It also shows why New Yorkers, who indirectly foot the tab for the fraud, need serious reform from Albany. (And never mind the ambulance-chaser — er, trial-lawyer — lobbyists fighting for the status quo.)
US Attorney Preet Bharara called the operation “the single largest no-fault-automobile-insurance fraud ever charged.” And he said the case is the first of its kind to involve racketeering charges.
But the crackdown casts a bright spotlight on the huge sums New Yorkers are paying unnecessarily for their auto insurance through the no-fault system. And for that, they can thank, in large part, the self-interested tort-law crowd.
The fraud ring, dominated by immigrants from the former Soviet Union, allegedly roped in scores of crooked doctors, clinic bosses, “runners” who chased down patients and, of course, lawyers.
The runners got accident victims to visit corrupt clinics, which billed insurers for phony treatments tied to exaggerated or “fabricated” injuries.
“The runners were literally ambulance chasers who often found their victims at accidents, in hospitals and on the street,” said Police Commissioner Ray Kelly, whose undercover cops aided in the probe.
And the fraudsters got away with it for so long (the scam dates back to 2007) partly because New York’s no-fault laws make it hard to expose the bogus claims.
Which is just how trial-law folks like it.
Ironically, no-fault was supposed to curb lawsuits, requiring insurers to pay claims regardless of who’s responsible for the accident; no longer would folks spend vast time finger-pointing in court. Great.
But the lawyers found a new opening: suing insurers whenever they reject claims — including, no doubt, the fraudulent ones filed by the gang charged on Thursday.
“There is tremendous lawsuit abuse,” says Kristina Baldwin, of the Property Casualty Insurers Association.
Lawyers try to overwhelm insurers, filing actions even when bills are small. They can file a separate suit for each denied claim, Baldwin notes.
“Fraud rings,” she says, “are common,” because it’s difficult to prove the fraud.
And the laws encourage them: Probes into dubious claims, for example, face 30-day deadlines. Doctors don’t have to send proof that treatments were truly necessary.
In the end, New Yorkers wind up paying, via higher insurance premiums.
So: Will lawmakersact— or continue to protect lawyers, a group to which many of them belong? (Both Assembly Speaker Sheldon Silver and state Senate Majority Leader Dean Skelos have tort-law links.)
Gov. Cuomo’s folks are vowing a crackdown on “straw doctors” and “billing mills.” And surely there’s enough corruption to warrant all kinds of new probes.
Alas, “without real reform,” Baldwin says, “these sophisticated criminal rackets will continue to bilk the system, only to leave honest ratepayers . . . in the red.”
And if a quarter-billion-dollar scam doesn’t light a fire in Albany, what will?
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