Allstate - You're in good hands

06/14/2004 Miami, FL -

Allstate Insurance Company today filed a civil lawsuit in United States District Court Southern District of Florida against 26 defendants, including clinic operators, individual runners, office managers, and an attorney. Allstate alleges that the SHP Enterprise Clinics, as they are referred to in the Complaint, are a North Miami Beach based group of multi-disciplinary professional corporations engaged in a massive fraudulent billing scheme. The complaint alleges that SHP Medical Rehabilitation Center, PC, among others, obtained its patient population by enlisting runners to coordinate staged accidents, paying runners to recruit participants for staged accidents and for referrals of patients who were involved in minor impacts, but not injured. In addition, the complaint alleges that the SHP Enterprise Clinics billed for services that were not medically necessary and at times never rendered. Allstate is seeking to recover more than $1.8 million in damages that resulted from the alleged scheme.

In the lawsuit, Allstate alleges that the defendants created the SHP Enterprise as a network of sham clinics whose sole purpose was to defraud insurance companies. As alleged in the complaint, licensed doctors and chiropractors were paid for the use of their names, signatures, and licenses to fraudulently bill insurance companies. These licensed professionals allowed the layperson clinic operators to dictate day-to-day operations and treatment protocols of the clinics without exercising their own independent professional judgment, the complaint allege.

Also named in the suit is attorney Alexander Fishman, who Allstate alleges represented the SHP Enterprise Clinics in a number of personal injury protection (PIP) suits involving disputed claims. In his role as a No-fault collection attorney for the SHP Enterprise Clinics, Allstate alleges in the complaint that Fishman facilitated the fraud by pressing claims on behalf of the clinics, even though he knew they were fraudulent. The complaint further alleges that Fishman recruited and referred patients to the SHP Enterprise Clinics, as well as represented these same individuals in personal injury actions.

"This lawsuit shows how far-reaching acts of fraud can be," said Edward J. Moran, Assistant Vice President for Allstate’s Special Investigations Unit. "Motivated by greed; some physicians, attorneys, and businessmen, like those involved in the alleged scheme, leave a scar on the reputations of medical and legal professionals who work to legitimately earn the trust of the people with whom they do business."

Among the clinics identified in the complaint as part of the SHP Enterprise are SHP Medical Rehabilitation Center, Inc. (17290 NE 19th Ave., North Miami Beach); Sun State Diagnostic, Inc. (16401 NW 2nd Ave., Ste. 100, Miami); Med Services Group, Inc. (3990 W. Flagler St., Ste. 407, Miami); and NMB Medical Group (951 NE 167th St., Ste. 105, North Miami Beach). The Complaint alleges that the clinics were created and operated over the course of four years. At least three of the clinics listed the same address as their principal place of business on incorporation papers filed with the Department of State.

"Insurance fraud continues to plague South Florida and we owe it to our customers to aggressively fight it," said Fred Wheeler, Allstate Florida Region Special Investigations Manager. "This type of alleged fraudulent activity drives up the cost of auto insurance for everyone."

Florida’s Division of Insurance Fraud investigates various forms of fraud in insurance, including health, life, auto, property and workers' compensation insurance. The department offers a reward of up to $25,000 for information leading to a conviction in complex fraud schemes. To report fraud, call the department's Fraud Hotline at 1-800-378-0445

The Allstate Corporation (NYSE: ALL) is the nation’s largest publicly held personal lines insurer. Widely known through the “You’re In Good Hands With Allstate^®” slogan, Allstate provides insurance products to more than 16 million households and has approximately 12,900 exclusive agencies and financial specialists in the U.S. and Canada. Customers can access Allstate products and services through Allstate agents, or in select states at allstate.com and 1-800 Allstate^®. Encompass^SM and Deerbrook^® Insurance brand property and casualty products are sold exclusively through independent agents. Allstate Financial Group includes the businesses that provide life insurance, annuity, retirement, banking and investment products through distribution channels that include Allstate agents, independent agents, worksite, financial institutions and broker-dealers.

FOR MORE INFORMATION:
Ryan Priest
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