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CFO Jimmy Patronis Announces Seven Arrests in $161,000 Miami PIP Fraud Scheme

4/15/2022
MIAMI – Today, Chief Financial Officer (CFO) Jimmy Patronis announced the arrest of seven individuals for their role in an alleged Personal Injury Protection (PIP) fraud scheme in Miami. The scheme was exposed during an undercover sting operation charging various therapists, runners, and staged accident patients with felony charges including Insurance Fraud, Grand Theft, Patient Brokering, and Organized Scheme to Defraud.
 
CFO Jimmy Patronis said, “Auto insurance fraud is a serious crime that raises insurance rates for every Floridian. This staged auto accident scheme is a perfect example of scam artists working to defraud the system for personal gain. Unfortunately, these costs are then passed on to hard-working Floridians in the form of higher premiums. I applaud my dedicated fraud detectives for their diligence over several months to crack this case and bring this PIP fraud crime ring down. Also, thank you to State Attorney Katherine Fernandez Rundle for prosecuting this case. When you work to game the system in Florida, you will be caught, and you will pay the price.”
 
CFO Patronis’ Division of Investigative & Forensic Services (DIFS), Bureau of Insurance Fraud conducted an undercover operation over the span of several months in late 2021 by utilizing an informant posing as a motor vehicle accident victim. The investigation revealed that physical therapy clinics would allegedly pay runners and organizers to find and recruit people to pose as vehicle accident victims. One of the organizers allegedly used Instagram to recruit people into the scheme and then set up the date, time, and location where the fake accident would occur. These accident victims were then taken to the physical therapy clinics where they were paid anywhere from $1,000 to $2,000 to register as patients. At these clinics, the individuals were instructed by therapist to complain of fabricated injuries resulting from the vehicle accident. In this investigation, these clinics submitted fraudulent billing to Kemper Insurance, United Auto, and Star Casualty for a total of more than $161,000.
 
The Miami physical therapy clinics involved were Life Medical Rehab, Premier Wellness, Red Diamond, Holistic Medical, and Evolution Med. Those arrested for their part in the PIP fraud scheme include William Malagon (Therapist), Gilbert Espinosa (Therapist), Kevin Pinilla (Runner), Miguel Divasto (Runner), Jose Montesino (Participant in Stage Accident), Michel Cribeiro (Participant in Stage Accident), and Alex Delgado (Participant in Stage Accident). Additional arrests are expected.
 
All invidivuals were booked into Turner Guilford Knight Correctional Center on charges ranging from Organized Scheme to Defraud, Patient Brokering, Staged Accident, Insurance Fraud, and Grand Theft. This case is being prosecuted by Miami-Dade State Attorney Katherine Rundle’s Office.