Doctor Pleads Guilty In Trip And Fall Lawsuit Scheme
A doctor is the second individual to plead guilty in a broad-scale fraud scheme against insurance companies. The doctor was a New York licensed pain management specialist and surgeon. He pleaded guilty to one count of conspiracy to commit mail fraud and one count of conspiracy to commit wire fraud. He has yet to be sentenced. A fellow conspirator, the owner of a litigation funding company, pleaded guilty to one count of conspiracy to commit wire fraud.
The doctor was accused of performing medically unnecessary surgeries to increase the value of personal injury claims filed on insurance policies. In terms of slip and fall accidents, these suits are generally filed on a business’s general liability policy. General liability policies can go pretty high and a $1 million policy would only cost a business a few thousand dollars a year. Slip and fall accidents are, by far, the most likely type of action to be filed against a general liability policy.
Understanding slip and fall accidents
99% of all slip-and-fall accidents result in a bit of embarrassment and a bruise on your bum. However, those that make it into the courts tend to include real injuries such as broken legs, ankles, wrists, and more. In some slip-and-fall accidents, you have catastrophic head injuries that severely reduce the plaintiff’s quality of life or ability to work. In a handful of these cases you have wrongful deaths. So, slip and fall accidents don’t necessarily pay out frequently, but when they do, the figure can go pretty high. It’s something insurance companies have raised alarms about because some of these suits are settling for 7 figures.
How to drive up the value of a personal injury claim
In this case, the prosecution was able to establish that the individuals involved in the fraud recruited potential plaintiffs to stage slip-and-fall lawsuits. The doctor’s role was to fabricate evidence for the damages portion of the trial. The doctor would claim that the individual suffered ligament damage or something else that had to be repaired and this prevented them from doing their job and whatever else. All told, the defendants are accused of attempting to steal $31 million in proceeds from insurance companies.
Essentially, personal injury lawsuits are driven up by damages. How injured the defendant is will determine how much money they receive in 99% of cases. While personal injury lawyers have been accused of exaggerating the amount of harm caused to their clients based on the hope of securing a larger personal injury settlement, recruiting 100 people to split $31 million based on entirely fabricated claims tends not to be our approach to business.
As part of the fraud, patients had to undergo unnecessary surgeries performed by the defendant. They were paid $1,000 to $1,500 per surgery and expected to undergo at least two surgeries. You’re probably wondering who would undergo a surgery for $1,500. The conspirators were recruiting very poor individuals for these claims.
Talk to a Tampa Federal Defense Attorney Today
If you have committed a massive fraud against insurance companies or alternatively, require a Tampa personal injury lawyer to litigate your (real) injury, don’t hesitate to call The Matassini Law Firm today to schedule an appointment and learn more about how we can help.
Source:
justice.gov/usao-sdny/pr/new-york-doctor-who-performed-unnecessary-back-surgeries-pleads-guilty-participating
