April 2014 Volume 4 - Issue 10 Gov. Rick Scott and Chief Financial Officer Jeff Atwater pushed for the law, saying that fraud primarily in the Tampa and Miami regions led the cost of auto insurance coverage to spike for Floridians. INSIDE THIS ISSUE 1 Supreme Court Refuses to Hear PIP Challenge HEADER HERE Florida Supreme Court Refuses to Hear Challenge to PIP Legislation The Florida Supreme Court won't hear a challenge by acupuncturists and massage therapists who sought to overturn a 2012 law that supporters claim would cut fraud from the state's no-fault auto insurance system. Monday's decision effectively ends the case, which focused during appeals on whether unnamed plaintiffs had legal "standing" to pursue the challenge. But Adam Levine, an attorney for the challengers, has said in the past he could re-file the case with named plaintiffs. With the decision, Insurance Commissioner Kevin McCarty said the law proceeds, "nothing changes." The 2012 law, considered a last-ditch effort to maintain the no-fault system, set benchmarks for insurers to lower rates on personal-injury protection coverage. It required people involved in motor vehicle crashes to seek treatment within 14 days and allowed up to $10,000 in benefits for emergency medical conditions, while putting a $2,500 cap on non-emergency conditions. Gov. Rick Scott and Chief Financial Officer Jeff Atwater pushed for the law, saying that fraud primarily in the Tampa and Miami regions led the cost of autoinsurance coverage to spike for Floridians. Read the entire article from WUSF News at http://wusfnews.wusf.usf.edu/post/ supreme-court-says-no-no-fault-case. Additional stories can be found at: 2 Most Wanted http://www.mypalmbeachpost.com/news/business/car-insurers-see-win-at-florida -supreme-court-but-/nffwC/ 3 Statewide Arrests http://www.news-press.com/story/money/insurance/2014/04/22/florida-supremecourt-refuses-to-review-pip-case/8007615/ 5 Statewide Contacts http://www.insurancejournal.com/news/southeast/2014/04/23/327078.htm http://www.insurangle.com/florida-supreme-court-leaves-pip-reforms-intact.html. April 2014 Page 2 Most Wanted: Fugitive Julio Socarras Mompeller aka “Julito” White Male, 34 years old 5’09”, 175 lbs, Brown Eyes, Brown Hair Warrant Information: Warrant/Case #: F11029314 Felony Warrant Charge: Insurance Fraud / Staged Accident Details: The Florida Department of Financial Services, Division of Insurance Fraud (DIF) is attempting to locate Julio Socarras Mompeller, in reference to an outstanding warrant. In December 2010, Mompeller allegedly organized a staged accident in Miami. As an organizer, Mompeller was the person who recruits and coordinates persons willing to fake accidents for money. As a result of this staged accident, fraudulent claims for treatment in excess of $41,000 were filed against two insurance carriers. Mompeller is believed to have fled to Cuba. If you know where Mompeller 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/ DIF Arrests Miami, Hollywood Clinic Owners Richar Calderin Remedios, 41, was arrested by the Division of Insurance Fraud (DIF) on eight counts of insurance fraud, eight counts of grand theft and one count of patient brokering in March 2014. Calderin, a licensed massage therapist and owner of RCR Rehabilitation Center Corp, allegedly filed nearly $100,000 in fraudulent claims against insurance carriers 21st Century, Geico and State Farm, between June 2011 and May 2012. Calderin billed for treatment of eight patients who were referred to his clinic after participating in staged accidents. Calderin gave the patients treatment forms to sign, but did not provide treatment. Calderin also gave the patients a tour of his clinic showing them the treatment rooms and machines used for therapy, in case they were questioned about the unrendered services by insurance carriers. Calderin was first licensed in Florida as a massage therapist in February 2011, and incorporated RCR Rehabilitation Center Corp in March 2011. Calderin is the sole officer. In an unrelated case, Ronie Petidos, 33, was arrested by the Division of Insurance Fraud (DIF) and charged with three counts of patient brokering. Petidos is allegedly a part-owner of Hollywood Pain & Rehab Center. An accident was staged on May 3, 2012 and participants went to Hollywood Pain & Rehab Center for treatment. Petidos allegedly offered the participants $2,000 to treat at his clinic, and promised an extra $7,000 from a future settlement. A total of $28,997 in fraudulent claims was submitted to Allstate by Hollywood Pain & Rehab Center as a result of the staged accident. The PIP Source Page 3 Statewide PIP Arrests – March 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. Eusebio Kin Gonzalez, 55 – staged acct 04/01/10 (passenger) $44,045 – CB Phenix Rehab Center (Allstate / Republic Western / State Farm) M Roberto Rivera, 42 – staged acct 04/16/11 (passenger) $76,765 – B & A Diagnostic / Clarke Medical Services / Emoge Medical Services / New Life Rehab Services (Imperial Fire / United Auto) M Angelo Wuisk Jean, 51 – staged acct 09/24/11 (recruiter /passenger) $21,330 - Advanced Medical Associates (Geico / RepWest) B Misael Ortega Ponce, 37 – staged acct 03/04/12 (recruiter) $59,673 – Cyma Massage / RCR Rehab (Geico / Imperial Fire / State Farm) M Oslay Acosta-Miguel, 36 – clinic owner – five staged accidents - $176,866 – One Touch Therapy Center (AGIC / Farmers / Gainsco / Geico / Kemper / Sentry / ) J Herbert Kerr, 78 – jump-in 02/17/13 - $5,775 – Alliance Health & Injury Center (Geico) B Nelson Cata Gacita, 39 – staged acct 07/21/11 (driver) $43,292 – EMED Primary Care / One Touch Therapy Center / Saint Jose Injury Center (Kemper / Nationwide) J Andres Alfonso Carbonell, 25 – staged acct 10/22/11 (recruiter) $27,876 - First Physical / Health & Wellness (21st Century / Star Casualty) M Jo Ann Hobson Parker, 71 – application fraud (California Casualty) TL Lupe M Rodriguez, 48 – staged acct 06/14/12 (driver) $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 Jasel Martinez Gonzalez, 38 – staged acct 07/21/11 (driver) $43,292 – EMED Primary Care / One Touch Therapy Center / Saint Jose Injury Center (Kemper / Nationwide) J Luis Valladares, 65 – staged acct 04/07/13 (driver) $70,103 – Med Union / Pain Relief Clinic of Homestead / YH Imaging (Geico / Ocean Harbor) M Reynaldo Burmudez, 51 – staged acct 04/07/13 (recruiter) $70,103 - Med Union / Pain Relief Clinic of Homestead / YH Imaging (Geico / Ocean Harbor) M Andrea Veerasammy, 37 – lost wages - $11,925 (Geico) B Angela Annette Looper, 42 – application fraud (National General) TL Ednuel Pacheco, 20 – fake ins card (Progressive American) T Mackens Iltima, 36 – paper acct 10/28/11 (driver) $32,417 - Spine Chiropractic Center (Imperial Fire) M Eddy Renodain, 33 – paper acct 10/28/11 (passenger) $32,417 - Spine Chiropractic Center (Imperial Fire) M Osmany Rodriguez, 42 – staged acct 09/19/12 (passenger) $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 Flora C Mateo Gonzalez, 55 – lost wages (USAA) O Iesha Nicole Robinson, 40 – staged acct 04/03/11 (passenger) $53,752 – Blessings Rehab Center (Geico) O Jivan Mukta Barreto Becerra, 31 – staged acct 12/08/11 (passenger) $43,089 - Palmetto Therapy Center / Westchester Therapy (State Farm / United Auto) M Nimai Das Manrique, 26 – staged acct 08/26/10 (Allstate / Progressive / USAA) T Ruben Dario Coello, 26 – staged acct 12/08/11 (recruiter) $43,089 - Palmetto Therapy Center / Westchester Therapy (State Farm / 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) April 2014 Page 4 Statewide PIP Arrests – March 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. Jose Carlos Buendia Tellez, 27 – staged acct 07/21/11 (passenger) $43,292 – EMED Primary Care / One Touch Therapy Center / Saint Jose Injury Center (Kemper / Nationwide) J Odalys Suarez Figueredo, 42 – staged acct 07/21/11 (driver) $43,292 – EMED Primary Care / One Touch Therapy Center / Saint Jose Injury Center (Kemper / Nationwide) J Faneta Flerimond, 22 – paper acct 10/28/11 (passenger) $32,417 - Spine Chiropractic Center (Imperial Fire) M Lisvan Zayas, 34 – staged acct 12/28/11 (recruiter) $63,751 – B & A Diagnostic / Emoge Medical Services / Doctors Professional Medical Center / M & N Rehabilitation Center / Magic Hands Medical Services (Imperial Fire & Casualty / United Auto) M Joel Marino, 31 – staged acct 10/22/11 (recruiter) $27,876 - First Physical / Health & Wellness (21st Century / Star Casualty) M Richar Calderin Remedios, 41 – clinic owner / massage therapist - $50,502 - RCR Rehabilitation Center (Geico / State Farm) M Richar Calderin Remedios, 41 – clinic owner / massage therapist - $4,473 - RCR Rehabilitation Center (State Farm) M Richar Calderin Remedios, 41 – clinic owner / massage therapist - $44,078 - RCR Rehabilitation Center (21st Century / Geico) M Reynier Betancourt, 38 – staged acct 04/21/12 (recruiter) $98,735 - Gentle Care Rehab Services / Well-Care Rehab Services (State Farm / Titan) M Arry Bertrand, 28 – staged acct 05/03/12 - $28,997 - Hollywood Pain & Rehab Center (Allstate) B Ronie Petidos, 33 – clinic owner / patient brokering – $28,997 - Hollywood Pain & Rehab Center (Allstate) B Marc Richard La Pierre, 26 – staged acct 05/03/12 (recruiter) $28,997 - Hollywood Pain & Rehab Center (Allstate) B Michelle Marie Cook, 38 – lost wages (Nationwide) F Fernando Ernesto Marti, 30 – fake ins card (United Auto) M Arrested in February 2014 Joshua M Willis, 34 – staged acct 08/26/10 (driver) (Allstate / Progressive / USAA) 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) Jacksonville Clinic Owner Arrested The Division of Insurance Fraud (DIF) arrested Oslay Acosta-Miguel, 36, on five counts of staged accidents, one count of insurance fraud over $100,000 and one count of organized scheme to defraud. Acosta could face 125 years in prison. Acosta, also known as El Guajiro, previously owned and operated a clinic in Tampa, but enforcement had gotten “hot”, causing Acosta to relocate to Jacksonville. Investigation by DIF revealed that Acosta had opened Baymeadows Injury Center and Saint Jose Injury Center, both located in Jacksonville. Investigation also revealed that Acosta was associated with the owners of two other Jacksonville clinics, Wellness Rehab Services and Indian Rehabilitation Center. More than 100 persons have been arrested in relation to insurance fraud involving these and other clinics. Acosta was known to have met with numerous recruiters to discuss the organization of staged accidents in the Jacksonville area. Acosta was charged in March 2014 for his role in staging five accidents between July and September, 2011 and bringing the participants to another clinic, One Touch Therapy Center, resulting in more than $176,000 being paid for false claims filed against six insurance carriers; AGIC, Farmers, Gainsco, Geico, Kemper and Sentry. The PIP Source Page 5 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 Supreme Court’s refusal to hear the challenge to the 2012 PIP reform. On page 2, we cover the arrests of clinic owners in Miami and Hollywood along with our latest installment of Insurance Fraud’s Most Wanted. On page 4, we highlight the arrest of a clinic owner / staged accident organizer in Jacksonville. As always, we report on the latest PIPrelated arrests statewide. 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
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