Those familiar with insurance fraud schemes in Florida will remember Operation Rubicon. That was the year-long investigation by Miami-Dade and Florida authorities into an alleged property insurance fraud scheme that involved public adjusters, restoration companies, insurance agents, a police officer and as many as 25 homeowners.
The investigation, begun in 2018, has now netted two more 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 of more than $100,000. That was followed the next day by the arrest of Ivan Alberto Camacho Rincon.
Police officials said that the arrests are part of the Rubicon investigation. Martin’s attorney confirmed the connection and that his client had been released on bond. He declined to say what Martin does for a living. Martin’s arraignment date has been set for Sept. 22 and Rincon’s is scheduled for Sept. 23.
The investigation made headlines in 2019 after the scale of the alleged fraud and the widespread involvement of homeowners in the Miami and Tampa areas was made public. The reported ringleader, Barbara Maria Diaz de Villegas, also known as Barbara Gonzalez, is still awaiting trial on racketeering, grand theft and insurance fraud charges, according to Miami-Dade County court filings. Cases against three other defendants also are pending.
Diaz de Villegas operated The Rubicon Group, a public adjusting firm in south Florida. Investigators said she, her father, her ex-husband and seven others were involved in the plan and recruited homeowners to participate. The scheme bilked or attempted to bilk Citizens Property Insurance Corp. and perhaps other insurers out of more than $600,000, according to court records and news reports.
The operation would send a contractor to a home to create evidence of water damage. Insurance agents also were involved, increasing coverage on homes or writing new policies at some point in the fraud, officials said. More than 100 claims were filed, Citizens has reported.
The insurer eventually became suspicious and tipped off authorities. Local police, investigators with the Florida Department of Financial Services and with Citizens’ special investigations unit participated in the case, and the Miami-Dade County state attorney is prosecuting.
“It’s scams like the one we are describing today that play a huge role … in what many believe are exploding insurance rates,” State Attorney Katherine Fernandez Rundle said at the time, according to one news report.
Operation Rubicon also nabbed the adjuster’s former husband, Miami-Dade Police Lt. Alexander Diaz de Villegas, a 25-year veteran of the police force. He was charged with organized fraud, filing false insurance claims and theft, after he admitted to knowing that fraudulent documents and receipts were submitted to Citizens as part of water damage claims, according to news reports and court records.
Investigators said the former couple conspired together from 2012 to 2018 to file numerous claims on the home, a Miami TV station reported at the time. Barbara was the public adjuster on the claims. The former officer’s case was not prosecuted after he completed a pre-trial diversion program, records show.
Also this week, five people in Miami were charged with staging auto accidents and billing insurers $59,000 for non-existent medical treatments, part of a personal injury protection or “no-fault” auto insurance plot.
Florida’s DFS reported that Yulisa Del Carmen Diaz, Malouly Moreira Rodriguez, Gonzala Ramos Delgado, Yarisel Rodriguez Garcia, and Camilo Leon Fernandez were charged with organized scheme to defraud, patient brokering, staged accident, insurance fraud and grand theft.
Undercover investigators with DFS found that Fernandez allegedly recruited a cooperating witness and convinced Moreira Rodriguez to participate in the staged crash in February, according to a local news report. After the crash, Fernandez had the supposedly injured parties to seek care at Blue Lake Physician Group in Miami.
After that, Fernandez paid the witness $1,500, with the understanding that she would get an additional $300 later, the arrest report shows. Gonzala Delgado and Yarisel Garcia, who worked at the physical therapy office, submitted false therapy forms to Infinity/Kemper Insurance and to National General Insurance, resulting in a total of $58,975 in fraudulent billing to the two insurance carriers.
Medical Insurance Fraud
The department also announced the arrest of Ivan Alberto Camacho Rincon in connection with a $367,000 prescription invoicing fraud scheme. Rincon was taken into custody by the Sunny Isles Beach Police.
An investigation by the DFS Bureau of Insurance Fraud found that in 2019, 2020 and 2021, Rincon sent fraudulent invoices to Best Doctors Insurance Co. for medications that were never purchased from a local pharmacy.
South Carolina Producer Fraud
In South Carolina, an insurance producer for Progressive Insurance pleaded guilty to submitting a faked medical bill after a car crash.
Keisha Keyona Williams in 2021 submitted the forged bill, for more than $5,000, but Progressive did not pay the claim after the carrier suspected that fraud was involved, the South Carolina Department of Insurance said in a bulletin.
Williams was sentenced to 18 months probation.