'Runner' behind auto insurance fraud scheme pleads guilty
Louis Aguirre masterminded an automobile accident scheme that cost insurance companies millions in fraudulent PIP claims.
A man who masterminded an automobile accident scheme that cost insurance companies millions in fraudulent claims plead guilty on Tuesday, March 11, 2020, before a federal judge.
A release from the U.S. Attorney’s Office said Louis G. Aguirre, 59, admitted he helped orchestrate the scheme in Bergen County, N.J., by acting as a “runner” who identified and recruited accident victims.
Aguirre was paid $500 for each accident victim he delivered by unnamed health care providers, who submitted fraudulent insurance claims to personal injury protection insurance plans to pay for medically unnecessary services, prosecutors said.
The scheme yielded a total loss in excess of $3.5 million, including $250,000 for which Aguirre was responsible, according to U.S. Attorney Craig Carpenito.
Aguirre pleaded guilty before U.S. District Judge Stanley R. Chesler in Newark to one count of conspiracy to commit health care fraud, and his sentencing is scheduled for July 14, the release said. He faces up to 10 years in prison and a fine of up to $250,000 or twice the gross gain or loss from the offense.
John Lynch, a solo in Union City, is representing Aguirre. Lynch could not be reached for comment late Tuesday.
According to the release, Aguirre introduced accident victims to various chiropractors, medical imaging centers, and others, who billed PIP insurance plans. He and an employee from an unnamed auto body shop in West New York, using word of mouth in the community, identified and recruited individuals who had been in car accidents, prosecutors said.
Aguirre paid the employee, who in turn paid the accident victims, they said.
Aguirre prompted the accident victims to file police reports and to visit specific health care providers to obtain medically unnecessary services such as X-rays and MRIs in order to claim fake or exaggerated injuries, the office said.
The release cited, as an example, a Sept. 25, 2018, rear-end accident in Elizabeth where “Individual-3″ refused medical treatment at the scene but later participated in the scheme in exchange for cash. Individual-3, directed by Aguirre, visited an MRI center in Rochelle Park and underwent medically unnecessary X-rays, after which the center billed Individual-3’s PIP insurance policy for inflated charges.
Assistant U.S. Attorney Jason S. Gould of the Health Care Fraud Unit prosecuted the case, the release noted.
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