct 11/28/11 (driver) $57,277 - Arlington Rehabilitation Services (Geico / Progressive) J
Juan Alejandro Fraga, 57 - massage therapist / fraudulent claims - $40,000 - Gate Parkway Diagnostic Center (Geico / Progressive /
United Auto) J
Osmel A Padroza Garcia, 49 - massage therapist / fraudulent claims - $87,426 - Arlington Rehabilitation Services (Allstate /
Esurance / Geico / Infinity / Progressive / Sentry / State Farm) J
Mark Christopher Williams, 44 - fake receipt - $3,109 (Progressive) J
Crescencio Velazquez Regalado, 60 - staged acct 11/16/12 (recruiter) $85,634 – CMI South / East Coast Medical Rehab / Facility
Medical / ISO Diagnostics Testing / Med Rehab of Florida / Miami Neurological Institute / Millennium Diagnostic Imaging / Rehab and
Wellness Services / YH Imaging (Geico / Progressive / State Farm) M
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
October 2015
Page 6
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
Lt. Ernie STOLL
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 cover the arrest of a massage
therapist in Jacksonville.
On page 2, we congratulate two winners from
this year’s IASIU Annual Seminar and 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