Allstate sues Florida doctor for alleged insurance fraud scheme

Insurer says he billed for unnecessary procedures, fabricated medical records

Allstate sues Florida doctor for alleged insurance fraud scheme

Insurance News

By Mika Pangilinan

Allstate has filed a lawsuit against a Florida doctor who allegedly fabricated medical records to bill the insurer for unnecessary spinal surgeries.

In a 70-page lawsuit filed in federal court in late December, Allstate accused Ravi Xavier of engaging in an “insurance fraud scheme” in which he would bill companies for treatments that were “excessive, and, in many instances, not performed at all.”

Xavier is the owner of Florida Anesthesiology & Pain Clinic, which was also named as a defendant in the suit.

According to Allstate’s initial complaint, Xavier issued invoices for multiple same-day procedures that are medically incompatible and should not be conducted simultaneously.

In one instance, Xavier billed Allstate for spinal injections using techniques described in the suit as “physiologically impossible,”

He also submitted multiple invoices for a more expensive procedure and “routinely skipped” the required preliminary test, the lawsuit claimed.

For other billed procedures, Xavier allegedly misrepresented diagnostic radiology results to justify his invoices.

The lawsuit went on to contend that Xavier consistently used similar language to describe patients’ injuries and symptoms in claims. The descriptions he provided were said to have identical typos and contradicted what patients communicated to Allstate about their reasons for seeking treatment.

Further in the suit, Allstate accused Xavier of collaborating with personal injury attorneys as part of his scheme, claiming that car crash victims who sought “little or no medical treatment” were referred to his clinic by “several law firms.”

Prior to filing its lawsuit, Allstate said it reached out to Xavier to negotiate a settlement agreement, with the doctor initially agreeing to pay $2.5 million and waive all his outstanding bills.

Xavier later rejected the agreement through his lawyer, according to the lawsuit.

What are your thoughts on the lawsuit filed by Allstate? Feel free to share your comments below.


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