3/17/2014 12:16:00 PM,
Philip A. Janquart
ORLANDO (CN) - Chiropractors who allegedly perpetrated a $2.3 million insurance scam must face RICO charges in a federal court, a federal judge ruled.
Geico Insurance Company filed a lawsuit against KJ Chiropractic Center LLC, Wellness Pain & Rehab Inc., its two founders and a slew of individuals, called "runners," who acted to advance an alleged scam based on fake accidents and injuries to willing third-party participants.
The rouse produced more than $2.3 million in unwarranted insurance benefits, the insurer's complaint said.
The chiropractors received the undeserved insurance benefits while others received payments or kickbacks for their participation, it continued.
"Geico alleges that the fraudulent PIP (personal injury protection) claims arose out of: (1) staged accidents; (2) real accidents wherein claimants received treatment at clinics even though they were not truly injured; or (3) real accidents wherein claimants incurred some injuries, but received treatment at the clinics that was pre-programmed, unnecessary, excessive and unlawful," U.S. District Judge Charlene Edwards Honeywell explained in her order.
Geico alleges the defendants "promoted their fraudulent enterprise by offering money to anyone who referred accident victims to the clinics, offering cash directly to patients who agreed to accept unnecessary chiropractic treatment and dispensing treatment in a manner designed to maximize profits, rather than heal patients."
Geico filed suit in July 2012 for claims of civil conspiracy, common law fraud, tortious interference with contractual relationships, tortious interference with advantageous business relationships and unjust enrichment, on top of violations of the Racketeer Influenced and Corrupt Organizations Act (RICO) and the Florida Deceptive and Unfair Trade Practices.
Magistrate Judge David Baker entered a report and recommendation in October 2013 that the defendants' motion to dismiss a second amended complaint be denied on all but one count.
The U.S. District Court for Florida's Middle District, Orlando Division, adopted Baker's recommendations in full.
The defendants argue the 143-page complaint
is "longwinded and makes conclusory allegations." Edwards agreed the complaint is long, but did not agree with their other assertions.
"The second amended complaint, at 143 pages, with hundreds of pages of exhibits, is indeed lengthy with some redundancies," she opined. "However, as the report and recommendation notes, this a complex case involving many defendants and numerous claims, all of which must be set forth sufficiently to meet the appropriate pleading standards."
She continued: "Here, Geico has set forth its allegations in numbered paragraphs, supporting each of its claims with sufficient factual allegations to state plausible claims for relief. As such, the court agrees with the Magistrate Judge that Geico's claims are sufficiently pled."