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State authorities target staged crashes in insurance fraud crackdown

After a truck struck her car in October, Floribel Figueroa Quiles submitted almost $50,000 in medical invoices to her insurance company for injuries she and her three children suffered.

The invoices purportedly came from TLC Medical Rehab LLC, where the driver of the truck in the Pinellas Park accident, Lazaro Hernandez Cabrales, had been working.

Authorities now say the personal injury protection insurance claim was a scam, another in a long line of staged crashes.

Over the past week, authorities arrested Cabrales at his Tampa home and Quiles in Osceola County and charged them with insurance fraud by staging an accident.

The arrests are the latest among about 201 for personal injury protection fraud so far this year by the insurance division of the state Department of Financial Services. That's up 55 percent from 130 arrests during the same period last year.

The department has been cracking down on insurance fraud since a growing problem with false claims in Florida came to light last year.

"It is always a great day when we are able to track down one of these fraudsters who, by their actions, cause each and every Floridian to pay more for auto insurance," said Jeff Atwater, the state's chief financial officer.

A new state law to combat insurance fraud that took effect July 1 means Cabrales and Quiles could face civil penalties in addition to criminal charges if convicted of auto insurance fraud or staging an accident.

Florida is second in the nation in questionable insurance claims after passing Texas last year, according to the National Insurance Crime Bureau. California is first.

Among Florida cities, Tampa ranks No. 1 in the state. The bureau's latest figures show Tampa reached 1,578 questionable claims by the end of 2010, more than 300 above Miami and almost twice as many as Orlando.

The practice of engaging in insurance fraud gained traction in South Florida, where illegal immigrants were told they could pay off the price of being smuggled into the country by faking injuries in staged crashes.

One of the biggest concerns is that criminals take advantage of the state's no-fault or PIP (personal injury protection) auto accident coverage. With that coverage, up to $10,000 per person becomes readily available to people who seek compensation once they go to a clinic for some type of treatment.

Frank G. Scafidi, a spokesman for the National Insurance Crime Bureau, said his organization is working to make recommendations for changes in Florida law to counter criminal manipulation of the no-fault or PIP auto accident coverage.

"It is a great system," Scafidi said. "It essentially was created for all the right reasons, but unfortunately it's been abused over the years."

Florida isn't alone in its problems with no-fault insurance, Scafidi said. "It's New York. It's Michigan. … It is the no-fault environment."

The National Insurance Crime Bureau is a nonprofit organization, supported by about 1,000 property/casualty insurance companies. The NICB partners with insurers and law enforcement to identify and stop insurance fraud.

In the recent arrests, Quiles, the woman who claimed she and her children suffered injuries, later admitted to her insurer, Assurance America, that the accident was staged, authorities said.

Investigators also concluded that the accident was staged.

"What the Division of Insurance Fraud typically sees in PIP fraud cases is participants getting together and discussing where and how they will stage the accident," said Alexis Lambert, a spokeswoman for the Atwater.

In Quiles' case, she and Cabrales devised the accident scheme after "someone she knew told her she could make money by staging an accident," Lambert said.

The state Department of Financial Services requests anyone with information about suspected insurance fraud to call toll-free 1-800-378-0445.

As part of its Anti-Fraud Reward Program, the department is offering rewards of up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme. To date, about 40 citizens received awards through the program, totaling $250,000.

Ivan Penn can be reached at ipenn@sptimes.com or (727) 892-2332. Follow him on Twitter at www.twitter.com/Consumers_Edge and find the Consumer's Edge on Facebook.

State authorities target staged crashes in insurance fraud crackdown 07/12/11 [Last modified: Wednesday, July 13, 2011 3:23pm]
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