Popular Florida insurance company State Farm has filed a lawsuit against three health care clinics in Miami for allegedly defrauding the insurance carrier out of $4.7 million for unnecessary or unprovided medical care for car accident victims .
[Click here to read the full complaint.]
State Farm lawsuit no-fault insurance centers aroundIs. Because Florida's PIP law requires insurers to pay a driver's medical bills no matter who caused the accident, the law is often the target of fraud by shady medical providers.
The new lawsuit claims the accused Florida healthcare clinic used a standardized treatment plan for all automobile accident victims, rather than treating each patient individually based on their unique needs.
The Miami healthcare clinics accused in the lawsuit are:
Health and Wellness Services Inc., its former and current owners, and its former and current medical directors;
Medical Wellness Services Inc., its owner, its former Medical Director, and its current Medical Director;
Naranja's Pain Relief Clinic of Homestead Corp., and its former and current medical directors.
All three clinics have some kind of family relationship.
Most PIP fraud, and the State Farm lawsuit alleges, center around billing insurance companies for either unnecessary or unreported medical treatment.
State Farm claims that some of the bills presented to them by designated healthcare clinics were false, misleading or fraudulent.
According to the lawsuit, healthcare clinics would fail to fully examine their car accident patients, then diagnose them with a very general condition (i.e., non-specific pain, sprain, and/or strain), then treat them with the same Order diagnostic imaging and treat each patient.
The lawsuit further accuses the clinics of reducing all of their patients' benefits so that they have no further coverage available if they later need other legitimate treatments.
Like most PIP fraud lawsuits, the insurance carrier accused the clinics and their medical directors of failing to properly review medical billing practices. One of the main roles of a medical director is to review diagnosis, treatment, and billing by their clinic to prevent abuse and catch malpractice.
State Farm claims the fraud occurred between 2007 and the present.
Dolman Law Group accident injury attorneys, PA is a personal injury firm representing clients throughout the state of Florida.
The information above is all of the allegations made in the publicly filed complaint by State Farm. None of the above information is the opinion of Doleman Law Group Accident Injury Attorney, PA and is merely a relaying of information from available news sources and public records.