Allstate Insurance is trying to recover more than $1.1 million from 16 New York-area Defendants in a civil lawsuit filed by the insurance company. This was the ninth insurance fraud lawsuit filed by Allstate in 2011. The Complaint, filed in Federal District Court, as a Declaratory Judgment/Recovery action, says that a chiropractor, along with one layperson and two lay entities, illegally owned and controlled three professional medical corporations allegedly owned on paper by a medical doctor and used them to submit fraudulent billing to Allstate. In addition, four other individuals and four other companies were also named as being part of the overall scheme to submit fraudulent bills to Allstate.
Allstate contends in the lawsuit that professional service corporations were actually owned and controlled by laypersons, rather than by licensed medical professionals. The lawsuit also alleges that the Defendants submitted claims for services that were performed by independent contractors in violation of the No-Fault Law. Allegedly, there were also incidents of illegal referrals to a person who had a financial interest. The suit contends that B.J.Y. Freeport Medical, P.C., B.Y.,M.D., P.C. and Innovative Medical, P.C. were fraudulently incorporated through a scheme using the name of Benjamin Yentel, M.D., a licensed medical doctor. But, in reality, those medical entities were actually run by Stanley Anderson, D.C. and his wife Jill Anderson. Not one of these individuals is a medical doctor. Two management companies also were utilized to effectuate this scheme, according to Allstate. They were HISLI, Inc. and Steady Management Corp.
Included in this lawsuit are claims for improper self-referral against Oasis Physical Therapy, P.C. and also an unjust enrichment claim against Ranj Corporation, Top Rehab Inc., and Soft Touch Acupuncture, P.C. The lawsuit was filed following an investigation by Allstate’s special investigative unit and seeks reimbursement for personal injury protection benefits Allstate paid on behalf of its customers during timeframes specified in the lawsuit.
It should be noted that since 2007, Allstate has filed 36 separate fraud lawsuits in New York alone. In these suits, Allstate sought almost $200 million in damages. It’s good to know that Allstate not only agrees that the civil justice system should be alive and well, but also that the insurance giant believes in punishing wrongdoers in the courts it plans to do.
Source: Insurance Journal