Florida Makes 4 Arrests in $145K PIP Fraud Scheme

August 10, 2015

The Florida Department of Financial Services’ Division of Insurance Fraud (DIF) announced the arrest of four South Florida arrests of individuals on charges related to their involvement in three separate personal injury protection (PIP) fraud schemes that resulted in the billing of more than $145,000 in fraudulent insurance claims.

Nayef Casas Diaz, owner of Miami PIP clinic M&N Rehabilitation Center, was arrested after allegedly organizing a staged accident scheme. Diaz reportedly paid each participant in the staged vehicle accident $1,000 to receive treatment from M&N and another clinic, Magic Hands Medical Service, for phony injury claims. As a result, fraudulent claims in excess of $63,000 were filed against two insurance carriers.

In a separate undercover investigation led by DIF, Alexis A. Gonzalez, owner of Health Max Medical Center (HMMC) in Hialeah, and HMMC clinic employee Erick A. Perez were both arrested for their involvement in a PIP fraud scheme. Both are alleged to have directed an undercover DIF agent posing as a patient to sign documents for treatment that were not rendered. Gonzalez compensated the undercover personnel with $1,000 for participating in the scheme which produced claims in excess of $11,000.

Vicente Ortiz Alpizar was also arrested for his participation in a staged accident that resulted in more than $70,000 in fraudulent claims. Alpizar went to A&J Rehabilitation Center and D&J Rehabilitation Center, both located in Miami, to allegedly receive fraudulent and unnecessary treatments following the staged accidents. DIF has now made 15 arrests for five different staged accidents involving redundant rehabilitation services provided by the two clinics for profit. Included in those additional arrests were the clinic owner and a runner from A&J Rehabilitation and two employees from D&J Rehabilitation, including a massage therapist.

All four subjects were booked into Turner Guilford Knight Correctional Facility on charges of Insurance Fraud and Grand Theft. Gonzalez, Perez, and Diaz also received charges of organized scheme to defraud. These cases are being prosecuted by the office of Miami-Dade County State Attorney Katherine Fernandez Rundle where if convicted, they each could face up to 15-30 years in prison.

Source: Florida Department of Financial Services

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