Allstate Files $4.5 Million Insurance Fraud Claim

Seeking to recover $4.5 million from medical providers in a scheme to allegedly bill insurance companies for procedures that were medically unnecessary and/or inappropriate, Allstate Insurance Company, filed counterclaims and complaints against the perpetrators.

Allstate filed counterclaims and a third party complaint alleging that two New York medical professional corporations – Cambridge Medical P.C. and Pine Hollow Medical, P.C. – were fraudulently incorporated through a scheme using the names of licensed medical physicians, and that a lay-owner, who was not a physician, secretly owned and controlled the medical professional corporations. Cambridge had filed an action seeking to recover billing from Allstate and the insurer responded with its counterclaims and third party complaint.

Allstate’s counterclaims and third party complaint further allege that these corporations fraudulently billed Allstate Insurance Company.

The claims were filed following an investigation by Allstate’s Special Investigative Unit and seek reimbursement for personal injury protection benefits Allstate paid on behalf of its customers during time frames specified in the counterclaims and third party complaint.

Since 2003, Allstate has filed 32 fraud lawsuits in New York State, seeking more than $175 million in damages.

Source: Allstate Insurance Company