Farmers Insurance Exchange, 21st Century Insurance Company, Coast National Insurance Company, Mid-Century Insurance Company, and Truck Insurance Exchange have filed a lawsuit in the Superior Court of California against two imaging providers — Glendale Diagnostic Imaging Network and Central Diagnostic Imaging Network.
According to the Farmers’ complaint, these two businesses and their owners billed the insurer for 3D rendering of MRI and CT scans that were never performed. The improper billing occurred in more than two hundred bodily injury and workers' compensation claims.
The complaint also alleges that Central Diagnostic Imaging Network was improperly owned and structured, because a licensed physician was not the majority owner. California law requires that corporations must practice medicine under the control of licensed medical doctors.
According to the complaint filed by Farmers, the two owners during the time the fraudulent claims were filed were Maurice Hale, MD, a radiologist, and Snezana Pavlovic.
"Farmers continues to take aggressive action to protect its policyholders and stop fraud," said Sean Zavala, Director of Special Investigations in a press release. "Our Special Investigative Unit is trained to detect this type of alleged fraud and prepared to protect the public by filing cases to stop it from continuing."
Among other requests, Farmers is asking the court to require that Central Diagnostic Imaging Network and Glendale Diagnostic Imaging Network pay Farmers three times the amount of each claim for compensation, a civil penalty of $10,000 for each of the 270 false claims, and cover all attorneys' fees, expenses and costs Farmers incurs.