Three Arrested in Alleged Insurance Fraud Scheme at Hialeah Clinic
Operation Exposes Large-Scale Fraud Ring
Three people were arrested in an alleged insurance fraud scheme in Hialeah, where they helped stage car accidents to defraud insurance companies, according to the Miami-Dade County Sheriff’s Office (MDSO).
Arrests Made
On Tuesday, MDSO deputies raided MO Medical Center, a clinic located at 900 W 49th Street, and arrested Yisell Rojas, 39; Ofir Macias, 55; and Ivian Nieto Lazo, 37.
[Image: Camerascaptured the moment suspects were taken away in handcuffs. A woman believed to be Rojas tried to cover her face with a piece of clothing.]
Investigation Uncovered
The investigation began when a driver involved in an alleged accident in November 2024 tried to add another man to the traffic crash report. Upon reviewing bodycam footage, it was discovered that the vehicle’s damage was not consistent with the way the crash had allegedly occurred.
Suspects’ Confessions
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.
Therapist’s Confession
When deputies raided the clinic, and Rojas was being taken into custody, Macias, the clinic’s therapist, arrived. 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."
Charges and Investigation
The suspects are being questioned and will face charges of racketeering, insurance fraud, patient brokering, and more. Rojas was also charged with possession of a controlled substance and cocaine. The MDSO 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.
Background and Impact
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 warn that these frauds directly impact the local economy, driving up insurance costs for all residents. 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.
Conclusion
The MDSO and other law enforcement agencies are working to combat this large-scale problem, which affects not only individuals but also the local economy. The implementation of a pilot program to detect fraudulent crashes and curb this type of crime is a step in the right direction.
Frequently Asked Questions
- What is the nature of the alleged insurance fraud scheme?
The scheme involves staging car accidents to defraud insurance companies. - Who was arrested in connection with the scheme?
Yisell Rojas, Ofir Macias, and Ivian Nieto Lazo were arrested. - What were the suspects’ alleged roles in the scheme?
Rojas is the owner of MO Medical Center and allegedly instructed patients to sign and place their thumbprints on therapy forms. Macias is the clinic’s therapist and allegedly signed medical therapy forms for patients he had not treated. Nieto Lazo allegedly recruited patients to report fake crashes. - What are the charges against the suspects?
The suspects will face charges of racketeering, insurance fraud, patient brokering, and more. Rojas was also charged with possession of a controlled substance and cocaine. - How prevalent is insurance fraud in the United States?
Insurance fraud in the United States exceeds $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.
