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Miami Clinic Owner, Manager Snared for Fraudulent Billings


TALLAHASSEE – Florida Treasurer and Insurance Commissioner Tom Gallagher announced today the arrest of a Miami clinic owner and his office manager who unknowingly recruited two undercover Department of Insurance investigators and their confidential informant into a scheme to file fraudulent auto accident insurance claims.

Ercides Iglesias, owner of Flagler PolyClinic, located at 6779 W. Flagler St., and his office manager Debora Garcia, were arrested by department investigators this morning. Iglesias, 53, of 10391 S.W. 56th Terrace, Miami, is 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, 39, of 1805 S.W. 97th Place, Miami, faces the same charges.

Investigators with the department's Division of Insurance Fraud are continuing the investigation and more arrests are expected. If convicted on every charge, Iglesias and Garcia could each face up to 40 years in prison if the maximum penalty of five years per charge were applied. They also could face fines of up to $5,000 per charge.

"Every Floridian is affected by insurance fraud because they pay for it through higher premiums," Gallagher said. "But every citizen can help combat fraud. They should immediately report any suspicions they may have and be wary of anyone who approaches them with a solicitation after an accident, whether at the scene, at the door of their home or by telephone."

The informant came to the department in July 2001, saying he had recently been solicited for the billing scheme following an auto accident. By September, both the investigators and informant had been "recruited" and allegedly were being offered kickbacks for referring other accident victims whose insurance companies could be billed. Garcia allegedly explained money could be made whether treatment was actually administered.

The informant and the investigators said they were provided no treatment other than cursory physical exams and X-rays, yet claims for more than $11,500 was billed to the personal injury protection (PIP) portion of their automobile 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 and explained to the investigators and informant how to describe their own non-existent injuries to their insurance companies. 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.

Shortly after bringing the two investigators into the scheme, the informant was paid $500. He was told the payment was for recruiting the two undercover investigators and for allowing his own insurance company to be billed.

Onyx's and Amstar's special investigative units assisted the department in the investigation.

The Department of Insurance, Division of Insurance Fraud, investigates various forms of fraud in insurance, including health, life, auto, property and workers' compensation insurance. Anyone with information about this case or another possible fraud scheme should call the department's Fraud Hotline at 1-800-378-0445. A reward of up to $25,000 is offered for information leading to a conviction.