Thursday, May 21, 2015

Accused fraudsters face charges after bilking insurance companies of millions

30 arrests after 'Operation Flames and Floods II' uncovers organized scheme to defraud insurance companies

From top left to right, Manuel Lopez, Maray Lopez, Nelson Fernandez, Barbara Diana Beer Rivero, Yaima Sanchez, Seth Horton, Marianela Hernandez, and Roberto Leon.
MIAMI-DADE COUNTY, FLORIDA
 
A homeowner in South Miami-Dade allowed men to walk into the bathroom of the master bedroom to loosen a pipe under a sink and let the water run. And to speed up the damage, the men also used a garden hose.

When water wasn't involved, flames were. In another incident, a man set a car on fire in a garage, police said. He watched the flames spread to the house. And they collected about $600,000, police said.Authorities said last year a group of fraudsters filed $7.6 million in false claims, after staging 13 fires and 5 floods.

On Wednesday, they announced there were 20 more fires and 5 more floods that lead to an extra $6.7 million in false claims and more arrests. Plus something terrible happened: A firefighter was injured, while working one of the fires, police said.
"Insurance fraud is not a victimless crime," said Tower Hill Insurance Group President Don Matz. "It impacts insurance policyholders around the state through increased rates that are required to recoup the funds stolen."

The organized scheme involved homeowners, recruiters, arsonists and a public adjuster, who filed the claims, authorities said. The recruiters looked for homeowners with different insurance companies to avoid leaving a trail. The deception took time, but eventually everyone involved got paid, police said.  

"If you are involved in this type of fraud, keep looking over your shoulder, because we are going to be there," said Miami-Dade State Attorney Katherine Fernandez Rundle said during a press conference Wednesday.

LIST OF CHARGES: 27 homeowners accused of insurance fraud 

Miami-Dade Police Department's Economic Crimes and Arson Investigation Division and Florida Fire Marshall's Office have been involved in the probes since 2012. The Sarasota, Lee, Collier and Highlands County Sheriffs’ Offices assisted with this week’s arrests, along with the Florida Fish and Wildlife Conservation Commission.

Charges keep piling up for public adjuster Jorge Fausto Espinosa, who owned Nationwide Adjusters. Authorities said Wednesday Espinosa's false claims actually totaled about $14.3 million. And as the leader of the ring, he was getting a cut of 20 to 35 percent, Fernandez Rundle said.

"Espinosa would be hired by policy holders to seriously damage the insured homes for one purpose only, to collect ill gotten gains from insurance companies," Fernandez Rundle said.

Espinosa trusted  Roberto Suarez Medina, who was accused of helping to set the scenes.

Espinosa was charged with arson resulting in injury, 18 counts of arson, 131 counts of grand theft, 27 counts of false and fraudulent insurance claims, organized crime to defraud, racketeering and racketeering conspiracy.
OPERATION FLAMES & FLOODS II
The agencies involved were the State Attorney's Office, Miami-Dade Police, Florida Fire Marshall and the Florida Department of Law Enforcement's division of insurance fraud.
- May 20, 2015 announcement
- Feb. 2, 2014 announcement
INSURANCE COMPANIES
Some of the insurance companies involved in the first operation include American Integrity, American Bankers, Citizens, Northern Capital, Northern Point, Gulf Stream Property & Casualty, Southern Oak, State Farm and Universal Property & Casualty.
Some of the insurance companies involved in the second operation include Tower Hill, Citizens, Federated National, GEICO, Bankers, Southern Fidelity, Mercury, State Farm, Florida Peninsula, Ascendant, United Property and Casualty, Ark Royal  and Southern Oak.
Suarez Medina was charged with arson, false and fraudulent insurance claims, organized crime to defraud, racketeering conspiracy and seven counts of grand theft.

"It is clear that this scheme was driven by greed, and unfortunately, it is the honest policyholders in our state who are left on the hook to cover the millions of dollars that were stolen,"said Florida Chief Financial Officer Jeff Atwater.
Espinosa also trusted the team that found him the willing list of homeowners. 
Erlis Chercoles, Argelio Menendez, Manuel Lopez and Nelson Fernandez were accused of working as recruiters.

Chercoles also helped to stage fires, police said. And Lopez and Menendez were among the  27 homeowners who were also involved, according to authorities.

"There are a lot of nervous people around town right now, wondering if their door is going to be knocked on," Atwater said.

Authorities were asking anyone with information of suspected insurance fraud to call 1-800-378-0445. Tipsters can get rewards of up to $25,000 for information that directly leads to an arrest and conviction in an insurance fraud scheme.