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State Fraud Investigators Tag Bogus Miami Laboratory

1/18/2001

TALLAHASSEE – Florida Treasurer and Insurance Commissioner Tom Gallagher announced today that Department of Insurance fraud investigators in Miami have shut down a health insurance fraud ring suspected of billing insurance companies at least $1 million for services never rendered.

Gallagher said one arrest was made last week and more are expected after investigators determined that Biolab Clinical, Inc., which listed its address as 14629 S.W. 104th St., #222, Miami, was only a drop box at a Mailbox Etc.

Jose R. Jimenez, 51, of Miami, was arrested Jan. 9 while picking up insurance checks at the drop box.

"We are aggressively pursuing and prosecuting those involved in insurance fraud," Gallagher said. "We're sending a clear message that Florida will not tolerate fraud against our citizens."

Insurance department investigators, as part of a special Medical Fraud Squad, said they began investigating Biolab after hearing complaints from several people that their insurance companies were being billed for lab services they didn't receive. Investigators traced Biolab's address from the Explanation of Benefits (EOB) statements the insureds were receiving from their insurance companies.

Investigators also were able to follow a trail of checks issued by insurance companies to a bank account in the name of Biolab at Bank of America. Investigators believe Biolab billed insurance companies as much as $1 million and received $305,869. The account has been seized.

Investigators are still trying to determine how Biolab got the insureds' names and personal information for billing, but they said this case points out the importance of reading the EOB statements that insurance companies send.

Gallagher warns that these types of scams can chip away at lifetime health insurance benefits, potentially causing problems later in life when the insurance may be needed.

Insurance fraud investigators have been assisted in the four-month investigation by the Defense Criminal Investigative Service, Office of Inspector General; Office of Personnel Management, Office of Inspector General; Metro-Dade Police Department; and the Economic Crimes Unit of the Miami-Dade State Attorney's Office.

The Department of Insurance, Division of Insurance Fraud, investigates various forms of fraud in insurance, including health, life, auto, property and workers' compensation insurance. Cualquier persona con información acerca de este caso u otra posible confabulación de fraude debe llamar a la Línea de Ayuda al Consumidor del departamento de Fraude al 1-800-378-0445. Se ofrece una recompensa de hasta $25,000 a cambio de información que conduzca a una condena en casos de fraude de seguros.