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WOODBURY, N.Y. - In a $1.8 million lawsuit filed on June 11, GEICO has challenged an alleged no-fault scheme involving the submission of thousands of suspect no-fault claims to the company (Government Employees Insurance Company, et al. v. Michael D. Green, M.D., et al., No. CV10-2671, E.D. N.Y.).
The claims, seeking payment for radiology services, were submitted through medical professional corporations, operating from a single imaging center in Kew Gardens, N.Y., which are alleged to have been secretly owned and controlled by non-physicians.
GEICO's lawsuit, filed in the U.S. District Court for the Eastern District of New York, names 10 defendants, including two physicians, two medical professional corporations, a non-physician (as well as the companies he formed to control the medical professional corporations and its profits) as well as two attorneys and a Long Island law firm.
GEICO said the alleged scheme was identified by GEICO's Special Investigations Unit based upon a systemic pattern of irregular and repetitive billing for radiology services as well as the filing of duplicative litigation against the company using forged documents to support their prosecution.
In the lawsuit, GEICO seeks to recover more than $1.8 million from the defendants in compensatory and treble damages under the Federal RICO statute and New York common law as well as punitive damages.
GEICO is actively working with the New York State Insurance Department's Fraud Bureau, the National Insurance Crime Bureau (NICB) and law enforcement agencies to curb no-fault insurance fraud and to increase public awareness of the problem.
According to the Insurance Information Institute, no-fault fraudulent claims in New York are 111 percent higher than the U.S. average. The NICB estimates that fraud against property and casualty insurers adds approximately $250 annually to the average household's premium. This fraud tax costs all of the insurance-paying public in the form of higher insurance premiums.
GEICO (Government Employees Insurance Company) - as part of Berkshire Hathaway - is the third-largest private passenger auto insurer in the United States. GEICO provides auto insurance coverage for 9 million policyholders and insures more than 16 million vehicles.
Download the complaint.