Allstate Seeks $3.5M in Fraud Lawsuit
Allstate Insurance Co. and Allstate Indemnity Co. began serving summons and complaints upon a Los Angeles County chiropractor and his wife, accusing them of taking part in schemes designed to defraud the companies.
Paul Yan, DC, Winnie Yan and Paul Yan Chiropractic Corporation are accused of reportedly operating a scheme of excessive billing, fraudulent billing and billing for services that were never rendered. The lawsuit alleges that more than 150 false or inflated claims were submitted to Allstate by Yan for patient services including examinations, diagnostic testing and treatment. According to the complaint, filed in Los Angeles Superior Court, most of the patients had been involved in minor car accidents and suffered from minor soft tissue injuries.
Allstate is seeking more than $3.5 million under a California law passed to help combat insurance fraud. Five years ago, Allstate Insurance Company filed the first lawsuit under the 1995 state law designed to augment law enforcement's efforts to prosecute defrauders and in 2001 won an $8.2 million jury award. Allstate has filed a number of similar lawsuits under this statute, emphasizing its zero tolerance for insurance fraud.
"The suit served today and similar ones filed across the country are a result of Allstate's nationwide commitment to protect our customers and shareholders from the added expense directly linked to insurance fraud," said Edward J. Moran, assistant vice president of the special investigative unit at Allstate. "We are committed to taking the profit out of fraud."
The National Insurance Crime Bureau estimates that insurance fraud schemes cost consumers $20 billion a year.
Former Claims Adjuster, Accomplices Arrested
A former workers' compensation claims adjuster and all eight of her alleged accomplices must now face felony grand theft charges after an investigation by the California Department of Insurance (CDI) Investigation Division revealed a $318,250 fraudulent check scheme.
According to CDI investigators, Linda Anne Wiser, 53, of Glendale, allegedly issued 125 fraudulent claims checks to her friends and associates over a one year period while working as a claims adjuster at Chubb Insurance Company in Los Angeles. Evidence obtained from search warrants reportedly shows that most of the checks were cashed and/or deposited into bank accounts held by the alleged accomplices, and that Wiser received 'kickbacks" for her role in the scheme.
In addition to Wiser, the following suspects are in custody or have posted bail: Lionel Dwayne Cannon, 39, of San Bernardino, Constantino Rufus Hall, 38, of San Bernardino; Marquette Duval Jenkins, 27, of Rialto; James William Johnson, 35, of Rialto, Melanee Ellise McInnis, 23, of San Bernardino; Larry Gilbert Moss, Jr., 28, of San Bernardino; Robert Christopher Raphael, 35, of Rialto; and Shannon Jemel Smith, 30, of Rialto.
The cases are being prosecuted by the San Bernardino County District Attorney's Office, Workers' Compensation Division. Bail for each of the suspects is from $25,000 to $100,000.
