HOUSTON - The U.S. Court of Appeals for the Fifth Circuit has affirmed a ruling denying Farmers’ motion for leave to amend its RICO complaint against several health care providers.
Farmers alleged a racketeering scheme involving 1st Choice Accident and Injury, Houston Pain Relief & Wellness Clinic and Smart Choice Chiropractic, plus others. The insurer accused the defendants of fraudulent billing for services that led to more than $14 million in damages.
Farmers claims the defendants engaged in a scheme to enrich themselves by overbilling and performing unwarranted diagnostic procedures for patients who were involved in motor vehicle accidents and suing the insurance company.
Court records show a federal court granted the defendants’ motions to dismiss the lawsuit and denied Farmers’ post-judgment motion for leave to amend its complaint.
The Fifth Circuit affirmed the denial of the motion to leave, according to an opinion filed on March 18.
Justices held that they have “repeatedly affirmed district courts’ decisions to deny requests for leave” when there was undue delay, “especially when the request came only after the case was dismissed.”
“On more than one occasion, we have affirmed a district court’s denial of post-judgment leave to amend when parties do not adequately explain their delay or when parties ‘concede they have not raised any facts which were not available previously,’” the opinion states. “Farmers fails to provide an adequate explanation for its delay and does not dispute that it could have asserted its proposed amended factual allegations earlier.”
Last January, 1st Choice sued Daniel, Williams & Associates in Harris County District Court on Jan. 8, seeking their share of settlement proceeds.
1st Choice claims it provided hundreds of thousands of dollars of work to the firm's clients with the promise it would be repaid from whatever was recovered.
Some of the other plaintiffs listed in the Fifth Circuit opinion include Foremost Insurance, HomeState Insurance, Truck Insurance Exchange, Mid-Century and Bristol West.
Fifth Circuit case No. 24-20275
