The Department of Financial Services Division of Insurance Fraud has announced the arrests of a number of individuals who allegedly participated in various schemes to defraud insurers. Several of the schemes involved illegally submitted claims for auto body damages and medical services under the state's personal injury protection law. Two of those arrested included individuals who organized over 70 phony vehicle accidents dating back to 2003.
Fraud investigators arrested Jesus Joel Trujillo, and his mother Elda Castro, for allegedly sending fraudulent claims to at least six different insurance companies. Trujillo and Castro set up fictitious auto body shops with corresponding bank accounts to make it appear they were conducting legitimate businesses. One scheme involved faking auto accidents in order to collect monies to repair the cars from the insurance companies. Trujillo and Castro obtained several automobiles and then damaged them so that they appeared to be involved in an accident. The ownerships of the vehicles then were transferred to other individuals that likewise filed claims with insurance companies for crashes that never occurred.
In another scheme, Trujillo and his associates would locate certain vehicles that had been involved in an accident. He would then use the unsuspecting owner's name and vehicle information to file a claim with an insurance company. A participant in the scheme would then pose as the driver for purposes of contacting the carrier. State investigators, along with the insurers' special investigations units, determined that some damaged vehicles were repeatedly used to file claims. All told, carriers paid out $32,000 in fraudulent claims.
Trujillo and Castro have been charged with nine counts of grant theft and one count of organized fraud. The Miami-Dade County State Attorney's Office is prosecuting the case and the two each face up to 60 years in prison if convicted on all charges.
In addition to Trujillo and Castro, fraud investigators made the following arrests:
Investigators arrested Milagros Pedraza and Susan Estevez for participating in a staged accident that resulted in an insurer paying out more than $11,000 in fraudulent PIP medical claims through the Havana Treatment Center. The two individuals face a minimum mandatory sentence of two years in prison if convicted.
Amalia Soto has been charged with insurance fraud and grand theft for allegedly altering a property claim stemming from Hurricane Wilma. Before submitting a claim to First Community Insurance Company for a replacement air conditioning unit, Soto changed the amount from $2,200 to $3,290. If convicted of the charges, she could face up to five years in prison.
Two medical providers have been arrested for their role in submitting false claims in conjunction with a staged accident ring. Rogelio Alonso and Marcia Alonso were charged with insurance fraud and grand theft. Alonso, owner of the Gables Medical Center submitted false bills totaling over $8,000 for allegedly treating two "accident" victims. If convicted, the two could face 10 years each in prison.
Eran Oliva-Sotomayor, a therapist at T&A Diagnostic Center, and Larry Yanez, are the latest arrested in an undercover sting operation dubbed "Operation TGIF." The operation has identified 10 staged accidents between December 2006 and April 2007, which resulted in carriers paying out some $328,000 in fraudulent claims.
Chief Financial Officer Alex Sink noted that although the state's no-fault PIP law is set to expire October 1, fraud investigators will continue to pursue PIP fraud cases until the statute of limitations runs out after five years. "Floridians should continue sending in tips and referrals so we can hold individuals responsible for this costly crime," she said.
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