MIAMI – GEICO has filed a lawsuit against a group of Florida chiropractic clinics, accusing the offices and its owners of insurance fraud.
GEICO filed its lawsuit last month in the U.S. District Court for the Southern District of Florida, Miami Division.
The named defendants include Chiropractic Clinics of South Florida PL, Medlink Now LLC, South Florida Diagnostic Group LLC, Garrett R. Weinstein DC PA, Garrett R. Weinstein DC, Davin R. Barbanell DC PA, Davin Barbanell DC, Keren H. Gomez DC PA, Keren Gomez DC, Dean M. Zusmer DC PA, and Dean Zusmer.
GEICO, in its 100-page filing, alleges the chiropractic clinics inflated billing, did unnecessary treatments, and generally abused Personal Injury Protection, or PIP, benefits.
PIP benefits primarily cover medical costs, lost wages, and essential services – like childcare/housekeeping – after a car accident, regardless of fault.
The fraudulent services purportedly were provided to individuals who claimed to have been involved in automobile accidents and were eligible for insurance coverage under GEICO PIP insurance policies, the insurer contends.
According to the complaint, Chiropractic Clinics of South Florida was owned and controlled by Weinstein, Gomez, and Barbanell. From August 2012 until at least January 2023, it also was owned and controlled by Zusmer.
Medlink was owned and controlled by Weinstein, Gomez, and Barbanell.
From April 2014 until November 2022, South Florida Diagnostic was owned and controlled by Weinstein, Gomez, Barbanell, and Zusmer. From November 2022 through the present, South Florida Diagnostic has been owned and controlled by Chiropractic Clinics of South Florida.
According to GEICO’s filing, Weinstein was licensed to practice chiropractic in Florida in January 2000. Gomez was licensed to practice chiropractic in Florida in December 2007. Barbanell was licensed to practice chiropractic in Florida in May 2006.
Zusmer, who is currently incarcerated in Alabama, was licensed to practice chiropractic in Florida in June 2005. However, in September 2024, his license was permanently revoked by the Florida Board of Chiropractic Medicine.
He was convicted in the Southern District of Florida for conspiracy to commit health care and wire fraud; health care fraud; conspiracy to defraud the United States and pay and receive health care kickbacks; payment of kickbacks in connection with a federal health care program; and false statements relating to health care matters.
As a result of Zusmer’s convictions – which came as the result of his involvement in a Medicare fraud scheme – he was ultimately sentenced to six and a half years in prison and ordered to pay more than $1.4 million in restitution.
GEICO’s lawsuit seeks to recover more than $2 million that it alleges the defendants wrongfully obtained from the insurer by submitting:
*Thousands of fraudulent and unlawful no-fault insurance charges through Chiropractic Clinics of South Florida for purported chiropractic services, physical therapy services, patient exams, and shockwave treatments;
*Hundreds of fraudulent and unlawful PIP insurance charges through Medlink for purported patient exams, “self-care” training, and interventional pain management services; and
*Hundreds of fraudulent and unlawful PIP insurance charges through South Florida Diagnostic for purported diagnostic imaging services, particularly MRIs.
GEICO also seeks a declaration that it is not legally obligated to pay reimbursement of more than $75,000 in “pending, fraudulent, and unlawful” PIP claims that the defendants have submitted through Chiropractic Clinics of South Florida, Medlink, and South Florida Diagnostic.
The insurer claims the defendants were “never entitled” to receive payment on the PIP insurance claims that they submitted to GEICO.
“The Defendants’ fraudulent and unlawful scheme began no later than 2020 and has continued uninterrupted since that time,” the complaint states. “As a result of the Defendants’ fraudulent and unlawful scheme, GEICO has incurred damages of more than $2,820,000.00.”
Jacksonville firm Rivkin Radler LLP is representing GEICO in the action.
