Those familiar with insurance fraud schemes in Florida will remember Operation Rubicon. It was a year-long investigation by Miami-Dade and Florida authorities into an alleged property insurance fraud scheme involving state comptrollers, restoration companies, insurance agents, a police officer and as many as 25 homeowners.
An investigation launched in 2018 identified two additional alleged participants. Police and court records show that Miami resident Andres Martin, 45, was arrested Aug. 24 on charges of grand theft and filing a false insurance claim for more than $100,000. This was followed the next day by the arrest of Ivan Alberto Camacho Rincon.
Police officials said the arrests are part of the Rubicon investigation. Martin’s lawyer confirmed the connection and that his client was released on bail. He declined to say what Martin does for a living. Martin’s arraignment date is set for September 22 and Rincon’s for September 23.
Investigation hit the headlines in 2019 after the extent of the alleged fraud and the widespread involvement of homeowners in the Miami and Tampa areas were made public. The ringleader, Barbara Maria Diaz de Villegas, also known as Barbara Gonzalez, is reportedly still awaiting trial on racketeering, grand larceny and insurance fraud charges, according to Miami-Dade County court documents. Cases against three more defendants are also pending.
Diaz de Villegas ran the public accounting firm Rubicon Group in south Florida. Investigators said she, her father, her ex-husband and seven other people were involved in the plan and got the homeowners involved. According to court records and news reports, the scheme defrauded or attempted to defraud Citizens Property Insurance Corp. and possibly other insurance companies for more than $600,000.
The operation will send a contractor to the house to create evidence of water damage. Insurance agents have also been involved in fraud, increasing insurance coverage on homes or writing new policies, officials said. More than 100 lawsuits have been filed, according to Citizens.
In the end, the insurer became suspicious and reported it to the authorities. The case involved local police, investigators from the Florida Department of Financial Services and Citizens’ Special Investigations, and the Miami-Dade County Attorney is leading the prosecution.
“Fraud like the one we are describing today is playing a huge role … in what many see as the explosion in insurance rates,” State Attorney Katherine Fernandez Rundle said at the time, according to one news report.
Operation Rubicon also apprehended the adjuster’s ex-husband, Miami-Dade Police Lieutenant Alexander Diaz de Villegas, a 25-year police veteran. According to news reports and court records, he was charged with organized fraud, making false insurance claims and theft after he admitted to knowing fake documents and receipts were presented to citizens as part of water damage claims.
Investigators said the former couple colluded from 2012 to 2018 to file numerous claims over the house, Miami Broadcaster reported at the time. Barbara was a public claims assessor. According to the documents, the case of the former officer was not initiated after he passed the pre-trial diversion program.
Also this week, five people in Miami were charged with faking car accidents and billing insurance companies $59,000 for non-existent medical treatment, part of personal injury protection, or a “no-fault” auto insurance scheme.
Florida DFS reported that Julisa Del Carmen Diaz, Malouli Moreira Rodriguez, Gonzala Ramos Delgado, Yaricel Rodríguez Garcia and Camilo Leon Fernandez were charged with organized fraud, patient mediation, staging an accident, insurance fraud and grand theft.
DFS undercover investigators discovered that Fernandez allegedly hired a witness who collaborated with him and persuaded Moreira Rodriguez to take part in the fake accident in February, according to local news reports. After the accident, Fernandez had the allegedly injured individuals seek help from the Blue Lake Medical Group in Miami.
Fernandez then paid the witness $1,500 on the condition that she would later receive another $300, according to the arrest report. Gonzala Delgado and Yarisel Garcia, who worked in a physical therapy office, submitted false therapy forms to Infinity/Kemper Insurance and National General Insurance, resulting in fraudulent invoices totaling $58,975 to the two insurance companies.
Health insurance fraud
The department also announced the arrest of Ivan Alberto Camacho Rincón in connection with a $367,000 prescription billing fraud scheme. Rincon was detained by Sunny Isles Beach police.
An investigation by the DFS Insurance Fraud Bureau found that in 2019, 2020, and 2021, Rincon sent to Best Doctors Insurance Co. fraudulent drug bills that were never bought from the local pharmacy.
Producer scam in South Carolina
In South Carolina, insurance provider Progressive Insurance pleaded guilty to falsifying medical bills after a car accident.
Keisha Keyona Williams submitted a fake bill for more than $5,000 in 2021, but Progressive did not pay the claim after the carrier suspected fraud, according to a bulletin from the South Carolina Insurance Department.
Williams was sentenced to 18 months probation.