Overview

Sandra Heller is a Fort Lauderdale attorney who focuses her practice on advising clients in the identification and prevention of complex fraud schemes, as well as seeking civil recovery on their behalf. Ms. Heller analyzes, counsels, investigates and litigates civil recovery actions in multiclaim insurance fraud cases on behalf of both large national and regional private health insurance carriers, as well as national property and casualty insurers. She assists in fraud investigations throughout the United States, and her work has created impactful and transformative case law in this arena.

Ms. Heller has experience in advancing affirmative litigation on behalf of insurance carriers, as well as providing vigorous defense in benefit-related litigation matters, including the investigation of fraud in the submission of claims to private health insurers, including claims governed by the Employee Retirement Income Security Act (ERISA). Ms. Heller also has extensive experience with matters involving Personal Injury Protection (PIP), Bodily Injury (BI) and Uninsured/Underinsured Motorist (UM) related coverages in state and federal courts. Ms. Heller guides and supports insurance clients by implementing strategies resulting from key legislative changes and regulatory reporting responsibilities.

In addition, Ms. Heller is an active speaker, often sharing her knowledge of insurance fraud at conferences nationwide. She began her career as an assistant district attorney in Tarrant County in Fort Worth, Texas. She was a member of the elite Crimes Against Children Unit, in which she took more than 90 prosecutions to jury verdict.

Prior to joining Holland & Knight, Ms. Heller was a board member and co-chair of the fraud and recovery practice group for a national law firm.

Experience

  • Represented a national health insurer in federal court involving claims against substance use disorder facilities and a related laboratory involving claims of violations of Florida's Deceptive and Unfair Trade Practice Act (FDUTPA) and Patient Brokering Act pertaining to the inappropriate use of urine drug testing and unlawful patient referrals
  • Represented a major auto insurance carrier in federal court involving claims of fraud, FDUTPA, unjust enrichment and declaratory relief against a medical provider, prevailing on all claims on summary judgment; created new and impactful case law regarding the submission of a fraudulent application for licensure from the Florida Agency for Healthcare Administration deeming the resulting licensure void ab initio
  • Represented a major auto insurance carrier in a federal court action involving unjust enrichment and declaratory relief, prevailing on all claims on summary judgment; created new and impactful law regarding the failure to collect copayments and deductibles insurance fraud as a matter of law, as well as confirming the statutory duties of medical directors under Florida's Health Care Clinic Licensing Act
  • Represented a major auto insurance carrier in state court declaratory action pertaining to allegations of provider coding and billing practices in contravention of American Medical Association (AMA) guidelines and the Florida No-Fault Law, prevailing at trial and establishing that failure to utilize AMA Editorial Panel Current Procedural Terminology (CPT) coding fails to place insurer on notice of a covered loss
  • Represented a client in a matter involving counterclaims for fraud and unjust enrichment, on behalf of a major auto insurance carrier in an action including defense of breach of contract claims pertaining to PIP benefits
  • Represented clients in defense of claims against major auto insurance carriers and their insureds, wherein damages included certain spinal procedures performed on personal injury claimants

  • Assisted a medical provider client in an internal investigation to determine compliance with Medicare reporting requirements and preparation of internal action plan

Credentials

Education
  • Texas Tech University School of Law, J.D.
  • Texas A&M University, B.B.A., Management
Bar Admissions/Licenses
  • Florida
  • Texas
Court Admissions
  • U.S. Court of Appeals for the Eleventh Circuit
  • U.S. District Court for the Middle District of Florida
  • U.S. District Court for the Southern District of Florida
  • U.S. Supreme Court
Memberships
  • Association of Certified Fraud Examiners
  • Florida Insurance Fraud Education Committee, Certified Trainer
  • International Association of Special Investigation Units (IASIU), Certified Trainer
  • Medical Claims Defense Network, Certified Trainer
  • Broward County Bar Association
  • Florida Association of Women Lawyers

Speaking Engagements

News