GEICO says two Brooklyn medical practices billed it more than $2 million for treatments its complaint describes as medically unnecessary and, in many cases, never provided.
In a complaint filed July 24, 2026, in federal court in Brooklyn, the auto insurer named two medical corporations, Kings County Physicians Group and Kings Highway Physicians Group, along with the physician the filing says owned and controlled both. The suit also names unidentified "John Doe" defendants.
The case turns on New York's no-fault system, which requires auto insurers to cover up to $50,000 per person for necessary health care goods and services after a crash. GEICO alleges the two practices treated drivers who said they were hurt in accidents, then filed hundreds of claims for care the complaint describes as "medically unnecessary, excessive, illusory, and otherwise non-reimbursable."
According to the filing, patients were run through "pre-determined fraudulent protocols" regardless of their actual injuries, including exams, follow-ups, outcome-assessment tests, nerve studies, platelet-rich plasma injections, and shockwave therapy. GEICO alleges the billing codes were inflated and that the services were provided, in the complaint's recurring phrase, "to the extent provided at all."
The complaint offers examples. It says initial exams were billed under high-level codes that, under the applicable fee schedule, call for 45 to 60 minutes of face-to-face time, while the exams themselves ran 10 to 30 minutes. It alleges that shockwave therapy was billed under a code meant for a "high energy" treatment when the devices delivered lower-energy radial pressure wave therapy that was, in the filing's words, "falsely billed as extracorporeal shockwave therapy." On nerve testing, the complaint cites professional guidance stating that "[p]re-set protocols automatically testing a large number of nerves are not appropriate."
The allegation with the widest reach for insurers concerns control. Under New York rules, a medical practice cannot collect no-fault money if it is owned or run by people without a medical license. GEICO alleges that unlicensed "laypersons," identified only as John Doe defendants, steered patients to the practices, dictated treatment plans, and shared in the profits. The complaint points to the regulation providing that a health care provider "is not eligible for reimbursement ... if the provider fails to meet any applicable New York State or local licensing requirement." GEICO also alleges that many services were performed by independent contractors rather than employees, which it cites as a separate basis for denying no-fault payment.
The complaint ties the two practices to a network of pharmacies, equipment suppliers, and imaging and testing providers, described as "downstream providers" that GEICO says billed off prescriptions written at the clinics. Many of those providers, the filing notes, are already being sued by GEICO or other insurers.
GEICO alleges the conduct began no later than September 2020 and continues, with the practices still pursuing unpaid claims. The insurer puts its losses at more than $2 million and asks the court to declare it owes nothing on more than $1.1 million in pending bills, which it attributes as more than $400,000 to Kings County and more than $700,000 to Kings Highway. Its claims include federal racketeering, common-law fraud, and unjust enrichment, with treble damages sought on the racketeering counts.
The allegations have not been tested, and no court has ruled on any of the claims.
