Mark Roman | January 26, 2018 | news
Geico recently filed a lawsuit in a Florida federal court against the parent company of 411 Pain, the medical-legal referral service. The breadth of the suit is astounding. Geico’s legal complaint is almost 200 pages long, and alleges the referral service, along with many co-defendants, engaged in racketeering, illegal kickback schemes, fraud, and other serious forms of misconduct. The co-defendants include chiropractors, physicians, and lawyers.
What are the Charges?
Geico’s central claim is that Path Medical, LLC, which operates under the 411 Pain brand name, caused Geico to be billed for millions of dollars of medical services which were unnecessary, overbilled, or not performed at all. Basically, Geico claims Path Medical and the other co-defendants conspired to evade the laws governing payment of auto insurance benefits for accident-related care. Geico seeks $15 million in damages which it says it paid out for the alleged wrongful billing in the last several years.
Ramifications of this Lawsuit
Of course, a legal complaint alone is not proof of anything. Whether Geico can prove even a fraction of the allegations it makes remains to be seen. However, if even a small part of the things it claims are true, the defendants involved in the case could be in deep financial trouble. Even if they can pay their share of any damages awarded, their business reputations will probably be ruined. And if they’re completely innocent, they’re still likely to be punished, because they’ll shoulder enormous costs to prove their innocence.
It’s Time to Do Away with No-Fault Insurance
If nothing else comes from this lawsuit, it reinforces the idea that our current no-fault auto insurance system doesn’t work. A scheme designed to ensure accident-related health care was paid for quickly, and with a minimum of administrative hassle, has morphed into a bureaucratic nightmare. Providers and patients feel insurance companies refuse to pay their legitimate bills, while insurers claim they can’t ferret out fraud quickly enough to avoid paying bogus claims.
Meanwhile, all the parties to this sorry spectacle spend a lot of time at the courthouse. They endlessly litigate about billing, coding, reasonable medical necessity, and other issues. Something which was designed to be simple has turned into a lawsuit quagmire.
No Matter Who Wins, Consumers are the Ones Who Lose
Regardless of the outcome of individual cases, consumers are collectively the ones who lose. They pay higher insurance premiums for their no-fault coverage and get stiffed for medical bills they incur just trying to get better.
Against this backdrop, it is good news indeed that the Florida legislature seems to be serious about scrapping the no-fault system. As we’ve said before, we welcome this change and hope it happens this year. A bill to repeal no-fault and replace it with a fault-based system is overdue for serious consideration.
In the meantime, anyone who thinks Florida’s no-fault auto insurance law still works can read the Geico complaint and see why it doesn’t.
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If you’ve been injured in a car accident and need legal assistance, please call the Personal Injury law firm of Roman Austin Personal Injury Lawyers at (727) 787-2500 or visit the nearest location to schedule a free case evaluation today.
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