Category Archives: Lawsuits

Geico Seeks To Recover $20M in Racketeering Suit

As reported by Law360, Geico is seeking to recover at least $20 million in compensatory damages, in addition to costs, fees and punitive damages from a Florida chiropractor and his network of clinics.

On Thursday, May 30th, the insurer filed suit in Florida federal court against Mark A. Cereceda claiming civil racketeering violations and unjust enrichment as well as common law fraud and other claims.

According to the complaint, Geico says Mark A. Cereceda and his various Ceda Orthopedics clinics in Miami billed for services that were unnecessary, never provided and performed by people who were not properly licensed. Geico paid for physical therapy services performed by unsupervised massage therapists who are unqualified to perform physical therapy and who, under Florida law, cannot be reimbursed under PIP insurance. The insurer is also requesting a declaration from the court that it is not legally obligated to pay reimbursement of more than $75,000 in pending fraudulent PIP claims submitted by Cereceda’s clinics.

Cereceda has been sued by insurers at least three times over fraudulent medical billing and coding, delivering medically unnecessary chiropractic care and engaging in an unlawful referral scheme.

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Filed under Insurance Fraud, Lawsuits, Miami-Dade County, Miami-Dade Fraud, PIP, Uncategorized, Unlicensed Clinics

The Evolution of Investigative Tools in Insurance Investigations

Since Hurricane Season is underway, here’s a Daily Business Review article published by Roig Lawyers Partner Patricia Preciado that still holds true today.

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Aerial image of Florida Keys after Hurricane Irma

Aerial image of Florida Keys after Hurricane Irma

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Filed under AOB, Assignment of Benefits, Claims Handling, Florida, Hurricane Andrew, Hurricane Irma, Hurricane Matthew, Insurance, Insurance Claims, Insurance Defense, Insurance Fraud, Lawsuits, Property Insurance

Appeal Court Backed Air Ambulance Firm in PIP Dispute

The 11th U.S. Circuit Court of Appeals backed air-ambulance firm Air Methods Corp. in a dispute stemming from a traffic accident that resulted in the death of accident victim Lemar Bailey about whether the amount paid for helicopter services should be limited by Florida’s no-fault auto insurance law. The federal appeals court ruled that the air-ambulance firm is considered an air carrier under federal law and should be able to bill the child’s father, Lenworth Bailey, for costs that exceeded the limits in the state’s no-fault system.

Following the March 2013 accident, Air Methods Corp. billed $27,975 for its services. Bailey’s auto insurer, State Farm Mutual Automobile Insurance Co., paid $6,911 under the fee schedule. His health insurer, Aetna Life Insurance Co. paid another $3,681. However, Bailey did not pay the remaining balance of nearly $17,400. He filed a potential class-action lawsuit alleging that the air ambulance company was trying to improperly collect amounts in excess of the fee schedule. However, the judge ruled in favor of the Air Method, which led Bailey to the appeals court that also rejected such arguments.

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Filed under auto insurance, FL Legislation, Florida, Insurance, Insurance Claims, Insurance Defense, Lawsuits, Personal Injury Protection, PIP, PIP/No Fault

Minor ADA Violations Cost Florida Businesses Thousands in Attorneys Fees

Central Florida businesses being sued by a Daytona Beach attorney for potential violations of the Americans with Disabilities Act are awaiting a federal ruling to determine whether they’ll have to pay settlements in the form of attorney fees. The law forbids plaintiffs from receiving money for “relief” regardless of a court’s decision.

The alleged violations are often quick fixes, but they can cost businesses thousands in legal fees and settlement costs that could be passed on to customers.

More than three dozen Central Florida businesses have recently been hit with almost identical lawsuits filed by attorney Joe Quick. Quick represents the same four clients, often referred to as “testers” by some critics, in each lawsuit filed in the U.S. District Court for the Middle District of Florida.

Last legislative session, State Rep. Tom Leek introduced and passed legislation that allows business owners to hire ADA experts to inspect their businesses. Businesses are able to apply for a grace period to fix violations, but so far, only two businesses in the state have done so. Click here for more information on the Florida Department of Business and Professional Regulation’s ADA Title III Registry.

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Filed under ADA, FL Legislation, Florida, Lawsuits

New Statute To Help Deflect Frivolous ADA Lawsuits

As reported in the Miami Herald, Florida lawmakers have implemented a new law aimed at ADA public accommodation compliance lawsuits often pressuring small businesses and property owners into quick settlements in order to avoid lengthy and costly court battles. In an analysis published in March by The News-Press (Fort Myers), of all the lawsuits filed under the ADA’s public accommodations law in Florida during the past five years, more than half of the approximately 6,000 suits were filed by just 12 plaintiffs. In addition, many of the plaintiffs are represented by the same law firms. The bill, receiving unanimous approval in both the Florida House and Senate during the 2017 legislative session, was recently signed into law by Gov. Rick Scott and is now in effect.

The new statute enables businesses and property owners to take substantive, preventative measures to help insulate themselves from the most frivolous claims. Under the law, a business or property owner may retain a qualified expert to conduct an inspection of their property to ensure compliance with building codes satisfying the ADA’s requirements. If the property is found to be in compliance with the ADA, the expert may issue a certificate of conformity that includes the date of inspection, proof of the expert’s qualifications, and a statement confirming that the property is in conformity. For properties that are not found to be in compliance, the owner may develop and submit a remediation plan approved by a qualified expert indicating that the property will be brought into conformity within a specified time period.

The compliance certifications or remediation plans may be filed with the state’s Department of Business and Professional Regulation, which will now maintain a publicly accessible website to serve as a registry for all of the certifications and remediation plans that it receives. Importantly, a remediation plan in existence before an ADA lawsuit is filed could serve to moot such a lawsuit.

The new law does not prohibit disabled plaintiffs from filing ADA public accommodations lawsuits, nor does it prohibit plaintiffs’ attorneys from seeking fees. It does, however, provide Florida businesses and property owners with a means to potentially defeat or limit frivolous ADA barrier-to-access lawsuits and greatly minimize their exposure to related attorney fees and costs.

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Filed under ADA, FL Legislation, Florida, Lawsuits