Case Highlights Staged Accidents, Insurance Fraud In Fla.

June 01--Although Junel Basile's job title was "driver," what he really did for Metro Chiropractic & Wellness Center, federal authorities say, was recruit people to participate in staged car accidents and meticulously plan the crashes.

At the same time, the manager at Metro Chiropractic, Sergei Kusyakov, paid Florida Hospital employees to steal patient data so the center could solicit legitimate car-accident victims for business, according to federal-court records.

Experts say the cases, both being prosecuted in Orlando federal court, are examples of the kind of insurance fraud that costs Americans billions of dollars each year.

"If you were going to do a TV series on [personal-injury-protection] fraud, this would be a great plot," said Frank G. Scafidi, spokesman for the National Insurance Crime Bureau.

Fraud is the second-most-costly white-collar crime in the United States, behind tax evasion, the National Insurance Crime Bureau reports.

And in Florida, authorities have noted a significant increase in the number of staged accidents in recent years.

Under Florida's personal-injury-protection (PIP) requirement for auto insurance, insurance companies are required to pay up to $10,000 per person for medical treatment, regardless of who was at fault.

Authorities say medical clinics that run staged-accident schemes make patients receive unnecessary treatments or bill for services never rendered, and exhaust the $10,000 PIP limits as quickly as possible.

Florida lawmakers made sweeping changes to the PIP system last year, but a judge found the new law unconstitutional in March. The state is appealing that ruling.

In a 17-page criminal complaint filed against Basile earlier this year, an FBI agent said clinics usually try to hide the role of "runners" -- those who solicit people to participate in staged accidents -- by employing them as "drivers."

Basile, they say, would brief his recruits how the crash would occur, which driver would be at fault, the number of passengers he wanted in each car and what to tell the police.

The recruits, some of whom were promised up to $1,500 apiece for their involvement, had to then seek treatment at Metro Chiropractic & Wellness Center, which paid Basile more than $140,000 in 2011 in his role as "driver."

Court records show the center took in more than $1.5 million in payments from insurance companies from January 2010 through October 2011. It's not clear, however, whether any of those payments were for legitimate claims.

Haitians recruited

The FBI learned about Basile's scheme through the cooperation of an informant who aided authorities because, according to the criminal complaint, the person objected to the fact that local Haitians were being recruited to participate in the staged accidents.

"The [informant] felt the Haitian community was being taken advantage of by clinic owners and Haitian people operating as runners," the complaint said.

Investigators recorded several conversations between the informant and Basile in 2011, in which Basile tried to plan an "accident" involving the informant.

It was clear 36-year-old Basile, who is Haitian, had an intimate knowledge of insurance policies, agents said.

On April 13, 2011, Basile met the informant in front of the clinic's office building on Vineland Road in southwest Orlando.

Records show Basile said he planned a crash for the next day and had already paid a man $1,000 to participate. He said he wanted three people in the informant's vehicle at the time of the accident and promised to pay them each $1,500.

Basile ended up delaying the crash because the driver of the other car recruited to participate had not paid his insurance premium.

Throughout their investigation, agents questioned several other people about their involvement with Basile and staged accidents. Basile told one person, whom he was recruiting to be another driver, that he would provide the two cars and the passengers for the accident.

Kusyakov, the manager at Metro Chiropractic who was arrested in September for paying two Florida Hospital employees to illegally access thousands of patient records, was sentenced in April to four years in federal prison.

Basile, who was indicted by a grand jury May 1 on a count of conspiracy to commit wire and health-care fraud, remains at the Orange County Jail. His defense attorney, H. Kyle Fletcher, would not comment.

And David Greydinger, the chiropractor associated with Metro Chiropractic and other clinics in Fort Myers and Lake Mary, was arrested May 9 on patient-brokering and insurance-fraud charges in Lee County. It's not clear whether those charges are related to the staged-accident scheme in Orlando; authorities in Fort Myers did not return calls seeking comment Friday.

'Unfortunate reality'

Scafidi, whose Des Plaines, Ill.-based organization partners with law enforcement and insurance companies to identify fraud cases, said Basile's alleged crimes aren't unusual.

It isn't surprising that the FBI's informant said Central Florida's Haitian community was being targeted either, Scafidi said. He said it isn't unlike the mafia and other organized-crime groups running scams through their close-knit communities.

"A lot of seedier elements within those communities always tend to victimize their own people. It's an unfortunate reality," Scafidi said.

Compounding the problem with insurance fraud is a common attitude that people don't think they are hurting anyone when they make false or exaggerated claims, Scafidi said.

Some people, he said, think that because they've been paying their insurance premiums, fraudulent claims are a form of payback.

"Ultimately, everybody who buys insurance is picking up the tab for that illegal activity," Scafidi said.

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