Florida Authorities Battle Lucrative Crime Rings: Insurance Fraud Scams

PHOTO: For months, authorities in Florida have been unraveling what they believe is a complex racket in personal injury insurance fraud.ABC News
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It was 5:30 in the morning in Miami, and agents and police officers were fanned out across the city. In the next couple of hours they would round up and arrest some 20 suspects, including two medical clinic owners.

This wasn't a drug or gang bust. These people were suspected of being involved in a personal injury insurance fraud ring.

For nine months, agents from Florida's Department of Financial Services who specialize in tracking insurance fraud have been unraveling what they believe is a complex racket in personal injury insurance fraud. Prosecutors allege medical clinic owners, physicians, therapists and supposed accident victims have organized fake car accidents to rake in money from insurance payments.

While it may not seems like the most glamorous law enforcement mission, authorities said insurance fraud is very lucrative and suspects can potentially rake in millions. It's estimated that personal injury fraud costs the state of Florida alone $1 billion a year, a loss that is passed along to consumers in the form of rising insurance premiums.

Police say that one way criminals commit fraud is that two people will intentionally crash their cars into each other, enough to cause just a couple hundred dollars' worth of damage.

Then, according to officials, the criminals will stage the cars on the street, then call the police, pretending to be victims of an accident.

"They want to make sure that they create a visible damage so the police will write up a report," said Lt. Rafael Delgado, an agent with the state's Department of Financial Services.

Then agents say the "victims," who are not actually injured, will go to personal injury clinics allegedly set up by fraudulent clinic owners, where they are paid. The clinic's employees will then file up to $10,000 per "victim" in insurance claims for massage or other therapy treatments that are never performed.

Police say that one car with four passengers could generate $40,000 in claims, and two cars involved in a fake collision could bring in double that.

Even though they are being arrested on insurance fraud charges, authorities said these criminals are sometimes involved in other illicit activities and can be dangerous.

"They are making a lot of money. A lot of money," Delgado said. "It's my understanding a lot of people that were once into narcotics are into committing staged accidents."

The Miami police and the state's financial services agents set their sights on busting a fraud operation from top to bottom: four clinics, two owners, various employees who allegedly organize the staged accidents and people accused of participating as paid passengers.

Delgado said the six car accidents these suspects were allegedly involved in cost insurance companies more than $400,000.

"It's volume, keep pumping them in, volume, volume, volume," Delgado said. "The more billings you do to the insurance companies, a bunch of it is going to get through, some of it's not going to get through. It's all volume. It's all about making as much money as possible."

After months and months of following paper trails, tracking down suspects, conducting surveillance, Delgado and the other teams were finally able to bring in their insurance fraud suspects. Nearly 20 people were taken into custody.

Within days, all were arraigned on insurance fraud charges and, according to their defense attorneys and court documents, all suspects have entered not guilty pleas. Even if they are found guilty, insurance fraud up to $20,000 carries a maximum sentence of five years in prison.

But whatever the outcome of these arrests, agents said the insurance fraud scams will keep coming, because the money is so easy and the stakes are so low.

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