In a recent crackdown on insurance fraud, three individuals were arrested in Hialeah, Florida, for allegedly staging car accidents to defraud insurance companies. The arrests took place at MO Medical Center, following a raid by the Miami-Dade County Sheriff's Office (MDSO) on Tuesday.
The accused are Yisell Rojas, 39, the clinic's owner; Ofir Macias, 55, a therapist; and Ivian Nieto Lazo, 37. Authorities became aware of the clinic's suspicious activities after a driver involved in a purported accident in November 2024 attempted to add another individual to the traffic crash report. Upon reviewing body camera footage, deputies observed inconsistencies between the vehicle's damage and the manner in which the crash was reported.
During police interviews, the suspects allegedly confessed that Nieto Lazo had instructed them to visit MO Medical Center to report a fabricated accident in order to receive compensation. Rojas reportedly guided them to sign and place their thumbprints on numerous therapy forms, which were essential for processing their fraudulent claims. Investigators revealed that the suspects were allegedly coached on what to say if questioned about their injuries, the names of therapists, and the location of their attorney's office. This systematic approach to staging accidents and submitting false claims indicates a well-organized operation.
When deputies executed the raid, Rojas was taken into custody in her office, while Macias arrived at the clinic shortly thereafter. During questioning, Macias reportedly confessed to signing medical therapy forms for patients he had neither seen nor treated. He stated that Rojas would provide him with patient charts that included pre-signed therapy forms and thumbprints, describing this practice as standard at the clinic.
The suspects are currently being questioned and are expected to face serious charges, including racketeering, insurance fraud, and patient brokering.
The investigation is part of a broader effort to dismantle a criminal ring that allegedly orchestrates fake car accidents, recruits fictitious patients, and submits fraudulent claims to secure millions in payouts. This operation underscores the importance of vigilance in the healthcare and insurance sectors, as authorities work diligently to combat fraudulent activities that threaten the integrity of the system.