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Auto Insurance Fraud Crackdown in Miami-Dade

The Fran Haasch Law Group

When the owner of a West Miami-Dade medical clinic schemed to bill insurance companies for staged auto accidents, she did not know that an undercover witness was secretly recording her, authorities say.

“Bring me good stuff,” Elsa Terrero, of New Horizon Practice, told a cooperating witness, according to an arrest warrant released Wednesday. “I control all the clinics in this building … you will get paid.”

Terrero was one of 25 people — including three doctors — charged Wednesday in a crackdown on “personal injury protection” fraud in Miami-Dade that officials say costs insurances companies millions of dollars each year, and ultimately raises rates for consumers. Terrero’s scam cost insurance companies nearly $800,000, though the amount is likely much more, officials said.

“This is not a clinic. This is a fraud mill,” Florida’s Chief Financial Officer Jeff Atwater said at a press conference Wednesday.

“Many people see the insurance fraud as a victimless crime. It is not,” said Miami-Dade State Attorney Katherine Fernandez Rundle.

The ring was cracked by detectives from the state’s Department of Financial Services fraud division, and Miami-Dade prosecutors. PIP insurance pays for up to $10,000 in medical bills and lost wages, and Florida ranks as one of the top states in the country for staged auto accident fraud.

Terrero, 40, is charged with racketeering, grand theft, organized scheme to defraud and a slew of other felonies. The others face similar charges.

The undercover investigation began in November 2009 when a man named Martin Triana, secretly working with detectives, agreed to stage an auto accident at a red light in Liberty City, according to an arrest warrant.

Triana later went to the clinic, 7171 Coral Way, where he signed 25 blank therapy forms, which would later be submitted to insurance companies, and was later X-rayed by an unlicensed technician. Later visits resulted in no treatment, the warrant said.

The clinic later billed State Farm insurance for 40 therapy sessions. The clinic also billed the company for three visits with Dr. Gerald Amado, who never examined Triana; the doctor was arrested Wednesday.

Triana later recruited a man named Miguel Hernandez, who was actually an undercover detective using a fake identity. Hernandez played along in another bogus accident, the warrant said, and the result was that clinic billed Imperial Fire & Casualty Insurance Company for $20,225.24.


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