The Dishonest Chiropractor/Physician

See the full video at https://rumble.com/vtw148-true-crime-stories-of-insurance-fraud-number-eleven.html and at https://youtu.be/iB8UgGRxf5A

Check out my latest article: True Crime Stories of Insurance Fraud Number Eleven https://www.linkedin.com/pulse/true-crime-stories-insurance-fraud-number-eleven-zalma-esq-cfe via @LinkedIn

A dishonest physician or chiropractor will, for a fee, prepare fictitious medical reports, including billings for multiple series of physical therapy treatments. Sometimes the report of a legitimate accident victim is modified only in the name, address, and physical attributes of the victim. In all other respects, the reports are legitimate. They are not a report of the victim’s actual injuries since the victim either did not exist or was not injured. Medical bills generated by such fiction total between $1200 and $3500. The numbers are kept small to avoid suspicion and tempt insurers into making a quick settlement.When I was a young adjuster I dealt with these scofflaws and paid fraudulent claims because I, like most young adjusters, was unaware of the amount of fraud being perpetrated. Within a year I learned and refused to pay the suspected frauds and advised them that the insurer I worked for would pay nothing and they should file suit. I was convinced it was a fraud when the suit was never filed.

Because of the ease of use a single clerk typist with a word processor can prepare two hundred medical reports a day with the doctors’ laser printer even generating his signature from a scanned image. The doctor, not involved in the procedure, receives $100 to $500 per report. The doctor is quite happy with his earnings since he need not see a patient nor provide treatment.

Occasionally, we read reports about the police or the fraud bureaus making arrests of a massive fraud ring. 

© 2022 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders.

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You can contact Mr. Zalma at https://www.zalma.com, https://www.claimschool.com, [email protected] and [email protected] . Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.

You may find interesting the podcast “Zalma On Insurance” at https://anchor.fm/barry-zalma; you can follow Mr. Zalma on Twitter at; you should see Barry Zalma’s videos on https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg/featured; or videos on https://rumble.com/zalma. Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims–library/ The last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud-letter-2/