Allstate Insurance v. Rozenberg

590 F. Supp. 2d 384, 2008 U.S. Dist. LEXIS 104735, 2008 WL 5383370
CourtDistrict Court, E.D. New York
DecidedDecember 29, 2008
Docket2:08-mj-00565
StatusPublished
Cited by10 cases

This text of 590 F. Supp. 2d 384 (Allstate Insurance v. Rozenberg) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allstate Insurance v. Rozenberg, 590 F. Supp. 2d 384, 2008 U.S. Dist. LEXIS 104735, 2008 WL 5383370 (E.D.N.Y. 2008).

Opinion

MEMORANDUM OF DECISION AND ORDER

SPATT, District Judge.

On February 12, 2008, the Plaintiffs (or “Allstate”), a group of nine insurers, commenced this action alleging that the numerous Defendants conspired to abuse New York’s No-Fault Insurance regime, N.Y. Ins. Law § 5101 et seq., in order to obtain payment for medical services and diagnostic tests that were not medically necessary, or in some cases, never performed at all. The Plaintiffs assert common law claims for fraud and unjust enrichment, and seek damages for violations of N.Y. Gen. Bus. L. § 349, and violations of the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. § 1961 et seq. (“RICO”).

On April 30, 2008, Defendants Inna Po-lack, Alexander Polack, Natalya Shvarts-man (“the Management Defendants”), and Mighty Management Group, Inc., Mighty Management LLC, and Blue Wave Management, Inc. (“the Management Companies”) moved to dismiss Counts I, II, III, IV, V, and VIII of the Plaintiffs’ complaint. On June 5, 2008, Defendants Dr. Alexander Rozenberg (“Rozenberg”), A.R. Medical Rehabilitation, P.C., A.R. Medical Art, P.C., and Yonkers Medical Art, P.C. (“the PC Defendants”) moved to dismiss Counts I-V. For the sake of judicial economy, and because these separate motions raise the same arguments, the Court will address both motions together.

/. BACKGROUND

A. The Alleged Scheme

Pursuant to New York’s No-Fault insurance regime, the Plaintiffs are required to provide benefits to eligible insured persons for medically necessary diagnostic tests. The insureds in turn may assign their rights to such benefits to their medical providers in order to reimburse them for services rendered. The Plaintiffs allege that Rozenberg, a licensed neurologist, is the straw owner of the PC Defendants. The PC Defendants are medical professional corporations that billed the Plaintiffs for consultations, neurological exams, and range of motion testing performed upon patients insured by Allstate. According to the Plaintiffs, Rozenberg played no role in the actual operation or management of the PC Defendants.

The Plaintiffs assert that the PC Defendants were in fact operated by the Management Companies; New York corporations that are owned and controlled by Inna Polack, Alexander Polack, and Yuliy Goldman. The Plaintiffs allege that the sole purpose of establishing the relationship between the PC Defendants and the Management Companies was to facilitate a scheme to defraud Allstate by creating and submitting, through the mail, fraudulent medical reports and invoices for medical services in support of hundreds of No-Fault insurance claims. In particular, the Plaintiffs aver that the Defendants submitted bills for services not rendered; charged excessive fees for unnecessary *388 medical treatment; and induced Allstate and the other insurers to pay No-Fault insurance claims to professional medical corporations that were owned by non-licensed individuals.

The Plaintiffs allege that Inna Polack, Alexander Polack, and Rozenberg created the PC Defendants with different names, addresses, and taxpayer identification numbers to reduce the likelihood that insurers would uncover their scheme. The Plaintiffs further allege that, through the Management Companies, Inna Polack, Alexander Polack, and Goldman instructed non-medical personnel, including the Defendant Natalya Shvartsman, to implement pre-established treatment regimens that would maximize the PC Defendants’ billing invoices.

The Plaintiffs contend that Rozenberg subjected their claimants to a battery of unnecessary tests and that the results of these examinations were often deliberately misrepresented or fabricated in order to justify further costly but unneeded treatments. The Plaintiff avers that, based upon these fabricated testing results, the Defendants submitted invoices to the Plaintiffs demanding payments for services that were not medically necessary or, in some cases, never rendered at all.

B. The Indictment

On or about July 31, 2006, Rozenberg, Inna Polack, Natalya Shvartsman, Emmanuel Kucherovsky, Shaun Robinson, A.R. Medical, P.C., Mighty Management, LLC, and Mighty Management Group, Inc. (“the criminal Defendants”) were indicted in Supreme Court, Kings County, in connection with a scheme to defraud No-Fault insurance carriers. According to the Indictment, the criminal Defendants controlled A.R. Medical. The Indictment alleges that the criminal Defendants paid a network of “steerers,” such as Shaun Robinson, to stage automobile accidents and refer the victims to AR Medical for treatment. The Indictment alleges that AR Medical then defrauded insurance carriers by submitting fraudulent claims for health services.

The Indictment further alleges that although Rozenberg was the straw owner of AR Medical, it was in fact owned by Inna Polack. The Indictment alleges that Inna Polack established and enforced rules governing the solicitation of patients and the administration of patient treatment. According to the Indictment, the criminal Defendants fraudulently diagnosed patients with extensive injuries and submitted claims to insurance carriers for unnecessary treatment or, in some cases, treatment that was never provided at all. The Indictment also alleges that Inna Po-lack used the clime’s manager, Natalya Shvartsman, to carry out Polaek’s alleged scheme.

According to the Indictment, checks were drawn from the accounts of the Management Companies and made payable to corporations owned or controlled by Ku-cherovsky who, for a transaction fee, transferred these monies to Inna Polack. The Indictment alleges that during the period from January of 2005 until March of 2006, more than $2.3 million was deposited into the accounts of the Management Companies. According to the Plaintiffs, to date, Inna Polack, Shvartsman, Kucherov-sky, and Robinson have all pled guilty to Insurance Fraud, Money Laundering, and Larceny.

C. The Plaintiffs’ Complaint

On February 12, 2008, the Plaintiffs commenced this lawsuit alleging that: (i) the Defendants violated RICO, 18 U.S.C. § 1962(c); (ii) the Defendants engaged in a RICO conspiracy in violation of 18 U.S.C. § 1962(d); (iii) the Defendants committed common law fraud and unjust enrichment; *389 and (iv) the Defendants are liable under N.Y. Gen. Bus. L. § 349 for deceptive business practices.

II. DISCUSSION

A. 12(b)(6) Standard

In considering a 12(b)(6) motion to dismiss, “ ‘[t]he issue is not whether a plaintiff will ultimately prevail but whether the claimant is entitled to offer evidence to support the claims.’ ” Todd v. Exxon Corp., 275 F.3d 191, 198 (2d Cir.2001) (quoting Scheuer v. Rhodes, 416 U.S. 232, 236, 94 S.Ct.

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Bluebook (online)
590 F. Supp. 2d 384, 2008 U.S. Dist. LEXIS 104735, 2008 WL 5383370, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allstate-insurance-v-rozenberg-nyed-2008.