Capitol to Courthouse Florida Insurance Week In Review: April 19-23, 2010

The following information is a summary of events from Week Eight of the 2010 Florida Legislative Session (April 19-23):

 

Florida Hurricane Catastrophe Fund Releases 2010 Proposed Rates

The Florida Hurricane Catastrophe Fund released its 2010 proposed rates on April 19, 2010.  To view the rates, click on the hyperlinks below: 

• Mandatory Rates 
• Rating Regions

Approved by Florida’s State Board of Administration on April 13, 2010, these rates represent the proposed 2010 rates as a result of the 2010 FHCF Premium Formula and are based on the 2010 FHCF Ratemaking Formula Report, a copy of which can be accessed by clicking here.      

The FHCF has cautioned that no rates are final until the conclusion of the 2010 Florida Legislative Session and subsequent passage of an Appropriations bill.   The rates, which may be revised at any time, assume: 

• Legislative funding of $10 million for mitigation
• No funding for financial product expense
• A FHCF per-event retention of $7.142 billion (which drops to one-third on the third largest and subsequent event)
• A FHCF limit level of $17.0 billion

 

Citizens Property Insurance Corporation Claims Committee Meeting Report:  April 19, 2010

Reports on new statistical tracking tools and other strategies to expedite claims service performance, the identification of inconsistent or fraudulent claims and the enhancement of training for independent adjusters was the focus of Citizens Property Insurance Corporation’s (“Citizens”) Claims Committee (“Committee”) agenda during its April 19, 2010 teleconference.

These goals, explained Citizens Senior Vice President of Claims Yong Gilroy during the meeting, are designed to assist in correcting deficiencies exposed by the 2004 and 2005 hurricane seasons, as well as to assure that Citizens is prepared to respond to the next hurricane or other catastrophic event.

“The industry needs to understand more where Citizens is,” Mr. Gilroy said.  “The memory they have is still of 2004 and 2005.  We want to make sure [to use] any opportunity we have to raise Citizens’ brand, and that we do it comprehensively and educationally.”

Among other examples cited, Mr. Gilroy said that Citizens’ first Quarterly Performance Review in December 2009 showed an average dispatch service response time of 202 minutes among its 25 independent adjuster firms, which is more than double the target response time of 60 minutes.  Mr. Gilroy related that the collective sharing of performance data among the adjuster firms spurred them to compete with each other, resulting in the improvement of average dispatch service time to 37 minutes by March 2010.

The Claims Committee’s staff presentation included the following reports:

• An analysis of key performance indicators revealed that the volume of new Citizens claims rose in March 2010 after declining during the previous two months. The number of closed assignments also rose in March, continuing a recent upward trend, while the ratio of closures of new cases dipped below 100 percent during the same time.
• Driven mostly by increased new litigation, the inventory of pending assignments has risen slowly since mid-year 2009.
• Overall cycle times – the average time a claim is open – have shortened, mostly due to a drop in the litigation and disputed claims cycle times from 142 days in December to 117 days in March. Mr. Gilroy attributed a rise in non-catastrophic cycle times from 39 to 48 days to a new policy of reviewing pending claims with adjusters on a weekly basis.
• The number of complaints relative to new claims has decreased. The most frequently cited reasons for complaints were the denial of claims (32 percent of all complaints) and claim delays (30 percent).
• Statistical tracking revealed that the average number of days to contact policyholders after a claim has been filed has been consistently less than half a day. The average number of days until a subsequent inspection is made has been 5.7 days or less since September 2009, while the average number of days for claim information to be uploaded has been consistently in the 10-14 day range.
• New assignments to the Special Investigative Unit (“SIU”) rose to 74 in March from an average of 63 during the previous three months.
• A slight increasing trend in new assignments for Citizens’ Shared Services Department has been noted.
• Independent adjusters have delivered 81 percent of their catastrophe case commitment, with the largest firms delivering 100 percent.
• The number of deployed non-catastrophic claims adjusters remained static in March.

It also was reported that Citizens’ catastrophe planning for 2010 is underway, with a related mock exercise planned for mid-May.  Procedures are being created that can be scaled upward as needed, depending on the size of the catastrophe.  Independent adjuster training exercises that include an “on-boarding” manual are also in progress.

To oversee adjusters in post-catastrophe events, a commercial claims specialist position has been created.  Mr. Gilroy reminded that this role did not exist in 2004 and 2005.

Ms. Sexton noted that improved SIU and subrogation-related statistical data mining, such as using ZIP codes to identify claims reported from outside the path of a catastrophic storm, should improve Citizens’ ability to detect fraud.

Additional fraud detection measures that will be taken as a result of analysis on 2009 data include the development of an analytics-based report specific to subrogation that incorporates a scoring feature, along with text mining within the report to identify certain key words.

In regard to the Citizens’ Wind Mitigation Re-inspection Project, Ms. Sexton noted what she described as issues with the Florida Office of Insurance Regulation’s updated Uniform Mitigation Verification Inspection Form OIR-B1-1802 (“Form”).  These include an implication that only policyholders, and not inspectors, are subject to criminal penalties that are minimal in nature; and that the Form allows inspections to be performed by staff members of a licensed inspector, which could allow what Ms. Sexton described as “inspections-by-proxy.”  She said this could make it more difficult for Citizens or law enforcement to hold inspectors accountable for fraudulent reports.

Lance Malcolm, Citizens’ Director of Claims Operations, reported an increase in sinkhole claims in the first quarter of 2010, with a 15-month average of 143 claims per month and a six-month average of 183 claims per month.  Nearly two-thirds of those claims are coming from Pasco and Hernando counties, he said. 

Chinese drywall claims during the same time period slowed to just four.            

New litigation assignments have been rising through the first quarter of 2010, Mr. Malcolm reported, with a 15-month average of 235 new lawsuits per month and a six-month average of 286 new suits per month.  Forty-four percent of new litigation cases are related to losses caused by water. 

Damage disputes and denial of claims are primary litigation drivers, with sinkhole-related cases account for 17 percent of the 400 litigation assignments reviewed.

Citizens’ “Best Practices” document, designed to bring consistency to claims handling across the organization, has been completed and is being reviewed internally.  Also completed is a Claims Estimating Guidelines document, which is intended to assure consistency in file handling, while focusing on damage estimating.   

After additional discussion, the meeting was concluded.

Meeting materials can be viewed by clicking on the following hyperlinks:

• April 19, 2010 Agenda
• Draft Claims Committee Minutes from January 27, 2010
• Key Performance Indicators
• Catastrophe Operations and Commercial Claims
• Shared Services Update
• Vendor Relations Update
• Non-Catastrophe Update
• Claims Consultant Update

 

Florida Automobile Joint Underwriting Association Board of Governors Meeting Report:  April 20, 2010

The Florida Automobile Joint Underwriting Association’s (“FAJUA”) Board of Governors (“Board”) met in Tampa on April 20, 2010.   

During the meeting, the Board devoted much debate to the question of whether to offer payment plans to consumers.  FAJUA General Manager Eugenia Tyus noted that Florida Insurance Commissioner Kevin McCarty has indicated that such a plan, if implemented, would not make the FAJUA competitive with the market insurers that make up its membership and fund its operations.

Kay Womble, Vice President of Dovetail Insurance, an insurance technology and service contractor to the FAJUA, presented the payment plan concept to the Board.  Motorists who turn to the FAJUA for insurance because they are unable to secure it in the voluntary market would be offered a six-payment plan that would require a 25 percent initial payment, she explained.  The proposed installment fee would be $6 per payment.

“If people were not buying insurance simply because they didn’t have money up front, this could be an answer,” Ms. Womble said. 

At present, consumers of FAJUA policies must pay for them in full at the outset of the policy, or seek premium financing from an outside vendor.  The observation was made that joint underwriting associations in some states offer payment plans to consumers, while others do not.

Defenders of the payment plan concept noted that it might encourage high-risk drivers who cannot afford a single large payment to purchase coverage rather than drive uninsured.  Critics, however, warned that many such motorists might make only the first payment to secure their automobile tags and then never make another one.

Certain speakers noted that an FAJUA payment plan would cost consumers considerably less than using premium financing, and might reduce FAJUA’s exposure during the 30- to 60-day period that typically passes before premium finance companies inform the FAJUA of cancelled policies. 

Speakers at the meeting questioned how much difference the offer of financing would make in a consumer’s decision to buy coverage and expressed concern about the additional effort required for the FAJUA to collect monthly payments.

Implementing a payment plan could cost as much as $700,000, with no certainty of resulting in significantly fewer uninsured motorists, Board members were told.

FAJUA staff was asked to review the experiences of similar agencies in other states that offer financing and to gather other information in time for the FAJUA Board’s scheduled September meeting.  

General Manager’s Report

Ms. Tyus reported to the Board that the FAJUA’s policy count has continued a downward trend.  She noted that Florida has one of the nation’s highest rates of uninsured drivers, and that less than half of the applications received by FAJUA result in policies being written.  Ms. Tyus voiced her concern that the two statistics might indicate that FAJUA has become so “insensitive” to the needs of high-risk motorists “that even people who want to do the right thing, can’t.”

By next year, one in every six U.S. drivers is likely to be uninsured due to the state of the economy and other factors, she added.

Reminding that the Board’s earlier decision to levy a $2,500 fee on its members rather than implementing a new FAJUA assessment “was favorably received,” Ms. Tyus said she anticipated that the next assessment would occur in February, 2011.      

Financial Report

The Finance and Audit Committee (“Committee”) reported that the FAJUA has approximately $1.5 million invested in Florida’s Special Purpose Investment Account (“SPIA”), a government-managed pooled-investment program oriented toward short-term returns.  As of January, 2010, the SPIA yield was 2.067 percent.

A recent SPIA directive limiting agencies such as FAJUA to a maximum investment of $3.5 million is not expected to affect FAJUA, since it is considered unlikely to have that much to invest. 

The Committee also reported that $1.5 million in policy fees was collected during the last year.

The Board was told that the U.S. Internal Revenue Service (“IRS”) Form 990, applicable to non-profit entities, now contains many more questions about governance and compensation.  The Finance and Audit Committee approved a proposal to have the FAJUA Board approve Form 990 before it is submitted to the IRS.

Litigation Report

It was reported that the number of FAJUA-related matters in litigation continues to decline.

A request was made to consider reviving funding of $150,000 for a prosecutor designated to uncovering insurance fraud.  A position funded in Miami-Dade County “made money on restitution and put people behind bars,” Mr. Graham said, before funding was terminated three years ago.

Captain John Askins, director of the Florida Division of Insurance Fraud, and officials from Hillsborough County have expressed great interest in creating a new insurance fraud prosecutor position, though it has not been determined if it should be under the oversight of the Division of Insurance Fraud or the State Attorney’s Office.

A presentation on this issue will be made to the Board during its next meeting. 

Auditor’s Report

The FAJUA is operating at “close to a break-even,” with an operating gain of $188,000 and total committed assets of $3.7 million.

Its pension plan is running a deficit of $74,000, but is expected to recover over time.

In response to a question from a Board member, the FAJUA auditor said he did not specifically scrutinize Travel and Entertainment expenses, nor examine the Board’s policies on such expenses.  He said he would do so in the future to help allay concerns about what the Board member said has “become a sensitive area.”

Ms. Tyus said she would present the FAJUA’s Travel and Entertainment policy to the Board at its next meeting.  She added, “We go to two Board meetings a year. That’s our travel.”

The FAJUA was created in 1973 to provide automobile insurance to qualified applicants unable to buy insurance in the voluntary market.  Every insurer authorized to write automobile liability insurance or automobile physical damage insurance in Florida is a member by law.

 

House Insurance Deregulation Bill Amended on Second Reading

The Florida House took up HB 447 on second reading on April 19, 2010.

State Representative Bill Proctor, the original sponsor, explained HB 447, noting that its primary purpose is to give homeowners a choice in purchasing property insurance.

State Representative Rick Kriseman asked series of questions on the definition of a “valid complaint” as provided by the bill in relation to Florida’s Annual Insurer Report Card.  Representative Kriseman urged House Members to include reference to “probable cause” in the definition of a “complaint.”

Additional concerns were raised by Representative Kriseman on the potential for double digit rate increases authorized by HB 447, along with the loss of mitigation credits to consumers and the payment of claims on the dwelling and contents.

Although HB 447 was temporarily postponed during a House recess, it was taken up again during the afternoon Session to complete the bill’s second reading.   Amendments were debated and acted upon as follows:

• Amendment 455231 by State Representative Bryan Nelson, which clarifies the definition of valid consumer complaints, was adopted.
• Also sponsored by Representative Nelson, Amendment 983881 was adopted, which clarifies that when the Florida Office of Insurance Regulation makes a formal or informal request to an insurer for additional information subsequent to a rate filing, the insurer is permitted to supplement the rate filing without rendering its certification false.
• Amendment 744401 by State Representative Alan Hays, which would have mandated that Citizens Property Insurance Corporation (“Citizens”), raise its rates by 10 percent per year until they are “financially sound,” was withdrawn.
• Amendment 175073 by Representative Nelson relating to changing the name of Citizens’ “High-Risk Account” to “Coastal Account,” was replaced by Substitute Amendment 195987 because of a technical oversight that excluded the specific statute, s. 627.351(6), F.S. in Amendment 175073. In response to a query from State Representative Evan Jenne, Representative Nelson explained that the name change is expected to facilitate raising additional capital in the bond markets.
• Amendment 789141, which changes HB 447’s language in lines 1953-1954 relating to claims payment to “actual cash value of incurred loss, less any deductible,” was late-filed by Representative Proctor, but not considered.

Ater being amended, HB 447 was rolled to third reading by the House.  SB 2044, the companion to HB 447, is expected to be heard by the Senate tomorrow, April 21.

Action also was taken today on the following bills:

• HB 159 relating to Guaranty Associations passed House on third reading and was sent to the Senate. Its companion, SB 2232, is on the Senate Special Order Calendar for consideration tomorrow. If passed, the bills would change state laws relating to the Florida Insurance Guaranty Association (“FIGA”), the Florida Workers’ Compensation Insurance Guaranty Association and the Florida Life and Health Insurance Guaranty Association. HB 159 and SB 2232 implement several policies adopted by the National Association of Insurance Commissioners Property and Casualty Insurance Guaranty Association Model Act. They also revise FIGA’s structure by consolidating its auto liability and auto physical damage accounts into one account. Further, the bills remove the requirement that an insurer must submit a rate filing to pass through an assessment to the policyholders. Instead, companies would be allowed to apply a recoupment factor to the premium of the policies subject to the FIGA assessment.
• SB 876, also known as the “Consumer Choice” bill, was considered today by the Senate Policy and Steering Committee on Ways and Means. The bill, which would deregulate residential property insurance rates in Florida, would also create a 10 percent statewide average cap on rate increases and a per-policy cap of 20 percent on a statewide average rate increase.
• HB 225 relating to Controlled Substances was temporarily passed in the House on Second Reading, but was placed on the Special Order Calendar for House consideration tomorrow, April 21. Among other provisions, HB 225 revises requirements for the registration of pain-management clinics, as well as requires the Florida Department of Health to refuse to register pain-management clinics under certain circumstances.

On Wednesday, April 21 the Senate also considered the following bills:

• SB 2046 relating to Employee Leasing Companies deletes the requirement that an employee leasing company must obtain approval of the Florida Board of Employee Leasing Companies before changing the name or location of a company. It also specifies that the regulatory requirements applicable to employee leasing companies do not affect the eligibility of such companies, their clients or leased employees for any local or state tax credit, economic incentive or other benefit.
• SB 2264 relating to Property Insurance Claims provides that certain statements may be considered deceptive or misleading if made in any public adjuster’s advertisement or solicitation. It also requires a disclaimer to be included in any public adjuster’s written advertisement. Under the provisions of SB 2264, certain persons who act on behalf of an insurer are required to provide notice to the insurer, claimant, public adjuster or legal representative for an on-site inspection of the insured property.
• SB 886 relating to the Open Government Sunset Review of the Insurance Claims Data Exchange extends a public records exemption for certain records obtained by the Florida Department of Revenue under the insurance claim data exchange system.

 

Updated Mitigation Forms Effective April 21, 2010, Florida Office of Insurance Regulation Advises 

The Florida Office of Insurance Regulation has issued an Informational Bulletin to Florida Residential Property Insurers advising that the “Uniform Mitigation Verification Inspection Form” (Form OIR-B1-1802) and the “Notice of Premium Discounts for Hurricane Loss Mitigation” (Form OIR-B1-1655) have been revised and are effective on April 21, 2010.  To view the Informational Memorandum and a copy of each updated form, click here.

 

Florida Insurance Legislative Bill Action:  April 21, 2010

Following is a summary of actions on two major insurance-related bills by the Florida Legislature on April 21, 2010:

CS2/SB 2264 relating to Property Insurance Claims by the Senate Committees on Judiciary; Banking and Insurance and Senator Mike Bennett

CS2/SB 2264, which makes significant changes to the regulation of public adjusters in Florida, was amended and rolled to third reading by the Florida Senate today, April 21, 2010.

Senator Mike Bennett, the bill’s original sponsor, noted that SB 2264 represents a collective negotiation effort by all interested parties. 

A provision in the bill that limits public adjuster payments to 20 percent on re-opened claims prompted limited debate among Senators. 

Of note, CS2/SB 2264 sets forth a time window of three years in which a claim for damage caused by a windstorm or hurricane may be filed.

To view the most recent legislative summary of SB 2264, click here.

CS2/1ST Eng. HB 447 relating  to Property Insurance by the House General Government Policy Council; Insurance, Business and Financial Affairs Policy  Council and State Representative Bill Proctor

After being amended on April 20 during second reading, HB 447, also known as the”Consumer Choice” bill, was heard by the Florida House of Representatives today, but temporarily postponed on third reading.   Subsequently additional amendments were filed to the bill.  A summary of each one follows:

• Amendment 466201, which was late-filed by State Representative Joe Gibbons, would add a provision in § 627.062, F.S. stating that an insurer or rating organization may not use credit scoring when establishing and using rates, rating schedules and rating manuals.
• Amendment 474951 filed by State Representative Rick Kriseman, would amend the rate deregulation portion of HB 447 to mandate that the Florida Office of Insurance Regulation (“OIR”) review all rates-at least annually-to determine whether any rate charged by an insurer is excessive.
• Amendment 517803 also filed by Representative Kriseman, provides that any additional information added to a pending filing that has not yet been disapproved by the OIR must include a new certification. Such additional information may not be considered a “new filing,” but rather must relate to a pending filing.
• Amendment 672333 filed by HB 447’s original sponsor, Representative Proctor, would amend § 627.7011, F.S. to provide that the insurer shall initially pay the actual cash value (“ACV”) of the insured loss, less any applicable deductible and deletes “ACV of the loss and shall pay the ACV of the insured loss, less any applicable deductible.”
• Amendment 710597, filed by Representative Kriseman would amend § 627.7011, F.S. to provide that, in order to receive payment from an insurer, a policyholder must subsequently enter into a contract for building and structural repairs. The insurer then would pay any remaining amounts for expenses incurred to perform such repairs as the work is performed. Payment by the insurer would be made within 15 days after the insurer’s receipt of a contractor’s invoice for work performed or expenses incurred. With the exception of incidental expenses to mitigate further damage, the insurer or any contractor or subcontractor may not require the policyholder to advance payment for such repairs or expenses. Under the provisions of Amendment 710597, the insurer also may waive the requirement for a contract. When an insurer pays a claim by applying the actual cash value provisions of this section, and when the insured has paid premiums based on replacement cost coverage, the insurer would then pay the insured a premium refund representing the difference between actual cash value premium and replacement cost value premium. If a total loss has occurred, Amendment 710597 also provides that the insurer must pay the replacement cost for a dwelling without reservation or holdback of any depreciation in value.
• Amendment 839113, also filed by Representative Kriseman, would amend § 627.7011 by providing that if a loss occurs to personal property that is insured on the basis of replacement cost value, the insurer may limit its initial payment to a lump sum in an amount no less than 50 percent of the total replacement cost value of all personal property to be replaced, less any applicable deductible, and must pay the remaining 50 percent of the total replacement cost value in a lump sum within 10 days after a policyholder provides the insurer with receipts showing that the initial payment was used to purchase replacement property. The insurer may not require an insured to advance payment for the purchase of replacement property. The insurer also may not refuse to pay a policyholder if replacement property purchased is not identical to the destroyed property. If a total loss occurs, Amendment 839113 provides that the insurer must pay the replacement cost for content coverage without reservation or holdback of any depreciation in value and the insured would not be required to submit receipts or an inventory of the contents.

Media coverage of action on HB 447 is reprinted below. 

THE NEWS SERVICE OF FLORIDA:  BENNETT–INSURANCE DE-REG BILL DEAD

By MICHAEL PELTIER
THE NEWS SERVICE OF FLORIDA

THE CAPITAL, TALLAHASSEE April 21, 2010…A skeptical governor and a rapidly shifting political landscape appears to be the death knell for a measure allowing property insurers to raise rates without regulatory approval, the Senate sponsor said Wednesday.

Sen. Mike Bennett, R-Bradenton, the sponsor of SB 876, said he’s throwing in the towel on the measure in the face of opposition from Gov. Charlie Crist, who vetoed a similar measure last year, and Insurance Commissioner Kevin McCarty, who has opposed the idea and with whom Bennett has feuded for some time.

The measure would allow insurance companies to raise individual rates up to 20 percent a year without Office of Insurance Regulation approval. Statewide increases would be capped at 10 percent. The companion House measure, HB 447, was scheduled for a floor vote Wednesday but it was postponed.

Sen. JD Alexander, R-Lake Wales, a supporter of the measure, said the votes aren’t there to override a veto and prolonged debate would be a waste of time.

“It doesn’t make any sense to spend time debating something the governor has come to a committee hearing to oppose,” Alexander said.  

Bennett’s measure is among a handful of industry-backed property insurance bills traveling through the Legislature. Another Senate bill, SB 2044, may still see the light of day. The measure does not contain the rate provision but does allow insurers to withhold a portion of claims payment until repairs are undertaken or replacements are purchased.  It also reduced the time policyholders have to file claims after a storm.

“If any insurance bills come out of the session this year I think that will be it.” Bennett said. “I just don’t see it happening otherwise.”

Political considerations may also play into the decision. With Crist considering dropping his party affiliation while he’s running for Senate, Republican leaders, who have already seen the governor veto party-backed legislation, may not want to give Crist more ammunition in any upcoming campaign.

“Why would you vote for an insurance increase when they know the governor will veto it?  All along he’s been saying “make my day,” said Rep. Ron Saunders, R-Key West. “They’ve already helped him enough,” said Saunders in reference to two recently vetoed bills on teacher tenure and leadership funds. “They don’t want to help him anymore.”

 

CFO Sink’s Statewide PIP Crackdown Continues

As part of an ongoing Personal Injury Protection (“PIP”)-related sweep by the Florida Division of Insurance Fraud that began earlier in 2010, Florida Chief Financial Officer Alex Sink announced the arrest of eight fraudsters on April 22, 2010.  Clinic owners and workers were among those charged who have been involved in PIP-related scams throughout the State.  A Florida Department of Financial Services press release detailing the arrests is reprinted below: 

CFO Sink Announces Arrest of Eight PIP Scammers in Continued PIP Sweep Arrests

April 22, 2010

TALLAHASSEE- Florida CFO Alex Sink’s Division of Insurance Fraud (DIF) today joined the Hillsborough County Sheriff’s Office and the National Insurance Crime Bureau (NICB) to announce a staged vehicle accident Personal Injury Protection (PIP) sweep, including clinic owners and workers involved in PIP fraud scams around the state.  

“Staged accidents put every Floridian at risk, both physically and financially,” said CFO Alex Sink. “I am taking aggressive action every day to get these scammers off our streets and behind bars where they belong.”           

CFO Sink investigators arrested Miguel Costillo Rivero, 47, outside of his Tampa residence this morning after an investigation showed that Rivero was soliciting people to be part of staged accidents, offering money in return for participation. Superior Injury Care, Inc., a Tampa, Fla., clinic received false PIP claims that provided the clinic with reimbursement funds from insurance companies on services never rendered.  Rivero is being charged with Patient Brokering and False/Fraudulent Insurance Claims, both 3rd degree felonies.          

Superior Injury Care clinic therapist Courtney Braden and receptionist Blanca Luz Villalobos were also arrested in the Rivero case, charged with Patient Brokering and False/Fraudulent Insurance Claims, both 3rd degree felonies.       

CFO Sink’s detectives were initially introduced to Miguel Castillo Rivero by David Vazquez Perez.  Perez was interviewed in Pasco County with assistance by the Pasco County Sheriff’s office, regarding a staged accident.  Perez admitted taking participants to Rivero’s house, where they received payments and reminders to return to the clinic once a week to fill out insurance paperwork.  Perez has been booked into the Pasco County Jail. Perez was charged with one count of False/Fraudulent Insurance Claim.

Tampa Pain Rehab, LLC Director Livan Diaz Acosta, 34, and therapist Jonathan Alfonso Rosero, 23, were also arrested this morning on the same PIP related charges – Patient Brokering and False/Fraudulent Insurance Claims which are both 3rd degree felonies.  Acosta and Rosero have been booked into the Hillsborough County Jail.

CFO Sink’s investigators arrested Joel Bauta Lopez, 37, and Claudia Valdes Diaz, 21, owners of Ganesha Medical Center Corporation located in Miami, Fla., yesterday on charges of insurance fraud, grand theft and operating an unlicensed clinic while attempting to collect more than $40,000.00 in fraudulent insurance claims. 

The charges stem from a previous arrest of both suspects in May 2009 for participating in a staged accident ring under a former business name, E & B Rehabilitation Center. After their first arrest, they posted bond and reopened a clinic under a new name, Ganesha Medical Center Corporation; continuing to work without a business license.

Since Lopez and Diaz committed this new crime while out on bond for their 2009 arrest, they could be held without bond until their trial. Both suspects were booked into the Miami-Dade County Jail yesterday afternoon and each charged with one count of operating without a license, eight counts of Insurance Fraud and eight counts of Grand Theft.  

These arrests are part of an ongoing PIP sweep by DIF that began earlier this year through partnership with the New Port Richey Police Department, Pasco County Sheriff’s Office, Hillsborough County Sheriff’s Office, Direct Insurance., Met Life Insurance and NICB.  Further arrests are pending around the State. 

For more information on PIP fraud in Florida, visit DIF’s website at http://www.myfloridacfo.com/fraud/.  

 

Florida Department of Financial Services License Applicants Cautioned on Possible Fingerprint Processing Delay

The Florida Department of Financial Services (“DFS”) has been notified that the Federal Bureau of Investigation (“FBI”), which is responsible for processing all fingerprint information for federal background checks, will not be available to process any license applicant fingerprints from April 28, 2010 through May 3, 2010.  This is due to a U.S. Census Bureau project that requires immediate attention.  The delay may create a three-week backlog once the FBI resumes normal fingerprint processing on May 4, 2010.

Applicants who are required to provide a set of fingerprints may be affected by this delay.  The DFS recommendeds that these applicants submit their fingerprints before this time to avoid a delay in receiving their license. 

 

House and Senate Omnibus Property Insurance Bills Amended Extensively; Status Remains Uncertain

While CS/CS/SB 2044 was temporarily postponed in the Senate on April 22, both this bill, and the House omnibus property insurance bill, CS/CS/1st Eng. HB 447, were on the Senate and House calendars for April 23, 2010. 

Both bills have been amended extensively.  To access a summary of the floor amendments filed to each, click here.