Filed Under:Claims, Investigative & Forensics

Dirty Dozen Busted for $23M PIP Fraud Ring

Fla. Cops Raid Two Clinics, Apprehend 12 Suspects

A 13-month probe into a string of suspicious car crashes culminated yesterday in the arrest of 12 individuals, including a Cape Coral, Fla.-based physician.

Authorities believe the “dirty dozen” were bilking insurers out of $22.5 million a year in yet another scheme designed to take advantage of Florida’s oft criticized personal injury protection (PIP) system.

According to the federal indictments, the accused helped carry out “Operation Whiplash,” whereby certain clinics billed for exaggerated or non-existent medical services. Moreover, clinics allegedly employed talent scouts to find willing actors to participate in orchestrated crashes and then visit clinics—or at least sign forms to attest that they had—all over Florida.

Initial suspicions about these odd traffic patterns gave way to a full-blown investigation and a sting operation involving undercover agents who posed as participants wanting in on the action. The investigation, believed to be the largest of its kind in southwest Florida, led to a police raid of two of the presumed 31 clinics involved in the scheme: Xtreme Care and the C&A Family Rehab Center, both in Cape Coral, Fla. The president of Xtreme Care, Dr. Stephen M. Lovell, was one of the 12 apprehended.

One might assume that these undeserved profits were fueling lavish lifestyles. However, as authorities explained at a multi-agency press conference on Thursday, purchases made by the accused were surprisingly mundane.

“The expenditures were going all the way from purchases at McDonald’s to cruises,” said Josh Silko, the Cape Coral police detective who headed the investigation. “They weren’t living lavish lifestyles, purchasing houses or real expensive cars, but it was evident that they were profiting from this to live their everyday lives.”

Charges against the defendants range from health care fraud to money laundering, with possible sentences of 20 years for each charge. This substantial arrest underscores the vulnerabilities created by the state’s current PIP system. In light of the recent legislative session, there is hope that schemes such as “Operation Whiplash” will one day become the anomaly and not the norm.

 

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