Los Angeles-based Farmers Insurance Group announced that Farmers Insurance Exchange, one of the insurers comprising Farmers Insurance Group, and affiliates have filed a lawsuit in the state Supreme Court of New York against more than six New York no-fault medical providers.
Farmers Insurance is seeking damages of approximately $360,000, in addition to punitive damages and the invalidity of any pending or future claims. The lawsuit alleges an illegal fee splitting scheme with unlicensed professionals, which may have resulted in planned courses of unnecessary treatment and testing for the purpose of profit.
As alleged in the complaint, the defendants are accused of engaging in a system scheme to defraud Farmers by submitting bills for reimbursement of no-fault related services purportedly rendered to individuals who were reportedly involved in auto incidents.
It is further alleged in Farmers’ lawsuit that this scheme included the creation of multiple sham professional corporate entities owned, operated and controlled by laypersons and non-medical professionals, and the submission of thousands of phony healthcare bills.
This is the 16th insurance fraud lawsuit filed by Farmers Insurance in New York since 2011.
“We are committed to investigating insurance fraud and working with the state to bring an end to this type of abuse,” said Sean Zavala, director of special investigations for Farmers Insurance.
Source: Farmers Insurance Group
Topics Lawsuits New York Agribusiness Medical Professional Liability
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