Allstate Wins Major Medical Fraud Lawsuit in Nevada

October 7, 2013

Allstate Insurance Co. received a judgment of more than $7 million following a Racketeering Influenced and Corrupt Organizations investigation nearly 10 years in the making.

It is the company’s first medical fraud lawsuit in the state.

“Medical insurance fraud affects all policyholder’s premiums, and it’s not fair for consumers to pay higher rates for criminal behavior,” said Chelci Vaughan, Allstate spokesperson.

The RICO complaint was filed in 2008 in the Las Vegas Federal District Court against chiropractor Obteen Nassiri, D.C., and his businesses: Advanced Accident Chiropractic Care; ONN Management; Digital Imaging Services; and Digital X-Ray. Since the suit was filed, the Chiropractic Physicians’ Board of Nevada has revoked Obteen Nassiri’s license.

Allstate’s lawsuit alleged Nassiri began defrauding Allstate in 2003 by exaggerating clinical findings, submitting improbable diagnoses, charging for treatment he did not provide, providing unnecessary and excessive treatment, grossly misrepresenting billing, making inappropriate referrals, and exhibiting a general pattern of illegal and fraudulent conduct. The jury in the case also found Nassiri’s spouse, Jennifer Nassiri, liable for negligent misrepresentation. The case accused Obteen Nassiri of running a practice that referred patients to his clinics for unnecessary medical consultations and expensive diagnostic studies in an effort to generate more revenue and profit.

The verdict sided with Allstate in June and the final judgment and award was made in late September. The total judgment against the defendants included an award to Allstate for $3.59 million in compensatory damages, $2.51 million in punitive damages and $1 million in pre-judgment interest. The company is pursuing more than $1 million in attorney’s fees and costs. The award means Allstate will recover money for the settlement of more than 150 auto accident claims that involved fraudulent costs. Allstate sought recovery against each defendant.

The Allstate Corp. serves roughly 16 million households through its Allstate, Encompass, Esurance and Answer Financial brand names and Allstate Financial business segment.

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Insurance Journal West October 7, 2013
October 7, 2013
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