Orange County District Attorney Arrests Twelve in Insurance Over-billing Scheme

Twelve individuals, most of them chiropractors, were arrested in Orange County, California and will be charged in relation to an insurance over-billing scheme.  The arrests resulted from a sting operation that targeted illegal patient referral and insurance over-billing tactics by Orange County, California physicians and attorneys.

The district attorney’s office, working from a list provided by the National Insurance Crime Bureau, sent out 248 letters to suspect health care providers, offering them an opportunity to engage in an illegal fee-splitting arrangement with a fake attorney.

The proposal was that the medical provider would pay a percentage of a referred patient’s billings as a “referral fee” to the attorney. Undercover agents then went into the practitioners’ offices claiming to be accident victims suffering from soft-tissue damage.

Twenty of the medical professionals contacted responded, and twelve were ultimately arrested.

Successfully litigating any business fraud or insurance issue requires a strong working knowledge of insurance law. Unfortunately, most law firms don’t have this, so insurance issues are often overlooked.

Callahan & Blaine’s expertise covers the full spectrum of insurance law. We’ve tried, litigated and handled hundreds of first party insurance claims, including major claims arising out of natural disasters, toxic mold contamination, water damage, pollution, life insurance and disability insurance. In the third party context, our cases have included advertising injury claims, Cumis counsel, duty to defend, wrongful failure to settle, reimbursement, rescission, trade secret misappropriation, and more.

If you’ve experienced business fraud or a bad faith denial of claim from your insurance provider, contact Callahan & Blaine right away.

Jake Gosselin

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