February 2014
Volume 4 - Issue 8
“The three massage
therapists allegedly
billed approximately
$57,000 for services not
rendered at clinics they
owned and operated in
both Tampa and
Miami. ”
INSIDE THIS ISSUE
1
Therapists Arrested
2
Most Wanted
3
FIFEC is coming!
5
Statewide Arrests
7
Statewide Contacts
HEADER HERE
DIF Arrests Three
Massage Therapists for
Insurance Fraud
The Division of Insurance Fraud arrested three massage therapists in
January 2014 on charges of insurance fraud. The three massage
therapists allegedly billed approximately $57,000 for services not
rendered at clinics they owned and operated in both Tampa and Miami.
Massage therapist Armando Terrelonge, 67, of Tampa, was arrested and
charged with filing false claims against GMAC Insurance in 2011 totaling
$1,214 for the alleged treatment of two patients at his clinic, A & T
Massage and Rehabilitation. Surveillance showed that the patients never
in fact received such treatment. Terrelonge, who has been a licensed
massage therapist in Florida since 2001, entered into a plea agreement
with the Hillsborough State Attorney’s Office, received 3 years probation
and agreed to surrender his license to the Department of Health.
Massage therapist Jhonnathan Allexis Blair, 35, was arrested and
charged with filing false claims against Travelers Insurance in 2012
totaling nearly half of the $13,526 billed for alleged treatment of a patient.
Blair conducted business under the corporate name of J.A.B. Fit Life,
LLC, and would travel to the patient’s home to provide treatment. Blair
also paid a relative of the patient $200 and other considerations for
referring the patient to him. Blair was charged with insurance fraud and
patient brokering. He has been licensed as a massage therapist in
Florida since 2009 and his case is still pending in Hillsborough County.
Fernando Luis Lamazares, 48, of Miami, was arrested and charged with
filing false claims against State Farm Insurance in 2012 and 2013, on
behalf of his clinic, LMG Medical Center. Lamazares treated patients who
staged accidents and allegedly fabricated treatment forms for services in
excess of $42,000. Lamazares has been licensed as a massage
therapist in Florida since 1991, and his case is pending in Miami-Dade
County.
February 2014
Page 2
Most Wanted: Fugitive
Ricardo Jimenez
Hispanic Male, 49 years old
5’11”, 210 lbs, Brown Eyes, Brown Hair
Warrant Information:
Warrant/Case #: F142773
Felony Warrant Charge: Insurance Fraud / Grand Theft
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud (DIF), is attempting to locate Ricardo Jimenez in reference to an
outstanding warrant for insurance fraud.
Investigation revealed that Jimenez was the true owner of three accident
clinics in Miami, two of which were operated using straw owners.
Jimenez also allegedly used recruiters to stage accidents to obtain
patients for his clinics. Jimenez is charged with insurance fraud in
excess of $309,000 involving four staged accidents.
If you know where Jimenez 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/
Six Subjects Arrested In “Operation On The Run”
Miami-Dade State Attorney Katherine Fernandez Rundle and City of Miami Police Chief Manuel Orosa announced the
arrests of six individuals who worked at the Miami clinic Central Therapy Center dba Central Medical & Therapy Center.
The undercover investigation, dubbed “Operation On The Run”, started in June 2013 after authorities learned several
individuals and clinics were allegedly involved in staged car crashes and PIP fraud.
Clinic owner Carlos A. Sanchez, 43; massage therapists Yunaisky Machado Madruga, 38, and Danelys Valdez
Granado, 40; office manager Belkys Hernandez, 54; and runners Rodolfo Rodriguez Gallo Blan, 71 and Vivian Caridad
Garcia, 51, were all charged with staged accident, insurance
fraud, grand theft, organized scheme to defraud and patient
brokering. Central Medical & Therapy Center billed $20,488. for
injuries which never occurred.
The insurance companies
included 21st Century, Infinity, Nationwide, State Farm and
United Auto. Also assisting in this investigation was the National
Insurance Crime Bureau (NICB).
“These types of clinics are the core elements of any ongoing PIP
insurance fraud scam, they exist to steal, not heal”, commented
State Attorney Katherine Fernandez Rundle. “Those individuals
who hope to snatch some cash from the pockets of Dade’s
insured motorists should know that the Miami Police Department
and my insurance fraud prosecutors are out to get you. Find a
new line of business or prepare for jail.”
The PIP Source
Page 3
PIP FRAUD SPOTLIGHT ON – FIFEC
This year the Florida Insurance Fraud Education Committee (FIFEC) 22st Annual Conference will take place June 11-13,
2014, in Orlando. The conference is attended by law enforcement, insurance investigators and professionals, members
of IASIU (International Association of Special Investigative Units) and NSPII (National Society of Professional Insurance
Investigators).
The Florida Insurance Fraud Education Committee began as the DIF/SIU Annual Training Seminar representing the
Florida Department of Insurance’s Division of Insurance Fraud and the Special Investigations Unit (SIU) community in
1992. DIF hosted this first seminar, which was actually a one-day, open forum-type workshop held in Altamonte Springs,
with no agenda other than to foster a favorable working environment between the public and private sectors involved in
the fight against insurance fraud.
This year's conference will again be held at the Caribe Royale Orlando All-Suites Hotel and Convention Center, located
at 8101 World Center Drive in Orlando, where it has been hosted since 2004. Expected to return this year as speakers
are Florida Chief Financial Officer Jeff Atwater and Division of Insurance Fraud Director Simon Blank, along with Joseph
H. Wehrle, Jr., President and Chief Executive Officer of the National Insurance Crime Bureau and Chief Barry Lanier of
the FLDFS Bureau of Investigations.
Scheduled among this year’s more than 65 course offerings are the following PIP-related courses:
Back to the Future
Mock Trial on Fraud
The Price Is Not Right
Ownership DOES Matter
Crash Test Dummies – Will It Ever Stop?
Combating Low Impact Insurance Claims
Clinic Investigations & Successful Litigation
Staged or Setup Accidents - the Tough Cases
Vehicular Accident Analysis – The Big Picture
Un-Invoking the Rule: The Anatomy of a Fraud
Florida Law and Effective Examinations Under Oath
High Quality IMEs and FCEs – Get What You Pay For
Definite “Do's” To Have a Winning Bad Faith Claim File
Criminal Prosecution of Automobile &PIP Fraud Claims
A Live IME Demonstration: Learn How to Combat Fraud
From Accident to Injury: What Really Happened & When?
Utilizing the TEAM Concept to Attack PIP Insurance Fraud
Beating Fraud with Accident Reconstruction with the Black Box
Milo & Broughan MRI Clinic - The Many Different Views of a Clinic
Hit & Run/ Uninsured Motorist Claims: The Proof is in the Damage
The ABC's of a Good Faith SIU Medical Provider Fraud Investigation
The What, Why, Who, When and Where of Examinations Under Oath
Strategies to Defend Against Attorney's Fee Claims in Insurance Cases
Finding & Getting Your Money Back: The Art of Affirmative Actions & Recovery
50 Shades of Green – How to Disguise Illegal Proceeds from Staged Accidents
Nip it in the Bud – Frontline Defenses to PIP and Workers Compensation Fraud
Money Laundering as it Pertains to Organized Crime and the Insurance Industry
Managing and Investigating Billing Misrepresentations Under the New PIP Statute
Emerging Use of State Regulatory Compliance in PIP Defense & Insurance Adjuster Law
The Florida Motor Vehicle No-Fault (Pip) Law - Current Trends, Issues, Legislative & Case Law Update 2014
Go to www.fifec.org and register today and join the fight against insurance fraud in Florida.
February 2014
Page 4
FIFEC Announces 2014 Conference
The Florida Insurance Fraud Education Committee (FIFEC) is pleased to announce the 22nd Annual Joint (DIF/SIU)
Division of Insurance Fraud / Special Investigative Units Conference at the Caribe Royale Hotel & Convention Center in
Orlando, Florida, June 11-13, 2014.
WHAT:
22nd Annual Conference – Insurance Fraud Conference
WHERE:
Caribe Royale Hotel & Convention Center in Orlando, Florida (800) 537-7737
WHEN:
June 11-13, 2014
WHY:
The FIFEC Conference is recognized both nationally and internationally for their role in creating an
alliance between the Special Investigative Units; the Division of Insurance Fraud (Florida Department of
Financial Services); Federal, State and Local Law Enforcement; and State Prosecutors through
educational courses, training and networking.
Please join us, our sponsors, counsels and exhibitors as we unite to fight against insurance fraud in
these most difficult financial times.
VISUALS:
The conference is very reasonably priced, and there are continuing education credits available for
attorneys and insurance adjusters. Our speakers are hand selected and many have spoken and
presented locally, nationally and some have even spoken internationally.
KEYNOTE:
FIFEC has invited Florida Chief Financial Officer, Honorable Jeff Atwater to be the Keynote speaker.
FIFEC is proud to have confirmation of the Florida (DFS-DIF) Director of the Division of Insurance
Fraud, Simon Blank, speaking as we unite in Fraud Awareness and Education efforts. Also on the
agenda for Opening Ceremonies is Chief Barry Lanier of the FLDFS Bureau of Investigations, Joseph H.
Wehrle, Jr., President and Chief Executive Officer of the National Insurance Crime Bureau and Ernie
King, Executive Chairman of FIFEC. We will start the conference at 11 AM after opening remarks by
Orange County Sheriff's Office, Major Nancy Brown, presentation of the OCSO's Honor Guard, and the
Pledge of Allegiance, to start the 22nd Annual FIFEC Conference.
CONTACTS:
Please visit our website @ WWW.FIFEC.ORG or e-mail us at PUBLICRELATIONS@FIFEC.ORG
Olimpia Albinson, Allstate Insurance Company and Brett Kelley, Personable Insurance Company
Important Dates
On-Line Registration: http://fifec.org/registration.html
Thru 4/30/2014 (postmarked):
$175 Early Bird Special
5/1 – 5/31/2014 (postmarked): $200
6/1 – 6/11/2014 (postmarked): $225
Walk In Fee:
$250
Mention FIFEC for the special room rate of $145.00 at Caribe Royale (Hotel sold out the past two years, so book early!)
Law Enforcement Grants: Apply On-Line: http://fifec.org/grants.html
Reserved for Law Enforcement, government investigators and prosecutors only!
Volunteers: Volunteer On-Line: http://fifec.org/volunteers.html
The PIP Source
Page 5
Statewide PIP Arrests – January 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.
Sheila Taina Garcia Castro, 31 - staged acct 07/18/12 (driver) $30,945 - Gate Parkway Diagnostic Center / Indian Rehabilitation
Center (Direct General / State Farm) J
Joel Santiago-Carmargo, 27 - staged acct 07/18/12 (passenger) $30,945 - Gate Parkway Diagnostic Center / Indian Rehabilitation
Center (Direct General / State Farm) J
Chrystal Lynn Smith, 28 - jump-in 05/06/12 - $7,142 - (Allstate) O
Ilien Latigue, 47 - jump-in 03/18/13 - $27,351 - Ave-Maria Chiropractic (Geico) F
Jean Baptiste Fritzne Simonis, 59 - statement in jump-in 03/18/13 - $27,351 - Ave-Maria Chiropractic (Geico) F
Augusto Sanders Valencia, 34 - staged acct 06/08/12 (passenger) - One Touch Therapy Center (Geico / USAA) J
Angel Luis Perez, 27 - fake ins card (Esurance) T
Giovanna Alef Torres Martinez, 33 - staged acct 06/08/12 (passenger) - One Touch Therapy Center (Geico / USAA) J
Jonathan Arevalo-Alfonso, 30 - staged acct 05/12/12 (passenger) $9,986 - Gate Parkway Diagnostic Center / Health Point Injury
Center (Direct General) J
April Rosita Wynn, 22 - staged acct 05/12/12 (recruiter) $19,845 - Gate Parkway Diagnostic Center / Health Point Injury Center
(Direct General / State Farm / Windhaven) J
Armando Terrelonge, 67 - massage therapist / clinic owner - $1,214 – A & T Massage and Rehabilitation (GMAC) T
Allen Guevara, 33 - staged acct 02/09/12 (recruiter) $57,810 - Diagnostic Radiology / Fast Rehab / Xtreme Medical (Geico / State
Farm / United Auto) M
Allen Guevara, 33 - staged acct 07/06/11 (recruiter) $57,513 - EPM Therapeutic / Fast Rehab (State Farm / United Auto) M
Patrick Lavar Frazier, 21 - staged acct 05/03/12 - Hollywood Pain & Rehab (State Farm) B
Jhonnathan Allexis Blair, 35 - massage therapist / clinic owner - $13,526 - JAB Fit Life (Travelers) T
Marvin E Cruz, 44 - PIP patient - $13,526 - JAB Fit Life (Travelers) T
Johnny Luis Blanco, 42 - staged acct 08/09/10 $10,700 - B & A Diagnostic / Golden Care Medical Center (State Farm) M
Yudeyvy Chavez Diaz, 37 - PIP patient - $1,390 - Better Rehab Center (State Farm) B
Yaumel Guerrero, 30 - staged acct 03/14/12 (driver) $33,867 - Gate Parkway Diagnostic Center / Indian Rehabilitation Center
(Geico / Sentry) J
Stephanie Elaine Cowart, 41 – application fraud (Assurance America) J
Dayleann Marie Vallejo-Ruiz, 28 - massage therapist / clinic owner - $13,549 - Injury Rehabilitation Center (Allstate) O
Carlos Gustavo Morales Lastayo, 27 - staged acct 06/14/12 (recruiter) $55,599 - B & A Diagnostic / Doctors Professional Medical /
Flores Chiropractic Group / Gentle Care Rehab / Gonzalez Medical Center / Psychologist Technology / Y & J Chiropractic Center
(Geico / State Farm) M
Marianela Cedeno, 44 - staged acct 11/17/09 (driver) $11,946 - New York Medical Rehabilitation aka Forest Hill Rehab (Gainsco) W
Yonuel Cedeno, 22 - staged acct 11/17/09 (driver) $12,656 - New York Medical Rehabilitation aka Forest Hill Rehab (Gainsco) W
Andres Alberto Padron, 35 - staged acct 03/30/12 (passenger) $58,920 - Med Care Medical Center / Well-Care Rehab Services
(Imperial Fire / Ocean Harbor) M
Manuel Gabino Ochoa, 51 - sale of fake ins card (RAC) 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)
February 2014
Page 6
Statewide PIP Arrests – January 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.
Leonardo Francisco Marquez-Garcia, 63 - ACN doctor / unlicensed activity - $672 - Global Rehabilitation Center / Injury
Rehabilitation Center (Allstate) O
Leonardo Francisco Marquez-Garcia, 63 - ACN doctor / unlicensed activity - $762 - Global Rehabilitation Center / Injury
Rehabilitation Center (Allstate) O
Mary Louise Walker, 38 - fake ins card (Geico) T
Jose Alberto Velez Ramos, 43 - staged acct 11/17/09 (driver) $14,379 - New York Medical Rehabilitation / Zohar Rehabilitation
(Ocean Harbor) W
Lilian Estevez, 41 - staged acct 11/17/09 (passenger) $13,930 - New York Medical Rehabilitation / Zohar Rehabilitation (Ocean
Harbor) W
Lois Felixia Walker, 20 - fake ins card (National Specialty) T
Augusto Valencia Perez, 54 - staged acct 06/08/12 (driver) - One Touch Therapy Center (Geico / USAA) J
Roilan Pineiro, 37 - staged acct 09/19/12 (recruiter) $69,625 –B & A Diagnostic / Doctor Professional Medical / Gentle Care Rehab /
Psychologist Technology / South Florida Medical Health Corp / Y H Imaging (Geico / United Auto) M
Yeimy B Ruiz, 25 - staged acct 03/30/12 (driver) $58,920 - Med Care Medical Center / Well-Care Rehab Services (Imperial Fire /
Ocean Harbor) M
Fernando Luis Lamazares, 48 - massage therapist - $23,200 - LMG Medical Center (State Farm) M
Fernando Luis Lamazares, 48 - massage therapist - $19,552 - LMG Medical Center (State Farm) M
Jorge Gonzalez, 45 - staged acct 10/25/08 (passenger) $29,841 - Medical Service Center of Florida (State Farm) M
Tammy Anntoinette Sterner, 44 – application fraud (National General) J
Charles Edward Jeffrey, 54 – false statement (National General) J
Jovan Mikia Mitchell, 27 - sale of fake ins card (Peak Property & Casualty) T
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 7
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
massage therapists for insurance fraud at
clinics they owned in Tampa and Miami.
On page 2, we feature another fugitive in
Insurance Fraud’s Most Wanted, and report on
the City of Miami’s Operation On The Run.
On page 4, we put the Spotlight on the 2014
FIFEC Conference scheduled for June 11-13 in
Orlando. Once again, there are many great
classes scheduled for this year.
As always, we report on the latest PIP-related
arrests.
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. John DYGON
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. Rafael DELGADO
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