If you've been living in the Florida area for just about any time at all, chances are you've heard the jingle for 411-PAIN blaring through the speakers of your vehicle or have seen the company's logo whiz by you on a Palm Tran bus. The company's presence is so significant; it's almost become second nature to sing along when the company's name is mentioned.
However, the tables have turned for the Davie-based corporation, as a recent $15 million lawsuit filed by the insurance giants at GEICO have left 411-PAIN in quite a bit of heartache.
Is 411-Pain Legitimate?
You've heard the famous line - "After 911, call 411." But, why? After an accident, seeking medical treatment from a qualified physician is crucial. If 411-PAIN is urging you to call them after an accident, they must offer a qualified network of doctors to tend to the various injuries you may have suffered, right?
Unfortunately, no. Though initially founded by chiropractor Dr. Robert Lewin, 411-PAIN is a for-profit lawyer referral service. In 2015, Lewin merged his network of chiropractic offices into a united company called Path Medical, LLC. When you dial 411-PAIN, an individual in a call center who holds neither a medical or legal license will refer you to a random attorney who is paying to be a part of the service. 411-PAIN will also turn clients in the direction of Path Medical, further padding the pockets of Lewin.
The GEICO Lawsuit
For insurance companies, 411-PAIN is quite literally a pain. From an automotive insurance company standpoint, the sole focus of these for-profit referral services is to bill insurance companies for PIP insurance money as quickly as possible. Personal Injury Protection, abbreviated as PIP, is an extension on auto insurance required under Florida law. PIP enforces a driver's insurance company to provide $10,000 in medical payments, regardless of fault.
According to the lawsuit filed on Nov. 27, 2017 by GEICO, the offices of Path Medical charged the insurance company for medical procedures that "were medically unnecessary, illusory, unlawful, and otherwise reimbursable." Examples of such procedures are physical therapy, initial examinations, and follow-up appointments. GEICO refers to these as "fraudulent no-fault insurance charges" and is seeking to recover over $15 million.
Fraudulent Insurance Charges
If you've been in an accident and are experiencing pain, you'll want a qualified, non-biased physician to tend to your injuries. For a patient and an insurance company alike, you don't want to have to undergo unnecessary treatments that are strictly meant to funnel money into pain clinics.
GEICO allegates Lewin has failed to meet legal responsibility for the treatments his clinics have claimed. As the medical director hired to oversee five of Path Medical's chiropractic clinics in the Tampa area, David A. Cheesman, D.O., failed to monitor the billings of the clinic for unlawful or fraudulent charges. This violates the Clinic Act, which in part requires health care facilities to appoint a qualified medical director that actively oversees activity on behalf of the facility. This led to thousands of fraudulent charges to be submitted to GEICO, and now the insurance company wants their money back.
Who Should You Trust?
Following an accident, after 911, do not call 411. Instead, research physicians in your area that would be best suited to fulfill your medical needs. Turning to a pay-for-hire company does not ensure you an attorney or physician that is qualified to handle your case. As a word to the wise: when it sounds too good to be true, it most likely is.