Florida Lawyer Gets Prison for Role in $23M PIP Fraud Scheme

A Florida man has been sentenced to more than a year in prison for his role in a $23 million auto insurance fraud involving chiropractors’ clinics.

The SunSentinel reports 55-year-old Jason Dalley wept in court Monday as a judge sentenced him to spend a year and nine months in prison and pay more than $1.8 million in restitution.

Dalley admitted he was part of a group of clinic owners, chiropractors and attorneys involved in the scheme. Felix Filenger, of Sunny Isles, Andrew Rubinstein, of Miami, and Olga Spivak, of Hollywood, were charged with RICO conspiracy, conspiracy to commit mail fraud, wire fraud, and health care fraud, and false statements relating to health care matters. Richard Yonover, of Boca Raton, Jason Dalley, of Lake Worth, and Linda Varisco, of Coral Springs, were charged with conspiracy to commit mail fraud, wire fraud, and healthcare fraud. Court records show the fraud involving clinics in Broward, Palm Beach and Miami-Dade counties brought in at least $23 million from 10 insurance companies between 2010 and 2017.

Dalley, who pled guilty to the charges against him, ran a personal injury and criminal defense law firm in Boca Raton.

According to the indictment, from 2010 to the present, Filenger and Rubinstein ran a criminal enterprise which was engaged in a pattern of racketeering activity that included conspiracy to commit mail, wire, and healthcare fraud and conspiring to commit money laundering. The criminal enterprise owned a dozen chiropractic clinics which were used to facilitate criminal activities involving automobile insurance fraud. Filenger and Rubinstein fraudulently utilized licensed chiropractors as nominee owners in order to obtain licensing for their clinics, including defendant Spivak. Filenger and Rubinstein paid illegal kickbacks ranging from $500-$2,100 to individuals associated with tow truck companies and other individuals who illegally solicited automobile accident victims in order to induce referrals of accident victims to their chiropractic clinics.

Filenger and Rubinstein fraudulently obtained tens of millions of dollars of insurance reimbursement from the Personal Injury Protection (PIP) policies of these accident victims. Filenger and Rubinstein and their employees conspired to bill the insurance companies for clinic visits and treatment modalities, designed to bill the entire $10,000 PIP coverage and not based on medical necessity. Filenger and Rubinstein directed their employees to falsify the initial pain levels of the accident victims in order to fraudulently ensure payment from the insurance companies. Based upon instructions from Filenger and Rubinstein, the co-conspirator chiropractic clinics would treat the patients based solely on a profit motive and without regard for patient health. This treatment would include costly and invasive nerve conduction velocity tests performed not based upon medical necessity but upon the amount of insurance compensation received.

The scheme involved convincing the accident victims to visit the co-conspirator chiropractic clinics at least thirty times, in order to bill the largest amount of PIP reimbursement. Filenger and Rubinstein would work with corrupt lawyers and would pay illegal kickbacks for patients. If the accident victims failed to treat for at least thirty visits at their chiropractic clinics, Filenger and Rubinstein would refer them back to the corrupt lawyers so that the victims could be instructed to return to the clinics.

Linda Varisco was a chiropractor who was the nominee owner of two chiropractic clinics for Filenger and Rubinstein, Advance Medical Associates and Forme Rehab, Inc., and Hollywood Wellness and Rehabilitation, Inc. Varisco and Olga Spivak filed false affidavits with insurance companies claiming that they were 100 percent owners of clinics that were, in fact, owned by Filenger and Rubinstein. Richard Yonover was the undisclosed owner of two clinics in Broward County and unlawfully utilized a nominee to obtain licensing for the clinics and to conceal his true ownership interests. Dalley, along with Richard Yonover, paid illegal kickback payments to obtain clients for personal injury lawsuits. Dalley, who paid in excess of one million dollars in illegal solicitation fees, would send the auto accident clients to co-conspirator chiropractic clinics owned by Filenger, Rubinstein, and Yonover.

Dalley faced a statutory maximum term of imprisonment of five years and a fine of up to $250,000.

Source: U.S. States Attorney’s Office Southern District of Florida/AP