Several Car Accident Treatment Clinic Owners In Orlando, Florida, Arrested For Fraud
As an Orlando car accident attorney, I am very concerned about recent news involving fairly widespread auto insurance fraud, allegedly being committed by car accident victim treatment clinics in Orlando. Anyone who commits fraud makes the plight of real victims, politically, much more difficult. Also, those currently needing or receiving treatment for auto accident injuries should be aware of these allegations. Finally, while I fully support arrests of anyone who committed auto accident fraud, I fear what I believe is a guaranteed negative impact of these campaigns on real auto accident victims. So we absolutely must remember that these campaigns found alleged fraud among medical clinic owners, not those receiving treatment.
Auto Accident Insurance Fraud Hurts Future Injury Victims
In any event, several individuals, running three different car accident treatment clinics, in Orlando, Florida, were recently arrested for personal injury protection (“PIP”) auto accident insurance fraud. They were also operating without medical licenses. Apparently there has been a heightened investigative effort by the Florida Division of Insurance Fraud, starting in 2014, targeting those suspected of committing insurance fraud. My hope is that they catch all fraudulent medical providers, since auto accident victims already struggle with unfair laws, regularly passed or amended, which tragically reduce or prevent needed recovery. Some of those “helping” car accident victims, really are just victimizing them all over again, and politically hurting other future victims in the process.
(The news reported in this article is only based on allegations. That means they might not be true; I have not investigated ANY of these claims myself.)
Orlando Auto Accident Treatment Clinic Allegedly Falsifying Auto Insurance Claims & Operating Without A License
In the first case, two individuals operating an auto accident victim treatment clinic called Spine Health Solutions PA, located at 1803 Park Center Drive, Suite 120, Orlando, Florida, 32835, were arrested on charges of defrauding three insurance companies, according to the Florida Division of Insurance Fraud (obviously, I have no way of knowing whether the allegations and charges are true and legitimate; they might not be). But the allegations are that the clinic falsified bills under PIP auto insurance plans, totaling 300K for 20 “patients.” Apparently the insurance companies are keeping a watchful eye on potential auto accident insurance fraud, since they reported the alleged scheme to the Florida Division of Insurance Fraud.
If the two owners are convicted on these felony charges, they potentially could serve more than 50 years in prison, including operating a health care clinic without a license, and filing fraudulent auto accident insurance claims.
How Can Auto Accident Victims Protect Themselves From Fraud?
I’m not sure how victims could make sure this never happens to them, other than to review the bills that any auto accident treatment clinic sends to their insurance company, and make sure they actually received the listed services. Additionally, at least with this particular clinic, one red flag is that they do not appear to have an actual website. This Orlando clinic is listed on local business directories, but I couldn’t find a dedicated company website. (Maybe they have one buried somewhere deep in the Google search results?) Any legitimate business, at a minimum, you would think would have a website. I’m not sure whether this should be a deal breaker. Still, I would be highly cautious if any auto accident treatment clinic didn’t have a website.
The real potential harm to patients, at least in my view, is receiving unnecessary treatment. Therefore, if you feel like you are receiving treatment that is not helping, or possibly is even hurting, then you need to follow your gut instincts.
Additionally, you might also want to check whether your preferred doctor is licensed in Florida, or has paid any malpractice claims. (Note, however, that there is a LONG LIST of relevant information missing from searches on the websites linked in the preceding sentences.) To further complicate matters, accident victims really need to visit doctors who are “plaintiff-friendly,” since your physician’s testimony may become critical evidence in your auto accident lawsuit.
Try To Make Sure You Actually SEE The Orlando Doctor Whose Name Is On The Door, Or Some Medical Doctor Under His Employ
In the second case, allegedly an Orlando clinic called Unity Pain & Injury Center, LLC, located at 1226 N Pine Hills Rd, Orlando, Florida, 32808, was operating without a license, and engaging in PIP fraud. The state claims that this clinic paid a real, licensed medical doctor a $1500 monthly fee for putting his name on the business, even though he never actually treated any of their patients. (The doctor was 82 years old, so maybe he just didn’t give a damn anymore?) Allegedly the clinic was illegally providing medical treatment and physical therapy to victims of motor vehicle accidents. The clinic then billed the PIP coverage under the insurance policies of those patients.
To prevent being treated by an unlicensed individual, injury victims should verify which doctors have their names on the door, and whether they ever actually see any of those doctors. Of course, fake doctor names, or name tags, would not be hard to create, if someone were really determined to deceive.
Orlando Chiropractic Clinic Also Allegedly Engaged In Unlicensed & Illegal PIP Billing
In a third case, allegedly a clinic called BlessCare Chiro, located at 750 S Orange Blossom Trail, Orlando, FL 32805, had an unlicensed person providing chiropractic services, using the same medical doctor’s name as a front. The state claims that this facility illegally billed patient PIP auto accident coverage more than 86K between 2012 and 2014. (The same doctor allegedly kept his hands in lots of pots–there are allegations that he was involved in similar PIP fraud schemes in Tamarac and Oakland Park, Florida (Broward County).) The state reports that the doctor has admitted that he allowed his name to be used for these clinics.
Once again, I couldn’t find any website for this clinic.
If convicted on charges of fraud, operating an unlicensed clinic, and grand theft, those involved in the scheme face prison sentences up to 30 years.
The Division of Insurance Fraud has made 249 PIP fraud arrests since July 1, 2014. If you believe that you might have received treatment from a facility engaging in these fraudulent activities, you should call the Florida Department of Financial Services, at 1-800-378-0445. If you provide information that leads directly to an arrest and conviction (involving insurance fraud), you could receive as much as a 25K reward.
My BIG Political Concern
As a bit of background, the Florida Division of Insurance Fraud claims at least that 21 percent of bodily injury claims, and 18 percent of PIP claims, had the appearance of fraud, according to file examiners in 2012. Further, claims involving possible fraud were more likely in cases involving chiropractic treatment, physical therapy, alternative medicine, and the use of pain clinics. (Twelve insurance companies allowed many thousands of files to be reviewed for the study.)
So, here’s the big political concern. In my experience as an injury and accident attorney, fraud has been very rare. Maybe I just get the angel clients. But I rarely believe that someone is even exaggerating their injuries, much less completely faking them. Fake injury calls have been nearly non-existent in my practice. And most people just want their medical bills paid, which is less than they are legally entitled to receive (they are also entitled to receive pain & suffering, and lost wages).
Further, if I have even the slightest concern that any potential client is being dishonest, I do not accept the case. To the contrary, I am highly skeptical, and drill my potential clients to be sure that their complaints are truly legitimate. I also prefer OBJECTIVE evidence of significant harm, such as broken bones, burns, bruises, lacerations, spinal cord injuries, eye injuries, etc. The main exception is back and neck injuries, or other invisible injuries. In those cases, I look for high impact collisions, which would likely lead to tendon or disc damage.
The last thing that I want is to spend a boatload of time and money, only to later discover that objective evidence, like doctor opinions, and test results, do not support my clients’ claims of moderate to severe injuries. Long story short, those govt / insurance company stats smell REALLY bad to me, and appear, very strongly, to be politically motivated (in the bogus “tort reform” category). One big unspoken goal of these campaigns is for insurance companies, and lawmakers who support them, to prevent or GREATLY reduce payment on ALL auto accident claims, including the OVERWHELMING majority of completely legitimate ones. During political campaigns, they use statistics from these campaigns to pass broad sweeping laws, rather than targeted or limited ones, which only injury & insurance lawyers understand, and which hurt all accident victims.
Obviously, I do not know what these medical clinics might have done. The fraud in these particular cases, if real, unquestionably needs to be stopped. But these anti-fraud campaigns must be very carefully orchestrated and reported, because misleading information makes everything more difficult for real victims. Unfortunately, these types of statistics often convince voters who do not know what really happened to support broad laws that seriously harm legitimate auto accident victims. That ALSO hurts everyone, because you never know when you, or someone you love, might be the next auto accident victim. Bottom line: any laws, or enforcement attempts, need to be very carefully nuanced so that they ONLY prevent fraud, but do not prevent REAL auto accident victims from recovering what they need, and deserve.
Finally, although tort reform & “frivolous” lawsuit debates are highly political, they really should not be. Both political parties should enact and support laws requiring that insurance companies pay every auto accident victim fairly.