Insurance Carriers Make Use of NJ’s Anti-Insurance Fraud Statute

Insurance Carriers Make Use of NJ’s Anti-Insurance Fraud Statute

On August 13, 2013, Allstate Insurance filed suit in the Superior Court, Bergen County, asking the Court to declare that it is not liable to pay 2.1 million dollars in claims presented by Dr. Nabil Yazgi, a medical doctor from Saddle River, NJ.

The Suit alleges that Dr. Yazgi was improperly performing expensive neurological tests on patients who did not require them. It alleges that these patients were referred to Dr. Yazgi by a chiropractor (Michael Haddad) who practices in Manalapan, NJ. More specifically, the complaint alleges that the neurological studies Yazgi performed were not medically necessary, were incompletely performed, or where performed as part of an unlawful referral scheme with a chiropractor.

Allstate alleges that in return for the referrals from the chiropractor, Dr. Yazgi consistently referred patients back to the chiropractor for continued and regular care which was not necessary. Such referrals may be considered an impermissible “gift” which is unlawful under NJ law.

Allstate seeks reimbursement of 2.1 million dollars from the defendants, representing the amount Allstate paid on the claims, plus treble damages as allowed by law.

Allstate, like other insurance carriers, has created a unit within the company whose mission is to identify and prosecute insurance fraud. Allstate ‘s actions are part of a growing list of cases brought by insurance companies who have sought redress through the NJ Insurance Fraud Protection Act.

Be sure to know what type of referrals are legal, and which are not. Romanowsky Law can guide you through these rules, and prevent you and your practice from becoming a headline.