Locklear allegedly allowed Dugazon, who

does not hold any medical license in Florida, to provide physical therapy

treatment and massage therapy to seven different patients.

Volume 4 - Issue 9 March 2014

The Division of Insurance Fraud arrested Orlando chiropractor Victor Ross Locklear, 46, and his unlicensed assistant, Elone Dugazon, 30, in February 2014.

Locklear and Dugazon were arrested for nearly $70,000 in fraudulent claims filed against three insurance carriers, Allstate, Esurance and Geico.

The scheme operated between December 2012 and March 2013 in a clinic purportedly owned by Locklear, West Colonial Rehab Center. Locklear allegedly allowed Dugazon, who does not hold any medical license in Florida, to provide physical therapy treatment and massage therapy on seven different patients. The bills submitted to the patients insurance companies contained false, misleading and inaccurate information as to who actually rendered the patient’s medical treatment.

Charges filed against Locklear and Dugazon included organized scheme to defraud, insurance fraud, grand theft, permitting an unlicensed person to practice massage and unlicensed practice of a health care profession.

The bills submitted to the patients insurance companies contained false, misleading and inaccurate information as to who actually rendered the patient’s medical treatment.

Locklear, who has been licensed in Florida as a chiropractor since 2010, incorporated West Colonial Rehab Center in February 2012. Locklear was the sole officer.

In an unrelated case, Junel Nicolas, 30, was arrested by Orlando DIF detectives for patient brokering and insurance fraud. Nicolas was involved in an auto accident on June 23, 2012, and solicited the persons in the other vehicle, who were not injured, to go to a clinic for treatment, resulting in more than $18,000 in payments for unnecessary treatment. Nicolas also allegedly inflated the amount of damage to his own vehicle, and collected over $4,000 to which he was not entitled.

INSIDE THIS ISSUE

1 Orlando Arrests

2 PIP Fraud News

3 Statewide Arrests

6 Statewide Contacts

HEADER HERE DIF Arrests Orlando Chiropractor and Unlicensed Therapist in Scheme to Defraud

Page 2 March 2014

Rafael Delgado Promoted to Captain of DIF’s South Central Region The Division of Insurance Fraud (DIF) announced the promotion of Rafael Delgado to Captain for their South Central Region, which includes four squads; two in Broward and one each in Miami and West Palm Beach. Delgado is a career law enforcement veteran with over 30 years of experience. Prior to joining DIF, he served 21 years with the New York City Police Department, including stints in Uniformed Patrol, Organized Crime Control Bureau, Detective Bureau and an FBI Task Force. Delgado retired in 2002 as a Sergeant. Delgado began his career with DIF in 2005 as a detective in Miami. In March 2012, he was promoted to lieutenant of the Miami workers compensation squad, and then transferred to supervise one of the Miami PIP squads in September 2012. We congratulate Captain Delgado on his promotion.

Florida’s No-Fault Reform: Trending in the Right Direction The National Insurance Crime Bureau (NICB) has released a new report revealing a decline in Florida's personal injury protection (PIP) questionable claims (QCs). In 2013, Florida PIP QCs declined by 7.6 percent from 2012. Meanwhile, for the period 2010 through 2013, Florida staged accident QCs decreased by 61.82 percent.

Tighter legislation, enhanced public awareness and a coordinated law enforcement response appear to be having the intended effect on PIP fraud in Florida. "We are encouraged by the decline in questionable claims that we've seen recently, but by no means are we declaring victory in Florida," said NICB President and CEO Joe Wehrle. "Florida remains a hotbed for fraudulent activity and we can't afford to ease up for a moment in our fight against those who would abuse the system and burden Florida consumers."

See the full article at http://www.prnewswire.com/news-releases/floridas-no-fault-reform-trending-in-the-right-direction-252609681.html.

Insurers Cheer Lower PIP Claims, Cite 2012 Law Insurance industry trade groups Friday lauded a report released this week by the National Insurance Crime Bureau showing questionable personal injury protection (PIP) claims stemming from auto accidents fell by 7.7 percent last year, and claimed a 2012 state law was largely responsible.

The NCIB report states that questionable PIP claims - which are referred for exaggerated injuries, overbilling, billing for treatments not given and other reasons - fell last year after rising by 22 percent in 2011 and 2012.

See the full article by Gray Rohrer at http://www.thefloridacurrent.com/article.cfm?id=37018299.

Judge Says Orlando Chiropractors Must Face RICO Charges U.S. District Judge Charlene Edwards Honeywell ruled that chiropractors who allegedly perpetrated a $2.3 million insurance scam must face RICO charges in a federal court.

Geico Insurance Company filed a lawsuit against Orlando clinics KJ Chiropractic Center LLC, and Wellness Pain & Rehab Inc., its two founders and a slew of individuals, called "runners," who acted to advance an alleged scam based on fake accidents and injuries to willing third-party participants, resulting in more than $2.3 million in unwarranted insurance benefits. Geico alleges that the fraudulent PIP (personal injury protection) claims arose out of: (1) staged accidents; (2) real accidents wherein claimants received treatment at clinics even though they were not truly injured; or (3) real accidents wherein claimants incurred some injuries, but received treatment at the clinics that was pre-programmed, unnecessary, excessive and unlawful.

See the full article by Philip A. Janquart at http://www.courthousenews.com/2014/03/17/66221.htm.

Data Proves Florida PIP Legislation is Working to Protect Consumers The Property Casualty Insurers Association of America issued a news release in response to the NICB report showing a decrease in PIP fraud in Florida. Donovan Brown, PCI counsel, stated "We now have further evidence that illustrates the PIP reforms enacted in 2012 to drive down unchecked fraud and abuse and protect the hardworking citizens in Florida are working. Stakeholders took bold steps to transform Florida's auto insurance system and enact reforms intended to stop criminals and protect Floridians from the damage and rate shock caused by those focused on lining their pockets at the expense of consumers. See the full release at http://insurancenewsnet.com/oarticle/2014/03/29/data-proves-florida-pip-legislation-is-working-to-protect-consumers-a-481812.html#.UzloMtfD_IU.

PIP FRAUD – In The News

Page 3 The PIP Source

Statewide PIP Arrests – February 2014

Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.

Luis Daniel Ferrer Figueroa, 23 – jump-in staged acct 06/08/12 (passenger) - One Touch Therapy Center (Geico) J

Anel Joseph, 37 – staged acct 05/03/12 - Hollywood Pain & Rehab (State Farm) B

Juvenal Castro Duque, 45 – staged acct 03/04/12 (recruiter) $59,673 - Cyma Massage and Therapy Group / RCR Rehabiltation Center (Geico / Imperial Fire / State Farm) M

Luis Ferrera, 54 – staged acct 07/06/11 (driver) $57,513 – EPM Therapeutic Center / Fast Rehabilitation Center (State Farm / United Auto) M

Miralis Talavera Velazquez, 42 – staged acct 07/06/11 (passenger) $57,513 – EPM Therapeutic Center / Fast Rehabilitation Center (State Farm / United Auto) M

Alina Rosa Reyes, 42 – clinic owner / patient brokering - Sunshine Rehabilitation Medical Center (Nationwide / Victoria Select) T

Dominique Danielle Croley, 27 – jump-in 06/12/13 - $8,350 (Geico) P

Jermaine Samuel Richardson, 31 – fraudulent claim (Geico) P

Alfredo Silva Marrero, 47 – staged acct 02/20/10 (driver) $49,287 (National Indemnity / Progressive) M

Raul Padilla-Ones, 45 – clinic owner / insurance fraud - $47,941 - AB Diagnostic Center / Francos Medical Center / YH Imaging (Gainsco / State Farm) M

Leesandra Abascal-Ramos, 24 – clinic employee / insurance fraud - $10,271 - CMD Medical Center (State Farm) B

Delvis Gonzalez, 31 – clinic owner / insurance fraud - $309,247 – Clarke Medical Services / Magic Hands Medical Services / New Life Rehab Services (Allstate / Geico / Imperial Fire / Kingsway Amigo / State Farm / United Auto) M

Osvaldo Martinez Casanas, 30 – staged acct 10/17/09 (driver) $31,600 (Progressive / Rental Insurance Services) M

Carlos R Leon Lam, 44 – massage therapist - $15,107 - M & N Rehabilitation Center (United Auto) M

Carlos R Leon Lam, 44 – massage therapist - $13,901 - M & N Rehabilitation Center (Geico) M

Carlos R Leon Lam, 44 – massage therapist - $33,616 - M & N Rehabilitation Center (Imperial Fire) M

Noel Sarduy Cardenas, 33 – patient brokering – Alternative Medical Clinic / Magic Therapy Rehabilitation Corp (Allied / Titan) T

Angela Rose Bajorek, 34 – sale of fake ins card (Occidental Fire & Casualty) O

Junel Nicolas, 30 – organized scheme to defraud / patient brokering - $33,987 - (Geico / Progressive / State Farm) O

Corey James Glenn, 33 – fake ins card (Geico) T

Gabino Garcia, Jr, 27 – fake ins card (Ocean Harbor) W

Aaron James Newton, 28 – application fraud (Geico) T

Annique Vivienne Newton, 35 – application fraud (Geico) T

Jeremy Aaron Glazier, 34 – application fraud (Kemper Specialty) T

Jeral William Dietlin, 29 – statement in support of jump-in 05/06/12 - $7,142 - (Allstate) O

Rachel Lynn Brazee, 25 – jump-in 06/21/13 - $5,333 – Access Rehab & Rejuvenation Clinic (Nationwide / State Farm) O

Nejah Elai Prince, 28 – paper accident 10/26/10 (recruiter) $37,587 - Personal Medical Center - (Farmers) T

Jose F Banos, 31 – staged acct 10/17/09 (driver) $31,600 (Progressive / Rental Insurance Services) M

Jorge Enrique Lemus, 24 – staged acct 03/12/12 (recruiter) $61,729 - All Future Medical Center / Benefica Health Center (United Auto) M

Josius Joseph, 52 – application fraud (GMAC) O

Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)

Page 4 March 2014

Statewide PIP Arrests – February 2014

Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.

Justin D Fletcher, 25 – statement in support of jump-in 06/21/13 - $5,333 – Access Rehab & Rejuvenation Clinic (Nationwide / State Farm) O

David Michael Perhats, 44 – false claim (Liberty Mutual) T

Audley Saunders, 45 – fake ins card (Ocean Harbor) M

Jose Alberto Velez, 30 – staged acct 05/12/12 (recruiter) $19,845 - Gate Parkway Diagnostic Center / Health Point Injury Center (Direct General / State Farm / Windhaven) J

Naderge Pierre, 35 – staged acct 04/03/11 (passenger) $53,752 – Blessings Rehab Center (Geico) O

Annie Franchan Howard, 32 – staged acct 02/05/13 (driver) $26,237 - Health & Rehab Services of South Florida / MRI Express Corp (Gainsco / RepWest) M

Wilian Martinez, 46 – lost wages - $2,033 - (Progressive) T

Roniel Fertil, 43 – staged acct 04/03/11 (passenger) $53,752 – Blessings Rehab Center (Geico) O

Jarris Anthony Andrews, 32 – false claim - $6,564 (Allstate) J

Darius Alexander White, 25 – staged acct 09/02/10 (passenger) $10,810 - Austin Health Center, LLC (USAA) T

Devon Aaron Mitchell Parnell, 22 – staged acct 04/03/11 (passenger) $53,752 – Blessings Rehab Center (Geico) O

Salvador Paulo Basmadji, 45 – staged acct 09/18/12 (vehicle owner) $32,738 - D & J Rehabilitation Center / Health and Wellness Services / Med Rehab of Florida / YH Imaging (Esurance / Geico) M

Jose Marin, 36 – staged acct 07/15/11 (passenger) $16,760 – Noba Rehabilitation Center / Rivero Diagnostic Center / Robert Hochfelder (Geico) M

Carlos M Toledo, 38 – staged acct 09/18/12 (passenger) $32,738 - D & J Rehabilitation Center / Health and Wellness Services / Med Rehab of Florida / YH Imaging (Esurance / Geico) M

Stevens Toledo, 41 – staged acct 09/18/12 (driver / recruiter) $32,738 - D & J Rehabilitation Center / Health and Wellness Services / Med Rehab of Florida / YH Imaging (Esurance / Geico) M

Kadeem Jae Fian Tyson, 23 – staged acct 09/28/10 (driver) $16,820 - Austin Health Center, LLC (USAA) T

Bobby Dave Worthen, Jr, 38 – jump-in 10/14/13 (Esurance) J

Brandi Michelle Zeigler, 29 – massage therapist - $3,793 - Columbus Rehabilitation Center (Geico) T

Brandi Michelle Zeigler, 29 – massage therapist - $1,294 - Columbus Rehabilitation Center (Geico) T

Brandi Michelle Zeigler, 29 – massage therapist - $1,513 - Columbus Rehabilitation Center (Safeco) T

Lucienda Romulus, 20 – staged acct 11/13/12 (passenger) $10,875 - Chiropractic Rehab & Wellness Center / Eugene Lusigarten, DC () W

Brandi Michelle Zeigler, 29 – massage therapist - $4,894 - Columbus Rehabilitation Center (Geico) T

Albert Lubin, 45 – solicitation (Geico) B

Eduardo Gonzalez, 24 – staged acct 06/14/12 (jump-in passenger) $55,599 - B & A Diagnostic / Doctors Professional Medical Group / Flores Chiropractic Group / Gentle Care Rehab Services / Gonzalez Medical Center / Psychologist Technology / Y & J Chiropractic Center (Geico / State Farm) M

Alexis Arcas, 59 – staged acct 12/08/11 (driver) $43,089 - Palmetto Therapy Center / Westchester Therapy (State Farm / United Auto) M

Victor R Locklear, 46 – chiropractor / organized scheme to defraud / insurance fraud / unlicensed activity - $8,120 - West Colonial Rehab Center (Geico) O

Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)

Page 5 The PIP Source

Statewide PIP Arrests – February 2014

Each issue will provide a list of PIP arrests made by the offices throughout the State. Along with each defendant’s name and age, we will include: the type of scheme involved; the fraud dollar amount; clinic name(s); victim insurance company name(s); and the arresting office. If you need additional details on any of these arrests, please contact Capt. Smith.

Victor R Locklear, 46 – chiropractor / organized scheme to defraud / insurance fraud / unlicensed activity - $33,729 - West Colonial Rehab Center (Esurance) O

Dianna Lashanda Rose, 38 – massage therapist / organized scheme to defraud / insurance fraud – $18,684 - KJ Chiropractic Clinic (Geico) O

Michael Andrew Walker, 52 – staged acct 04/03/11 (recruiter) $53,752 – Blessings Rehab Center (Geico) O

Victor R Locklear, 46 – chiropractor / organized scheme to defraud / insurance fraud / unlicensed activity - $28,144 - West Colonial Rehab Center (Allstate) O

Elone Dugazon, 30 – unlicensed therapist / organized scheme to defraud - $8,120 - West Colonial Rehab Center (Geico) O

Elone Dugazon, 30 – unlicensed therapist / organized scheme to defraud - $33,729 - West Colonial Rehab Center (Esurance) O

Elone Dugazon, 30 – unlicensed therapist / organized scheme to defraud - $28,144 - West Colonial Rehab Center (Allstate) O

Code – B (Broward) F (Ft Myers) J (Jacksonville) M (Miami) O (Orlando) P (Pensacola) TL (Tallahassee) T (Tampa/St Pete) W (West Palm Beach)

Ft. Myers Chiropractor Convicted in Patient Brokering Case

Chiropractor David Greydinger, 42, was convicted in March 2014 and sentenced to 18 months probation. Greydinger was arrested by the Division of Insurance Fraud (DIF) in May 2013 for insurance fraud and patient brokering.

Greydinger paid an undercover patient $800 to treat at his clinic, DISA Med dba MYO Health Clinic, located in Ft Myers.

Greydinger billed Nationwide Insurance $7,785 and was paid $5,939.48.

Greydinger has been licensed in the state of Florida as a chiropractor since 2005, and he opened DISA Med that same year.

NICB and Florida Authorities Work to Stop PIP Clinics and Staged Accidents

The National Insurance Crime Bureau has released a new report revealing a decline in Florida's personal injury protection (PIP) questionable claims.

Click here to see the full NICB press release, with a link to their report: https://www.nicb.org/newsroom/news-releases/bd499bd9-38e2-465f-a3b4-0f612ba6aa0f.

They also posted a video report that shows how NICB worked with the Division of Insurance Fraud (DIF) in Jacksonville to stop the influx of PIP clinics and staged accidents in that area.

Click this link to watch the video report: https://www.youtube.com/watch?v=U3WxZtyzT9k&feature=youtube_gdata.

Copy goes her. Editor’s Corner

On page 1, we cover the arrests of an Orlando chiropractor and his unlicensed therapist, and an unrelated arrest for patient brokering.

On page 2, we feature PIP Fraud in the News.

On page 5, we report on the conviction of a chiropractor in Ft Myers and a new report and video posted by NICB regarding PIP fraud in Florida.

As always, we report on the latest PIP-related arrests throughout the state.

Page 6 March 2014

PANHANDLE REGION Counties: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Lafayette, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, Washington

Pensacola Field Office - 850.453.7802 Capt. David LINDSAY Tallahassee Field Office - 850.413.3115 Lt. Ernie STOLL

NORTH REGION Counties: Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Levy, Marion, Nassau, Putnam, St. Johns, Sumter, Suwannee, Union

Jacksonville Field Office - 904.798.5802 Capt. Brian McCOY Lt. Kevin JONES

WEST CENTRAL REGION Counties: Charlotte, Collier, DeSoto, Glades, Hardee, Hendry, Hernando, Hillsborough, Lee, Manatee, Pasco, Pinellas, Polk, Sarasota

Tampa Field Office - 813.972.8602 Capt. Michael BYRNE Lt. Carlos ROSARIO Fort Myers Field Office - 239.278.7527 Lt. Mark FRITZ

EAST CENTRAL REGION Counties: Brevard, Lake, Orange, Osceola, Seminole, Volusia

Orlando Field Office - 407.835.4402 Capt. Glen HUGHES Lt. Laquanda GREEN Lt. John SAVINO

SOUTH CENTRAL REGION Counties: Broward, Highlands, Indian River, Martin, Okeechobee, Palm Beach, St. Lucie

Plantation Field Office - 954.958.5402 Capt. Rafael DELGADO Lt. Bill LEE West Palm Beach Field Office - 561.837.5601 Lt. Evangelina BROOKS

SOUTH REGION Counties: Dade, Monroe

Miami Field Office - 305.536.0302 Capt. Steven SMITH Lt. Violeta SERRANO Lt. Stanley JEAN-FELIX Lt. PENDING

South Florida Major Medical Fraud Task Force Supervisory Special Agent Fred Burkhardt 847.544.7141 Central Florida Major Medical Fraud Task Force Supervisory Special Agent Jose Olivier 813.558.6387

Statewide PIP Contacts