News Summary
Roosevelt Road Specialty has filed a $450 million federal RICO lawsuit against a personal injury law firm and medical providers for allegedly staging construction accidents and inflating claims. The 162-page suit details a well-organized scheme executed from Brooklyn, involving undocumented workers and multiple medical practices. This case is part of a broader trend of legal actions targeting fraudulent activities in the insurance and medical sectors, with significant implications for personal injury claims in New York City.
New York City Law Firm and Medical Providers Hit with $450 Million Fraud Lawsuit
In a shocking revelation of alleged criminal activities, Roosevelt Road Specialty, a specialty insurance managing underwriter based in New York, has initiated a major lawsuit targeting a prominent personal injury law firm and several medical providers. This legal action, a sprawling 162-page federal RICO (Racketeer Influenced and Corrupt Organizations Act) case, was filed on June 16, 2024, aiming to unveil a blatant scheme to defraud insurance companies through staged construction accidents and fraudulent medical treatments.
Unraveling a Complex Scheme
The defendants in this elaborate setup include William Schwitzer & Associates, P.C., alongside its principals, William Schwitzer and Giovani Merlino. According to the lawsuit, these individuals conspired to recruit construction workers—many of whom were undocumented immigrants—to stage or significantly exaggerate workplace injuries. These injured workers were allegedly directed to specific clinics that performed unnecessary and invasive medical procedures, all to inflate personal injury and workers’ compensation claims.
Roosevelt Road’s lawsuit asserts that this fraudulent operation has been active since at least 2018, with a noted uptick in nefarious activities since 2020. The magnitude of this fraud is underscored by the identification of approximately 30 medical practices involved, specializing in orthopedics, radiology, pain management, and acupuncture, that operated in close affiliation.
The Brooklyn Nexus
An investigation by Roosevelt Road revealed a cluster of fraudulent activities that conveniently converged from a single address at 410 Ditmas Ave. in Brooklyn. This location is shared by ten named defendants, consisting of various medical entities and practitioners, signifying a well-organized network designed to exploit vulnerable individuals and deprive insurers of millions of dollars in claims.
The lawsuit makes grim assertions that “persons of unknown citizenship” participated in this alarming scheme, creating a system to stage fake construction accidents throughout New York City. The Schwitzer defendants are alleged to have actively directed potential claimants to corresponding medical providers who were well aware of the fraudulent arrangements. Documentation purporting to validate workplace accidents and associated injuries was reportedly submitted to claim workers’ compensation and general liability claims, taking advantage of strict laws that govern New York’s workers’ compensation systems.
A Pattern of Legal Action
Interestingly, this lawsuit marks only the latest in a series of legal actions initiated by Roosevelt Road Specialty and its reinsurance endeavor, Tradesman Program Managers. Since March 2024, the organization has filed a total of five lawsuits concerning alleged fraud in the legal and medical networks surrounding worker’s compensation claims.
This case stands alongside similar high-profile legal actions, such as one in January 2024 against the Liakas Firm and its managing partner, Dena Liakas, and another notable suit filed by Uber Technologies that targeted law firms and medical providers involved in staging fake car accidents. Even American Transit Insurance Co. (ATIC), which has been grappling with financial challenges, has launched a grave lawsuit, claiming $450 million in damages due to a network of medical providers implicated in fraudulent practices.
Continued Battle Against Fraud
The construction industry hasn’t been immune either. Ionian RE, a captive insurer operating within the sector, along with three contractors, have also filed a lawsuit alleging a massive fraudulent scheme tied to staged accidents, once again pointing fingers at several law firms, including the very same William Schwitzer & Associates. This case raises grave concerns about the extent of collusion between legal and medical providers, further complicating an already intricate fight against corruption in the industry.
As this momentous lawsuit unfolds, industry observers will be keenly watching. The implications of a favorable ruling for Roosevelt Road Specialty could yield wide-ranging effects on the legal and medical practices surrounding personal injury claims throughout New York City, potentially quelling such egregious fraudulent activities.
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Author: STAFF HERE CHARLESTON
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