Los Angeles County Superior Court has ruled in favor of AllstateInsurance Company and the State of California in a lawsuit topping$7 million that ends fraudulent business and billing schemes byseveral unlicensed medical and chiropractic personnel.

In its lawsuit, Allstate alleged Maria Miranda, Frank Rivera,and LA Healthcare Management, Inc. violated the state's InsuranceFraud Protection Act when they submitted more than 390 chiropracticclaims that were falsely generated by unlicensed and untrainedpersonnel, or because the billed treatments did not reflectpatients' physical needs.

Judge William Fahey agreed with Allstate and ordered Miranda andRivera to pay Allstate $3.9 million in penalties, plus $3.8 millionin assessments and fees—a $7.7 million judgment.

“Submitting even one false insurance claim is more than just abad idea—it's fraud, and insurance fraud is a crime,”said Phil Telgenhoff, Allstate's California field vicepresident. ”Fraud drives up the cost we all pay for insuranceby stealing millions of dollars from insurers. This cannot and willnot be tolerated in California or anywhere.”

Telgenhoff added that Allstate will continue to fight fraud tohelp protect its customers and keep insurance costs down.

Allstate's suit identified Miranda and Rivera as two unlicensednon-professionals operating through LA Health Care and LynwoodHealth Care clinics and catering to attorneys representing peoplewho all made claims of soft tissue injuries. The clinics are nolonger in operation.

During court proceedings, Allstate successfully argued thatMiranda violated California's Unfair Business Practices Act,claiming that—as owner of L.A. Healthcare Management, Inc.—she wassolely responsible for overseeing the fraudulent operation of bothclinics, which included the recruitment and steering of patients,setting standard operating procedures for patient treatmentregardless of medical need, and submitting false narrative reportsand bills.

Other violations recognized by the judge include Miranda andRivera practicing medicine and chiropractic without a license,operating a professional medical corporation in violation of statelaw and falsifying patient medical records.

This is the second multi-million dollar ruling against insurancefraud in Los Angeles Superior Court that Allstate has successfullyargued within the past year.