Doctor in Queens Falsely Billed Accident Victims

A physician employed at a Jamaica, Queens, medical clinic has been charged with insurance fraud for allegedly falsely billing insurance carriers under New York’s no-fault law for costly medical tests never provided to motor vehicle accident victims.  To make matters worse, he is the second doctor at this clinic to be charged with insurance fraud in less than a month.

Alexander Israeli, 53, was arraigned before Queens Criminal Court Judge Alex J. Zigman on charges of third-degree grand larceny, third-degree insurance fraud, and first-degree falsifying business records.

Israeli, who faces up to seven years in prison if convicted and the loss of his medical license, was ordered released without bail and to return to court on June 17.

“No-fault fraud and abuse is a billion dollar a year business in New York fueled by unethical health care professionals”, district attorney Richard Brown said. “Such rip-offs are costing the typical New York motorist $300 to $400 a year in higher insurance premiums and are the major reason why New York’s automobile insurance coverage costs an average of nearly $2,000 per driver, the second highest in the nation. This arrest sends a clear message to those who are attempting to use the system for their own personal gain that law enforcement’s fight against insurance fraud is ongoing and that those who cheat will be sought out and vigorously prosecuted.”

The district attorney said that under New York’s no-fault law, a person injured in a motor vehicle accident can receive up to $50,000 coverage for medical expenses incurred as a result of an accident. Most health providers are reimbursed directly by the insurance carriers for services provided.

Brown said that, according to the criminal court complaint, between January and December 2006, the defendant submitted insurance claims for costly nerve conduction studies and needle electromyographs (“NCV/EMGs”) that, in fact, were not performed on seven individuals. A NCV tests the flow of electrical currents across the nerves, and an EMG is a recording of the electrical activity in muscles and nerves. The defendant is alleged to have caused fraudulent claims for these unrendered and unnecessary medical tests to be submitted to a number of no-fault insurance companies in an amount totaling more than $21,000.

Among the insurance companies allegedly victimized by the defendant’s scheme were GMAC Insurance Company, KEMPER Auto and Home Insurance, AllState Insurance Company and GEICO Insurance.

According to the district attorney, Dr. Yakov Raufov, a physician who also practices at L&B Medical, was charged on May 22 with third- and fourth-degree grand larceny, third- and fourth-degree insurance fraud and first-degree falsifying business records.

Raufov faces up to seven years in prison if convicted.