S. Fla. Cracks Down: Car-wreck Insurance Fraud Con Artists Targeted

January 17, 2005

  • January 17, 2005 at 5:44 am
    JOHN says:
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    2 years is still not enough to stop these guys, when you look at the millions some of these rings have taken in on bogus claims, some of the players on the bottom will laugh at the sentence, that assuming they get convicted. It takes 5 years on average to get enough on these guys, whats cheaper the increased cost of coverage of the cost to investigate & prosecute?

  • January 18, 2005 at 2:54 am
    Larry says:
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    Will the day ever arrive when people who disseminate the “news” realize that the extent of the fraud being perpetrated by the auto insurance industry dwarfs the fraud reported in these articles?

    For example, auto insurers have illegally accessed PPO discounts which medical providers gave to PPO networks resulting in hundreds of millions of dollars in savings to these insurers. They accomplished this despite failing to offer their insureds’ PPO policies at discounted premiums. They also failed to give their insureds lists or directories of doctors who were part of this “PPO network” resulting in absolutely no consideration to the doctor who had agreed to reduce his fee. This is but one example of the blatant fraud being perpetrated by the auto insurance industry.

    A second example is the systematic practice of unilaterally and arbitrarily reducing “usual and customary” reimbursement rates to medical providers despite an acknowledged increase in medical costs and a rise in premiums.

    It’s no wonder that the majority of medical providers will tell you that they are working twice as hard today for about 70% of the income they earned 10 years ago.

    It is truly sad and frightening when an industry as strong and powerful as the auto insurers are able to create the perception that they are being abused by fraud artists, when in fact,their creativity in concocting fraudulent scenarios for their own benefit knows no bounds.

  • January 18, 2005 at 4:03 am
    John says:
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    Larry, As long as you are not paying the medical bill for seeing the doctor after an auto accident what do you care what kind of a deal the companies are making to save money? This is really not a very common occurrence and some of the companies that do it, do offer the PPO discount to the insureds or as in one case they waive the 20% co pay and pay the entire 100% (without adding extended pip)
    this sounds pretty good to me. If you are a medical provider and you dont like what is being presented as a fair payment deal DON’T AGREE TO DO IT. If anyone signs a bad agreement dont complain about it later. There are other options. I will also bring to your attention that MOST professional careers today do not make what they made 10 or 20 years ago, with the obvious exception of scum bag attorneys.

  • January 18, 2005 at 4:26 am
    Larry says:
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    John:

    Unfortunately it would take too long to describe to you the manner in which the doctors were defrauded. Bottom line is that when they entered into contracts with PPO networks, the contracts were only supposed to apply to Group Health and Workers Comp policies, not auto policies.

    What difference does it make to the insured? If there is non compliance of the contract between the provider and the network, the insured is subject to bill balancing by the provider. Florida law gave the insurers an opportunity to do this legally with full disclosure, but they chose to circumvent the law once again.

    Don’t you find it interesting that the bottom line profits for P/C insurers keeps increasing?

    As far as usual and customary reimbursements go, these doctors have no contracts with anyone and are at the total whim of the insurers. Do you think it’s a coincidence that about 95% of all suits filed by doctors or insureds against their PIP carriers are settled by the company. Why don’t they pay what they are supposed to from the start? Because for every person who files suit to get what they are legally entitled to, there are 100 who will just walk away.

  • January 18, 2005 at 4:36 am
    Clay says:
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    John,

    Looks like Larry must be an ambulance chaser.

  • January 18, 2005 at 4:50 am
    Hubert says:
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    Lets keep in mind that these folks who are illegally creating these staged loss scenarios are also hurting (and sometimes killing) innocent people, for their own personal & financial gain. We have laws to enforce insurance fraud, and SIU departments dedicated to investigating and reporting these miserable criminals.

  • January 18, 2005 at 6:34 am
    John says:
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    I dont know what carriers you are talking about that have increased profits, but I assure you that if it increased it was probably 1% or 2%. Florida does not allow insurance companies to make large profits, it is called the excess profits law and companies have actually had to reduce rates and give back money to comply, the only one in Florida that has recently done this to comply is Progressive, which pays a whole lot in fraudulent claims as do all other carriers. Trust me, I am not out to see any doctor fail or get paid peanuts, or any other reputable business person, but the pip factories must be stopped, Good honest Doctors should stop accepting low ball contracts that they can afford to live with, I have 20 insurance companies that will let me write all the business I want, but they only want to pay half the commission of some others, the rates are the same to the insured so why would I write for half the pay. If Doctors would stop taking HMO & PPO provider contracts your customers will still have to pay. If consumers want to shop medical services to the lowest bidder they deserve the malpractice that comes with it. My medical care is worth spending more on than the low cost generic brand. You get what you pay for, it applies to everything in life.
    As far as Hubert, I agree that fraud is a problem, but if the SIU teams and laws work why do we still have such a problem, the answer is enforcement and punishment are a joke. It is disgusting to see how many convicted fraud ring leaders set back up in business within days of getting released from jail which is usually a few months of time. Lock them up and don’t let them out or they will do it again,

  • January 24, 2008 at 4:48 am
    Paul says:
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    They should set the mandatory minimum at 5 years. 20 for the second offense.



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