July 2014
Volume 5 - Issue 1
“PIP fraud schemes
drive up auto insurance
rates for all Floridians,
which is why we are
working day and night
to prevent it from
happening in the future
and hold the fraudsters
who have broken the
law accountable.”
- CFO Jeff Atwater
INSIDE THIS ISSUE
1
Broward Arrests
2
PIP Fraud News
3
Most Wanted
4
FIFEC Awards
5
Statewide Arrests
6
Statewide Contacts
HEADER HERE
CFO Atwater Announces
Three PIP Arrests
and Staged Accident Recruiter Conviction
Florida Chief Financial Officer Jeff Atwater announced the arrests of three
individuals in Fort Lauderdale for their involvement in a staged accident that
resulted in fraudulent personal injury protection (PIP) billings in excess of
$80,000. He also announced the conviction of David Arteaga Torres, a recruiter
for Indian Rehabilitation Center in Jacksonville.
“PIP fraud schemes drive up auto insurance rates for all Floridians, which is why
we are working day and night to prevent it from happening in the future and hold
the fraudsters who have broken the law accountable," said CFO Atwater. "I
applaud our investigators for their diligence in bringing these fraudsters to
justice.”
An investigation by the Department of Financial Services’ Division of Insurance
Fraud discovered that a U-Haul truck that allegedly crashed into a parked Dodge
Caravan with eight passengers was, in fact, a staged accident. The occupants of
the caravan filed fraudulent claims in excess of $80,000 from multiple clinics in
Miami-Dade and Broward counties. Claudio Boyett, Leslie Sanchez Martinez
and Claudia Hoy were charged with insurance fraud, and additional arrests
resulting from this incident are expected.
See a related article by the Sun Sentinel’s Wayne K. Roustan at http://www.sunsentinel.com/news/broward/fort-lauderdale/fl-lauderdale-staged-crash-arrests20140619,0,4998662.story.
Torres, 23, pled guilty to eight counts of participating in staged accidents and
was sentenced to five years in prison. Torres helped arrange staged accidents
and subsequently filed fraudulent PIP claims for the participants through Indian
Rehabilitation Center to various insurance providers. Torres was ordered to pay
more than $109,000 in restitution to eight victim insurance companies, including
Allstate, Direct General, Geico, Mendota, MGA, Ocean Harbor, Peachtree and
Sentry.
Anyone with information of suspected insurance fraud is asked to call 1-800-378
-0445. Citizens who provide tips can remain anonymous. The Department of
Financial Services to date has awarded nearly $350,000 to more than 50
citizens as part of its Anti-Fraud Reward Program. The program rewards
individuals up to $25,000 for information that directly leads to an arrest and
conviction in an insurance fraud scheme.
July 2014
Page 2
PIP FRAUD – In The News
Missael Diaz Named New Lieutenant for Miami PIP Squad
The Division of Insurance Fraud (DIF) has named Missael Diaz to serve as the new lieutenant for one of the
dedicated PIP squads in the South Region’s Miami office. He succeeds Rafael Delgado, who was recently
promoted to Captain of the South Central Region.
Lt. Diaz is a career law enforcement veteran with more than 17 years of experience. Prior to joining DIF, he
worked for the Florida Highway Patrol and the Miami-Dade Police Department. In 2001, Lt. Diaz began his
career with DIF as a detective assigned to the Miami general fraud squad and in 2004 he moved to a dedicated
PIP squad.
Lt. Diaz has also served DIF as a lead detective and a certified field training officer for the Division since
2007. Lt. Diaz has a Bachelor of Arts in Political Science from St. Thomas University, graduating Summa
Cum Laude.
We congratulate Lt. Diaz and wish him much success in his new role.
Hollywood Police Conduct Insurance Card Sweep
The City of Hollywood Police Department conducted a six-hour operation in May under the umbrella of traffic
safety and proof of insurance. The results were 90 moving violations, 48 non-moving violations, 19 seat belt
violations, 36 traffic warnings, 14 arrests for various criminal violations, and eight vehicles towed. The
operation was coordinated with the National Insurance Crime Bureau (NICB).
The insurance companies that participated included 21st Century, Allied, Allstate, Direct General, Esurance,
Farmers, Gainsco, Geico, Imperial Fire, Infinity, The General, Mercury, MetLife, National General,
Nationwide, Personable, State Farm, Titan, Travelers, United Auto, Victoria and Windhaven.
Another Anti-Fraud Billboard Goes Up in Jacksonville
The North Florida Chapter of IASIU, in partnership with NICB, has taken additional steps to bring fraud
awareness to the Jacksonville area.
Digital billboards are currently being shown throughout the Jacksonville
area to bring fraud awareness to the public.
The billboards are sponsored by the North Florida Chapter of IASIU and
NICB.
The new billboard can be seen at Phillips Highway and Baymeadows
Road.
Pictured l to r: Anthony Parker Direct General, Dana Ferrin Travelers,
Wayne Pollaci NICB, and Jill Gottschalk State Farm.
The PIP Source
Page 3
Most Wanted: Fugitive
Doe Rivera
White Male, 39 years old
5’06”, Brown Eyes, Black Hair
Warrant Information:
Warrant/Case #: 22051014 and 22051015
Felony Warrant Charge: Structuring exceeding $100,000
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud, DIF is attempting to locate Doe Rivera in reference to the
referenced outstanding warrants.
In 2010, DIF initiated an investigation into American Best Clinic, a PIP
clinic in Tampa controlled by Rivera. Investigation revealed that Rivera
structured cash withdrawals in excess of $1,785,000 from two bank
accounts he controlled, intentionally avoiding currency reporting
requirements. American Best Clinic opened in 2008 and closed in 2010.
Rivera is believed to have fled to either Mexico or Cuba.
If you know where Rivera 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/
2014 FIFEC Conference Notes
The 2014 FIFEC Conference was a record setting success. This year, the 22nd Annual meeting of insurance industry
representatives, law enforcement and lawyers had a record 1,009 registered attendees that included the largest
participation of law enforcement and state prosecutors attending the largest number of classes presented.
The opening ceremony had a wide array of speakers, including Orange County Sheriff’s
Office Major Nancy Brown; National Insurance Crime Bureau President and CEO Joseph H.
Wehrle, Jr; Department of Financial Services Agent and
Agency Services Bureau Chief Barry Lanier; Division of
Insurance Fraud Director Simon Blank; and Florida
Department of Financial Services Deputy CFO Jay
Etheridge.
Also, it was announced this year that Denise Prather, a
senior management analyst with the Division of
Insurance Fraud since 1992, will retire at the end of the
DCFO Jay Etheridge
year. Prather has been involved with the planning and
organization of the annual FIFEC conferences since 1997. Prather, who has been a
friendly face at the conferences and always helpful to those in need, was presented
with a special award for her years of service. She will be missed.
Denise Prather and Simon Blank
July 2014
PIP FRAUD SPOTLIGHT ON –
Page 4
2014 FIFEC Awards
We present the 2014 FIFEC award winners (pictured at right) along with the other nominees
listed below:
Insurance Investigator of the Year
Vicki Kirby, SMI, and Laureen Leary, Allstate, were this year’s co-winners.
Other nominees included John Oral, Esurance.
Insurance Attorney of the Year
Tammy M. Denbo, Masten, Peterson & Denbo, was this year’s winner.
Other nominees included Donald J. Masten, Masten, Peterson & Denbo; William J.
McFarlane, III, McFarlane & Dolan; and Angela C. de Cespedes Wenke, Akerman LLP.
Law Enforcement Detective of the Year
Detective Billy Brantley, Division of Insurance Fraud, was this year’s winner.
Other nominees included Detectives Kyle Routt, Sherry Webster, Mark Johnson, Craig
Kimble, Glen Clausen, Christian Menzel, Francisco Gonzalez and the Tampa DIF Office, all
from the Division of Insurance Fraud.
Law Enforcement Analyst of the Year
Clara Pirez, Division of Insurance Fraud, was this year’s winner.
Law Enforcement Prosecutor of the Year
Michael Lennon, Hillsborough County SAO, was this year’s winner.
Other nominees included Rick Wallsh, Office of the State Attorney, 9th Judicial Circuit and
Michael-Anthony Pica, Office of the Attorney General.
The Jerry Zappolo Distinguished Service Award
Dr. Don “Rick” Wakefield, International Healthcare Consultants, Inc., was this year’s winner.
Other nominees included Marlene Toledo, Florida Department of Health; Tammy Denbo,
Masten, Peterson & Denbo; and Director Simon Blank, Division of Insurance Fraud.
We congratulate all the winners and nominees alike for their dedication and efforts in the fight
against insurance fraud.
The PIP Source
Page 5
Statewide PIP Arrests – June 2014
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.
Laritza S Gonzalez, 51 - false billing - $20,731 - Two Stepping Business Solutions (Allstate / Geico / Ocean Harbor) M
Donna Jean Bottoms, 70 - burning to defraud / staged acct 09/23/13 (driver) $6,151 (Geico) TL
Rodney Allan Bottoms, 45 - burning to defraud / staged acct 09/23/13 (recruiter) $6,151 (Geico) TL
Jessica Sosa Caballero, 38 - false injury claim (Assurance America) T
Joe Eusebio Masias, 34 - false statement in support of injury claim (Assurance America) T
Velanca Nicole Evans, 26 - fake ins card (Occidental Fire & Casualty) O
Pamala Mechelle Mayo, 45 - burning to defraud / staged acct 09/23/13 (passenger) $6,151 (Geico) TL
Anthony Allen Polly, 32 - burning to defraud / staged acct 09/23/13 (driver) $6,151 (Geico) TL
Diego Junior Serrano, 39 - staged acct 02/24/12 (recruiter / driver) $29,023 - HR Healthy Rehab (Assurance America) O
Talisha Danielle Gonzalez, 26 - burning to defraud / staged acct 09/23/13 (driver) $6,151 (Geico) TL
Federico Martinez, 49 - clinic owner – $29,023 - HR Healthy Rehab (Assurance America) O
Latoya Nicole Bridges, 29 - sale of fake ins card (Equity) T
Dontell Rashad Polite, 23 - sale of fake ins card (Geico) T
Wilmer Hernandez Lopez, 38 - staged acct 02/24/12 (recruiter) $29,023 - HR Healthy Rehab (Assurance America) O
Raziel Periu, 23 - massage therapist - $29,023 - HR Healthy Rehab (Assurance America) O
Luis Vicente Cotto-Rivera, 46 - staged acct 02/24/12 (passenger) $29,023 - HR Healthy Rehab (Assurance America) O
Sanon Zimero, 67 - false statement in support of jump-in - $8,492 - Cardinal Chiropractic Center (Geico) F
Claudia Hoy, 32 - staged acct 08/07/12 (passenger) $80,000 - Synergy Medical Wellness / Total Rehab & Wellness Center (United
Auto) B
Leslie Jeanette Sanchez, 45 - staged acct 08/07/12 (driver) $80,000 - Synergy Medical Wellness / Total Rehab & Wellness Center
(United Auto) B
Christopher Omar Sanchez-Figueroa, 23 - fake ins card (Peak Property) O
Latoya Stephan Carlyle, 33 - fake ins card (Geico) T
Claudio R Boyett, 44 - staged acct 08/07/12 (driver) $80,000 - Synergy Medical Wellness / Total Rehab & Wellness Center (United
Auto) B
Juan Albizu-Martinez, 37 - fake ins card (Geico) O
Beverly J Stevens, 53 - fake injury claim pedestrian (Geico) P
April Deshay Curtis, 36 - fake ins card (Occidental Fire & Casualty) O
Nikita Leonora Hosley, 38 - massage therapist - $4,830 - Dr Wilson Straight Up Chiropractic (Progressive / State Farm) O
Kenia Candelario, 41 - staged acct 07/02/13 (driver) $48,607 - Best Rehab Team / New Health Rehabilitation (Esurance / State
Farm / United Auto) M
Keysha Bazile, 28 - fake ins card (Geico) T
Beatriz Concepcion Castelao Castro, 59 - staged acct 07/02/13 (driver) $48,607 - Best Rehab Team / New Health Rehabilitation
(Esurance / State Farm / United Auto) M
Tonya Russell Lavender, 44 - fake ins card (Direct General) T
Ileana Melian Rodriguez, 61 - staged acct 07/02/13 (passenger) $48,607 - Best Rehab Team / New Health Rehabilitation
(Esurance / State Farm / United Auto) M
Miraisy B Guevara, 42 - perjury 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)
July 2014
Page 6
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. David LINDSAY
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
WEST CENTRAL REGION
Counties: Charlotte, Collier, DeSoto, Glades, Hardee, Hendry,
Hernando, Hillsborough, Lee, Manatee, Pasco, Pinellas, Polk,
Sarasota
Tampa Field Office - 813.972.8602
Capt. Michael BYRNE
Lt. Carlos ROSARIO
Fort Myers Field Office - 239.278.7527
Lt. Mark FRITZ
Copy goes her.
Editor’s
Corner
On page 1, we cover the arrests of three
staged accident participants and the
conviction of a staged accident organizer.
On page 3, we feature another fugitive in
Insurance Fraud’s Most Wanted.
On page 4, we turn the Spotlight on the 2014
FIFEC award winners.
As always, we report on PIP Fraud in the News
and the latest PIP-related arrests.
Summer is here - take a vacation.
EAST CENTRAL REGION
Counties: Brevard, Lake, Orange, Osceola, Seminole, Volusia
Orlando Field Office - 407.835.4402
Capt. Glen HUGHES
Lt. Laquanda GREEN
Lt. John SAVINO
SOUTH CENTRAL REGION
Counties: Broward, Highlands, Indian River, Martin,
Okeechobee, Palm Beach, St. Lucie
Plantation Field Office - 954.958.5402
Capt. Rafael DELGAGO
Lt. Bill LEE
West Palm Beach Field Office - 561.837.5601
Lt. Evangelina BROOKS
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 813.558.6387