Five Naples Residents Charged For Defrauding Auto Insurance Companies |
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U.S. Attorney’s Office
Middle District of Florida
12 August 2015
FOR IMMEDIATE RELEASE
Fort Myers, Florida – United States Attorney A. Lee Bentley, III announces the unsealing of two indictments charging five individuals with conspiracy charges related to fraudulently operating chiropractic clinics that defrauded automobile insurance companies. These charges are the culmination of a two-year joint federal and state law enforcement investigation dubbed Operation Fraudulent Pain.
Garry Joseph (36), Nesly Loute (51), Wisler Cyrius (34), Anouce Toussaint (32), and Sijames Melus (32) are charged with conspiracy to commit mail fraud. Cyrius and Toussaint have also been charged with conspiracy to commit money laundering. Each charge carries a maximum penalty of 20 years in federal prison. The indictments also notify the defendants that the United States is seeking money judgments in the amount of the proceeds of the charged criminal conduct.
According to the indictment, Joseph and Melus were the true owners of two chiropractic clinics in Naples, Parkway Medical and Rehab LLC and T&C Consultants d/b/a Collier Chiropractic Center. To circumvent State of Florida licensing requirements, they paid licensed health care practitioners to allow their names to be used on official documents as though they were the true owners of the clinics. Between October 2012 and February 2015, Parkway and Collier Chiropractic submitted claims to automobile insurance companies for payment for services purportedly rendered to accident victims treated at the clinics. The true owners of the clinics caused the insurance companies to be billed for claims that violated Florida law because the clinics were not properly licensed. In addition, they caused the insurance companies to be billed for claims for unnecessary treatments and/or services that had not been actually rendered. Joseph and Melus allegedly defrauded the auto insurance companies of more than $2 million.
According to the second indictment, between June 2013 and February 2015, Cyrius, Loute, and Toussaint participated in a scheme to defraud insurance companies by filing fraudulent claims. Cyrius and Toussaint were the actual owners of Tamiami Pain and Rehab LLC and First Choice Pain and Rehab Inc. As part of the conspiracy, they paid a licensed health care practitioner to act as the owner of the clinics. The conspirators fraudulently submitted multiple claims to the insurance companies that were unlawful because the clinics were not properly licensed under Florida law and were not exempt from the Florida licensing statutes. In addition, the conspirators allegedly solicited individuals to participate in staged automobile accidents in exchange for compensation, and caused clinics that they controlled to submit claims for payment by the automobile insurance companies for unnecessary services rendered to the staged accident participants. The indictment further alleges that Cyrius and Toussaint conspired to launder the proceeds of the mail fraud by concealing the nature of the funds and by taking steps to avoid reporting requirements related to financial transactions.
An indictment is merely a formal charge that a defendant has committed one or more violations of federal criminal law, and every defendant is presumed innocent unless, and until, proven guilty.
This case was investigated by the Federal Bureau of Investigation, the State of Florida’s Department of Financial Services Division of Insurance Fraud, the Internal Revenue Service - Criminal Investigation, and U. S. Immigration and Customs Enforcement’s Homeland Security Investigations. Assistance was also provided by the Florida Highway Patrol, the National Insurance Crime Bureau, the Florida Department of Health, and the State Attorneys’ Offices for the 13th and 19th Judicial Circuits. The following insurance companies also assisted with the case: Travelers, Nationwide, Bristol West, Esurance, Windhaven, Farmers, Direct General, Allstate, State Farm, Progressive, Geico, Infinity, and Foremost. It will be prosecuted by Assistant United States Attorney David G. Lazarus.