Florida Spine & Joint Institute (FSJI) have sued Geico for over $750,000, alleging intentional interference with contractual relations and defamation.
Florida Spine and Joint Institute Sue Geico for Over $750,000
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FSJI claims that Geico refused to reimburse FSJI for personal injury protection (PIP) benefits coverage and that Geico disseminated false statements concerning FSJI’s business practices. FSJI claims that Geico wrongfully denied claims for reimbursement that FSJI submitted on behalf of its clients. Florida’s motor vehicle no-fault law requires motor vehicle owners to maintain PIP coverage which pays the insured’s medical expenses regardless of fault.
FSJI argues that Geico sent defamatory letters to its patients. The letters say in part “GEICO has a reasonable belief that a fraudulent insurance act under Section 626.989 or 817.234, Fla. Stat., has been committed with respect to [your] Claim. GEICO is therefore investigating [your] Claim for suspected fraud.” FSJI claims these statements were false, damaged FSJI’s reputation, and caused FSJI to lose clients.
In support of its defamation claim, FSJI provided deposition transcripts from Geico representatives. In one representative’s transcript, she states she sent the letter because she needed “additional time to investigate the file” and she “did not know if a fraudulent act had been committed.”
Four days after FSJI filed in state court, Geico filed a separate lawsuit against FSJI and 17 other defendants in federal court. Geico’s claim is for more than $2,000,000. Geico alleges the defendants wrongfully obtained more than $2,000,000 from Geico by submitting “thousands of fraudulent no-fault” PIP insurance charges through FSJI. Geico also alleges that FSJI’s “business is racketeering activity, inasmuch as the enterprise exists for the purpose of submitting fraudulent charges to insurers.”
At the beginning of 2020 FSJI rebranded itself as iRise Spine and Joint. iRISE stands for “imaging, rehab, injections, surgery and extremity.” iRise has 18 different facilities in Florida and Tennessee.
Geico is the second largest auto insurance company in the United States.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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