November 2013
Volume 4 - Issue 5
“This is a great
win in the fight
against PIP fraud
in Florida.”
- CFO Jeff Atwater
INSIDE THIS ISSUE
HEADER HERE
Jacksonville Clinic
Owner Convicted,
Faces 75 Years in Prison
Florida Chief Financial Officer Jeff Atwater announced the conviction of David Rodriguez
Lopez, 46, a Tampa clinic owner for orchestrating a large scale personal injury protection
(PIP) fraud scheme in Tampa and Jacksonville. Lopez, who will be sentenced in
November, faces up to 75 years in prison.
“This is a great win in the fight against PIP fraud in Florida,” said CFO Atwater. “I
applaud our fraud investigators in Jacksonville and our dedicated prosecutor at the State
Attorney’s Office, because it takes a well coordinated effort from the fraud prevention
community to bring a fraud ring leader to justice.”
An investigation conducted by the Florida Department of Financial Services’ Division of
Insurance Fraud revealed that Lopez directed the opening of Indian Rehabilitation
Center Inc., located at 3636 University Boulevard South in Jacksonville. Lopez
previously owned General Rehabilitation Center and Crystal Rehabilitation Center
located in Tampa.
Since March 2012, 26 staged accidents have occurred involving more than 60
individuals claiming to have been treated at Indian Rehab Center. The investigation
revealed that many claims included treatment involving equipment the facility did not
posses or treatments that never took place. Lopez was found to be the lead in securing
a straw owner, controlling bank accounts and directing fraudulent clinic operations.
Since mid 2012, 60 arrests have occurred involving accident participants, recruiters and
office personnel of these fraudulent accident clinics. Investigations continue and
additional arrests are expected.
1
Jacksonville Clinic
Owner Convicted
2
Strike Force DSO
Assistant State Attorney Joe Licandro of the 4th Judicial Circuit prosecuted the charges
against Lopez, who was found guilty of schemes to defraud, insurance fraud and
participation in a staged accident. The total amount received after billing by the clinic
was in excess of $240,000.
3
PIP Fraud News
See a related story from News4 in Jacksonville at http://www.news4jax.com/news/clinicowner-convicted-in-auto-insurance-scheme/-/475880/22312986/-/105qeee/-/index.html.
6
Statewide Arrests
7
Most Wanted
8
Statewide Contacts
Anyone with information involving suspected insurance fraud is asked to call 1-800-3780445. Citizens who provide tips can remain anonymous. The Department of Financial
Services to date has awarded almost $342,000 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.
November 2013
Page 2
A Word from the Auto Insurance Fraud Strike Force
- by Chair Al Lamberti
In 2012, the Florida Legislature directed the Department of Financial Services, under CFO Jeff Atwater, to
organize the “Automobile Insurance Fraud Strike Force” with the end goal of better protecting consumers by
monitoring fraudulent activity in the auto insurance industry and identifying resources to proactively assist law
enforcement, prosecutors and other stakeholders in the fight against auto insurance fraud.
The Florida Division of Insurance Fraud established a direct-support organization (DSO), known as the
“Automobile Insurance Fraud Strike Force” whose sole purpose is to support the prosecution, investigation
and prevention of motor vehicle insurance fraud. The strike force is organized and operated to conduct
programs and activities and to raise funds and receive grants to be used exclusively to combat auto
insurance fraud. Grants and expenditures by the strike force may include the cost of salaries of fraud
investigators, prosecutors or support personnel.
The DSO was established pursuant to Florida State Statute 626.9895.
Read more about Florida’s Insurance Fraud Statute
The perpetrators of insurance fraud have made Florida the top state in the nation for staged automobile
crashes. The Miami and Tampa areas have been the most affected by auto insurance fraud due to staged
crashes.
The Insurance Information Institute estimates that this type of fraud could cost up to $1 billion annually in the
State of Florida.
The number of suspicious auto accidents that are staged or deliberately caused by criminals in Florida has
increased dramatically over the past several years and is expanding throughout the state. According to the
Division of Insurance Fraud, most recent fraud cases started with a staged vehicle crash.
The “Automobile Insurance Fraud Strike Force” was established to safeguard the residents and visitors of
Florida and their assets by working in collaboration with the Division of Insurance Fraud and its stakeholders.
Its mission is to provide needed resources from private sources to enable its partners to be able to reduce
and eliminate fraudulent activities related to Personal Injury Protection (PIP) Insurance. These partners/
stakeholders include law enforcement agencies, State Attorneys’ Offices, Statewide Prosecutor, Agency for
Healthcare Administration and the Department of Health. In this era of limited resources, it is necessary to
establish public/private partnerships in order to effectively combat fraudulent criminal activity. Extremely
limited law enforcement resources need a force multiplier that can come from the private sector’s assistance.
This assistance will bolster law enforcement efforts to combat automobile insurance fraud.
Read more at: Mission to Combat and Reduce PIP Fraud
Anyone in the Florida insurance industry who is interested in assisting and willing to help support the
Automobile Insurance Fraud Strike Force, please contact Sheriff Al Lamberti (Ret.), Chairman of the “Strike
Force”.
*************************************************************************************************
Sheriff Al Lamberti (Ret.) is the Chairman of the Florida Auto Insurance Fraud Strike Force. For more
information regarding the “Strike Force” contact Sheriff Lamberti at 954-340-0005 or by email at
alamberti@mcfarlanedolanlaw.com.
The PIP Source
Page 3
PIP FRAUD – In The News
Three More Sledgehammer Defendants Sentenced to Federal Prison
Three more defendants from Operation Sledgehammer were sentenced earlier this month. Chiropractor Aaron
Freedlander, 51, clinic owner Luis Ivan Hernandez, 40, and staged accident recruiter and participant Daviel Castro, 27,
were sentenced on November 4, 2013 by U.S. District Judge Kenneth A. Marra for their participation in an PIP fraud
scheme involving staged automobile accidents. Freedlander was sentenced to 40 months in prison; Hernandez was
sentenced to 108 months in prison; and Castro was sentenced to 58 months in prison. Hernandez was the owner of six
clinics involved in the scheme.
In addition, Freedlander was ordered to pay $900,697.92 in restitution; Hernandez was ordered to pay $4,232,248.04 in
restitution and Castro was ordered to pay $1,359,208.73 in restitution. Freedlander will also be required to surrender his
chiropractic license.
To date, 92 defendants have been charged for their participation in this automobile insurance fraud scheme, 56 of which
have been charged federally by the U.S. Attorney's Office, resulting in court-ordered restitution of more than $5 million to
the defrauded insurance companies. The other 36 defendants have been charged by the Palm Beach County State
Attorney's Office.
Operation Sledgehammer is a joint investigation by the FBI, IRS-CI, the Division of Insurance Fraud (DIF), the Palm
Beach County State Attorney's Office, the Greater Palm Beach County Health Care Fraud Task Force, the National
Insurance Crime Bureau (NICB) and the U.S. Attorney’s Office.
See the full press release at http://www.justice.gov/usao/fls/PressReleases/131105-01.html.
Jacksonville Chiropractor Arrested For Unlicensed Practice
Donald Warren Lowery, 49, was arrested by the Division of Insurance Fraud (DIF) for unlicensed practice. The Florida
Department of Health (DOH) suspended Lowery’s license in December 2012. Lowery was working for Doc Tony’s
Northside Chiropractice while his license was suspended. Lowery told DIF detectives that he thought there was an
administrative hold on his license, and believed he could still treat patients. Lowery’s license was suspended for nonpayment of child support.
Steve Burgess Named Florida Insurance Consumer Advocate
CFO Jeff Atwater announced the appointment of Steve Burgess as Florida’s Insurance Consumer Advocate.
Burgess, 65, of Tallahassee, previously served as Florida’s Insurance Consumer Advocate from 1990 to 1997 and 2004
to 2007. He most recently served as the staff director of the Florida Senate’s Committee on Banking and Insurance, and
he has also served as an associate and deputy public counsel. Burgess received his bachelor’s degree in accounting
and his law degree from Florida State University.
“Steve’s career experience and his understanding of the insurance industry will help further our efforts to hold insurance
companies accountable and ensure that Floridians are being treated fairly,” said CFO Atwater. “He is a proven advocate
for Florida consumers and I am confident he will represent the best interests of Florida families.”
You can visit the ICA website at http://www.myfloridacfo.com/ica/ICAWestcott.asp.
November 2013
Page 4
PIP FRAUD SPOTLIGHT ON – Fraud Awareness Week
Between November 3-9, 2013, businesses and
organizations around the country and globe participated in
Fraud Awareness Week. The goal is to promote
awareness, detection and prevention of these often hardto-spot crimes.
As Florida’s Chief Financial Officer, it is my top priority to
fight to help keep your hard-earned money in your pocket
where it belongs. Unfortunately, there is a segment of
Florida’s population that is working just as hard to empty
your pockets - fraudsters and scam artists. Their frauds
and scams range from Personal Injury Protection (PIP)
fraud, workers’ compensation fraud, home improvement
scams, debt reduction scams, fake lotteries and many
more.
Recognizing frauds and scams is the most important step
to avoid becoming a victim. In an effort to help inform,
empower and protect Florida’s families, seniors in
particular, against financial scams, we have been hosting
a series of workshops across the state. Our tips to avoid
fraud include advice such as:
 Be suspicious of something that sounds too good to
be true.
 Don’t pay upfront fees to companies or organizations
you are unfamiliar with.
 Only buy insurance from licensed companies and
agents.
 Don’t provide personal or confidential information by
email, phone, or text to someone you don’t trust.


Don’t post your travel plans online.
Do not wire money in response to any threats.
I am proud to say that insurance fraud related arrests are
up nearly 55 percent since 2010. The success of our
dedicated and tireless employees to fight fraud and abuse
in our state is incredible, yet the fight against fraud
remains an ongoing battle.
If you suspect fraud, reporting it is easy and just a phone
call away. Please call 1-800-378-0445 to report suspected
fraud and help curb this growing problem that is driving up
the cost of living for all Floridians. Citizens can remain
anonymous, and tips that lead to an arrest and conviction
in an insurance fraud scheme can even collect up to
$25,000 as part of our Anti-Fraud Reward Program. To
date, we’ve awarded nearly $350,000 to more than 50
citizens.
Do not allow yourself to become a victim. Take charge
and learn what you can do to protect yourself and your
loved ones. For more information about fraud and
consumer protection, visit our website at http://
www.myfloridacfo.com/Division/Consumers/
fraudscams.htm.
The PIP Source
Page 5
DIF West Central Region Recognizes
Outstanding Work by Detectives, Prosecutor
In December of 2009, Division of Insurance Fraud (DIF) detective Billy Brantley initiated
an investigation into Medical Therapy Practitioners (MTP), an accident clinic located in
Tampa. Brantley quickly developed evidence that led to the execution of a search
warrant at the clinic. The investigation showed that MTP was involved in a scheme to
stage accidents, pay patients to treat at the clinic and falsely bill insurance carriers for
services not rendered. Brantley discovered how this clinic liquidated their income by
laundering money through straw companies, personal bank accounts and cash
withdrawals at or below the banking reporting requirements.
During the investigation Detective Brantley developed evidence that MTP had obtained a
fraudulent exemption from the Agency for Health Care Administration (AHCA), using a
chiropractor to file an application attesting he was 100% owner of the clinic when he was
not.
Det. Billy Brantley and
Brantley’s investigation and analysis of bank records provided him with evidence to
ASA Mike Lennon
document an organized criminal network operating in Hillsborough County. This criminal
enterprise involved in excess of 42 subjects and 18 clinics with a combined income of over $20 million. These clinics
created straw companies which in concert laundered more than $6 million. Additionally, a substantial amount of money
was laundered through private bank accounts, enlarging the layer of concealment.
Brantley developed evidence that nine members of the criminal enterprise purchased eight high end homes in the same
Tampa development with proceeds from their operation of the fraudulent clinics. During the course of the investigation,
seven of the properties were sold for more than $2 million.
Based on the magnitude of the investigation and the potential of forfeiture and seizures, DIF sought assistance from
federal prosecutors. While the matter was being reviewed by federal authorities, Brantley developed several spin-off
cases resulting in the arrest of eight subjects on charges of insurance fraud and money laundering. In the summer of
2013, a federal case was deemed unlikely and DIF turned to the Hillsborough County assistant state attorney Michael
Lennon, who had prosecuted the spin-off cases, to now target the top level defendants.
Up against the statute of limitations, ASA Lennon worked tirelessly with Brantley and filed RICO and money laundering
charges against four subjects in August 2013. Two subjects have been arrested and two remain at large.
West Central region Captain Mike Byrne believes this investigation has had a significant impact on insurance fraud
relating to PIP clinics in Hillsborough County and is a contributing factor for a reduction in
PIP fraud in that area, which has seen a 50% decline in referrals since 2009-10. As a
result, Capt. Byrne presented Brantley with the Detective of the Year award, and also
presented ASA Lennon with the Prosecutor of the Year award.
Capt. Byrne also presented Detectives Robert Nichols and Christian Menzel (pictured at
right) with the Detective of the Quarter award for the West Central region as a result of their
outstanding work in the undercover investigation of a PIP fraud scheme that operated in Lee
and Charlotte counties, which resulted in the arrests of nine subjects last month (see front
page story in the October 2013 PIP Source). The nine arrested included clinic owners, a
chiropractor and a massage therapist. The scheme involved staged accidents, patient
brokering and solicitation at two clinics, Evans Rehab Center in Fort Myers and Charlotte
Wellness and Rehab Center in Port Charlotte.
Their investigation also revealed that Charlotte Wellness and Rehab Center was operating
without the required license from the Agency for Health Care Administration (AHCA).
Dets. Robert Nichols and
Christian Menzel
November 2013
Page 6
Statewide PIP Arrests – October 2013
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.
Ricardo Concepcion, 40 – staged acct 02/09/12 (driver) $57,810 – Diagnostic Radiology / Fast Rehab / Xtreme Medical (Geico /
State Farm / United Auto) M
Yaneisy Trimino Aranda, 23 – staged acct 09/19/12 (passenger) $69,725 – B & A Diagnostic / Doctors Professional Medical / Gentle
Care Rehab Services / Psychologist Technology / South Florida Medical Health Corp / YH Imaging (Geico / United Auto) M
Michelle Anne Castillo, 31 – staged acct 09/17/12 (driver) $3,273 - (Progressive / Repwest) J
Bernard Andrew Ethier, 21 – staged acct 09/17/12 (jump-in) $3,273 - (Progressive / Repwest) J
Paulesky Eric Mauney, 41 – fake ins card (Hartford) F
Julio Angel Vargas Rodriguez, 36 – staged acct 03/31/11 (driver) $1,487 - Clearview Open MRI / Recovery Rehabilitation Services
(RepWest) T
Paulesky Eric Mauney, 41 – sale of fake ins cards (MGA) F
Destin Sanon, 38 – staged acct 05/13/11 (recruiter) $21,980 – First Choice Chiropractic (Allstate / Kingsway Amigo / Permanent
General) O
Tarvis Terrell Sabb, 22 – staged acct 05/19/12 (driver) $26,322 – Cintex Urgent Care / High Definition Mobile MRI / Metric Diagnostic
(RepWest / Responsive) B
Marc Christopher Bryant, 26 – staged acct 05/19/12 (recruiter) $26,322 – Cintex Urgent Care / High Definition Mobile MRI / Metric
Diagnostic (RepWest / Responsive) B
Ariel Martinez, 37 – staged acct 10/14/12 (driver) $32,725 – K & J Medical Center (Ocean Harbor) M
Donald Warren Lowery, 48 – chiropractor / unlicensed activity – Doc Tony’s Northside Chiropractic (Geico) J
Laura Esther Broche Diaz, 44 – PIP patient - $3,793 – Columbus Rehabilitation Center (Geico) T
Yoel Sotolongo Caro, 40 – PIP patient - $3,793 – Columbus Rehabilitation Center (Geico) T
Ismel Sotolongo Broche, 20 – PIP patient - $3,793 – Columbus Rehabilitation Center (Geico) T
Pedro Pablo Montes, 42 – staged acct 02/09/12 (passenger) $57,810 – Diagnostic Radiology / Fast Rehab / Xtreme Medical (Geico /
State Farm / United Auto) M
Luz Maria Perez, 54 – paper acct 01/04/09 (driver) $37,197 – Choice Medical Center (State Farm) F
Verimond Atellus, 29 – staged acct 05/13/11 (driver) $21,980 – First Choice Chiropractic (Allstate / Kingsway Amigo / Permanent
General) O
Jill Lori Scott, 58 – massage therapist / false claim - $5,800 (Amica) O
Frenel David, 50 – application fraud (Amica) O
Nadine Laurent, 52 – clinic owner / fraudulent claim - $1,335 – Optimum Medical Care (Security National) W
Andre Saleem Worrell, 28 – PIP patient / false claim - $15,000 – Central Florida Medical & Chiropractic Center (Auto Owners) O
Alisha Londe Lamb, 34 – lost wages - $0 (USAA) TL
Samantha Lee, 34 –fake ins card (Peak Property and Casualty) T
Desmond Darryl Hanna, 26 – fake ins card (United Auto) B
Alfredo Cortes, Jr, 55 – staged acct 06/14/11 (driver) $27,366 – Excellent Rehab (State Farm) B
Corey Antwon Hastey, 26 – staged acct 02/05/13 (passenger) $26,237 – Health & Rehab Services of South Florida #2 / MRI
Express Corp (Gainsco / RepWest) M
Lois Jean Walker, 58 – paper acct 10/17/10 (driver) $37,507 – Personal Medical Center (Geico / Sentry) 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 Arrests – October 2013
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.
Renesha Marie Williams, 32 – fake ins card (Ocean Harbor) T
Deborah Yvette Burney, 43 – sale of fake ins card (Equity) T
Gloria Moraima Feliz, 31 – clinic employee - $ - Evans Rehab Center (Nationwide / Titan) F
Andres Bravo, 52 – massage therapist – Evans Rehab Center (Nationwide / Titan) F
Josue Daniel Tolento, 25 – fake ins card (Ocean Harbor) W
Enrico Gedeon Scutt, 26 – staged acct 09/03/11 (recruiter) $20,000 - Injury Treatment Center of Coral Springs (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)
Most Wanted: Fugitive
Frine Tovar aka Frine Trimpin Colon
White Female, 58 years old
5’04”, 130 lbs, Brown Eyes, Black Hair
Warrant Information:
Warrant/Case #: 2010-CF-17110-0
Felony Warrant Charge: Organized scheme to defraud / conspiracy
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud (DIF) is attempting to locate Frine Tovar. in reference to an
outstanding warrant.
Tovar was involved in a scheme to defraud where she and others
conspired to set up a straw owner of a PIP clinic in Orlando, using a
licensed physical therapist. This concealed the true ownership of the
clinic by obtaining a false certificate of exemption from the Florida
Agency for Health Care (AHCA). Tovar has been involved in the PIP
clinic business for many years, mostly in the Orlando area.
If you know where Tovar 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/
November 2013
Page 8
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 conviction of a
Jacksonville clinic owner.
On page 2, we present the Auto Insurance
Fraud Strike Force Chair Al Lamberti who
explains how the Direct Service Organization
(DSO) works.
On page 4, we spotlight Fraud Awareness
Week.
On page 7, 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.
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