Published: 2011-05-18 10:19:57
Author: Enhanced Online News
BOSTON--(EON: Enhanced Online News)--The Commerce Insurance Company, a member of the MAPFRE U.S.A. Group of Companies, today announced its victory in a multi-million dollar civil insurance fraud lawsuit filed in the Superior Court in Boston, Massachusetts.
Judge John Cratsley ordered the defendants, Alan Cohen and Marc Cohen and their chiropractic clinics, to pay Commerce more than $3,835,900 in damages. Three other insurance companies were also awarded separate judgments against the defendants. With prejudgment interest added to the judgment, the Court’s total award to Commerce will likely exceed $4.5 million.
In reaching its decision, the Court found that the Cohens and their chiropractic clinics engaged in a pattern and practice of submitting fraudulent medical bills resulting from alleged motor vehicle collisions. The Cohen chiropractic clinics initially had sued Commerce, alleging that they were owed money for chiropractic services reportedly given to patients involved in automobile accidents. The Court dismissed all of the Cohen chiropractic clinics’ claims. Commerce countersued for fraud, conspiracy, unfair business practices, and violations of the Federal Racketeer Influenced and Corrupt Organizations (“RICO”) Act. The Court agreed with Commerce, holding that the Cohens’ widespread use of “runners” and a “pre-established treatment recipe” constituted fraud.
“This victory demonstrates the excellent results that can be achieved when insurers work proactively to protect their customers from insurance fraud schemes,” said Jaime Tamayo, President and Chief Executive Officer of MAPFRE U.S.A. Corp. and The Commerce Insurance Company. Mr. Tamayo further stated, “Commerce will continue to work diligently to combat all forms of insurance fraud to the benefit of our policyholders.”