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Police Arrest 20 in Miami Insurance Fraud Scheme

Last week police in Miami made 20 arrests in connection with what they believe is a complex racket in personal injury insurance fraud. After roughly 9 months of following paper trails, tracking down suspects, and conducting surveillance, police had gathered enough evidence to make the arrests. Among those arrested were medical clinic owners, physicians, therapists and supposed accident victims. All 20 suspects have been accused of insurance fraud for allegedly staging fake car accidents in order to cash in on insurance money.

According to police officials t
he scam allegedly works as follows: Two people will intentionally crash their cars into each other just hard enough to cause some minor damage. Next, the two drivers call the police posing as legitimate accident victims. They are sure to create visible damage on the cars so that the police will write up a report. Then, the two alleged victims will go to medical clinics run by fraudulent owners who will write up false paperwork making it seem like the accident victims received treatment. The clinic owner then bills the insurance provider of the accident victims under their Personal Injury Protection (PIP) coverage for the services that were never actually rendered. Depending on the type of treatment this bill to the insurance company can be as high as $10,000.

Personal Injury Protection, or PIP is it most commonly referred to, is Florida’s required no-fault insurance coverage. It covers the insured for up to $10,000 of medical treatment after an accident regardless of whether he/she was at fault. Those in opposition to PIP claim that PIP fraud costs Florida up to $1 billion a year, a cost that is passed onto consumers in the form of higher insurance premiums. When estimates like that are tossed around it’s understandable that PIP is often referred to as fraud-plagued insurance. Still, it’s no guarantee that eliminating PIP altogether would lead to lower insurance premiums. One proposed solution is to replace PIP with mandatory bodily injury coverage but there is always the risk that many of the same frauds infecting PIP would simply migrate into bodily injury coverage.

Prevalent PIP fraud in Florida is certainly one of the factors that led to a 2012 amendment to the Florida PIP law. The amendment bans insurance providers from reimbursing accident victims for treatment at chiropractors, massage therapists and acupuncturists under PIP coverage. This ban had yet to go into effect due to a temporary injunction that declared this provision unconstitutional. That was until the First District Court of Appeal’s recent decision in McCarty v. Myers, which lifted the temporary injunction. The practical effect of the injunction being lifted is that now Florida motorists involved in an accident will not be able to seek treatment from chiropractors or massage therapists under their PIP coverage. Consequently, chiropractors and massage therapists will surely lose out on business from customers who cannot afford to pay for needed treatment out of pocket.

If you are a medical care provider having difficulty collecting PIP benefits from insurance companies or if you are a victim of a motor vehicle accident, don’t go at the insurance companies alone. At Sibley Dolman Gipe Accident Injury Lawyers, PA, we are experienced professionals who would love to help you with your claim. Call us today, at (727) 451-6900.