Geico files $4.4M lawsuit claiming medical providers submitted fraudulent claims

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Geico lawsuit overview:

• Who: Geico has filed a lawsuit against a New York chiropractor and several of his purported businesses.
• Why: The chiropractor and other defendants allegedly engaged in a fraudulent scheme to exploit New York’s no-fault insurance system.
• Where: The Geico lawsuit was filed in New York federal court.

A group of Geico entities has filed a nearly $4.4 million lawsuit against several healthcare providers, alleging they submitted fraudulent no-fault insurance claims related to medically unnecessary and otherwise unreimbursable healthcare services.

The Geico lawsuit was filed against Anthony Michael Riotto, a chiropractor licensed to practice in New York, plus a series of chiropractic businesses that Riotto purportedly owns.

Geico claims Riotto’s businesses purport to be legitimate professional companies, “but they operate on a transient basis, maintain no stand-alone practices, have no patients of their own, and provide no legitimate or medically necessary healthcare services.”

Geico lawsuit says defendants perpetrated fraudulent scheme by exploiting New York’s no-fault insurance system

According to the Geico lawsuit, Riotto and John Doe defendants 1-10 perpetuated a fraudulent scheme to grant Riotto’s illegitimate companies access to “a steady stream of patients,” exploiting New York’s no-fault insurance system for financial gain, in exchange for kickbacks.

New York’s no-fault laws are intended to ensure car crash victims are able to receive health care for their injuries, and require auto insurers to provide up to $50,000 in personal injury protection benefits for each person covered by a policy.

Geico says the defendants fraudulently billed the insurer for medically unnecessary services and utilized billing codes that exaggerated the nature of services purportedly provided.

The lawsuit seeks to recover $740,000 for fraudulent claims it paid to the defendants and a declaration from the court releasing it from its obligation to pay more than $542,000 in pending no fault claims submitted by the Geico providers.

The Geico lawsuit asserts claims for violations of the Racketeer Influenced and Corrupt Organizations Act (RICO), common law fraud and unjust enrichment. The insurer also filed claims of aiding and abetting fraud against the John Doe Geico providers.

Geico is seeking a total of nearly $4.4 million in compensatory and punitive damages, claiming the defendants’ “extensive fraudulent conduct demonstrates a high degree of moral turpitude and wanton dishonesty that entitles Geico to recover punitive damages.”

An Illinois federal judge recently allowed Geico to appeal a ruling that rejected the insurer’s motion to dismiss a class action lawsuit alleging it charged excessive premiums during the COVID-19 pandemic when consumers were driving less.

What do you think about the claims against the Geico providers? Join the discussion in the comments!

Geico is represented by Barry I. Levy, Michael A. Sirignano and Jennifer Abreau of Rivkin Radler LLP.

The Geico lawsuit is Government Employees Insurance Co., et al. v. Apple Chiropractic of NY PC, et al., Case No.1:23-cv-05075, in the U.S. District Court for the Eastern District of New York.

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