Los Angeles-based Farmers Insurance Exchange filed a lawsuit in the Superior Court of California against two radiological corporations and their owners for allegedly submitting false documentation to get paid for services they didn’t provide.
The civil complaint seeks restitution for unfair business practices, insurance fraud and seeks a cease and desist order to prevent the companies from engaging in alleged improper billing practices.
The lawsuit alleges that the corporations and their owners billed Farmers for 3D Rendering of MRI and CT scans that were never performed in more than 200 bodily injury and workers’ compensation claims under policies issued to Farmers policyholders.
The complaint also alleges that one of the corporations was improperly owned and structured, because a lay person was the majority owner, and not a licensed physician. That would be a violation of state law.
The Farmers Exchanges are three reciprocal insurers (Farmers Insurance Exchange, Fire Insurance Exchange and Truck Insurance Exchange), including their subsidiaries and affiliates, owned by their policyholders. Farmers Group, Inc. is wholly owned by the Zurich Insurance Group.