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Allstate sues Florida physician for alleged insurance coverage fraud scheme

Allstate sues Florida physician for alleged insurance coverage fraud scheme | Insurance coverage Enterprise America

Insurer says he billed for pointless procedures, fabricated medical information

Allstate sues Florida doctor for alleged insurance fraud scheme

Insurance coverage Information

Mika Pangilinan

Allstate has filed a lawsuit towards a Florida physician who allegedly fabricated medical information to invoice the insurer for pointless spinal surgical procedures.

In a 70-page lawsuit filed in federal court docket in late December, Allstate accused Ravi Xavier of partaking in an “insurance coverage fraud scheme” wherein he would invoice corporations for remedies that had been “extreme, and, in lots of cases, not carried out in any respect.”

Xavier is the proprietor of Florida Anesthesiology & Ache Clinic, which was additionally named as a defendant within the go well with.

In response to Allstate’s preliminary grievance, Xavier issued invoices for a number of same-day procedures which might be medically incompatible and shouldn’t be carried out concurrently.

In a single occasion, Xavier billed Allstate for spinal injections utilizing strategies described within the go well with as “physiologically unattainable,”

He additionally submitted a number of invoices for a costlier process and “routinely skipped” the required preliminary check, the lawsuit claimed.

For different billed procedures, Xavier allegedly misrepresented diagnostic radiology outcomes to justify his invoices.

The lawsuit went on to contend that Xavier constantly used comparable language to explain sufferers’ accidents and signs in claims. The descriptions he supplied had been mentioned to have an identical typos and contradicted what sufferers communicated to Allstate about their causes for in search of therapy.

Additional within the go well with, Allstate accused Xavier of collaborating with private damage attorneys as a part of his scheme, claiming that automobile crash victims who sought “little or no medical therapy” had been referred to his clinic by “a number of legislation corporations.”

Xavier later rejected the settlement by his lawyer, based on the lawsuit.

What are your ideas on the lawsuit filed by Allstate? Be at liberty to share your feedback under.

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