New York Jury Convicts Lawyer, Doctor in $31M Trip-and-Fall Insurance Fraud

A New York legal professional and surgeon have been convicted by a Manhattan jury of 6 counts of fraud for participation in an illegal plan that provided untrue insurance plan claims and unwanted surgical procedures for alleged injuries from staged trips and falls, a plan prosecutors say resulted in a lot more than $31 million in phony statements.

Pursuing a a few-7 days demo prior to U.S. District Choose Sidney H. Stein, the jury on December 16 unanimously convicted George Constantine, an attorney, and Andrew Dowd, an orthopedic surgeon, for their participation in the large individual harm promises fraud plan between 2013 and 2018.

A quantity of co-conspirators including other licensed specialists have currently been convicted or pled responsible in the scheme.

The plan involved the recruitment of individuals — including some who had been homeless— to phase vacation-and-slide accidents and endure medically needless surgeries executed by Dowd that had been created to boost the worth of fraudulent own personal injury lawsuits submitted by Constantine, according to U.S. Legal professional Damian Williams and prosecutors.

Williams reported the men “preyed upon inadequate, vulnerable, and at-situations homeless individuals” when abusing “their qualified licenses, levels, and titles to line their individual pockets with millions of bucks, and they now experience the prospect of prolonged prison sentences for their crimes.”

Attorney Is Most current to Plead Guilty in $31M Journey-and-Drop Insurance coverage Fraud Scheme

New York Surgeon Pleads Responsible to Collaborating In $31M Excursion-and-Fall Fraud

Fifth Member of $31M New York City Journey-And-Fall Plan Arrested, Billed

Constantine and Dowd made use of a workforce of “runners” who were being compensated dollars kickbacks by Constantine to recruit the sufferers to phase or falsely declare to have endured journey-and-drop incidents at certain places during the New York City location. Prevalent accident sites utilised throughout the fraud scheme bundled cellar doorways, cracks in concrete sidewalks, and purported “potholes” in entrance of industrial establishments, these kinds of as fuel stations, diners, and other firms.

Immediately after their staged accidents, the “patients” have been directed to go to the medical center to receive discharge papers and then ended up introduced to Constantine’s workplace, by the carloads, the place they fulfilled with him briefly. He would uniformly accept their situations. According to prosecutors, Constantine submitted practically 200 fraudulent lawsuits and attained extra than $5 million in settlement expenses from these fraudulent conditions.

Adhering to the patients’ conference with Constantine, the people would be pushed to several health-related appointments, which includes visits with chiropractors, bodily therapists, and to receive MRIs. This was finished to justify the surgical treatments on their knees, shoulders, and backs that sufferers were being expected to have as portion of the plan.

In accordance to prosecutors, the individuals had been then driven to satisfy with Dowd, who would conduct arthroscopic knee and shoulder surgeries in just one particular to two months of initial conference the individuals. He paid hundreds of 1000’s of dollars in kickbacks for these individual referrals. He fabricated clinical stories to make it appear to be like the clients had been injured, when in fact they have been not. To incentivize the sufferers to get surgical treatment, they have been compensated around $1,000 just after each surgical procedure. For the duration of the class of the plan, Dowd executed practically 300 medically unneeded surgeries and acquired far more than $3.2 million, about $10,000 for every medical procedures, according to prosecutors.

The surgical procedures, as effectively as the other healthcare strategies, have been funded by litigation funding corporations, such as a funding firm owned by co-conspirator Adrian Alexander. The funding organizations also paid out the fraud plan organizers and individuals referral fees, generally $1,000 to $2,500, for every individual who signed a funding settlement for their clinical and legal charges at substantial fascination premiums. The fascination premiums were being so higher that in many cases the bulk of the proceeds that were being awarded in the fraudulent lawsuits had been paid to the funding corporations, Constantine, and other scheme members, with the patients obtaining a considerably lesser percentage of the remaining recovery.

Prosecutors instructed the jury that the clients were being “overwhelmingly poor – persons determined more than enough to submit to surgeries in trade for the little payments they would acquire after surgical procedure.”

Every of the 6 counts of wire and mail fraud carries a highest phrase of 20 several years in jail. Sentencing of Constantine and Dowd has been scheduled for March 21, 2023.

Co-conspirators Marc Elefant, Sady Ribeiro, Adrian Alexander, Kerry Gordon, and Peter Kalkanis previously pled responsible before Decide Stein for their involvement in the same excursion-and-slide fraud scheme. Co-conspirators Bryan Duncan, Ryan Rainford, and Robert Locust have been convicted at trial in May well 2019 for their participation in the identical journey-and-fall fraud plan.

Topics
Fraud
New York