Federal Jury Finds Naples Man Guilty In Connection With “PIP” Scheme To Defraud Automobile Insurance Companies

U.S. Attorney’s Office
Middle District of Florida
30 September 2016

FOR IMMEDIATE RELEASE

Fort Myers, Florida – United States Attorney A. Lee Bentley, III announces that a federal jury has found Nesly Loute (52, Naples) guilty of conspiracy to commit mail fraud. He faces a maximum penalty of 20 years in federal prison. He was ordered detained pending sentencing on January 17, 2017. In addition, Loute must pay restitution to the victim automobile insurance companies and forfeit the proceeds of the offense.

Loute is the sixth individual to be convicted following the culmination of a two-year joint federal and state law enforcement investigation, dubbed Operation Fraudulent Pain. The investigation disrupted five unlicensed chiropractic clinics that had received more than $2 million in ill-gotten Personal Injury Protection (PIP) payments from automobile insurance companies.

According to testimony during the six-day trial, Loute conspired with others to operate unlicensed chiropractic clinics and bill automobile insurance companies for PIP benefits. Members of the conspiracy also paid patients to induce them to seek treatment at the unlicensed clinics so that the automobile insurance companies could be billed for their PIP benefits. In addition, members of the conspiracy participated in staged motor vehicle accidents and then submitted claims to automobile insurance companies for PIP benefits based on those fake accidents. More than $1 million in fraud proceeds were withdrawn from various bank accounts and through the use of a shell corporation.

Five other individuals previously pleaded guilty and are awaiting sentencing as a result of Operation Fraudulent Pain. They are Wisler Cyrius (35, Naples), Anouce Toussaint (33, Naples), Garry Joseph (37, Naples), Maria Victoria Lopez (44, Moore Haven), and David Adamson (47, Bonita Springs). Each faces a maximum penalty of 20 years in federal prison and must make restitution to the automobile insurance companies. In addition, the United States will seek a forfeiture money judgment from each defendant equal to the amount of proceeds obtained as a result of each offense.

This case was investigated by the Fort Myers offices of the Federal Bureau of Investigation, the State of Florida’s Department of Financial Services Division of Insurance Fraud’s, the Internal Revenue Service Criminal Investigation, and U.S. Immigration and Customs Enforcement’s Homeland Security Investigations. Assistance was also provided by the National Insurance Crime Bureau, the Florida Highway Patrol, the Florida Department of Health, Florida’s Agency for Health Care Administration, 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 is being prosecuted by Assistant United States Attorneys David G. Lazarus and Charles D. Schmitz.