Since the mid-1980’s, Getnick & Getnick LLP has worked with the insurance industry to establish systems to combat complex insurance fraud. In conjunction with co-counsel, Getnick & Getnick filed on behalf of a consortium of insurance companies a civil RICO prosecution arising from a complex attorney-generated fraud in Southern California. That case successfully detailed the activities of “The Alliance”, estimated to have cost the industry up to $200 million dollars in fraudulent billings.
The case led to a parallel criminal RICO prosecution by the United States Attorney, Southern District of California, resulting in convictions with restitution orders and settlements arising from the civil case. See “Fireman’s Gets Tough,” Forbes, March 19, 1990; “The ‘Alliance’ Insurance Fraud: A Case Study in the Civil Prosecution of Business Crime,” by Neil V. Getnick and James P. Schratz, Civil Prosecution News.
In 2000, Getnick & Getnick LLP, together with co-counsel, representing a consortium of health insurance companies, achieved a $6.8 settlement with Laboratory Corporation of America arising from alleged overbilling for clinical tests provided to health plan subscribers. Labcorp allegedly included in routine laboratory screens millions of unnecessary tests that had not been ordered by doctors.