Large scale auto insurance fraud being investigated by the State


State investigators in Tallahassee are mulling over the possibility of filing criminal charges after unearthing violations in over ninety percent of clinics that have provided treatment to patients involved in accidents in Miami-Dade county.

One of the reports filed by AHCA (Agency For Health Care Administration) unveiled the fact that these discrepancies were found during the latest sweep conducted over three days by the investigators in the Miami-Dade county. One among the 49 cases that were investigated showed that the customer has charged the insurance company up to $19000 under PIP while the money was actually used for massage therapy.

During the investigations conducted as a part of the sweep, investigators found only seventeen patients at the clinics while a few employees even mentioned they did not see any patient for a long time. The staff at one particular clinic said they had neither seen the medical director nor the doctor for the last 6 months.

Shelisha Coleman, the spokesperson, mentioned that this report will instigate the agency to immediately take action and revoke licenses of many clinics and also file criminal charges against them. Though the investigative agency is bringing its investigation to an end, the Division of Insurance Fraud has taken the initiative of continuing this probe.

Lawmakers in Florida have been unsuccessfully struggling for years to curtail the fraudulent claims filed by customers with personal insurance policies. Republican Governor Rick Scott is now challenging them to find the best solution during the session that commences the following Tuesday. A few of the ideas that are being considered include options such emergency care access only within the first 3 days or completely doing away with this program.

During the course of the investigation it was found that a lot of Dade county clinics provided treatment to victims of auto accidents exclusively and billed them for massage therapy. The people in charge of the investigation also found out that most of these clinics do not have any prior experience in health care and opened their clinics only after discovering that starting such clinics is a lucrative venture. These clinics also advertised their services to many attorneys as well as law firms who engaged the services of these “doctors” without conducting any background check.

The PIP plan was brought into effect in the year 1972 to make it easier for people involved in auto insurance accidents to avail money for treatment at the earliest.  However, in recent times, many fraudulent people are misusing this policy and filing false claims.