Fraud Costs NY

Examples of Fraud

While no-fault insurance fraud is on the rise, it is mainly perpetrated by a handful of health care providers and law firms. Here are few examples of what we are up against:

Staged Accidents

A 19-month investigation led to the indictment of 62 individuals charged with staging more than 40 auto accidents over a three-year period. The ring targeted unsuspecting drivers who, while backing out of a driveway or a parking lot, would be deliberately hit by a car full of passengers, all of whom were participants in the fraud. Occupants of the cars involved were then sent to the same Upper Manhattan medical clinic whose operators were knowing participants in the scheme. In fact, these operators allegedly paid “runners” up to $2,500 for each person referred to the clinic. The “patients” were also paid. The scheme defrauded consumers and insurers of $1.6 million.

Videos of Staged Accidents (Source: NICB)

Criminal Medical Mills

A medical mill that cheated consumers and insurers out of more than $6.2 million over a five-year period was shut down last year with an 84-count indictment against 11 persons, including three doctors, a chiropractor and two acupuncturists, and ten corporations. The enterprise used “runners” to stage accidents and bring “patients” to the clinic where medical providers prescribed unnecessary treatments and procedures, falsified medical records and submitted fraudulent claims to insurers.

Unnecessary Treatment and Testing

A manager of a medical clinic was arrested after orchestrating cursory medical evaluations and fabricating patients’ symptoms, falsely diagnosing extensive soft tissue injuries, and referring patients for prolonged, unnecessary treatment and testing. This treatment included months of physical therapy, chiropractic care, acupuncture, and psychological counseling, as well as MRIs, x-rays, and nerve testing

Fraudulent Medical Claims

A sophisticated fraud ring was arrested in New York City that lured motor vehicle accident victims to corrupt medical clinics, where medical personnel submitted over a million dollars in fraudulent claims for unnecessary medical treatment and the attorneys filed bodily injury lawsuits. These individuals turned a huge profit, but it was at your expense.