Dailies Discover PIP Fraud but Let 411-PAIN Off the Hook

Categories: Broward, News, News
Thumbnail image for 411 Facebook.jpg
Facebook.com
411-PAIN escaped scutiny by the dailies.
A month after New Times published an exposé on 1-800-411-PAIN, a local referral service that seeks clients who have been in car accidents, South Florida's daily newspapers have woken up to the problem of personal injury protection (PIP) fraud.
 
Under Florida's "no fault" insurance law, every driver is required to carry PIP insurance, which can provide up to $10,000 in medical benefits and lost wages if you're in an accident. This weekend, the Sun-Sentinel and the Miami Herald devoted tremendous ink to the unscrupulous doctors, lawyers, and consumers who scam the system to collect those benefits.

The Herald focused on people who stage fake accidents. The Sentinel discussed the thousands of dollars in fees that lawyers can earn when fighting insurance companies over small PIP claims.But neither paper paid much attention to the most visible symptom of the PIP bonanza -- a barrage of billboards and TV commercials luring car accident victims to certain networks of doctors and lawyers.

411-PAIN, which calls itself a "medical and legal referral service," is now facing a class-action lawsuit accusing it of false advertising and misleading consumers.
 
"After 911, call 411!" the firm's commercials say. "Let them explain to you the $10,000 of injury and lost wage benefits you may be entitled to."

The suit alleges that clients who call 411-PAIN's hotline are sent to chiropractic clinics that burn through their PIP insurance by billing for multiple treatments, some of which are unnecessary or don't treat their injuries properly. Patients rack up thousands of dollars in medical debt and are then referred to personal injury lawyers who will sue to cover those medical expenses -- and collect hefty fees along the way.

411-PAIN has denied all the allegations in the suit.

Strangely, the Herald and the Sentinel articles never discuss this lawsuit. The Herald briefly notes that 411-PAIN is one of many referral services that advertise for clients.

"All of these companies are advertising for a reason, which is to get patients into their clinics and to attorneys. They are looking for legitimate cases,'' Lester Perling, attorney for 411-PAIN, told the Herald.

That's fine. But the ads also promise $10,000 in benefits, which end up in the pockets of doctors and lawyers in the 411-PAIN network, not consumers. 


Follow The Juice on Twitter: @TheJuiceBPB.

My Voice Nation Help
16 comments
Sort: Newest | Oldest
Carlorodri
Carlorodri

No you should stay away from 411 gain! Sorry i meant 411 pain. First of all it is a cheap therapy. Every one who is involved in a cra accident has the right to have 10,000.00 for medical service. Find an independant lawyer and find a local friendly chiropractor family practice near you place if you want to have a better treatments. 411 pains have daily 100 to 150 patients a day. I know because i work there and that would be the last place i would go after a car accident. 411 pain treat their patient like there employees (abusing). If you go to 411 pain be ready to visit between 50 to 52 times before your case is over. Even if you feel better. I saw patient having to go there even if they felt better.

The 2 first weeks you have therapy every day and after 3 times a week. The lawyer work with 411 pain. So of course the lawyer will tell you to keep having your therapy. On the 10,000.00 that you are allow, the lawyer get 3.5K and the rest of 6.5k will go for your medical expense so to 411 pain. Robert lewin (The owner and legal thief) is proud to say that 411 pain is helping the injured. The only think he has in mind is your 10k from the insurance company. He will keep you in treatment till you have no money. So I hope you will feel better after because once your 10k is over they will drop your case. Let me explain you how it works. First you will receive 8 minutes of hydro chair, then you will lie down on a traction bed with a heat pad and tens units (electrical stimulation) for 8 minutes again. Then comes your 8 minutes massage. So if you have a sore shoulder, lower back pain and neck pain the massage therapist will give you 8 minutes on those areas so 2. 6 minutes on each part oh yes I forgot on those 8 minutes they also make you stretch so you get 2 for 1 in 8 minutes. After the massage you need to do your exercises. They always make you do 2 exercises at $75.00/each and the exercices last 2 minutes. But Robert lewin became more greedy he told us that 411 pain was not making enough money so every patients need to be adjust by the chiropractor. So the adjustment could take 2 to 3 minutes. Wow! Again do you think that you have for your money??????? If you want to know more about Robert Lewin just look for the Broward and Palm Beach New Times December 9-15, 2010 volume 14 number 6. «Crash course calling 411-Pain could teach you an expensive lesson» by Lisa Rab. A really good article that tell you more about 411 pain.

So the decision is yours.

I hope that Robert Lewin feel proud of his success being a legal thief!

By the way Robert you should give us a raise of salary. A front desk person make 10.00/hr and a massage therapist 14.00/hr and have to deal with your niece Cara. The little Hitler of 411 pain.

Guest
Guest

Its a shame what these chiro's are doing because they are ruining it for the rest of us legitimate ones. All the public see's is the crap and poor care these organized criminal rings that employ young unknowing or bad chiros and drag the whole profession down. The new pip bill should have been aimed at talking the head off these referral services. Instead, they adapted over night while your real local family chiro, the guy who actually cares about you, is severely hit by this and trying to keep his in the black. Thanks FL and gov Rick Scoot, good job, you did real good!

PIPDEFENDER
PIPDEFENDER

Chiropractors that deal with PIP In Florida are all in on the deal of ripping people off. I work in the PI field and I witness it everyday. 45 dollars for an ice pack is FRAUD! 400 dollars a visit for a phony adjustment and a electrode massage is FRAUD! Allen is completely on the money. The state needs to devise a plan to go after chiropractors and their fraudulent billing tactics. Patients with real injuries are being suckered on a daily basis by these wannabe doctors. 10K is suppose to last longer than a month. Injuries to the spine and neck do not get cured in 4 weeks. Anyone who tells you different, RED FLAG!!! I educate people on a daily basis as to the dangers of chiropractors. I tell them to question billing and to ask for statements from the Chiros that are treating them. I tell them to check the statements sent by their insurance companies on a monthly basis that detail what they are paying per visit. I tell them that they are better off not going at all. Go to an ortho and have him refer you to a reputable physical therapy place. Some listen and some dont. The ones that dont regret it when they receive their settlements and are left with nothing for their injuries. The attorneys get a big chunk but the chiros get a lot more after you calculate the PIP and anything on top of that! As long as I am educating one person a day, that one person is passing that message along to others.For those of you that think insurance companies are evil and they deserve it, this isnt about that. Its about the policyholder who is injured and gets taken for a 10,000 dollar ride that lasts 1 month or less. It might be you if you ever have an accident and have to get treatment. Chiros, beware! I am here in Florida to educate all those people who are injured. You will lose money if I get to your patients!

Accident
Accident

Yeah, I was referred to an accident clinic by my PCP's office who doesn't treat auto accidents. I had some back pain and wanted to have an examination. I felt like I would be going there forever, and there was never any discussion made about costs and how long treatment would last. I was going three times per week and was only there for 15 min, but my auto insurance got charged about $250 per visit.

After being diagnosed with a 3 herniated discs via the MRI, the chiro "adjustments" not helping, and the clinic getting a new chiro overnight with no notice, I got my PCP to give me a referral to an orthopedist. The ortho told me that the MRI language was a little overdone and that I have a muscle strain. He put me on physical therapy and two Rxs. I am finally getting some improvement with my back pain. I like how the ortho was specific with what needed to be done, how much it would cost, and how long treatment would last. The physical therapist even said to only come as much as I can afford (because they bill my health insurance for the 20% and I have a deductible to meet) and that he would give me some exercises to do at home and in my own gym. The Rx for therapy was 2x per week for 4-6 weeks. Awesome!

God-forbid if there is a "next time," I'm going to Urgent Care if the accident doesn't warrant an ER visit, and then going to the Orthopedist or something if there are other complications.

Insurance_fraud
Insurance_fraud

so instead of therapy...you take pills...hallelujah...good choice (not)...open the phonebook and get a second opinion...

Duffy
Duffy

MRI's don't determine the value of anything, b/c no one in the population has had them in the past simply to get one, such that they can compare pre-accident to post-accident scans. Treating neuro reports on causation notwithstanding, you can bet the insurance company will have a doctor who opines it pre-exists, is due to a different incident, or is an unrelated red herring that isn't causing the problem at all. Does that mean either is lying? No, but both have slanted perspective and no one can ever have these opinions with 100 percent certainty. Doctors aren't magicians and should not be put on pedestals, whether you're an MD who does adverses or a chiro who thinks you channel Jesus through your hands. A very significant portion of the population would have positive finding of bulging or herniation on an MRI, but without symptoms and without regard to having an accident, and the older you get the more likely you are to find this on a scan. If you're hurt in an accident feel free to treat, but use common sense. If treatment helps, great, knock yourself out. You paid for your coverage so feel free to use it. If treatment doesn't help, try something else. If you get better, stop going. Let claims be what they are, don't reach (over OR under). And so I say that for all the people involved. Sure chiros want money. So do insurance companies. So do lawyers. So do IME whores (I mean doctors). So do people in accidents. This doesn't imply the whole system is dirty, just that everyone has their own interest. Ultimately, it still comes down to the individuals on all sides using common sense.

You want to fix no-fault in Florida? Get rid of direct action by providers and make the insured the only one who can maintain the action, and get rid of attorney fee awards for PIP suits. Both would force providers to treat their patients as something more than a revenue source would and eliminate the providers' incentive to only buddy up with the lawyers rather than treat their patients well. The lawyers would be forced to pay better attention to the client/insured b/c they don't directly serve the doctors' interests and the lawyer would also not have incentive to litigate bad claims, b/c all claims would then only be contingency on the amount of disputed benefits recovered. Any system like Florida's, which allows the provider to cut the patient out of the claim process, and which allows the attorney to directly serve provider and claim fees in addition to the recovered benefits, is ripe for abuse.

Insurance_fraud
Insurance_fraud

we need checks and balances...the insurance industry cries fowl when they are sued for pennies and have to pay huge attorney fees afterwards..what they don't tell you is that prior to the lawsuit they have a second bite of the apple to pay those pennies that "they forgot to pay"..why not at that time don't they pay the pennies?...answer, their greed!, they feel they can deny, delay, and not pay without any repercussion..that is where the check and balance comes in play..if we were to eliminate that function, insurance companies would never pay a claim...

also lets look at the recent article where they denied a man his chance of living, and denied him his transplant, because his wife transposed the numbers and shorted the (ceridian) 2 pennies and they cancelled his policy, leaving him to die...

big insurance is called big insurance for a reason, they are a profit driven business, with many lobbyist to change laws to their favor...they manipulate facts and figures and publish it to the media, to justify their rate hikes..and average joe buys into this crap....

wake up and smell the coffee folks...big business, big payoffs for shareholders and company execs....

Allen Dulles
Allen Dulles

Lisa: Don't let the detractors get to you. They are all chiropractors and p.i. attorneys in the syndicate, and while they make some valid points about insurance companies, let me tell you the real deal.

The p.i. attorneys are always chasing the Holy Grail, namely million dollar cases. Of course, these cases are uncommon, so an overwhelming majority of the cases they procure through the syndicate are "soft tissue" cases, which have very limited value. So, many of these hacks make their money on volume.

The chiropractors want warm bodies, plain and simple. Warm bodies mean that the chiropractor can feed from the pip policy, which they often do at lightening speed. The problem arises when the patient has a real injury like a herniated disc and the chiropractor blows through their pip coverage without sending them to an orthopedic doctor or for an mri. Quite often, when the patient's pip benefits are exhausted, the chiro's attitude is, "It was nice knowing you".

So, the patient is still in pain and is still exhibiting symptoms associated with a herniated disc, pain accompanied by radiculopathy. However, they have no benefits left because their chiropractor just billed their insurance company ten thousand dollars for massages, ice, ultrasound therapy, chiropractic adjustments, and other modalities that provide nothing more than temporary relief. In other words, a band aid.

The problem is compounded by some of the hack p.i. attorneys who then turn around and settle this same client's case for pennies on the dollar while the client still has an undiagnosed and untreated injury. This is not always the case because most of the chiropractors do send their patients for an mri. The MRI is the one diagnostic test that often determines the value of the case, but it is not always dispositive.

Finally, we know that there are some attorneys out there who are paying a certain referral service for cases. We know that some of the advertising is financed and paid for by some of the attorneys, who receive referrals from the same advertisements that they indirectly finance. We also know that there are chiropractors who are paying attorneys cash for cases.

We know who you are...

Crime and punishment grow out of one stem. Punishment is a fruit that, unsuspected, ripens with the flower of the pleasure that concealed it.Ralph Waldo Emerson

Itslegal
Itslegal

You are so right  in your assessment of what is happening in pip.  A bigger problem is the misleading and deceptive advertising that the lawyer and medical referral services is running on tv.  Promising $10,000, really?  The only people that will see that money are the doctors that work for the referral service.  Most people dont know that these so called medical and lawyer referral services are not really referral services at all, they are fronts for their own wholly owned  chiropractic clinics.  Their sole objective is to get people in to their clinics, then blast thru the pip.  If there is cooperative advertising between the lawyers and referral services, it violates a bar rule of ethics, in that a lawyer cannot allow another lawyer to pay for his advertising. I for one will not let this go.

PIPDEFENDER
PIPDEFENDER

You are so right Allen! I wish we could form a task force and go after all these crooks!

Gilding
Gilding

Awww, is the author butthurt that Sentinel and Herald chose not to follow New Times this time?

Lisa Rab
Lisa Rab

Fair point about the insurance companies. New Times published a lengthy story on United Auto five years ago. Check it out, it discusses many of the things you're talking about:http://www.browardpalmbeach.co...

Pheringart
Pheringart

http://www.flickriver.com/phot...Please tell me how did casualty insurers earn 63% more in the first 3 quarters of 2010 and this cleck on web address 60 million dollar home in Chicago of Richard Parillo CEO of United Auto, the biggest fraud perpetrator Florida has ever seen, get built on PIP premiums if these stories about a few bad apples cause you to write such one sided stories. Are you part of the insurance company deal

Smitty
Smitty

The story is not accurate. The lawyer does not take a penny of the $10,000. The facts are wrong. There should be a story written about how insurance companies deny claims. That is the real fraud.

Robert
Robert

I don't understand the point of this article. Didn't the New Times piece already mention the case. Please do an article on insurance companies. They are making millions of dollars and deny tons of legitimate complaints. Then, they find a couple cases of fraud (which should be prosecuted and the perpetrators should be punished) and ask the papers to run articles on it. Isn't the more interesting story the thousands of denied claims that result in insurance company executives lining their pockets.

Now Trending

From the Vault

 

General

Loading...