Allstate Sues Florida Pain Clinics, Alleging Millions in Fraudulent Billings

By Insurance Journal staff | January 3, 2024

After an Allstate Insurance investigation alleged that a well-known Florida pain clinic had conspired with an injury law firm and had fraudulently billed the auto insurer for unnecessary surgeries and risky procedures, Allstate took the unusual step of striking an agreement with the clinics to stop the practices.

Less than a month after that November agreement was signed, though, the clinics had breached the agreement and were at it again, Allstate claims in a federal lawsuit asking for millions of dollars from Florida Anesthesiology & Pain Clinic and its manager and chief physician, Dr. Ravi Xavier.

“The defendants’ relationships with their personal injury attorney referral sources directly and intentionally led to the bills for medically unnecessary and excessive services detailed herein,” reads the complaint, filed Dec. 28 in the U.S. District Court for Southern Florida.

One law firm that made the referrals was Steinger, Iscoe & Greene, now known as Steinger, Greene & Feiner, one of the largest injury firms in Florida, the complaint reads. The firm went through a shakeup in 2019 when several employees filed suit, alleging that the firm’s leaders had pressured them to encourage clients to undergo unnecessary surgeries to boost the size of auto accident claims and bills sent to insurance companies. “No surgery, no case” was the law firm’s alleged rule, the lawsuits argued.

“This practice has clearly continued with referrals of patients to Florida Anesthesiology, which, as detailed herein, immediately billed tens (sometimes hundreds) of thousands of dollars for alleged surgeries and invasive procedures at initial visits and made little to no effort to attempt any conservative treatment or to follow up with patients after they were used to generate bills,” the Allstate complaint reads.

Xavier (Linkedin)

The Allstate lawsuit, first reported by the South Florida Sun Sentinel newspaper over the weekend, argues that Allstate paid millions of dollars for surgeries and spinal procedures that, in most cases, the drivers and passengers never asked for or never received.

“The patients … were seeking little or no medical treatment on their own before they were steered by layperson attorneys to the defendants in order to bolster the perceived value of their insurance claims,” the lawsuit contends.

The insurance company charged that the clinics had engaged in fraud, which violated that federal anti-racketeering statutes. The complaint did not say if Allstate is also pursuing criminal charges.

The clinics’ alleged practices were easy to spot, Allstate said. Besides billing “outrageous sums,” the clinics’ fabricated records showed “remarkably incorrect” vital statistics for patients, including heights that differed by six inches and weights that were off by more than 100 pounds. The insurer compared the statistics to those recorded for the same patients by other providers, the lawsuit explains.

Allstate said it initially felt obligated to pay the claims.

“Because the defendants’ bills and records were intended to appear valid on their face, and because Allstate and its insureds could face substantial liability for rejecting a valid demand, the defendants and their associates knew that they would induce Allstate to make payments without the opportunity to conduct meaningful investigation to discover the fraud,” the suit notes.

Florida Anesthesiology & Pain is one of the largest and financially successful chains of pain clinics in the state, with six sites around Florida and one in Houston. In 2021, a company owned by Dr. Xavier and his wife purchased a waterfront mansion near Palm Beach for $19 million, according to news reports.

Xavier and the Steinger attorneys could not be reached for comment. The clinics have not yet filed an answer to the lawsuit nor a motion to dismiss.

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