Clinic Owner, Manager Charged

A Miami clinic owner and his office manager were arrested after allegedly recruiting two undercover Department of Insurance investigators into a scheme to file fraudulent auto accident insurance claims, according to Florida Insurance Commissioner Tom Gallagher. Flagler PolyClinic owner Ercides Iglesias and his office manager Debora Garcia were arrested Jan. 17. Iglesias was charged with three counts each of insurance fraud and third-degree grand theft, and one count each of patient brokering and organized scheme to defraud. Garcia faces identical charges. The investigation is ongoing and more arrests are expected. If convicted on all charges, Iglesias and Garcia face up to 40 years in prison, and fines of up to $5,000 per charge. An informant contacted the insurance department in July 2001, saying he had been solicited to participate in the billing scheme after an auto accident. By September, he and the two undercover investigators had been recruited and were allegedly being offered kickbacks for referring other accident victims to the clinic. Reportedly the three were given no medical treatment beyond physical exams and X-rays, but claims of more than $11,500 were billed to the personal injury protection (PIP) portions of their auto insurance plans. During secretly recorded meetings, Iglesias and Garcia allegedly explained that compensation would be based on a percentage of the amount billed out to the insurance carriers, and Garcia allegedly detailed the types of injuries she would describe on the treatment forms. In all, the investigators and informant signed almost 100 fraudulent medical treatment logs for services never rendered. The insurance company used by the investigators, Onyx Insurance Group, has been billed for more than $3,500. The informant’s insurer, Amstar Insurance, has been billed for more than $8,000. The informant was paid $500 for bringing the investigators into the scheme, and for allowing his insurer to be billed.