Insights

Ten People Arrested in $42.7 M Insurance Fraud Scheme

February 8, 2019

Florida Department of Financial Services detectives arrested ten people for using 15 fake clinics to submit 23,000 fraudulent claims totaling $42.7 million. They used fake clinics as drop boxes for insurance payments. Four...

Drone and Aerial Imagery Key in the Wake of 2018 Natural Disasters

January 31, 2019

According to the Insurance Journal, drones and aerial imagery have become very important to the insurance industry as a result of natural catastrophes, particularly in the southeast region of the U.S. Drones allowed insurers...

Physical Assistant Pleaded Guilty for Role in $1B Medicare Fraud Scheme

January 17, 2019

Arnaldo Carmouze, a former physician assistant, is facing up to 10 years in prison time for his role in a Medicare fraud scheme. Carmouze was one of three defendants who pleaded guilty to conspiracy to commit healthcare fraud...

Kendall Man Arrested for Bogus Boat Accident Insurance Claim

January 9, 2019

Florida Department of Financial Services Bureau of Insurance Fraud investigators arrested Jose Alberto Vargas for allegedly attempting to defraud Boat U.S. out of $14,000. Vargas filed a false claim for a grounded 1993 Mako...

Two Arrested in Patient-Brokering and Insurance Fraud Scheme

January 3, 2019

Licensed pharmacist Richard Vallette and a “middleman” Todd Mulvaney were arrested in patient-brokering and insurance fraud scheme. Vallette and Mulvaney conspired to split thousands of dollars in insurance reimbursements...

Miami Home Health Care Worker Sentenced in Health Care Fraud Scam

December 20, 2018

Margarita Palomino of Homestead, Florida pleaded guilty to conspiracy to commit health care fraud and wire fraud. Palomino who worked for three home health agencies where she allegedly accepted kickbacks for the referral of...

Judge Unfreezes Personal Assets for Defendant in Health Insurance Scheme

December 16, 2018

Federal Judge Darrin B. Gayles ruled that Steven J. Dorfman, CEO of Simple Health Plans LLC and accused architect of a massive health insurance scheme, can have $75,000 for legal fees and $5,000 a month from his frozen...

Brothers Sentenced In Smart Labs Healthcare Fraud Scheme

December 5, 2018

H. Hamilton Wayne (CEO) and Justin Wayne (COO) of Smart Labs of Palm Beach have been sentenced to prison for healthcare fraud charges they pleaded guilty to back in August. They were also ordered to pay more than $9.6 million...

Duval County Public Schools Principal Arrested for Insurance Fraud

November 28, 2018

Florida CFO Jimmy Patronis announced the arrest of Darrell Perry, a Jacksonville elementary school principal for allegedly trying to submit altered insurance claims and false invoices for over $16,000 in the wake of Hurricane...

Crooked Opioid Treatment Center Owner Arrested for Insurance Fraud

November 16, 2018

James Durkin, owner of a Boynton Beach opioid treatment facility The Hope Center of Recovery, has been arrested for insurance fraud. Durkin was charged for allegedly submitting fraudulent insurance billing for over $104,000....