July 2012
Volume 3 - Issue 1
Chiropractor Adams
served as named
owner of the clinics,
although the other
defendants would
maintain financial
control of the
businesses.
INSIDE THIS ISSUE
1
New Sledgehammer
Arrests
2
FHP Launches
Staged Crash Page
3
PIP Fraud News
4
FIFEC Awards
6
Statewide Arrests
7
Statewide Contacts
HEADER HERE
Chiropractor Among
Latest Arrests in
Operation Sledgehammer Case
Eleven defendants, including a licensed chiropractor and massage therapist, were
charged in a multi-million dollar staged accident fraud scheme in Palm Beach County. In
total, the U.S. Attorney’s Office has charged 26 defendants in less than 12 months as
part of Operation Sledgehammer.
Chiropractor Jennifer Adams, 38; massage therapist Moises Madrid, 40; Obelio
Rodriguez, 43; Maria Molina, 41; Yuliet Tapanes, 25; Dagoberto Milian Lopez, 56;
Amaurys Hernandez, 40; Gilda Garcia, 49; Javier De La Caridad Troncoso, 45; Ana
Ovando, 42; and Janice Velez, 39, were each charged with one count of conspiracy to
commit mail fraud. Defendant Rodriguez is at large and considered a fugitive.
The defendants allegedly unlawfully profited by submitting fraudulent PIP claims for
chiropractic and massage therapy treatments for individuals who had participated in
staged automobile accidents. The defendants recruited individuals to participate,
instructed them on how to conduct accidents and what to tell responding police officers,
insurance company representatives and independent medical examination (IME)
physicians. They also instructed them on how to collect police reports and what clinic to
go to for treatment, even though the participants did not need treatment.
Chiropractor Adams served as the named owner of the clinics, although the other
defendants maintained financial control of the businesses. The clinics involved in the
scheme were OVY Rehabilitation Medical Center, HHR Rehab Medical Center, Florida
Chiropractic Center of Palm Beach Corp, Chiropractic Office of South Florida, Florida
Mango Massage Therapy Center, New York Medical and Rehab Center and KCC.
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida,
commended the investigative efforts of the FBI, IRS-CID, Defense Criminal Investigative
Service, Florida Department of Financial Services Division of Insurance Fraud, and
issued a special thanks to the National Insurance Crime Bureau (NICB) for its assistance
in this investigation. The cases are being prosecuted by Assistant U.S. Attorney A. Marie
Villafaña.
Victim companies include 21st Century, Affirmative, Agency, AIG National, Allied
Property & Casualty, Allstate, American Vehicle, Ameriprise, Apollo Casualty, Assurance
America, Bristol West, Castlepoint, Corvel, Direct General, Esurance, Farmers, First
Acceptance, Florida Farm Bureau, Geico, GMAC, Granada, Hallmark, Infinity, Infinity
Indemnity, Kingsway Amigo, Liberty Mutual, Mapfre, Mendota, Mercury, Metlife, MGA,
New Hampshire Indemnity, Occidental Fire & Casualty, Ocean Harbor, Peak Property &
Casualty, PGCS, Praetorian, Progressive, Redland, Safeco, Security National, Seminole
Casualty, Star Casualty, State Farm, Travelers, Unitrin, Victoria Fire & Casualty, and
Windhaven.
You can find the full press release at http://www.justice.gov/usao/fls/
PressReleases/120618-01.html.
July 2012
Page 2
FHP Launches New Webpage “Protect Yourself Against Staged Crashes”
The Florida Highway Patrol launched a new webpage on its site called “Protect Yourself Against Staged Crashes.”
The new site provides information, videos and links from its partners the Florida Division of Insurance Fraud (DIF) and
the National Insurance Crime Bureau (NICB) regarding staged accidents and insurance fraud. Included are brochures
from both DIF and NICB and data forecast reports from NICB.
Included on the new page are three informative videos of caused crashes, including the swoop and squat, the panic stop
and the drive down. The Florida Highway Patrol demonstrated these crashes during the PIP fraud legislative push
earlier in the year. Check out these links to see more: http://www.putthebrakesonaccidentfraud.com/
http://www.wtsp.com/news/article/239043/19/Police-crash-cars-to-demonstrate-Floridas-growing-problem-with-accident-fraud
http://www.youtube.com/watch?v=UM0VVGCXiB8
http://www.youtube.com/watch?v=UyfxvUhF198
The new site also posts the hotline numbers for NICB (1-800-TEL-NICB) and DIF (1-800-378-0445). You may be
eligible for a reward of up to $25,000 for reporting fraud to DIF.
You can visit the new website at http://www.flhsmv.gov/fhp/misc/StagedCrashes.htm.
The PIP Source
Page 3
PIP FRAUD – In The News
Massage Therapist Arrested as Straw Owner in Miami Clinic Fraud Case
Maritza Ruano, 53, a licensed massage therapist, was arrested last month for her role in Operation Dark Horizon.
Ruano allegedly posed as the owner of Coral Way Rehabilitation Services so the true owner, Daisy Sarmiento, did not
have to obtain a clinic license from the Florida Agency for Health Care Administration (AHCA). Ruano, who has been
licensed as a massage therapist in Florida since 2004, is also listed as an officer of at least three other clinics, including
Maritza’s Healing Hands, LLC, M J Medical Center and 5757 Medical Rehabilitation, all in Miami-Dade County. Along
with Coral Way Rehabilitation Services, MJ Medical Center and 5757 Medical Rehabilitation operated with an exemption
from AHCA.
Ruano is the 28th defendant to be charged by the Miami-Dade State Attorney’s office in the Dark Horizon case.
PIP Fraud Kidnapping Case Update
The second defendant in the previously reported (March and May 2012 issues of the PIP Source) kidnapping case
entered a plea last month in a Miami-Dade court. Alberto Montalvan Rey, 25, was sentenced to 2 years in prison and 3
years probation for his role in the strong-arm tactics which resulted in both he and co-defendant Yasmani Marquez being
shot by a staged accident participant. In the case, the participant from a May 2011 staged accident was taken to a clinic
where he was allegedly threatened and accosted about money. When the participant could not satisfy the clinic’s
demands, he was taken away in a car and was under the belief that the driver and accomplice were going to kill him.
Instead, the participant pulled out his own handgun and shot Marquez and Montalvan Rey.
Co-defendant Marquez was previously sentenced to five years in state prison.
CFO Jeff Atwater Speaks at FIFEC in Orlando
Florida Chief Financial Officer Jeff Atwater was the keynote speaker at the 2012 FIFEC Conference held
last month in Orlando. CFO Atwater spoke about his efforts since taking office in 2011, highlighting the
more than 1,700 arrests and $155 million in court-ordered restitution. “These are real results that continue
to help stabilize Florida’s economy as a whole and increase consumer confidence throughout our state,”
CFO Atwater said. “We could have no stronger team in the fight against fraud in Florida than the one we
have.”
Inflated auto-insurance claims? Law firm denies allegations
One of central Florida's best-known law firms and a prominent Brevard County surgeon may have had an "across-theboard agreement" in recent years to inflate by millions of dollars the charges for spinal surgeries in auto-accident claims,
according to insurance-company allegations that have surfaced from a pair of routine personal-injury lawsuits.
Dan Newlin denied State Farm's allegation that Morgan & Morgan sent clients to surgeon Ara Deukmedjian in exchange
for him agreeing in advance to accept less than the fees incorporated in the firm's lawsuits. He clarified that he had little
knowledge of how lawsuits played out because his job had been to attract new clients, who were then assigned to other
Morgan & Morgan lawyers.
Doctors routinely agree to reduce their medical fees during negotiations to settle cases based on the circumstances of
each lawsuit. But lawyers are not allowed to intentionally overstate medical costs in lawsuits, said Amy Mashburn, a
University of Florida legal-ethics professor who is not familiar with the Morgan & Morgan lawsuits. "That's fraud on the
court, and it's a breach of the lawyer's professional ethics," Mashburn said.
Neither of the personal-injury lawsuits has gone smoothly. The federal judge, dissatisfied with Deukmedjian's responses
during depositions, said the doctor was showing "a lack of respect for the authority of the court." As a result, in an
extremely rare move, the judge has ordered that the next deposition be held in the courthouse, where he can preside if
needed.
Capt. Steve Smith would not comment on whether an investigation is under way. He did say that excessive cooperation
between doctors and lawyers generally has been a concern of the agency's. "Some of the problems we've had are
doctors and lawyers probably working too closely together," Smith said. "They have a plan in place to go after the bowl
of money ... where the priority is enriching themselves rather than taking care of the patient, who is secondary — or a
means to the end."
To view the full article by Kevin Spear, please click here: http://articles.orlandosentinel.com/2012-05-27/business/osauto-insurance-inflated-claims-20120527_1_state-farm-morgan-morgan-firm.
July 2012
Page 4
2012 FIFEC Awards Announced in Orlando
The 20th anniversary of FIFEC was a tremendous success. With nearly 740 attendees, the annual
conference was abuzz with the latest information about insurance fraud in Florida. But one of the big
stories this year was the award nominations. This year saw the addition of four new categories, and
also a record number of 26 nominees. Here are the 2012 FIFEC award winners and nominees:
Insurance Investigator of the Year
Jeff Phifer, Allstate, was this year’s winner. Other nominees included John Oral, Esurance; Randy
Gibson, Geico; Carlos Torres, Infinity and Linda Hanley Armstrong, State Farm.
Law Enforcement Detective of the Year
Raymond Gonzalez, Miami Police Department, was this year’s winner (not pictured due to his
undercover status). Other nominees included Robert Batista, Dwight Murphy, John Savino, Miguel
Mora, Rafael Delgado and Oscar Sigler, Division of Insurance Fraud and Victor Chica and Julie
Medico, Cape Coral Police Department.
Jeff Phifer
The Jerry Zappolo Distinguished Service Award
Scott Dutton was this year’s winner. Also nominated were Blanca Aparicio, United Automobile and
Kevin Beckner, Hillsborough County Commissioner.
The four new award categories for this year were:
Insurance Attorney of the Year
Crystal Broughan, Allen, Dyer, Doppelt, Milbrath & Gilchrist, PA, was this year’s winner. Other
nominees included Anthony Parrino, Reynolds Parrino Spano, PA; Steven Manno, Andrews &
Manno, PA; Frank Goldstein, Goldstein Law Group; Scott Dutton, Dutton Law Group and Miguel
Roura and Peter Nayrouz, Law Firm of Banker, Lopez & Gassler.
Scott Dutton
Insurance Analyst of the Year
Wendy Sassman, United Automobile, was this year’s winner.
Law Enforcement Analyst of the Year
Lori Rodabaugh, Division of Insurance Fraud, was this year’s winner. Other nominees included Lorie
Wiese, also from the Division of Insurance Fraud.
Law Enforcement Prosecutor of the Year
Juliana Millon, Miami-Dade State Attorney’s Office, was this year’s winner. Other nominees included
Ann Marie Villafana, United States Attorney’s Office in Palm Beach County.
Crystal Broughan
Special Recognition Award
Commissioner Kevin Beckner, Hillsborough County Commission, was given special recognition for
his leadership and support in getting the county ordinance passed last year in Hillsborough County to
combat PIP fraud.
We congratulate all the winners and nominees for their dedication and efforts in the fight against
insurance fraud.
Wendy Sassman
Juliana Millon and her co-workers at the MiamiDade State Attorney’s Office
Kevin Beckner
Lori Rodabaugh
The PIP Source
Page 5
Most Wanted: Fugitive
Vladimir Lopez
Hispanic Male, 38 years old
6’00”, Brown Eyes, Brown Hair
Warrant Information:
Warrant/Case Number: 209B-MM-113865
Monetary Structuring Transactions, Mail Fraud and Conspiracy to
Commit Mail Fraud
Details:
The Florida Department of Financial Services, Division of Insurance
Fraud is attempting to locate Vladimir Lopez in reference to the
outstanding warrant.
Lopez was indicted by the U.S. Attorney’s Office in July 2011 as part of
Operation Sledgehammer for his involvement in a massive insurance
fraud / staged accident ring operating in Palm Beach County.
If you know where Lopez can be located, please contact the Division of
Insurance Fraud at 800-378-0445.
Check out the latest Most Wanted at http://www.myfloridacfo.com/PressOffice/MostWanted/.
How You Can Help Fight Insurance Fraud in Florida
Last year, the Florida Legislature created a fund to which anyone can contribute to the fight against insurance fraud by
making a donation, gift or grant to the Insurance Regulatory Trust Fund. The proceeds will be used by the Division of
Insurance Fraud to hire additional dedicated prosecutors and insurance fraud detectives, as well as fund anti-fraud
programs around the state. This is an exciting program that we believe will have a substantial impact on insurance fraud
in Florida.
Payments should be made payable to: The Department of Financial Services
(Please write “Code 1201F” on the memo line of your check.)
The mailing address is:
Department of Financial Services
Revenue Processing Section
P.O. Box 6100
Tallahassee, FL 32314-6100
The donor should include correspondence with the check indicating it is a grant or donation for the Division of Insurance
Fraud. The letter should include his / her intent that the grant or donation be deposited to the Insurance Regulatory Trust
Fund and used for anti-fraud efforts. Also include a statement that if the donation is to be used for any other purpose,
the funding should be withdrawn.
If you have any questions, you can contact us at the PIP Source and we will get an answer. Thank you for your help.
Join the Fight. Be a part of the Solution. Make a Difference.
July 2012
Page 6
Statewide PIP Arrests – June 2012
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.
Jose Rodriguez, 29 - staged acct 02/01/10 (passenger) $122,351 – Pompano Family Chiropractic (Progressive / Security National) B
Iliana Londono, 40 - statement in support of jump-ins - $0 (Geico) B
Marcel S Holman, 22 - fake ins card (Geico / Ocean Harbor) W
Gardy Jeune, 54 - clinic owner – US Chiromatrix (Progressive) O
Lazaro Baldomero Almeida Pareda, 64 - massage therapist - $710 - Performance Health & Wellness (Allstate) W
Pascal Charite, 32 - PIP patient - $10,000 (Farmers) F
Charles A Parker, 31 - jump-in - $0 - PMC Deerfield (Allstate / Geico) W
Pedro Rodriguez, 53 - staged acct 04/16/09 (driver) $43,522 - Better Life Medical Center (State Farm) M
Ericka N West, 38 - fake ins card (MGA) W
George Thompson, 32 - false claim (Progressive) T
Yuliet Tapanes, 25 - clinic employee - Florida Mango / New York Medical and Rehab Center () W
Moises Madrid, 40 - massage therapist - New York Medical and Rehab Center () W
Amaurys Hernandez, 40 - staged acct (recruiter) - New York Medical and Rehab Center () W
Javier Troncoso, 45 - staged acct (recruiter) - New York Medical and Rehab Center () W
Ana Ovando, 42 - staged acct - New York Medical and Rehab Center () W
Janice Velez, 39 - staged acct - Chiropractic Office of South Florida / New York Medical and Rehab Center () W
Maria Molina, 41 - clinic straw owner—OVY Rehabilitation Medical Center / HHR Rehab Medical Center () W
Wilfredo Rodriguez Martinez, 47 - staged acct 02/11/09 (recruiter) $27,374 - E & B Rehabilitation Center (Allstate) M
Maitte Pluma Palma, 40 - staged acct 04/27/11 (recruiter) $80,584 - AZJ Medical / La Maison / YH Imaging / (Allstate / Geico / State
Farm) M
Jennifer Adams, 38 - chiropractor - Chiropractic Office of South Florida / HHR Rehab Medical Center / OVY Rehabilitation Medical
Center () W
Gilda Garcia, 49 - staged acct (recruiter) - Chiropractic Office of South Florida / New York Medical and Rehab Center () W
Marc Maxis, 42 - staged acct 01/07/09 (recruiter) $45,898 - Michigan Health & Rehab (Avis Budget / State Farm) O
Maritza Ruano, 53 - massage therapist / straw clinic owner – Coral Way Rehabilitation Services (Imperial Fire & Casualty) M
Esteban Grueiro Gonzalez, 42 - runner solicitation - Certified Pro Collision / (United Auto) 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)
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
Tallahassee Field Office - 850.413.3115
Capt. Robert BRONGEL
Pensacola Field Office - 850.453.7802
Lt. Joseph HOLOKAN
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, Highlands, Hillsborough, Lee, Manatee, Pasco,
Pinellas, Polk, Sarasota
Tampa Field Office - 813.972.8602
Capt. Michael BYRNE
Lt. Carlos ROSARIO
Lt. Darrell WILSON
Fort Myers Field Office - 239.278.7527
Lt. Mark FRITZ
Copy goes her.
Editor’s
Corner
On page one, we cover the latest arrests in Palm
Beach County in Operation Sledgehammer. To
date, 26 defendants have been charged...with more
to follow.
On page two, we spotlight a new website from the
Florida Highway Patrol called “Protect Yourself
Against Staged Crashes.”
On page four, we report on the 20th anniversary of
FIFEC, and publish the names of this years award
winners.
As always, we report on PIP Fraud in the News and
the latest PIP-related arrests.
Finally, we proudly start our third year of the PIP
Source. We are thankful for the support and the
interest from our readers.
EAST CENTRAL REGION
Counties: Brevard, Indian River, Lake, Martin, Okeechobee,
Orange, Osceola, Palm Beach, Seminole, St. Lucie, Volusia
West Palm Beach Field Office - 561.837.5601
Major Simon BLANK
Capt. Glen HUGHES
Lt. Evangelina BROOKS
Orlando Field Office - 407.835.4402
Lt. Jewel CAMERON
Lt. Paul MEYERS
SOUTH REGION
Counties: Broward, Dade, Monroe
Miami Field Office - 305.536.0302
Capt. Steven SMITH
Lt. Violeta SERRANO
Lt. John DYGON
Lt. Stanley JEAN-FELIX
Plantation Field Office - 954.321.2902
Lt. Bill LEE
South Florida Major Medical Fraud Task Force
Supervisory Special Agent Fred Burkhardt 954.329.7427
Central Florida Major Medical Fraud Task Force
Director Southeast Region Dennis Russo 863.967.6904