March 2014
Volume 4 - Issue 9
Locklear allegedly
allowed Dugazon, who
does not hold any
medical license in
Florida, to provide
physical therapy
treatment and massage
therapy to seven
different patients.
HEADER HERE
DIF Arrests Orlando
Chiropractor and
Unlicensed Therapist in Scheme to Defraud
The Division of Insurance Fraud arrested Orlando chiropractor Victor
Ross Locklear, 46, and his unlicensed assistant, Elone Dugazon, 30, in
February 2014.
Locklear and Dugazon were arrested for nearly $70,000 in fraudulent
claims filed against three insurance carriers, Allstate, Esurance and
Geico.
The scheme operated between December 2012 and March 2013 in a
clinic purportedly owned by Locklear, West Colonial Rehab Center.
Locklear allegedly allowed Dugazon, who does not hold any medical
license in Florida, to provide physical therapy treatment and massage
therapy on seven different patients. The bills submitted to the patients
insurance companies contained false, misleading and inaccurate
information as to who actually rendered the patient’s medical treatment.
Charges filed against Locklear and Dugazon included organized scheme
to defraud, insurance fraud, grand theft, permitting an unlicensed person
to practice massage and unlicensed practice of a health care profession.
INSIDE THIS ISSUE
1
Orlando Arrests
2
PIP Fraud News
3
Statewide Arrests
6
Statewide Contacts
The bills submitted to the patients insurance companies contained false,
misleading and inaccurate information as to who actually rendered the
patient’s medical treatment.
Locklear, who has been licensed in Florida as a chiropractor since 2010,
incorporated West Colonial Rehab Center in February 2012. Locklear
was the sole officer.
In an unrelated case, Junel Nicolas, 30, was arrested by Orlando DIF
detectives for patient brokering and insurance fraud. Nicolas was
involved in an auto accident on June 23, 2012, and solicited the persons
in the other vehicle, who were not injured, to go to a clinic for treatment,
resulting in more than $18,000 in payments for unnecessary treatment.
Nicolas also allegedly inflated the amount of damage to his own vehicle,
and collected over $4,000 to which he was not entitled.
March 2014
Page 2
PIP FRAUD – In The News
Rafael Delgado Promoted to Captain of DIF’s South Central Region
The Division of Insurance Fraud (DIF) announced the promotion of Rafael Delgado to Captain for their South Central
Region, which includes four squads; two in Broward and one each in Miami and West Palm Beach. Delgado is a career
law enforcement veteran with over 30 years of experience. Prior to joining DIF, he served 21 years with the New York
City Police Department, including stints in Uniformed Patrol, Organized Crime Control Bureau, Detective Bureau and an
FBI Task Force. Delgado retired in 2002 as a Sergeant. Delgado began his career with DIF in 2005 as a detective in
Miami. In March 2012, he was promoted to lieutenant of the Miami workers compensation squad, and then transferred to
supervise one of the Miami PIP squads in September 2012. We congratulate Captain Delgado on his promotion.
Florida’s No-Fault Reform: Trending in the Right Direction
The National Insurance Crime Bureau (NICB) has released a new report revealing a decline in Florida's personal injury
protection (PIP) questionable claims (QCs). In 2013, Florida PIP QCs declined by 7.6 percent from 2012. Meanwhile,
for the period 2010 through 2013, Florida staged accident QCs decreased by 61.82 percent.
Tighter legislation, enhanced public awareness and a coordinated law enforcement response appear to be having the
intended effect on PIP fraud in Florida. "We are encouraged by the decline in questionable claims that we've seen
recently, but by no means are we declaring victory in Florida," said NICB President and CEO Joe Wehrle. "Florida
remains a hotbed for fraudulent activity and we can't afford to ease up for a moment in our fight against those who would
abuse the system and burden Florida consumers."
See the full article at http://www.prnewswire.com/news-releases/floridas-no-fault-reform-trending-in-the-right-direction252609681.html.
Insurers Cheer Lower PIP Claims, Cite 2012 Law
Insurance industry trade groups Friday lauded a report released this week by the National Insurance Crime Bureau
showing questionable personal injury protection (PIP) claims stemming from auto accidents fell by 7.7 percent last year,
and claimed a 2012 state law was largely responsible.
The NCIB report states that questionable PIP claims - which are referred for exaggerated injuries, overbilling, billing for
treatments not given and other reasons - fell last year after rising by 22 percent in 2011 and 2012.
See the full article by Gray Rohrer at http://www.thefloridacurrent.com/article.cfm?id=37018299.
Judge Says Orlando Chiropractors Must Face RICO Charges
U.S. District Judge Charlene Edwards Honeywell ruled that chiropractors who allegedly perpetrated a $2.3 million
insurance scam must face RICO charges in a federal court.
Geico Insurance Company filed a lawsuit against Orlando clinics KJ Chiropractic Center LLC, and Wellness Pain &
Rehab Inc., its two founders and a slew of individuals, called "runners," who acted to advance an alleged scam based on
fake accidents and injuries to willing third-party participants, resulting in more than $2.3 million in unwarranted insurance
benefits. Geico alleges that the fraudulent PIP (personal injury protection) claims arose out of: (1) staged accidents; (2)
real accidents wherein claimants received treatment at clinics even though they were not truly injured; or (3) real
accidents wherein claimants incurred some injuries, but received treatment at the clinics that was pre-programmed,
unnecessary, excessive and unlawful.
See the full article by Philip A. Janquart at http://www.courthousenews.com/2014/03/17/66221.htm.
Data Proves Florida PIP Legislation is Working to Protect Consumers
The Property Casualty Insurers Association of America issued a news release in response to the NICB report
showing a decrease in PIP fraud in Florida. Donovan Brown, PCI counsel, stated "We now have further evidence
that illustrates the PIP reforms enacted in 2012 to drive down unchecked fraud and abuse and protect the
hardworking citizens in Florida are working. Stakeholders took bold steps to transform Florida's auto insurance
system and enact reforms intended to stop criminals and protect Floridians from the damage and rate shock caused
by those focused on lining their pockets at the expense of consumers. See the full release at http://
insurancenewsnet.com/oarticle/2014/03/29/data-proves-florida-pip-legislation-is-working-to-protect-consumers-a481812.html#.UzloMtfD_IU.
The PIP Source
Page 3
Statewide PIP Arrests – February 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.
Luis Daniel Ferrer Figueroa, 23 – jump-in staged acct 06/08/12 (passenger) - One Touch Therapy Center (Geico) J
Anel Joseph, 37 – staged acct 05/03/12 - Hollywood Pain & Rehab (State Farm) B
Juvenal Castro Duque, 45 – staged acct 03/04/12 (recruiter) $59,673 - Cyma Massage and Therapy Group / RCR Rehabiltation
Center (Geico / Imperial Fire / State Farm) M
Luis Ferrera, 54 – staged acct 07/06/11 (driver) $57,513 – EPM Therapeutic Center / Fast Rehabilitation Center (State Farm / United
Auto) M
Miralis Talavera Velazquez, 42 – staged acct 07/06/11 (passenger) $57,513 – EPM Therapeutic Center / Fast Rehabilitation Center
(State Farm / United Auto) M
Alina Rosa Reyes, 42 – clinic owner / patient brokering - Sunshine Rehabilitation Medical Center (Nationwide / Victoria Select) T
Dominique Danielle Croley, 27 – jump-in 06/12/13 - $8,350 (Geico) P
Jermaine Samuel Richardson, 31 – fraudulent claim (Geico) P
Alfredo Silva Marrero, 47 – staged acct 02/20/10 (driver) $49,287 (National Indemnity / Progressive) M
Raul Padilla-Ones, 45 – clinic owner / insurance fraud - $47,941 - AB Diagnostic Center / Francos Medical Center / YH Imaging
(Gainsco / State Farm) M
Leesandra Abascal-Ramos, 24 – clinic employee / insurance fraud - $10,271 - CMD Medical Center (State Farm) B
Delvis Gonzalez, 31 – clinic owner / insurance fraud - $309,247 – Clarke Medical Services / Magic Hands Medical Services / New
Life Rehab Services (Allstate / Geico / Imperial Fire / Kingsway Amigo / State Farm / United Auto) M
Osvaldo Martinez Casanas, 30 – staged acct 10/17/09 (driver) $31,600 (Progressive / Rental Insurance Services) M
Carlos R Leon Lam, 44 – massage therapist - $15,107 - M & N Rehabilitation Center (United Auto) M
Carlos R Leon Lam, 44 – massage therapist - $13,901 - M & N Rehabilitation Center (Geico) M
Carlos R Leon Lam, 44 – massage therapist - $33,616 - M & N Rehabilitation Center (Imperial Fire) M
Noel Sarduy Cardenas, 33 – patient brokering – Alternative Medical Clinic / Magic Therapy Rehabilitation Corp (Allied / Titan) T
Angela Rose Bajorek, 34 – sale of fake ins card (Occidental Fire & Casualty) O
Junel Nicolas, 30 – organized scheme to defraud / patient brokering - $33,987 - (Geico / Progressive / State Farm) O
Corey James Glenn, 33 – fake ins card (Geico) T
Gabino Garcia, Jr, 27 – fake ins card (Ocean Harbor) W
Aaron James Newton, 28 – application fraud (Geico) T
Annique Vivienne Newton, 35 – application fraud (Geico) T
Jeremy Aaron Glazier, 34 – application fraud (Kemper Specialty) T
Jeral William Dietlin, 29 – statement in support of jump-in 05/06/12 - $7,142 - (Allstate) O
Rachel Lynn Brazee, 25 – jump-in 06/21/13 - $5,333 – Access Rehab & Rejuvenation Clinic (Nationwide / State Farm) O
Nejah Elai Prince, 28 – paper accident 10/26/10 (recruiter) $37,587 - Personal Medical Center - (Farmers) T
Jose F Banos, 31 – staged acct 10/17/09 (driver) $31,600 (Progressive / Rental Insurance Services) M
Jorge Enrique Lemus, 24 – staged acct 03/12/12 (recruiter) $61,729 - All Future Medical Center / Benefica Health Center (United
Auto) M
Josius Joseph, 52 – application fraud (GMAC) O
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
March 2014
Page 4
Statewide PIP Arrests – February 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.
Justin D Fletcher, 25 – statement in support of jump-in 06/21/13 - $5,333 – Access Rehab & Rejuvenation Clinic (Nationwide / State
Farm) O
David Michael Perhats, 44 – false claim (Liberty Mutual) T
Audley Saunders, 45 – fake ins card (Ocean Harbor) M
Jose Alberto Velez, 30 – staged acct 05/12/12 (recruiter) $19,845 - Gate Parkway Diagnostic Center / Health Point Injury Center
(Direct General / State Farm / Windhaven) J
Naderge Pierre, 35 – staged acct 04/03/11 (passenger) $53,752 – Blessings Rehab Center (Geico) O
Annie Franchan Howard, 32 – staged acct 02/05/13 (driver) $26,237 - Health & Rehab Services of South Florida / MRI Express Corp
(Gainsco / RepWest) M
Wilian Martinez, 46 – lost wages - $2,033 - (Progressive) T
Roniel Fertil, 43 – staged acct 04/03/11 (passenger) $53,752 – Blessings Rehab Center (Geico) O
Jarris Anthony Andrews, 32 – false claim - $6,564 (Allstate) J
Darius Alexander White, 25 – staged acct 09/02/10 (passenger) $10,810 - Austin Health Center, LLC (USAA) T
Devon Aaron Mitchell Parnell, 22 – staged acct 04/03/11 (passenger) $53,752 – Blessings Rehab Center (Geico) O
Salvador Paulo Basmadji, 45 – staged acct 09/18/12 (vehicle owner) $32,738 - D & J Rehabilitation Center / Health and Wellness
Services / Med Rehab of Florida / YH Imaging (Esurance / Geico) M
Jose Marin, 36 – staged acct 07/15/11 (passenger) $16,760 – Noba Rehabilitation Center / Rivero Diagnostic Center / Robert
Hochfelder (Geico) M
Carlos M Toledo, 38 – staged acct 09/18/12 (passenger) $32,738 - D & J Rehabilitation Center / Health and Wellness Services / Med
Rehab of Florida / YH Imaging (Esurance / Geico) M
Stevens Toledo, 41 – staged acct 09/18/12 (driver / recruiter) $32,738 - D & J Rehabilitation Center / Health and Wellness Services /
Med Rehab of Florida / YH Imaging (Esurance / Geico) M
Kadeem Jae Fian Tyson, 23 – staged acct 09/28/10 (driver) $16,820 - Austin Health Center, LLC (USAA) T
Bobby Dave Worthen, Jr, 38 – jump-in 10/14/13 (Esurance) J
Brandi Michelle Zeigler, 29 – massage therapist - $3,793 - Columbus Rehabilitation Center (Geico) T
Brandi Michelle Zeigler, 29 – massage therapist - $1,294 - Columbus Rehabilitation Center (Geico) T
Brandi Michelle Zeigler, 29 – massage therapist - $1,513 - Columbus Rehabilitation Center (Safeco) T
Lucienda Romulus, 20 – staged acct 11/13/12 (passenger) $10,875 - Chiropractic Rehab & Wellness Center / Eugene Lusigarten,
DC () W
Brandi Michelle Zeigler, 29 – massage therapist - $4,894 - Columbus Rehabilitation Center (Geico) T
Albert Lubin, 45 – solicitation (Geico) B
Eduardo Gonzalez, 24 – staged acct 06/14/12 (jump-in passenger) $55,599 - B & A Diagnostic / Doctors Professional Medical
Group / Flores Chiropractic Group / Gentle Care Rehab Services / Gonzalez Medical Center / Psychologist Technology / Y & J
Chiropractic Center (Geico / State Farm) M
Alexis Arcas, 59 – staged acct 12/08/11 (driver) $43,089 - Palmetto Therapy Center / Westchester Therapy (State Farm / United
Auto) M
Victor R Locklear, 46 – chiropractor / organized scheme to defraud / insurance fraud / unlicensed activity - $8,120 - West Colonial
Rehab Center (Geico) O
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 – February 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.
Victor R Locklear, 46 – chiropractor / organized scheme to defraud / insurance fraud / unlicensed activity - $33,729 - West Colonial
Rehab Center (Esurance) O
Dianna Lashanda Rose, 38 – massage therapist / organized scheme to defraud / insurance fraud – $18,684 - KJ Chiropractic Clinic
(Geico) O
Michael Andrew Walker, 52 – staged acct 04/03/11 (recruiter) $53,752 – Blessings Rehab Center (Geico) O
Victor R Locklear, 46 – chiropractor / organized scheme to defraud / insurance fraud / unlicensed activity - $28,144 - West Colonial
Rehab Center (Allstate) O
Elone Dugazon, 30 – unlicensed therapist / organized scheme to defraud - $8,120 - West Colonial Rehab Center (Geico) O
Elone Dugazon, 30 – unlicensed therapist / organized scheme to defraud - $33,729 - West Colonial Rehab Center (Esurance) O
Elone Dugazon, 30 – unlicensed therapist / organized scheme to defraud - $28,144 - West Colonial Rehab Center (Allstate) O
Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)
Ft. Myers Chiropractor Convicted
in Patient Brokering Case
Chiropractor David Greydinger, 42, was convicted in March 2014 and sentenced to 18 months probation. Greydinger
was arrested by the Division of Insurance Fraud (DIF) in May 2013 for insurance fraud and patient brokering.
Greydinger paid an undercover patient $800 to treat at his clinic, DISA Med dba MYO Health Clinic, located in Ft Myers.
Greydinger billed Nationwide Insurance $7,785 and was paid $5,939.48.
Greydinger has been licensed in the state of Florida as a chiropractor since 2005, and he opened DISA Med that same
year.
NICB and Florida Authorities Work to Stop
PIP Clinics and Staged Accidents
The National Insurance Crime Bureau has released a new report revealing a decline in Florida's personal injury
protection (PIP) questionable claims.
Click here to see the full NICB press release, with a link to their report: https://www.nicb.org/newsroom/news-releases/
bd499bd9-38e2-465f-a3b4-0f612ba6aa0f.
They also posted a video report that shows how NICB worked with the Division of Insurance Fraud (DIF) in Jacksonville
to stop the influx of PIP clinics and staged accidents in that area.
Click this link to watch the video report: https://www.youtube.com/watch?v=U3WxZtyzT9k&feature=youtube_gdata.
March 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 an
Orlando chiropractor and his unlicensed
therapist, and an unrelated arrest for
patient brokering.
On page 2, we feature PIP Fraud in the
News.
On page 5, we report on the conviction of a
chiropractor in Ft Myers and a new report
and video posted by NICB regarding PIP
fraud in Florida.
As always, we report on the latest PIPrelated arrests throughout the state.
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 DELGADO
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. PENDING
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