3 arrested at Hialeah clinic that operated alleged insurance fraud scheme
www.nbcmiami.com, Eduardo "Yusnaby" Rodriguez and Briana Trujillo, February 19, 2025
Three people were arrested in an alleged insurance fraud scheme in Hialeah, where they helped stage car accidents to defraud insurance companies, according to authorities.
The Miami-Dade County Sheriff's Office (MDSO) deputies raided MO Medical Center, a clinic located at 900 W 49th Street on Tuesday, arresting Yisell Rojas, 39; Ofir Macias, 55; and Ivian Nieto Lazo, 37.
Cameras captured the moment suspects were taken away in handcuffs. A woman believed to be Rojas tried to cover her face with a piece of clothing.
Authorities found out about the clinic when a driver involved in an supposed accident in November of 2024 tried to add another man to the traffic crash report. Upon reviewing bodycam, "it was discovered that the vehicle's damage was not consistent with the way the crash had allegedly occurred," an arrest report states.
The men were interviewed and allegedly confessed to police that Nieto Lazo told them to go to MO Medical Center to report a fake crash so they could receive compensation. There, owner Rojas instructed them to sign and place their thumbprints on numerous therapy forms, according to the sheriff's office.
The men were also allegedly "coached on what to say if they were questioned regarding their injury, the therapists name, and the attorneys office location."
When deputies raided the clinic on Tuesday, and Rojas was being taken into custody in her office, arrest reports state that the clinic's therapist, Macias, arrived.
While speaking to detectives, authorities said he "confessed to signing medical therapy forms for patients whom he had not seen or treated. Mr. Macias further stated that Ms. Rojas would provide him with the patient charts which already contained signed therapy forms, including the patients thumbprints prior to him completing the form and affixing his signature. According to Mr. Macias, this was standard practice at the clinic."
MDSO said the suspects are being questioned and will face charges of racketeering, insurance fraud, patient brokering and more. Rojas additionally was charged with possession of a controlled substance and cocaine.
According to the sheriff's office, this operation is part of a larger investigation into a criminal ring that fakes car accidents, recruits fake patients and submits fraudulent claims to obtain million-dollar payouts.
Similar cases have been detected in other parts of the county, and an operation in northwest Miami-Dade last December landed three women behind bars on similar charges.
Authorities have said that these organizations often operate in conjunction with medical clinics, lawyers, auto body shops and even towing services to stage the crashes.
In response, Miami-Dade County implemented a pilot program to detect fraudulent crashes and curb this type of crime.
Fake crash fraud is a large-scale problem. In the United States, these scams exceed $2 billion annually in losses. In Miami-Dade, one out of every three suspected fraud claims comes from this area, according to the National Insurance Crime Bureau.
Authorities warn that these frauds directly impact the local economy, driving up insurance costs for all residents.
News Article: 3 arrested at Hialeah clinic in alleged insurance fraud scheme – NBC 6 South Florida