Allstate has sued a Florida orthopedic group under federal racketeering law, accusing it of running a kickback-driven billing scheme that cost the insurer millions.
The complaint, filed May 15, 2026, in US District Court for the Middle District of Florida, names Florida Orthopedics and Neurosurgery, LLC - which does business as University Orthopedic Care - along with owner Bradford Estra and Dr. Angel Rigueras. According to the filing, the clinic runs 13 locations across Florida and uses what Allstate calls a "predetermined treatment protocol" to push patients into unnecessary injections, surgeries, drug cocktails and durable medical equipment to inflate insurance bills.
The case is a PIP fraud claim, built on Florida's no-fault auto insurance law. Allstate pleads counts under the federal RICO Act, Florida's Deceptive and Unfair Trade Practices Act, common law fraud, civil conspiracy and unjust enrichment, and asks the court to wipe out pending and previously denied claims from the clinic.
At the center of the complaint is a kickback structure Allstate says was built to multiply facility fees. The filing alleges that when University Orthopedic sent a patient to an ambulatory surgery center for routine pain treatment, the surgery center would bill Allstate a large facility fee - then sell the right to collect that fee to a related company, ASC Lender, LLC, for a fraction of the amount. In one example, a surgery center billed $16,500 for a radiofrequency ablation and sold the right to collect to ASC Lender for $1,500. The complaint alleges the same $16,500-for-$1,500 swap on a second patient. In another, the facility fee for a shoulder surgery was $65,020.
ASC Lender, the filing says, is partly owned by Dale Hersey, who has a financial interest in University Orthopedic, and Phillip Ray, the clinic's CFO. Estra was a former part-owner of ASC Lender. Allstate describes the returns on these fee purchases as "potential 1,000% returns" and casts them as a kickback meant to drive referrals and unnecessary surgery-center use.
The filing also alleges the clinic paid its own doctors to steer procedures into surgery centers. It says a recruitment email from Estra to a prospective physician conveyed that the clinic paid bonuses of $1,000 for radiofrequency ablations performed in surgery centers and $250 for those done in office, and $250 for injections in surgery centers but no bonus for in-office injections. Allstate cites Florida's anti-kickback statute, which makes it unlawful for a health care provider to "offer, pay, solicit, or receive a kickback, directly or indirectly, overtly or covertly, in cash or in kind, for referring or soliciting patients."
The billing-for-services-not-rendered allegations are blunt. The complaint alleges the clinic routinely billed a CPT code that describes open-incision spine surgery for needle-based laser disc procedures with no incision at all. It says the clinic billed for "extensive debridement" of shoulders when fewer than three structures were actually debrided. It says the clinic billed for x-rays, pulse oximetry, surgical trays, needles, ice packs and "transportation" charges the filing says were never documented or performed. The clinic also billed $700 each time, under one CPT code, for "Comprehensive Orthopedic Narrative" reports the complaint characterizes as litigation-support summaries.
Allstate puts a hard number on one slice of the alleged double billing: more than $970,000 during the relevant period for piggyback charges on injections - fluoroscopic guidance, ice packs, pulse oximetry, surgical trays, needles and contrast dye - that the filing says were never properly billable. A table in the complaint breaks the $972,317 down by code.
The lawsuit also targets the clinic's licensing. Under Florida's Health Care Clinic Act, a clinic owned by non-physicians must be licensed and must appoint a medical director who conducts "systematic reviews of clinic billings to ensure that the billings are not fraudulent or unlawful." Florida's PIP statute also says an insurer is not required to pay "For any service or treatment that was not lawful at the time rendered."
According to the filing, one former medical director told Allstate he had been asked to sign a form stating that he was the medical director even though he "performed zero work in the role." Another said he was given 10 to 20 patient files a month to review. Estra has testified, the complaint says, that the clinic sees roughly 2,000 new patients a month across its 13 locations. A nurse practitioner at the clinic testified that he alone sees "20 to 30 different patients a day."
The complaint also alleges the clinic did not obtain office surgery registration until March 18, 2025, despite routinely claiming to administer sedation for in-office injections and ablations before that date. Any Level II or Level III office surgery billed before March 18, 2025, the filing says, is unlawful and unpayable.
On the records side, the complaint reproduces what it says are several different signatures all purporting to be Dr. Rigueras's, and an identical signature attributed to four different providers at the clinic. It also flags pre-signed consent forms. In one example, a former physician at the clinic, Liam Fitzpatrick, signed a patient-specific informed-consent certification in 2022 for a patient who was not seen at the clinic until 2024. According to the filing, Fitzpatrick later testified that "it may have been a form I signed kind of in the beginning that they [University Orthopedic] used moving forward."
Attorney referrals drove the volume, the complaint alleges. It says the clinic kept spreadsheets tracking patient care next to litigation status, with entries showing attorneys advising the clinic to "hold off" on procedures, marking files "CASE SETTLED" or signing off on treatment. In one case involving a patient identified as J.N., the filing says the clinic issued a letter on February 13, 2024, claiming a physician had recommended a cervical fusion that would cost over $200,000 - then issued a second letter the next day saying the actual recommendation was a cervical epidural steroid injection. According to the complaint, neither procedure was planned by the patient and the letters were used to push for policy-limits payouts.
Allstate is seeking treble damages under federal RICO law, attorney's fees, an injunction and a declaration that it owes nothing on the disputed claims. The complaint says the insurer's damages cover direct payments to the clinic, inflated payments to patients and the cost of investigating the alleged scheme.
The allegations have not been tested in court. The defendants have not yet filed a response, and no court has ruled.
