Grand Rapids Man Sentenced to 37 Months in Prison for Auto Crash Fraud Scheme
Marvin David Ramirez of Grand Rapids, Michigan has been sentenced to 37 months in prison after pleading guilty on charges to conspire to commit mail fraud. The 45-year-old Ramirez participated in a multi-state insurance fraud scheme and was handed his sentence by United States District Judge Paul L. Maloney.
Ramirez is also ordered to pay $298,992 back to insurance companies as restitution.
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The man, along with others, ran the scheme for several years at Primary Rehab. Between December 2011 and May 2014, Ramirez engaged in staged automobile accidents, paying cash to individuals to stage the accidents and file police reports. Insurance claims where then filed with the auto insurance companies to profit off of settlements.
The group would have managers of the clinic prep the participants of the accident, explaining what symptoms to complain about to physicians involved in the fraud. Participants were to seek prescriptions for physical therapy and seek the therapy at clinic.
Participants went to great lengths to stage their claims, going to therapy offices and even having therapy treatment forms signed by massage therapists, although the treatment was never provided.
“Car accident injuries vary in terms of type and severity,” explains Queener Law, including: whiplash, neck injuries, head injuries, back injuries, mental injuries, cuts and broken bones.
Participants often complained of the most common issues experienced after a car accident, helping those involved in the scheme profit in the process.
The clinic billed insurers over $1 million in fraudulent claims, collecting on $600,000 in the process. Primary Rehab’s part-owner, Maria Del Carmen Ramirez-Rodriguez, was sentenced to 40 months’ imprisonment, Alder Hernandez, also part-owner, was sentenced to 37 months of imprisonment.
Prosecution took multiple years to complete and included other clinics: H&H Rehab, Renue Therapy and Revive Therapy.
Officials claim that staged-crash rings are responsible for billions of dollars of payouts annually. Phantom injuries are common, and soft-tissue injuries, which are hard to prove, are the most commonly reported injuries.
Auto claim fraud was between $5.6 billion and $7.7 billion in 2012, and excess payments accounted for 13% to 17% of all total payments.
Fraudsters are also vetting insurance companies to determine their chances of defrauding the company with larger settlements. These individuals will file an initial, small claim with a carrier to determine if the carrier detects fraud. If the carrier doesn’t detect fraud with a smaller claim, fraudsters may file larger claims in the future.
Author: Jacob Maslow
