According to Larry Neumeister of Insurance Journal, two doctors and two lawyers have officially been charged in Manhattan federal court late last month in connection to a $31 million fraud scheme fueled by recruiting and manipulating homeless and vulnerable individuals in fraudulent trip-and-fall accidents and pointless surgeries to collect large lawsuit settlements. The scheme spanned from January 2013 through April 2018.
49-year-old lawyer Marc Elefant, 58-year-old lawyer George Constantine, 45-year-old doctor Andrew Dowd, and 51-year-old doctor Sady Ribeiro, have all been indicted.
Key points regarding the indictment according to Neumeister:
“An indictment said lawsuit settlements exceeded $20 million while Constantine collected more than $5 million in legal fees.”
“It said Down, an orthopedic surgeon, earned $9,500 per surgery as he performed hundreds of knee and shoulder surgeries on scheme patients. Ribeiro, the indictment said, was a pain management doctor and surgeon who performed back surgeries and other procedures, treating nearly 200 patients.”
“The indictment said participants in the scheme recruited more than 400 people to either claim they had fallen where no accident occurred or to deliberately fall at New York City locations where they could claim there were cracks in concrete sidewalks, potholes or unsecured cellar doors. Lawyers then filed lawsuits claiming that falls resulted from the negligence of the owners of accident sites.”
“Authorities said the lawsuits attempted to defraud victims of more than $31 million.”
“As part of the scam, individuals who claimed or staged fake accidents were urged to receive continuing chiropractic care and eventually were told they needed to undergo surgeries to boost the value of their lawsuits, the indictment said.”
“The medical procedures included spinal fusions, knee and shoulder surgeries and epidural injections and ‘at least one patient who underwent a surgery as part of the fraud scheme was told after awaking from general anesthesia that she almost died during the surgery,’ the indictment said.”
“The patients were generally told to undergo two surgeries and were encouraged to do so through loans of between $1,000 and $1,500 per surgery, it said.”
“The individuals recruited to take falls and become plaintiffs in lawsuits were ‘extremely poor,’ insufficiently clothed, and they often asked for food when they appeared for meetings with their lawyers, court papers said.”
“Some of them were drug users and it was common for participants in the fraud to recruit them at New York City homeless shelters, according to the indictment.”
We don’t think we could say it any better than U.S. Attorney Audrey Strauss, who indicated the defendants “preyed upon the most vulnerable members of society,” and “The defendants abused their professional licenses and positions of trust to steal millions of dollars from New York City businesses and their insurance companies through a massive trip-and-fall fraud scheme.”
We will be monitoring the progress of this case.
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