BROWARD REGION

The Broward Regional Office is located at the Atrium Building, 499 NW 70th Avenue, Suite 309 in Plantation, Florida. The office is divided into 3 squads, tasked with investigating insurance related crimes, ranging from general investigations, licensee fraud, PIP cases, and workers compensation fraud. Additionally, the office has 3 crime intelligence analysts, and 3 administrative assistants.

Captain Robert Joura

Captain Robert Joura is a Certified Fraud Examiner and Certified Protection Professional, and has 37 years of law enforcement experience. He is a graduate of Pace University in New York City, and served with the U.S. Bureau of Narcotics & Dangerous Drugs, the Drug Enforcement Administration, and the Office of the Attorney General prior to joining the Division in January 2008

Squads

Squad 1, when fully staffed, is comprised of six sworn officers, one Crime Intelligence Analyst, an administrative assistant, and is supervised by Lieutenant Evelyn Valles. Lt. Valles has been with the Division of Insurance Fraud since 1991.  Initially assigned as an investigator with the 440 Workers’ Compensation Strike Force, she was promoted to her present position in December 1997. Lt. Valles has 31years of law enforcement experience; 22 of those in the field of insurance fraud. She has a B.A. from John Jay College of Criminal Justice, an MS.ED from Fordham University, and is a Certified Fraud Examiner and graduate of the Florida Leadership Succession Program. Squad 1 concentrates its efforts on dealing with Personal Injury Protection (PIP) fraud, crimes committed by medical practitioners and Department licensees, and vehicle related offenses.

Squad 2, when fully staffed, consists of seven sworn officers, a Crime Intelligence Analyst, an administrative assistant, and is supervised by Lieutenant John Dygon. Lt. Dygon began his law enforcement career in 1976 as a sheriff’s deputy in Ohio. He moved to Florida in 1981, working for a variety of police agencies including Miami P.D. and the Florida Dept. of Law Enforcement before joining the Division in 1999. Squad 2 investigates the full spectrum of insurance fraud.

Squad 3, when fully staffed, has six sworn officers (two dedicated solely to Workers’ Compensation fraud), one Crime Intelligence Analyst, an administrative assistant, and is supervised by Lieutenant Kathy Clarke-Scott. Lt. Scott is an 8 year veteran of the Division who was promoted to Lieutenant in December 2003. Prior to coming to Insurance Fraud, she conducted investigations for 5 years in non-sworn positions with the Divisions of Unemployment Compensation and Workers’ Compensation, respectively. Lt. Scott is a graduate of Seton Hall University. Although the focus of Squad 3 is Workers’ Compensation, the squad works all facets of insurance fraud Statistics

Fiscal Year 2007-08

• Cases Opened:286
• Arrests: 115
• Presentations to Prosecutors: 106
• Court-Ordered Restitution: $2,564,895.74 

Case Highlights

In January 2008, an insurance agent was arrested as a result of a scheme targeting senior citizens over the age of 65, in an attempt to collect new commissions. The licensed insurance agent switched the health insurance coverage of over 100 elderly victims to alternate health care policies, without the victims' knowledge. Several of the victims’ health care coverage and access to health care practitioners was affected as a result of the agent’s actions. The suspect was charged with Application Fraud, Uttering Forged Documents, and Exploitation of the Elderly.

In June 2008, an arrest was made of a suspect who purchased two previously- damaged vehicles from a salvage yard in Orlando. The suspect did not have the vehicles repaired; however, he obtained insurance coverage for the vehicles.

The suspect subsequently filed two separate claims with his insurance company for property damage and personal injury benefits as a result of two alleged accidents. The first claim resulted in payments of $26,027.56 for the vehicle and $20,000 in PIP benefits for medical treatment to the suspect and his alleged passenger. The subsequent claim for the second vehicle totaled $20,000 for vehicle damage and an additional $8,180.00 for medical services. In both instances, the subject treated at the same medical facility. Our investigation confirmed that the damage to the vehicles claimed by the suspect was the same damage sustained prior to their purchase. The second claim was not paid by the subject’s insurance carrier. The suspect was charged with False and Fraudulent Insurance Claims in the 2nd Degree.

In December 2007, and again in April 2008, a Broward county civil attorney was arrested as a result of an investigation based on allegations that the suspect received settlement money from insurance carriers on behalf of his clients, but never forwarded the funds to them. Instead, the attorney deposited the funds in his personal account. Documentation provided by the respective carriers verified that settlement money was forwarded to the suspect, who deposited the insurance claim monies into his account but never paid eleven of his clients. Although the attorney received payment from the insurance companies totaling approximately $150,000, his clients received no remuneration, nor were their medical bills paid.

In March 2008, a Broward County chiropractor was arrested and charged with knowingly submitting fraudulent health insurance claims with intent to defraud two insurance companies. In addition, the suspect also billed healthcare carriers for services which were not rendered, and double-billed two insurance providers, collecting a total of $13,400.01. The documents provided by the insurance companies indicate that the suspect chiropractor submitted duplicate bills to both insurance companies for more than 25 treatment dates. The patient confirmed that he had never been treated by the suspect; in fact, they had never met.

Representatives from the Fort Lauderdale Police Trust Fund contacted the division regarding allegations of both insurance fraud and grand theft. They were able to identify a potential suspect at that time, a dentist whose husband was a current police officer. The investigation centered on interviews of patients, and a local dentist was used as an expert to re-examine patients treated by the doctor. The investigation found that the procedures billed had not been performed. Additionally, the investigation showed that the suspect dentist billed the insurance carrier for dental work allegedly performed on the dentist and the dentist’s family members when, in fact, no such work had been performed. This was corroborated by the execution of search warrants for the mouths of both the dentist and the dentist’s spouse. Ultimately, the dentist pled guilty, and agreed to reimburse $4,895 in investigative costs and $16,985 to the insurer.

In June 2008, arrests were made of two individuals who had been operating a staged accident ring since 2002. The duo solicited young adults and oftentimes purchased policies in their names. They instructed the individuals to recruit friends, place them in two vehicles, and have accidents. The pair would then send the participants to different clinics for the purpose of billing insurance companies for PIP benefits. These clinics appeared to be owned by chiropractors, but were actually owned by the subjects. As a result of this scheme, they were able to fraudulently obtain millions of dollars from the insurance companies. Through a joint investigation with the Internal Revenue Service, and with the cooperation of the National Insurance Crime Bureau, the two were arrested and charged with a total of forty counts which include Healthcare Fraud, Money Laundering, and Fraudulent Use of a Social Security Number. They are being held on “No Bond” as they are flight risks.

In 2008, an arrest was made of a suspect who had reported his vehicle stolen. Unbeknownst to the suspect, the vehicle had been recovered in Pennsylvania days before the date that that the suspect said it was stolen. In August 2007, detectives of the Lancaster Police Department were notified by a confidential informant that he had delivered a vehicle from Florida to be destroyed and subsequently reported stolen by the owner of the vehicle. The vehicle was impounded by the department. In September 2007, the suspect contacted the City of Miami Police Department and reported that his vehicle stolen in Miami the prior day (although it was already in possession of the Lancaster police). He later filed a claim with his insurance company stating the same facts. In November 2007, the suspect swore in an Examination Under Oath that he was in possession of his vehicle in September 2007. Investigation revealed the suspect filed a false police report and fraudulent insurance claim for the theft of his vehicle when it was already in the possession of the police in Pennsylvania. He was charged with False and Fraudulent Insurance Claim, and False Reports of Commission of Crimes.