GEICO has used massive federal fraud lawsuits to attack medical providers of all kinds, including chiropractors, family physicians, physiatrists, neurologists, orthopedic surgeons, massage therapists, medical assistants, physical therapists, and diagnostic testing facilities, all of whom have been guilty of exactly one crime: costing GEICO money.  Any medical provider who bills GEICO for treatment and services provided to GEICO insureds injured in auto accidents is a potential target of GEICO’s ginned-up fraud allegations. 

GEICO’s federal lawsuits have enabled it to avoid tens of millions of dollars in claims expense.  But this is not because GEICO is actually proving the fraud it alleges.  No, the success of GEICO’s whole litigation strategy is dependent upon never having to justify its allegations with actual evidence. 

How can this be? How can anyone, much less one of America’s most prominent corporations, get away with repeatedly filing the same basic lawsuit over and over again in federal courts without ever having to actually back up its claims?

GEICO makes no secret of the answer.  Its litigation strategy is based entirely on overwhelming targeted medical providers with what its own lawyers call “In Terrorem” lawsuits.  In Terrorem is a Latin phrase meaning “about fear,” but it is of course more familiar as the root of the word Terrorism, the nature and purpose of which no one in today’s day and age has any trouble understanding.  By design, GEICO lards its lawsuits with such over the top and overblown accusations of intentional wrongdoing that no rational person hit with one would not be terrified.  Anyone reading one of these lawsuits, which invariably include claims of “racketeering” and” conspiracy,” would believe the medical provider being sued is guilty of the same heinous criminality associated with violent mobsters and street gangs.  Such implication is overtly intentional as GEICO’s lawsuits, which invariably run to the hundreds of pages, always demand damages under RICO, the statute devised by Congress in the early 1970’s to go after the Mafia.

Engendering terror, however, only works as atactic so long as the target allows their fear to overcome their resolve.  Remember, “emotions may win arguments, but they don’t win wars.”  GEICO’s in terrorem strategy is simple, but so is beating it.  Simple, of course, does not mean easy.  Winning is emotionally and economically difficult, just like it is any time you have to stand up to a bully. But the clear path to defeating a GEICO fraud lawsuit is no different than defeating any other bully: stand your ground and punch back, and, if you get advance warning that the bully is coming, punch first.

The punch is in the proofs.  The best example of this recently occurred in the Middle District Federal Court of Florida.  In GEICO v. Merced, GEICO sued 22 medical doctors, chiropractors, physical therapists, massage therapists, and numerous clinics, in a 406-page Complaint, alleging criminal fraud, RICO, deceptive business practices, and more.  In other words, it was the typical in terrorem GEICO fraud suit.  But a funny thing happened when one of the clinics and its medical providers willed themselves not to succumb to fear and forced GEICO to prove its case. 

As in all cases in which an insurer accuses a medical provider of fraud in their diagnoses and treatment, GEICO was required to support its claims with the opinion of an expert doctor.  But the terrorizing effect of GEICO’s initial onslaught is usually so effective that it is surprisingly rare for GEICO to ever have to actually produce an expert to testify.  When the clinic sued in the Merced case stood its ground and demanded GEICO do so, the results were incredible.  The “expert report” which GEICO proffered as the supposed foundation for its 406-page criminal indictment, was revealed to have been written not by any medical expert after reviewing the clinic’s records, but rather by GEICO’s lawyers.

The Court granted the clinic’s Motion to strike GEICO’s expert from the case.  In doing so, the Court found that the expert whose signature was affixed to the report upon which GEICO’s entire case was supposedly premised, “did not contribute a single word to the Report” and had not even participated in the drafting process.  See Gov’t Emps. Ins. Co. v. Right Spinal Clinic, Inc., 608 F. Supp. 3d 1184, 1189 (M.D. Fla. 2022).  The Court found that GEICO’s purported expert “was so far removed from the drafting process that he does not know who wrote the Report” and “GEICO’s attorneys did not merely paraphrase or legalize” the expert’s words, “[t]hey wrote the Report from beginning to end.”  Id.  The Court also pointed out that the expert report submitted by GEICO was identical to an expert report submitted by GEICO under the name of an entirely different expert in an entirely different case, and the judge ultimately wondered whether the whole report was nothing more than the opinions of GEICO’s attorneys.

Exposing GEICO’s expert report as having been written completely by GEICO’s lawyers and successfully having the expert stricken required an enormous amount of effort by counsel.  But it was entirely worth it for the clinic and its medical staff, against whom GEICO was thereafter forced as a result to withdraw every allegation of fraud its Complaint had so breathlessly brayed.

No innocent medical provider, whether a doctor, a therapist, or diagnostic testing facility, need succumb to the terror tactics of GEICO (or State Farm or Allstate).  Fraud claims based on ginned up premises like “predetermined treatment” or “non-individualized care” or “non-credible patterns” can be defeated with the truth.  All it takes is the fortitude not to be bullied and, of course, the right lawyer. 

Over the past 20 years, Andrew P. Baratta, Esquire has successfully represented scores of medical providers as both Plaintiffs and Defendants against insurers such as State Farm, Allstate, GEICO and others, in courts across the country. Andy can be reached at 215-914-8132 or    

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