GEICO has sued a Queens-based medical equipment supplier and its owner, alleging they fleeced the insurer for more than $1 million through a No-Fault fraud scheme built on kickbacks and fake prescriptions.
The complaint, filed May 26, 2026 in the Eastern District of New York, names ROM DME Inc. and its owner Avraam Shimonov as defendants, alongside ten John Doe defendants the insurer describes as the "Clinic Controllers" - unlicensed laypersons who allegedly ran the No-Fault clinics behind the scheme.
ROM DME billed GEICO more than $1.2 million between March 2024 and February 2025 for durable medical equipment and orthotic devices supposedly dispensed to people hurt in car accidents, according to the filing. GEICO says it paid out more than $1 million before catching on. It is now fighting another $500,000 in pending claims.
GEICO alleges Shimonov did not run ROM DME like a real equipment supplier. The complaint says he did "virtually nothing" to market the company or build a reputation in the medical community. Instead, the filing claims, he cut deals with the people running No-Fault clinics, paying "kickbacks and other financial incentives" for a steady stream of prescriptions steered straight to ROM DME.
The prescriptions, GEICO says, were not about patient care. The complaint alleges they were issued under "predetermined fraudulent protocols" - meaning nearly every accident victim treated at certain clinics walked out with the same list of equipment, regardless of age, injury, or what actually happened in the crash. Patients in low-impact "fender-bender" accidents, often with nothing worse than a sprain or strain, were allegedly prescribed the same routine kit - cervical collars, lumbar supports, egg crate mattresses, heating pads - with additional prescriptions for custom-fitted orthotic devices.
The filing identifies a group of healthcare practitioners it calls the "Referring Providers" - including a physician, a chiropractor, a nurse practitioner, and a physician assistant - whose names appeared on prescriptions used to support ROM DME's bills. None of these practitioners are named as defendants. The complaint alleges that prescriptions bearing their names were "stamped, photocopied, and/or electronically generated," and that some were dated before ROM DME was even incorporated on February 7, 2024.
In one example, a prescription dated November 21, 2023 was used to support equipment supposedly dispensed 130 days later - by a company that did not yet exist when the prescription was written.
GEICO also alleges Shimonov used vague prescriptions to bill under the most expensive HCPCS codes available. The complaint walks through it: a generic prescription for a "Lumbo Sacral Support" could map to more than 20 different codes, with reimbursement rates ranging from $43.27 to $1,150. ROM DME, the insurer alleges, consistently picked one of the higher-paying options, typically billing $563.60 under code L0650 - even though the prescription itself named no code, and Shimonov, as an unlicensed layperson, had no legal authority to choose.
Three other examples stand out in the filing.
An "Egg Crate Mattress" was billed under code E0272 at $118.19 per unit. That code covers a foam rubber mattress - the real thing, full size. What patients allegedly got was a topper pad, which carries a $19.48 cap under a different code.
A "Lumbar Cushion" was billed under code E2611 at $214.62. That code is for a wheelchair back cushion. According to the complaint, "virtually none" of the patients who received these cushions were in wheelchairs. A plain positioning cushion is reimbursable at $22.04.
An "Orthopedic Car Seat" was billed under code T5001 at $574.58. That code, GEICO says, is meant for postural seating used by children with cerebral palsy. What patients actually received, the filing alleges, were positioning cushions reimbursable at $22.04.
The insurer also alleges some equipment was never delivered at all. The complaint says ROM DME's delivery receipts showed "glaring inconsistencies" - patient signatures that did not match their names, signatures that differed across multiple receipts from the same patient, and signatures that did not line up with the signature on the patient's No-Fault application.
GEICO points to Shimonov's history. The complaint says Shimonov and another company he owns, Supply4U Inc., "were recently named as defendants in a lawsuit brought by Allstate" alleging a "complex No-Fault insurance fraud scheme" involving "illicit financial arrangements." The article does not characterize the current status of that Allstate suit, which the GEICO complaint does not address.
The complaint brings six causes of action, including civil RICO claims under 18 U.S.C. § 1962(c) and (d), common law fraud, unjust enrichment, and aiding and abetting fraud. GEICO is asking for treble damages, punitive damages, attorneys' fees, and a declaration that it owes nothing on the pending claims.
The filing also flags the clinic infrastructure that allegedly enabled the scheme. GEICO says it has received bills from one Brooklyn clinic from "a 'revolving door' of over 110 different healthcare providers," and from a Lynbrook clinic from "at least 70 different healthcare providers" - all, the insurer alleges, controlled by unlicensed laypersons who steered prescriptions to suppliers like ROM DME.
Under New York's No-Fault laws, accident victims get up to $50,000 in Personal Injury Protection Benefits. GEICO argues that inflated DME charges eat into that cap and leave less coverage for real care. The complaint cites a June 16, 2004 New York Insurance Department opinion letter warning that inflated DME fees can result in "less benefits available for other necessary health related services."
The allegations have not been tested in court. ROM DME and Shimonov have not yet filed a response, and no court has ruled on the claims.
