GEICO wants $5.9 million back from five Florida clinics it says billed personal injury protection claims for treatment that was never lawfully provided.
Four GEICO companies filed the complaint in the US District Court for the Middle District of Florida on August 18, 2026. It names five clinics, the individuals the filing says owned and controlled them, and five physicians the filing says were listed as their medical directors. The complaint runs 126 pages and pleads 26 causes of action, including claims under the federal racketeering statute, Florida's deceptive trade practices law, common law fraud and unjust enrichment. GEICO has demanded a jury trial and also asks the court to declare it owes nothing on more than $75,000 in pending claims.
The legal hinge will be familiar to anyone who handles Florida no-fault. Under the state's Health Care Clinic Act, a clinic has to be licensed and has to appoint a physician medical director who accepts written legal responsibility for a defined list of duties. One of those duties is to “[c]onduct systematic reviews of clinic billings to ensure that the billings are not fraudulent or unlawful.” Another is to ensure every practitioner holds “a current active and unencumbered Florida license.” Fall outside those rules and, in the Act's own words, any charge the clinic submits “is an unlawful charge and is noncompensable and unenforceable” - regardless of whether the treatment happened and regardless of whether it was needed.
That is where GEICO starts. Each clinic, the complaint alleges, “falsely purported to operate a properly-licensed health care clinic,” while the physicians listed as medical directors “were never genuine medical directors” and instead ceded day-to-day oversight of care and billing to the clinic owners.
The second strand concerns who actually delivered the treatment. Florida's no-fault law was amended, effective January 1, 2013, to bar PIP reimbursement for massage or for any service performed by a massage therapist. GEICO alleges the physical therapy it paid for was performed - “to the extent they were performed at all” - by “unlicensed and unsupervised individuals, and by massage therapists,” and that the defendants “deliberately omitted any reference to the massage therapists and unlicensed individuals” from Box 31 of the HCFA-1500 claim form. Box 31 is the field identifying who personally performed or directly supervised the service.
Licensed practitioners were listed there instead, according to the filing. GEICO's argument for why that cannot hold up is arithmetic. On June 13, 2022, the complaint alleges, one practitioner purported to perform or directly supervise at least 71.25 hours of physical therapy and related services for at least 45 insureds, spread across one clinic and four other locations. Other single-day examples in the filing range from 22.25 hours up to 63.5 hours. The complaint describes the volume as impossible.
The filing then works through the line items. Initial examinations were billed under CPT codes 99203 and 99204 at $250, $300 or $350 depending on the clinic. Follow-up examinations under CPT code 99211 were billed at $40 or $45 alongside the same physical therapy sessions - charges GEICO characterises as illusory rather than separate services. Extracorporeal shockwave therapy was billed under CPT code 0101T at $600 a session at one clinic and $803.60 at another. The complaint says the therapy has no FDA approval for back, neck or shoulder pain, and cites coverage guidance from a Medicare contractor stating that it “is neither reasonable nor necessary for the treatment of musculoskeletal conditions.”
Rigid lower-back braces went out under HCPCS codes L0631 and L0637 at $1,214.45, $2,628.00 and $2,717.98 a unit. In a legitimate clinical setting, the complaint says, those braces are reserved for patients with spinal instability or recent spinal surgery, and restricting spinal movement works against the goals of the physical therapy being billed alongside them.
One further allegation will land with special investigations teams. GEICO says that in almost all of the thousands of claim forms at issue, the defendants reported collecting no money from the patient - no co-payment, no deductible. Under Florida's False and Fraudulent Insurance Claims Statute, making a general business practice of waiving deductibles, or failing to make a good-faith effort to collect them, renders the underlying charges unlawful and noncompensable on its own footing. The complaint frames the practice as deliberate, alleging that genuine collection efforts would have made insureds “less likely to continue presenting to the Clinic Defendants for medically unnecessary treatment.”
Damages are pleaded clinic by clinic, at not less than $1,632,000, $2,270,000, $1,002,000, $151,000 and $877,000. GEICO seeks treble damages, costs and attorneys' fees on the racketeering counts. The conduct alleged began no later than 2020 and, according to the filing, has continued uninterrupted since.
The allegations have not been tested in court. The defendants have not filed a response, and no court has ruled on any of the claims.
