Allstate Insurance Co. filed suit in Cook County Circuit Court Wednesday, seeking $14.5 million in damages stemming from alleged insurance fraud. The suit claims that Chicago area medical providers bilked the company out of more than $4.5 million in false or enhanced claims for medical payments and bodily injuries.
Among the defendants are lawyers Harvey L. Wainer and David A. Milks of Chicago, Dr. John Gregor of Wheaton, Ill., Dr. John Stafford of Oak Brook, Ill. and Dr. Patricia Zanelli of Glen Ellyn, Ill. The lawsuit is the result of an intensive investigation of over 1400 claims by Allstate’s Special Investigative Unit, dating back to 1992. The long list of defendants includes 10 Chicago area chiropractic clinics, two x-ray facilities, two MRI facilities, two orthopedic consultation facilities and five currently licensed chiropractors.
In addition, four currently licensed and two disbarred Chicago lawyers are accused of unjustly benefiting from the conduct of the medical providers. “This was not a one-time, one-man operation. This was an on-going effort by a sophisticated ring of medical providers as well as people pretending to be,” said Edward J. Moran, assistant vice president for Allstate’s Special Investigative Unit.
In the suit, Allstate alleges the medical providers engaged in numerous wrongful acts including the unlicensed practice of medicine, illegal self-referrals and fee splitting, charging for higher-level office visits than what actually occurred, and false statements related to the delivery of chiropractic and other health care. The suit further alleges the licensed and disbarred lawyers were unjustly enriched from Allstate’s payment of these claims. According to the Illinois Department of Insurance, insurance fraud costs Illinois consumers approximately $4.5 billion every year.
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