Liberty Mutual Wins $1.8M Award in New Jersey Case

Morris County (New Jersey) Superior Court Judge Charles Villanueva has ordered Healthcare Integrated Services Inc., based in Shrewsbury, N.J., (HIS) to repay more than $1.8 million in damages and fees to Liberty Mutual Insurance Company for violations of the New Jersey Insurance Fraud Prevention Act.

The court reportedly found HIS and four of its New Jersey subsidiaries – Edgewater Diagnostic Imaging P.A., Monmouth Diagnostic Imaging P.A., Wayne MRI P.A., and Meadowlands Diagnostic Imaging P.A. – created illegally owned businesses, failed to obtain licenses, unlawfully used unlicensed medical professionals to perform diagnostic services, and filed false or misleading claims.

“This verdict is a substantial victory for the insurance industry, and for every consumer that pays for insurance fraud through higher premiums,” said Glenn Wolf, manager of special investigations for Liberty Mutual. “Fraud costs our customers and the industry billions of dollars a year, and we will continue to be relentless in our ‘zero tolerance’ policy against these crimes.”

In March, Judge Villanueva determined HIS owed Liberty Mutual $594,468 for paid claims, plus reimbursement for attorneys fees, costs and reasonable investigative expenses.

Under the New Jersey Fraud Prevention Act, treble (triple) damages are mandatory when the actions prove to be a pattern of fraud. Judge Villanueva’s decision orders HIS to pay $1,783,404 for damages, plus $64,735 for fees and expenses, amounting to $1,848,139. Liberty Mutual also has no obligation to pay approximately $200,000 in outstanding bills from these facilities.

The Insurance Information Institute estimates that property/casualty fraud costs more than $24 billion a year.