Some settlements reached in fraud lawsuit involving Sunny Hostin’s husband
A New York City civil lawsuit accusing dozens of clinics and doctors – including the husband of longtime co-host of “The View,” Sunny Hostin – of massive medical fraud is moving closer to a settlement.
According to documents filed Monday, the insurance company American Transit Insurance Co., which insures taxi companies and Uber and Lyft drivers, settled with 141 of the 186 defendants named in the 698-page complaint.
“Based on settlement discussions with other defendants, American Transit anticipates it will soon be advising the Court of agreements in principle with several other defendants,” wrote Lee Pinzow of Manning Kass, one of the attorneys for the insurer.
It is not known whether Dr. Emmanuel Hostin is one of the defendants reaching a settlement. Most recently, a Brooklyn judge granted a motion giving Dr. Hostin until Feb. 10 to answer the fraud lawsuit.
Millions in damages sought
American Transit filed a civil lawsuit Dec. 17 in U.S. District Court for the Eastern District of New York. The lawsuit lists dozens of surgical centers, orthopedic services and doctors and is reported to be one of the largest Racketeer Influenced and Corrupt Organizations Act (RICO) cases ever filed in New York.
American Transit seeks to recover compensatory damages in excess of $153 million and treble damages in excess of $459 million.
The insurer alleges that Hostin, who owns Hostin Orthopaedics, performed surgeries at other ambulatory surgical centers and billed American Transit through each of those entities “in exchange for kickbacks and/or other compensation which were disguised as dividends or other cash distributions” for an investment Hostin has in Empire State ASC, the lawsuit claims.
Licensed to practice medicine in New York since August 2002, Emmanuel Hostin married Sunny in 1998 and has two children with the talk show host, a lawyer and former federal prosecutor.
In a statement given to the Daily Mail, Emmanuel's lawyer, Daniel Thwaites, said that his client "denies each and every allegation" and believes the lawsuit to be a "blanket, scattershot, meritless lawsuit by a near-bankrupt insurance carrier."
No-fault statute blamed
American Transit traces its complaint to New York’s no-fault law, which states that plaintiffs are required to pay for health service expenses that are “reasonably incurred as a result of injuries suffered by occupants of their insureds’ motor vehicles, pedestrians, and bicyclists,” the lawsuit says.
Enacted in 1974, the no-fault law requires insurers to compensate covered persons for “basic economic loss,” which includes medical costs, incidental costs, and lost earnings. Across the country, officials are taking a closer look at no-fault laws enacted during the 1970s.
Personal line auto insurers that insure personal or private passenger vehicles are required to provide benefits up to $50,000 per person. Commercial auto insurers are required to provide up to $200,000 per person.
“This has put a target on the backs of livery vehicles, and the insurance companies which insure them, for unsavory persons seeking to capitalize on payouts following injuries. In the aggregate, those abusing the No-Fault Law have racked up hundreds of millions in fraudulent payments, destabilized the livery insurance markets in New York City,” the lawsuit states.
The alleged fraud was led by a group of ambulatory surgical centers from 2009 to the present, the lawsuit claims. Injured people were first treated at clinic, then transferred to an ASCs for “orthopedic and/or pain management evaluations,” the lawsuit says.
American Transit names 5,800 people who received such treatment “as part of the predetermined fraudulent protocol of treatment.”
The goal of the alleged fraud was always “to maximize reimbursement from insurers in general, and Plaintiff in particular, for No-Fault benefits for medically unnecessary services,” the lawsuit says.
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InsuranceNewsNet Senior Editor John Hilton has covered business and other beats in more than 20 years of daily journalism. John may be reached at [email protected]. Follow him on Twitter @INNJohnH.
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