Pine Hills FL Clinic Mired in Fraud Charges

In Pine Hills Florida -which is not-so affectionately referred to as “Crime Hills” by area locals- a clinic owner and several of his employees have been charged with allegedly paying patients for staged accidents and then fraudulently billing a car insurance company.

According to the Orlando Sentinel and Florida’s Chief Financial Officer Jeff Atwater’s office, the Bethel Health and Rehab Center supposedly billed Direct General Insurance Co. for treatment it never performed, and then paid the people who were “treated” after staged crashes.

Atwater’s office also stated that the clinic billed Direct General for $64,000 in fraudulent claims.

A summary of the investigation states that it started last June after a woman reported that she and her 16-year-old daughter were in a car crash in January 2010 and sought treatment from the clinic. According to their website, the clinic offers chiropractic care, massage, pain treatment and physical, occupational and speech therapy.

The manager referred her to a law firm, which several weeks later sent her a letter saying the firm would no longer represent her, documents state. With the letter were medical documents the mother said were forged. She also told authorities that bills submitted to an insurance company contained charges for treatment that never was received.

Florida’s Division of Insurance Fraud declared that the insurance company was billed for 21 sessions of massage therapy for the mother and 20 for the daughter. Court documents note that her daughter only ever received one massage session, while her mother never even had one.

The clinic billed the insurance company $27,548, but the company only paid a little over $2,000.

Investigators noted that the massage therapist, who no longer works at the clinic, cooperated with them and admitted to fabricating the treatment forms for the mother and daughter, along with other patients. He said the manager, Jean Fritz Petiote, and two employees, Oliver Steven Zidor and Myrlene Saint Preux, pressured him to commit the fraud.

Investigators were told by another former massage therapist that Saint Preux had asked her to fabricate patient treatment forms as well.

On a separate occasion, a 22-year-old former patient told investigators that Petiote had staged a car crash on Feb. 14, 2010, promising the woman $1,000 if she would visit his clinic 15 times after the “accident,” investigators said.

The woman also went on to identify others who participated in the crash as Patricia Placek, a massage therapist at another west Orange County chiropractic clinic, and a man named Alejandro Estrada.

Bethel Health and Rehab Center billed Direct General Insurance $36,460 for visits by the three involved in the fake accident, prosecutors said. The center claimed Placek visited 46 times and Estrada was treated 43 times, documents show.

These arrests happen as the Florida legislature is debating a bill which includes requiring law enforcement officials to list all persons involved in an accident and creating civil penalties for fraud. The proceeds would be used to fund additional anti-fraud efforts.

Atwater praised investigators for their efforts. “These arrests represent the kind of manipulation and fraud that take place in accident clinics throughout the state and drive up auto insurance costs for all Floridians,” he said. “I am committed to cracking down on PIP fraud and putting thieves behind bars.”

As listed by the Insurance Journal, Petoite and his brother Zidor were arrested on April 29^th. They are both facing charges of staging an accident, insurance fraud, grand theft, patient brokering and organizing a scheme to defraud.

Arrest warrants have been issued for Saint Preux, Placek and Estrada.

If they are convicted, each individual could face up to two years in jail for staging an accident and up to 30 years for organizing a scheme to defraud insurers