Thank you for sharing!

Your article was successfully shared with the contacts you provided.

Insurance giant State Farm has filed suit against 12 medical providers across New Jersey for unjust enrichment and violations of the state’s Insurance Fraud Prevention Act. The 80-page complaint, filed in federal district court for the District of New Jersey, alleges that, for the past eight years, the defendants participated in an auto insurance fraud scheme abusing personal injury protection (PIP) benefits available in New Jersey. According to the complaint, State Farm named several individuals and businesses as defendants, including Tri-County Chiropractic and Rehabilitation Center, Robert Matturro, D.C., and Advanced Spine and Pain Management. 

According to State Farm, the providers followed a troubling pattern of prescribing the same course of treatment for patients who gave similar responses to questions or tests after an auto accident. The doctors allegedly failed to perform an honest evaluation of injuries suffered by patients in auto accidents and recommended nearly identical treatments without regard for a patient’s particular circumstances. For example, a patient with a neck injury would receive hot and cold packs, chiropractic adjustments, physical medicine, massages, manual therapy, and even mechanical traction in a single visit, only to do the same thing over again in most subsequent visits. The doctors also took advantage of the availability of PIP benefits by referring patients for services that were either never performed or not medically necessary. 

This premium content is locked for
FC&S Expert Coverage Interpretation subscribers.

Enjoy unlimited access to the trusted solution for successful interpretation and analyses of complex insurance policies.

  • Quality content from industry experts with over 60 years insurance experience, combined
  • Customizable alerts of changes in relevant policies and trends
  • Search and navigate Q&As to find answers to your specific questions
  • Filter by article, discussion, analysis and more to find the exact information you’re looking for
  • Continually updated to bring you the latest reports, trending topics, and coverage analysis

Already have an account?
For enterprise-wide or corporate access, please contact our Sales Department at 1-800-543-0874 or email [email protected].


Get Answers Directly From the FC&S Experts

Submit your coverage interpretation question to the editors of FC&S for quick and reliable information.

Question of the Week

Insurance Coverage Q&A: Date of Loss or Date of Assessment ›

When loss assessment language refers to an event, is the event the date of loss, or the date of the assessment?

Question of the Week Archive ›

Copyright © 2024 ALM Global, LLC. All Rights Reserved.