Geico v. 45678
In Geico v. 45678 filed in 2017, Geico claimed that a self-referral violation took place. There were approximately 20 clinics owned by one chiropractor.
Geico claimed that the Clinics created a cross referral relationship with a personal injury law firm called KP that also owned a PIP litigation law firm called LA. Geico claims that there was a massive amount of referrals of people involved in auto accidents between the personal injury law firm and the Clinics (ie quid pro quo referrals). In exchange, the Clinics would also refer their underpaid PIP claims to LA. The lawyers that owned KP also had a financial interest in LA. Geico reported that at least 15% of the patients that treated at the Clinics were represented by KP and 90% of the PIP litigation on behalf of the Clinics was performed by LA.
Geico claims that the Clinic would use its 1-800 number to obtain new clients that were in a car accident and, as part of the deal, required personal injury lawyers that received the referral would be required to direct the patient to the Clinics even though it might not be in their best interest in terms of medical care, distance from their home, etc.
Geico claimed that the 1-800 number failed to disclose that it was owned by a chiropractor and that any referrals would lead patients to the Clinics owned by that same chiropractor. The advertising failed to disclose the names of the treating physicians. Also, the 1-800 number advertised that it “specialized in auto accidents” and chiropractors are prohibited from advertising a “specialty” in car accidents. Also, the 1-800 number claimed that the doctors in their network were “vetted”, however, that wasn’t accurate as several medical directors for the Clinics had been disciplined for serious issues in the past and “vetted” portrayed the doctors of the Clinics as “better than others” which Geico claimed was a violation of the rule prohibiting chiropractors from portraying themselves as “superior to other chiropractors”. The website also stated that it would get patients to “stop experiencing pain.”
DISCLAIMER
This is based on a real court case that was previously filed against a medical provider/doctor. The case number has been partially redacted and names have been changed to protect the Defendants’ names. This example is posted to help educate others on the laws and potential pitfalls. This posting is not intended to embarrass or defame anyone. I have limited the information and simplified some of the facts in the lawsuit to reflect key points and make a complicated case easier to understand. This “example” is directly from a complaint filed by an insurance company; therefore, I am using the facts THEY presented. There are always two sides to a story so please understand this is just one side of the story. This information was found through records available to the public.