Fraud Rings Uncovered in Florida and Texas
Major Insurance Fraud Schemes: Authorities in Florida and Texas have charged five individuals in separate insurance fraud schemes, including a former licensed broker accused of ACA enrollment fraud and a medical clinic group allegedly staging auto accidents for financial gain.
Staged Auto Accidents in Hialeah
In Hialeah, Florida, law enforcement arrested three individuals connected to a medical clinic fraud operation. The suspects allegedly orchestrated staged car accidents to file fraudulent insurance claims.
The Miami-Dade Sheriff’s Office identified the accused as:
- Ofir Macias, 55 – Therapist at MO Medical Center
- Yisell Rojas, 39
- Ivian Nieto Lazo, 37
Authorities uncovered the fraud after a driver involved in a staged crash attempted to add an unrelated person to the accident report. Bodycam footage from an officer revealed inconsistencies in the damage and crash description, leading to further investigation.
Individuals claiming to be victims of the crash later admitted they had been directed to MO Medical Center to report fake injuries for insurance payouts.
Charges Against the Florida Defendants
Miami-Dade arrest records indicate that Macias faces multiple charges, including:
- Racketeering
- Filing fraudulent insurance claims
- General fraud
As of late Wednesday, his bond had not been set.
ACA Fraud Scheme Tied to Ex-Broker
Separately, federal prosecutors have charged Cory Lloyd, 46, a former Florida-licensed insurance broker, and Steven Strong, 42, of Mansfield, Texas, in a scheme to fraudulently enroll homeless individuals in ACA insurance plans to collect commission payments.
According to the U.S. Department of Justice (DOJ), Lloyd and Strong orchestrated a deceptive enrollment scheme by:
- Using misleading sales scripts to encourage individuals to inflate income estimates for ACA eligibility
- Offering bribes, including cash, gift cards, food, and alcohol, to entice individuals into enrolling
- Coaching consumers on how to answer application questions to maximize government subsidies
- Using false addresses and Social Security numbers for fraudulent enrollments
The fraudulent enrollments led to over $161 million in government payouts.
Lloyd’s Insurance Background and Licensing History
Records from Florida’s Department of Financial Services (DFS) show that:
- Lloyd previously held life, health, and general lines licenses, but they were canceled through administrative action.
- He was appointed by multiple property-casualty insurers, with some appointments extending as recently as 2022.
- His insurance agency, FloridaCare Insurance, played a key role in the fraudulent activities.
Lloyd and Strong now face federal indictment and potential severe penalties.
For more updates on insurance fraud cases, visit JacobiJournal.com.
Read the full DOJ bulletin here.