On February 7, Allstate Insurance Company filed a lawsuit, accusing several medical practices and individuals of orchestrating a massive insurance fraud scheme. The complaint names Chiropractic Associates of Richmond Hill P.C., Kanter Physical Medicine & Rehab, P.C., Miriam Kanter, M.D., P.C., Miriam E. Kanter, M.D., Steven R. Nissenbaum, D.C., and other unidentified parties as defendants.
The lawsuit alleges that from November 2001 through the filing date, the defendants engaged in a systematic scheme to defraud Allstate and other automobile insurance companies by submitting fraudulent claims under New York State's No-fault system. According to Allstate's attorneys at Manning & Kass, Ellrod, Ramirez, Trester LLP, the defendants operated a "medical mill" in Richmond Hill, New York. This facility allegedly billed Allstate for unnecessary or non-existent services such as diagnostic testing and various healthcare treatments provided to individuals involved in automobile accidents insured by Allstate.
Allstate claims that these fraudulent activities were carried out through multiple professional corporations owned by the defendants. They allegedly followed a predetermined treatment protocol designed to maximize their profits rather than addressing the actual medical needs of patients. The lawsuit highlights how initial and follow-up examinations were conducted not based on medical necessity but rather as part of an elaborate scheme involving kickbacks and unlawful referrals.
The complaint further details that both Miriam E. Kanter and Steven R. Nissenbaum have histories of engaging in similar fraudulent schemes. It references past legal actions where they were implicated in defrauding insurance companies through bogus medical practices. In this case, Allstate accuses them of using fictitious bills and reports to misrepresent patients' conditions and justify unwarranted treatments.
Allstate is seeking compensatory damages exceeding $2.9 million for payments made under false pretenses due to these fraudulent activities. Additionally, they are pursuing treble damages under the Racketeer Influenced and Corrupt Organizations Act (RICO) for the defendants' systematic pattern of racketeering activity involving mail fraud related to their use of the No-fault system.
Allstate is also requesting declaratory judgments stating they are not obligated to pay any No-fault claims submitted by the defendant PCs due to their engagement in illegal activities like kickback arrangements and fraudulent treatment protocols. They also seek recovery based on unjust enrichment principles for all payments made during this period.
The case is being presided over by Judge Kiyo A. Matsumoto with representation from Manning & Kass law firm for Allstate Insurance Company. The case was filed in the United States District Court for the Eastern District of New York under Case ID 25-CV-715.