Insurance Company Files $2.1 Million DMEPOS Fraud Case

According to a press release, Allstate Insurance Company is seeking to recover $2.1 million against 37 New York area defendants in its second insurance fraud lawsuit of 2011. The complaint, filed under the Racketeer Influenced and Corrupt Organizations Act and principles of the common law, alleges that the defendants engaged in a scheme in which fraudulent and misleading bills were submitted to Allstate for durable medical equipment, medical supplies and orthotic devices.

The complaint cites 11 durable medical retail equipment companies, owned by nine individuals, and 11 durable medical wholesale companies, owned by six individuals.

Among the allegations in the complaint are that the retailers – through their respective individual owners and in conspiracy with the wholesalers and their respective owners – submitted or facilitated the submission of fraudulent and misleading bills and medical records to Allstate for reimbursement under New York State’s no-fault law.

The lawsuit was filed following an investigation by Allstate’s Special Investigative Unit and seeks to recover personal injury protection benefits Allstate paid on behalf of its customers during timeframes specified in the lawsuit. The lawsuit is the latest in a string of actions taken by the insurer to protect consumers from these and similar activities.

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