Insurance Fraud NEWS
Michigan crash-ring member gets 3 years, must repay $298K
November 08, 2018, Wyoming, MI
Marvin David Ramirez, 45, of Grand Rapids, Michigan, was sentenced to prison in federal court yesterday. Ramirez pled guilty in June of this year to conspiracy to commit mail fraud related to a staged automobile accident ring that operated at Primary Rehab Center in Wyoming. United States District Judge Paul L. Maloney sentenced Ramirez to 37 months in prison. When imposing the sentence, Judge Maloney commented that "Michigan residents pay some of the highest auto insurance rates in the country and fraud schemes like the present case contribute significantly to these high premiums." The court also ordered Ramirez to pay restitution of $298,992.29 to the automobile insurance companies that he defrauded.
"Ramirez and his cohorts operated a sophisticated scheme over several years in our community," stated U.S. Attorney Andrew Byerly Birge. "The well-deserved sentence imposed by the court reflects the leadership role played by Ramirez and the fact that he greatly profited from this fraud at the expense of Michigan’s automobile insurance system."
The staged automobile accident ring operated at Primary Rehab from December 2011 to May 2014. The ring recruited and paid cash to individuals to stage automobile accidents and obtain police reports so that insurance claims could be made with their automobile insurance companies. The managers of the clinics and others working with them then told the accident participants what symptoms to present to physicians affiliated with the ring so that they would sign a prescription for physical therapy. The accident participants then sought unnecessary therapy treatment at the clinics. Typically, after a few therapy sessions, the accident participants signed blank therapy treatment forms that were later signed by massage therapists to make it appear as if the accident participants obtained treatment when they truly did not. The therapy clinics then used the treatment forms to send false insurance claims through the United States mail to automobile insurance companies for therapy treatment that was either not necessary or not actually provided. The clinic billed automobile insurers over $1,000,000.00, and obtained fraudulent payments in excess of $600,000.00.
"Elaborate insurance fraud schemes like the one perpetrated in this case disrupt the economy and cause law-abiding citizens to pay more for their coverage," said HSI Special Agent in Charge Steve Francis. "HSI is committed to working with our law enforcement partners to bring down organized criminals that have no concern for the law or their affected victims."
"These defendants engaged in conduct that drives up insurance rates and health care costs," said Timothy Slater, Special Agent in Charge, Detroit Division of the FBI. "The FBI remains committed to working alongside our partners at Homeland Security Investigations and the U.S. Attorney’s Office to ensure that individuals who engage in this type of fraudulent conduct are brought to justice."
Three other individuals were also convicted and sentenced in conjunction with the staged auto accident insurance fraud scheme at Primary Rehab Center:
• Maria Del Carmen Ramirez-Rodriguez, 64, Wyoming, Michigan, part-owner of Primary Rehab (40 months’ imprisonment)
• Alder Hernandez, 45, Tampa, Florida, part-owner of Primary Rehab (37 months’ imprisonment)
• Osvaldo Rivas-Martinez, 46, Port Richey, Florida, patient-recruiter for Primary Rehab (3 years’ probation)
The sentencing of Marvin Ramirez completes a multi-year prosecution of individuals in West Michigan engaged in defrauding Michigan automobile insurers. Previously sentenced for their roles at three other clinics, Revive Therapy, Renue Therapy, and H&H Rehab, were:
• Belkis Soca-Fernandez, 58, Tampa, Florida, part-owner of Revive Therapy and Renue Therapy (135 months’ imprisonment)
• David Sosa-Baladron, 43, Tampa, Florida, part-owner of Revive Therapy and Renue Therapy (120 months’ imprisonment)
• Antonio Ramon Martinez-Lopez, 35, Tampa, Florida, manager of Revive Therapy (87 months’ imprisonment)
• Gustavo Acuna-Rosa, 30, Versailles, Kentucky, manager of Renue Therapy (32 months’ imprisonment)
• Yoisler Herrera-Enriquez, 31,Wyoming,Michigan, manager and massage therapist, H&H Rehab (57 months’ imprisonment)
• Eduardo Pardo-Oiz, 35, Nashville, Tennessee, recruiter and accident participant (2months’ imprisonment)
• Dolis Rojas-Lopez, 31, Wyoming, Michigan, recruiter and accident participant (3 years’ probation)
• Yosvany Gonzalez-Duran, 42, Lansing, Michigan, recruiter and accident participant (1 year probation)
The Department of Homeland Security, Homeland Security Investigations, and the Federal Bureau of Investigation, in Grand Rapids, Michigan, conducted the investigation of the case. Assistant United States Attorneys Ronald M. Stella and Timothy VerHey handled the prosecution.
Source: United States Department of Justice