Archive for the ‘ Insurance Fraud ’ Category

Recently, U.S. District Court Judge Ursula Ungaro sentenced a Miami man, Remberto Sarmiento, to 8 years in prison.  In November, Mr. Sarmiento was found guilty of 20 counts of health care fraud.  Sarmiento had submitted more than seven million dollars of fraudulent claims to the Medicare program.  Using stolen patient information, Mr. Sarmiento bought two medical companies, APR Medical Equipment and Super Medical Supply, created corporate bank accounts for each and signed checks drawn on the accounts.  Mr. Sarmiento was also found to have lied to the FBI, when he denied any knowledge of two DMEs.  The South Florida Business Journal has more.


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Allstate Lets Go Of Documents
STAFF, WIRE REPORTS

Allstate Corp. on Friday released thousands of documents that have been cited by trial lawyers across the country, including in Kentucky, as a blueprint for fraud.

The release came the same day that an appeals court in Florida ruled that the stateʼs insurance regulators can stop Allstateʼs companies from writing new policies in the state until it complies with subpoenas for documents.

Included in those subpoenas were the now-released “McKinsey & Co.” documents, prepared by the McKinsey & Co. consulting firm to help Allstate overhaul the way it handled claims.

The Florida Office of Insurance Regulation suspended Allstate from writing new policies in January because it did not supply pricing information requested in an earlier subpoena.

The state wants documents to determine why Allstateʼs property insurance rates had not dropped after a state law designed to reduce premiums that rose due to hurricanes in 2004 and 2005.

Allstate, based in Northbrook, Ill., was able to keep writing new business as it appealed. The state, however, said the company must immediately comply after Fridayʼs decision by the 1st District Court of Appeal in Tallahassee, pending a motion for a rehearing within 15 days.

“They have blatantly and flagrantly disregarded the law as has been pointed out in the 1st District Court opinions,” Insurance Commissioner Kevin McCarty said. “If you look at what the court says as it goes through the history, they did not take this process seriously.”

Allstate had turned over some of the McKinsey documents, according to media reports, but McCarty told the South Florida Sun-Sentinel on Friday that Allstate is “far from” finished complying with the requests.

An Allstate spokesman told the newspaper that the company will continue doing business in the state and plans to ask the court to reconsider its decision.

The McKinsey documents, which can now be viewed at http://media.allstate.com/categories/52/releases/4390, were cited during a high-profile trial in Lexington last year.

Geneva Hager of Richmond had sought more than $1 billion on allegations that Allstateʼs procedures violate Kentucky insurance laws. Jurors unanimously found in favor of Allstate.

Allstate has continued to fight demands that the documents be released. It is appealing a Fayette County judgeʼs ruling that specific documents shown during Hagerʼs trial should be made public.

It has also previously defied court orders in three states to produce them without protective orders. The insurer says they contain valuable trade secrets.

In a news release accompanying the documents on its Website, Allstate writes it decided to release them “because of the need to address misunderstandings resulting from the growing misplaced focus by our critics on very small pieces of the whole.”

Read the full article here.

Dorothy Clay Sims, Esq. ~ Sims, Stakenborg & Henry, PA.

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