‘The View’ host Sunny Hostin’s husband accused in NYC insurance fraud

The husband of longtime co-host of “The View,” Sunny Hostin, is among dozens of doctors and medical personnel accused of massive medical insurance fraud.

Emmanuel Hostin is alleged to have received "kickbacks" by "performing surgery and fraudulently billing" the insurance company American Transit Insurance Co., which insures taxi companies and Uber and Lyft drivers.

American Transit filed a civil lawsuit Dec. 17 in U.S. District Court for the Eastern District of New York. The 698-page 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 “provided examinations to Covered Persons through Hostin Orthopaedics, and fraudulently billed American Transit for medical and other healthcare services, pursuant to a fraudulent predetermined treatment protocol irrespective of medical necessity in exchange for kickbacks and/or other financial compensation.”

Hostin allegedly 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."

NY no-fault law

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 john.hilton@innfeedback.com. Follow him on Twitter @INNJohnH.