Miami Insurance Agent Arrested Over Assisted Living Facility Fraud Scheme

August 22, 2017

An investigation led by the Florida Department of Financial Services (DFS) Bureau of Insurance Fraud has led to the arrest of a Miami insurance agent for attempting to evade a higher insurance premium for his assisted living facility (ALF) client.

According to Chief Financial Officer Jimmy Patronis and DFS, an investigation found insurance agent Claudia Estevez aided Ariel Mora by helping him submit a fictitious insurance application, allowing Mora to fraudulently obtain a less expensive, inadequate insurance policy.

Investigators allege Mora completed a residential homeowners insurance application indicating the structure he was insuring was not being used for business or commercial purposes. Estevez authorized the application allowing Mora to purchase a home owner’s insurance policy instead of obtaining a commercial insurance policy for his ALF, as required by Florida law.

DFS’ said the investigation found Estevez knew the property was intended to be an ALF and was attempting to help Mora obtain a lower insurance premium. As a result of Estevez’s actions, Citizens Property Insurance lost $1,536 in underpaid premiums. In addition, any future claims against Mora’s ALF policy would have been denied due to inadequate insurance coverage.

Investigators arrested Estevez Aug. 9, 2017 and charged her with insurance fraud, grand theft and organized scheme to defraud. Estevez was transported to Turner Guilford Knight Correctional Center without incident and is being held with a $15,000 bond. If convicted, she could face up to 15 years in prison.

Investigators arrested Mora May 24, 2017 and charged him with insurance fraud and grand theft. Mora was transported to Turner Guilford Knight Correctional Center and is being held with a $10,000 bond.

These cases will be prosecuted by the Miami-Dade State Attorney’s Office. If convicted, he could face up to 10 years in prison.

ALF’s are long-term care residences that offer various services such as health and medicine management, transportation and meal services in an effort to support seniors and developmentally or physically disabled members of our local communities.

Source: Florida Department of Financial Services

Latest Comments

  • August 28, 2017 at 10:51 am
    Agent says:
    What carrier would write a HO on an Assisted Living Center? Inquiring minds want to know.
  • August 25, 2017 at 10:39 am
    Rocky Moore says:
    Ethics training is one of the most basic continuing education requirements. So she certainly would have had ethics training. The question is, did she understand that it was to... read more
  • August 22, 2017 at 3:50 pm
    Agent says:
    Hmm, did this agent pass a licensing exam or is he just a crook? Probably had no ethics training either.
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