Jacksonville clinic owner charged with PIP fraud

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A clinic that was owned by Sandy Morales named Gate Parkway Drug is closed.  The clinic was closed after Mr. Morales was arrested on charges of personal injury protection (PIP) fraud.  According to the Florida Department of Financial Services, he fraudulently filed $100,000 in billings to at least 20 insurance carriers. He also staged multiple car crashes, paid participants to pose as passengers and then paid those participants to seek treatment in his clinic for fake injuries.  Authorities allege Morales was at the center of a racketeering ring connected with 18 arrests tied to this fraud network that have been made since September 2012.

Action News interviewed local insurance agent Matt Carlucci to get his opinion on the topic of PIP fraud.  Mr. Carlucci said it started in South Florida but once the insurance companies started finding out about the fraud, the fraud slowed down.  Consequently, the fraud has moved north, now in Jacksonville.  It is his opinion that this type of fraud could affect many people.  How?  Since the insurance companies have more claims and they are paying on the claims, the insurance companies will have to raise premiums to make up for lost profit.

The investigation also revealed Morales recruited additional clinic owners and directed patients to PIP clinics to create a larger fraud network.   Here is a list of other clinics that were shut down.

***To date, the clinics involved include: Indian Rehabilitation Center Inc., Arlington Rehabilitation Services Inc., Baymeadows Injury Center LLC, Health Point Injury Center LLC, One Touch Therapy Center, Inc., Saint Jose Injury Center, LLC, Therapy Diagnostic Tech Medical Inc., Wellness Rehab Services Inc., Atlas Massage Therapy Corp., and Gate Parkway Diagnostic Center.  All clinics are now closed.

According to the Florida Office of Insurance Regulation, the number of PIP claims and payouts has gone up in recent years, while the number of drivers and auto accidents has remained relatively constant. The National Insurance Crime Bureau lists Florida as having several cities reporting the highest amount of “questionable claims” nationally.

While PIP premiums represent roughly 2 percent of Florida’s collected insurance premiums, this category accounts for nearly 50 percent of fraud referrals.

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