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Volume 6, No. 5 - May 2017

News You Can Use

- Updating you on what's going on

 

CFO ATWATER: INSURANCE EXPERTS ONLY ONE CALL AWAY
~For free insurance assistance, Floridians can call 1-877-693-5236~

Ahead of the June 1 start to the 2017 Atlantic Hurricane Season, Chief Financial Officer Jeff Atwater reminds Floridians to write down the State of Florida’s toll-free insurance helpline number (1-877-693-5236). Operated by the Department of Financial Services, the helpline connects Floridians directly to insurance experts who can help them file an insurance claim, better understand their policy, and settle setbacks that can arise during the claims-filing process.

“Getting back on your feet following a storm can be a stressful state of affairs, but I hope that having free and ready access to insurance expertise can help the recovery process run more efficiently for Florida families,” said CFO Atwater. “All Floridians should keep the helpline phone number on their emergency contact list and inside their family’s hurricane kit.”

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14 Arrested in Miami Following Assisted Living Facility Fraud Scheme

Chief Financial Officer Jeff Atwater announced 14 arrests following a year-long investigation led by insurance fraud investigators with the Department of Financial Services. Investigators uncovered an alleged fraud scheme in which an assisted living facility (ALF) in Miami intentionally misrepresented its business activities in an attempt to obtain an inadequate but cheaper insurance policy. When an insurance policy is knowingly secured under false pretenses, the insurance carrier oftentimes reserves the right to deny claims for loss or injury.

Citizens Property Insurance Corporation (Citizens), the company’s insurance carrier, first discovered the fraud following the filing of a claim for a broken pipe in 2014. During the processing of the claim, Citizens suspected that the ALF had intentionally misrepresented its business activities in an attempt to secure a cheaper, residential insurance policy rather than the required commercial policy. Citizens referred their findings to the Department’s Division of Investigative and Forensic Services.

The case ultimately initiated a larger series of investigations that took place between June 2016 and May 2017 which identified a trend of misrepresentation taking place within the ALF industry. The Department, with support from Citizens and the National Insurance Crime Bureau, identified a total of 14 ALF operators in Miami-Dade County who allegedly defrauded their insurance carrier.

Those arrested include:

• Jose Perez - Living Well, 21280 Old Cutler Rd. Miami, Fla. 33189 FL. 33032
• Aida Salguiro - Amor Y Esperanza Home Care, 3224 West 14 Avenue, Hialeah Fla. 33012
• Gilberto Peralta - Angel's Home, 7935 SW 146th CT Miami, Fla. 33183
• Thelma Waite-Blake - B & B Home Care Service, 20625 SW 114th Place Miami, Fla. 33189
• Idalberto Brito - Brito Home Corp., 7361 Pine Valley Dr. Miami, Fla. 33015
• Odalys Amaro & Eduardo Rodriguez - Loving Hands ALF, 2291 SW 100 Ave., Miami, Fla. 33165
• Anna Kaplan - Flamingo Care LLC, 1270 NE 174Th St, N Miami Beach, Fla. 33162
• Teresita Leon - Teresita Home Care, Inc., 4840 SW 89Th PL, Miami, Fla. 33165
• Guillermo Jesus Mendez - La Casita Nuestra Home II, 14909 SW 22nd Street, Miami, Fla. 33185
• Barbara Plaza - Cornell ALF, 581-583 Central Blvd, Miami, Fla. 33144
• Jorge Pulido - La Casita Nuestra Home II, 14909 SW 22nd Street, Miami, Fla. 33185
• Leonel Burmudez - Bermudez Senior Care, 5301 SW 162 Place, Miami, Fla. 33185

Additionally, investigators arrested an insurance agent, Alina Fernandez, after she was found to have forged another insurance agent’s name on two fraudulent ALF insurance applications for Jorge Pulido. She was also found to have been acting without the proper license.

Fernandez was transported to Turner Guilford Knight Correctional Facility and was charged with acting as an unlicensed agent, ID fraud, and organized fraud. The Department’s Division of Agent and Agency Services' Bureau of Investigation has revoked her license and banned her from working in the insurance industry.

The remaining 13 subjects arrested were transported to Turner Guilford Knight Correctional Facility and have been charged with one count of application fraud, a third-degree felony. These cases will be prosecuted by the Miami Dade State Attorney’s Office and if convicted, those arrested face up to 5 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.

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Insurance Commissioner Altmaier’s Message to Floridians:
Prepare Now for the 2017 Hurricane Season

Florida Insurance Commissioner David Altmaier has an important message for Floridians ahead of the hurricane season beginning on June 1.

“Florida’s unique risk to tropical weather, especially during the hurricane season, means all Floridians need a disaster plan,” said Altmaier. “The time to evaluate your insurance coverage, fortify your home and prepare for how to protect yourself and your family is now.”

Altmaier is also advising Floridians to take advantage of numerous hurricane preparedness resources available to them on the Office of Insurance Regulation’s (Office) website and offers the following additional tips:

  • Review your insurance policy with your insurance agent or insurance company to make sure the coverage is adequate to your individual needs. The “Declarations Page” of your policy will summarize the coverage you have purchased.
  • Understand the differences between your insurance policy’s coverages and deductibles.
  • Strengthen your home’s defenses against a storm through simple mitigation techniques, such as replacing worn weather stripping under doors and removing tree limbs that may fall on your home or become flying projectiles.
  • Inventory your valuables and possessions using a home inventory checklist, which is available as a form you can download and print. If you prefer to use a smartphone, there is a link to a free app created by the National Association of Insurance Commissioners, which allows you to take pictures and add descriptions of your belongings.
  • Know the phone number and contact information for your insurance agent and insurance company. Make sure to have easy access to it if you must evacuate your home.
  • Most importantly, have a plan for what you will do if a storm system is expected to impact where you live. Do not wait to evacuate if it becomes necessary.

For more information, visit the Office’s “Hurricane Season Resources” webpage at: http://www.floir.com/Office/HurricaneSeason/hurricaneresourcepage.aspx.

Click here to read the press release>>

CFO Atwater’s Insurance Consumer Helpline Recovers $8 Million for Floridians in First Quarter of 2017

Florida’s Chief Financial Officer Jeff Atwater announced that assistance provided to Floridians by insurance specialists working Florida’s insurance consumer helpline led to the recovery of nearly $8.1 million in the first quarter of 2017. Recoveries included insurance claim payments and premium refunds that consumers sought the Department of Financial Services’ help collecting.

The helpline assists Floridians with financial and insurance-related matters including disaster preparation and insurance fraud as well as questions and complaints regarding auto, home, health, life, and small business insurance. Between January 1, 2017 and March 31, 2017, the helpline’s insurance specialists answered 70,634 calls and opened nearly 5,000 assistance requests. More than $8.1 million was recovered on behalf of 866 consumers.

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CFO and State Fire Marshal Jeff Atwater Talks Fire Safety Basics During Arson Awareness Week

Florida’s Chief Financial Officer, who also serves as Florida’s State Fire Marshal, recognized May 7-13 as Arson Awareness Week by reminding Floridians to practice basic fire safety.

“Lives are put needlessly at risk, homes are destroyed and acres of land are ruined by this senseless, preventable crime,” said CFO Atwater. “As wildfires have ravaged parts of Florida, some started by human intervention, now is the time to focus on this costly, detrimental crime and how we can all do more to stop it".

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CFO Atwater’s Fraud-Fighting Efforts Successful in First Quarter of 2017

Florida’s Chief Financial Officer Jeff Atwater announced that fraud-fighting efforts led by the Department of Financial Services took 322 law-breaking fraudsters off the streets during the first quarter of 2017. The Department’s anti-fraud efforts focus on the areas of public assistance and insurance fraud, arson, and the theft or abuse of state funds.

“Fraud of any form drives up costs for all Floridians, and I’m proud of the work we’ve done to hold the line on fraud in our state,” said CFO Atwater. “Our efforts are amplified by the partnerships we’ve forged with local law enforcement agencies, and I hope these results send a shockwave to other would-be criminals that they should think twice before committing a crime.”

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Office Update on Florida Blue’s Payment Processing Issue

The Florida Office of Insurance Regulation (Office) is aware that many Florida Blue customers experienced multiple fund withdrawals from their bank accounts to pay for what should have been a one-time scheduled payment of their May health insurance policy premium. Florida Blue advised this was a processing error by the company’s third-party vendor.

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