Plaintiff alleges widespread fraud by Stand Up MRI facilities


Margo Kitsy Brodie, Chief Judge | https://en.wikipedia.org/

Union Mutual Fire Insurance Company has filed a lawsuit alleging a complex scheme of fraudulent medical practices that have cost the company millions. The complaint, filed in the United States District Court for the Eastern District of New York on September 20, 2024, targets Stand Up MRI facilities across multiple New York locations and several associated doctors.

The plaintiff, Union Mutual Fire Insurance Company ("Union"), represented by The Willis Law Group, LLC, accuses Stand Up MRI facilities in Brooklyn, Bronx, Queens, East Elmhurst, Lynbrook, and Canarsie—along with Drs. Stephen Hershowitz, Harold M. Tice, and Robert Diamond—of orchestrating a fraudulent scheme to defraud insurance companies by submitting false medical diagnoses and unnecessary healthcare services for reimbursement. According to Union's filing, this alleged fraud has been ongoing since at least 2018 and involves creating false medical reports to support claims for injuries from accidents such as slips and falls or motor vehicle incidents.

Union alleges that the defendants conducted radiological diagnostics like MRIs and X-rays on patients referred by other medical providers. These diagnostics resulted in fabricated or exaggerated findings intended to mislead Union into paying for unnecessary treatments. For instance, one patient identified as Claimant A was diagnosed with non-existent tears and herniations after an alleged slip-and-fall accident in February 2021. An independent review by Dr. Jonathan S. Luchs found no evidence supporting these diagnoses.

The complaint details several similar cases involving different claimants who were allegedly misdiagnosed following various accidents. In each case, Union claims that the defendants knowingly submitted false reports to justify expensive treatments and subsequent legal actions. These fraudulent activities are said to violate New York Insurance Law § 403, New York Penal Law § 176.05, and New York Workers’ Compensation Law § 114.

Union is seeking substantial relief from the court: actual and consequential damages amounting to at least $6,267,254.26; punitive damages; costs incurred from defending against lawsuits based on these fraudulent claims; and a declaration that the defendants' activities are unlawful under New York law. Additionally, Union requests that all payments made directly to the defendants due to their unlawful conduct be returned.

The case is being handled by attorneys William J. Clay (pro hac vice pending), Michael A. Graves, Aaron E. Meyer, and Kirk D. Willis (pro hac vice pending) of The Willis Law Group PLLC. Case ID is 1:24-cv-06652.

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