Recognizing Excellence in the Fight Against Insurance Fraud in 2020! Please help us congratulate and celebrate this year's winners and nominees!
Law Enforcement Insurance Fraud Fighter of the Year winner
Detective - Division of Investigative and Forensic Services/ Bureau of Insurance Fraud
In 2018, Detective James Gardner launched a criminal investigation of a funeral home revealing a sophisticated multi-year fraudulent insurance scheme carried out by the owners, a Florida-licensed funeral director and his wife, a Florida-licensed insurance agent. The funeral director would contract a funeral pre-need agreement with the proposed insured. His wife, the licensed insurance agent would sign and submit the application to the insurance company. The insureds would pay monthly insurance premiums until the policy was paid in full, believing the funds would be available when needed. Detective Gardner’s in-depth investigation exposed that from 2006 – 2013 numerous false claims totaling over $100,000 were presented to the insurer alleging that the insureds were deceased, when in fact they were still living.
In 2019, Detective Gardner discovered evidence that this individual also misappropriated over $133,617.66 invested by 17 elderly victims for pre-need funeral contracts. Instead of depositing their payments into a state-approved trust fund, as required under Florida State Statue Chapter 497, the funds were used to fund a lavish lifestyle that included vacations, cars, and leisurely activities. In December 2019, Detective Gardner arrested the funeral director who was charged with organized fraud and unlawful withdrawal of funds for pre- need contracts. The court ordered him to surrender his funeral director’s license and to reimburse all the victims within an 18-month period. Furthermore, a State of Florida, Department of Financial Services consumer protection trust fund application process was established to ensure all victims were provided the services, if needed, before the restitution was fully recovered.
Insurance Industry Fraud Fighter of the Year winner
SIU Expert - Kemper Insurance Company
Investigator Mario Figueredo investigated alleged Lyft related accidents. His thorough database searches revealed an extensive history of Lyft related crashes in February - April 2020. NICB opened cases on these accidents. Social media searches revealed correlations between all the involved parties. Mr. Figueredo contacted Lyft’s carrier, Travelers Insurance, and they determined that an alarming amount of Lyft claims appeared to involve ring activity.
Mr. Figueredo contacted the claimant and presented him with the investigation discrepancies. The claimant admitted to staging accidents and being compensated $800 for each one. The claimant provided the names and contact information of the organizers who were responsible for recruiting the staged accident participants. Mr. Figueredo coordinated with NICB Agent Jayme Harrington and relayed the ring confessions to Travelers Insurance, United Auto Insurance and National General Insurance who also secured confessions in these staged losses. The Department of Insurance Fraud has opened their own investigation. Travelers Insurance has not paid these Lyft-ring cases as they have had the most exposure of all companies.
The Jerry Zappolo Distinguished Service Award winner
Director of Law Enforcement & Policy - Auto Data Direct - Miami-Dade Police Dept (Retired)
Les has been a continuous force in the fight against fraud. His impressive career includes three years in the U.S. Army Military Police followed by over 30 years with the Miami-Dade Police Department. During his tenure with the Miami-Dade PD he specialized in auto theft prevention and developed instructional programs for law enforcement and industry members aimed at prevention and compliance with federal, state, and local laws pertaining to auto theft and related crimes. Additionally, he is a training fixture at the South Florida Auto Task Force, the Regional 7 Task Force, Cargo Theft Task Force, individual insurance companies, and the annual FIFEC conference.
Les is the founding partner and C.E.O. of Auto Theft Task Force, Inc., established to provide networking, consulting, investigative services, inspection services, and specialized training to individuals or companies in the automotive industry and law enforcement. He was recently named to the Board of Directors for the National Salvage Vehicle Reporting Program (NSVRP). He serves on the Board of Directors of the Florida Auto Theft Intelligence Unit, as well as being a member and instructor for the Southeastern Chapter of the International Association of Auto Theft Investigators.
The Guy E. “Sandy” Burnette Insurance Fraud Fighter Team Award winner
This investigation was a multi-department effort led by a South Florida Task Force and included representatives of the Miami-Dade Police Department and State Fire Marshall’s office, with the participation of SIU representatives from Citizens, Tower Hill and Universal Property and Casualty Insurance. This team revealed that for several years, Citizens Property Insurance Corporation, Tower Hill Insurance Group, and other carriers were targeted by criminal networks who staged losses to exploit their policyholders’ homeowner’s insurance benefits in an elaborate $2.5 million claim fraud scheme.
Their investigative prowess and collaborative efforts discovered text and email communications between public adjusting firms and eight individuals within the network discussing planning, staging, and report of insurance claims to insurers, and key evidence that connected what would appear to be unrelated claims submitted from Miami to Tampa. Their relentless investigation resulted in exposing and dismantling of a criminal network leading to 49 arrests including the principal owner and operator of a public adjusting firm, insurance agents, insurance appraisers, contractors, and 41 individual policyholders impacting 44 claim files. Additional arrests are anticipated. The information gleaned by the investigation has aided in the defense of dozens of claims that were actively in litigation with insurers.
Kyle Abernathy - SIU Investigator - Tower Hill Insurance Group
Howard Bennett - Detective - Division of Investigative and Forensic Services Bureau of Fire Arson and Explosives Inv.
Audrey Burns - SIU Principal - Citizens Property Insurance Corp
Robert Fortich (Retired) - Sergeant - Miami-Dade Police Department Economic Crimes Bureau
Gonzalo Garcia - Sergeant - Miami-Dade Police Department Economic Crimes Bureau
Stephen ImMasche (Retired) Florida Atty General – Retired
Summer Jerla - Criminal Analyst - Division of Investigative and Forensic Services Bureau of Fire Arson and Explosives Inv.
Gladys MaClao - Secretary - Miami-Dade State Attorney
Alfonso Najera - Arson Detective - Miami Dade Police Dept
Jeanne Parker - Criminal Analyst - Division of Investigative and Forensic Services Bureau of Fire Arson and Explosives Inv.
Rebeca Perez - Lead Detective - Miami-Dade Police Department Economic Crimes Bureau
Tammy Pitiriciu - Asst State Atty - Miami -Dade State Attorney Office
Maria Elena Quintana - SIU Investigator III - Citizens Property Insurance Corp.
Noel Rodriguez - Lieutenant – Miami Dade Police Dept
Robert Ruiz - Asst State Attorney -Miami - Dade State Attorney Office
Ayme Sacramento - Police Officer - Miami Dade Police Dept
Raymond Taboada - Police Officer - Miami Dade Police Dept
Charles "Charlie" Toledo - Detective - Division of Investigative and Forensic Services Bureau of Fire Arson and Explosives Inv.
Laura Uriarte - Chief Insurance Fraud Unit - Assistant State Attorney Miami-Dade State Attorney Office
Jennifer Vera - Insurance Fraud Paralegal - Miami-Dade State Attorney Office
And congratulations to our other nominees on being recognized by your peers! We appreciate your dedication to fighting insurance fraud!
Jesus Amarante – Detective - Division of Investigative and Forensic Services/ Bureau of Insurance Fraud
Law Enforcement Insurance Fraud Fighter of the Year Nominee for Licensee/Insurance Agent Fraud targeting seniors in annuity investment scam.
Jarred Dichek – Shareholder - Kubicki Draper
Insurance Industry Fraud Fighter of the Year Nominee for Litigation investigations concerning Homeowner policy fraud (manually enhanced roof damage, water damages, overlapping claims for damages) and PIP fraud (fraudulent licensing and ownership of medical facility; claims for medical treatment not received).
Emilio Lopez – Detective - Division of Investigative and Forensic Services/ Bureau of Insurance Fraud
Law Enforcement Insurance Fraud Fighter of the Year Nominee for Medical fraud – medical clinic billing for treatment not received – undercover operation.
Paula Murphy – Professional Accountant Specialist - Division of Investigative and Forensic Services/ Office of Fiscal Integrity
Insurance Industry Fraud Fighter of the Year Nominee for Professional Account Analysis assisting DFIS detective investigation of financial fraud. Her in-depth analysis of financial records revealed 2 dozen bank account previously unknown.
Rick Smith - SIU Investigator - Allstate Insurance Company
Insurance Industry Fraud Fighter of the Year Nominee for Identity Theft - Multi-state identity theft to secure Insurance policy for staged accidents.
Retired - SIU
Chief Evangelina Brooks
Division of Investigative and Forensic Services
400 W Robinson St., Suite S-823, Hurston Bldg, Orlando,FL 32801
IHC Academy, 3657 Canton Rd, Marietta, GA 30120
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