American Transit Insurance Co. Files RICO Lawsuit Against A Multitude of Providers for Fraud, Seeking $153 Million in Compensatory Damages Plus Punitive Damages, and Treble Damages.

On December 17, 2024, American Transit Insurance Co.(“ATIC”), an auto liability insurer, filed a lawsuit, American Transit Insurance Company v. All City Family Healthcare Center Inc., et. al., Case No. 24-cv-08606, in the United States District Court of the Eastern District of New York against at least 180 medical providers in the New York and New Jersey area., alleging fraudulent insurance claims to ATIC under the New York No-Fault insurance law. This lawsuit represents one of the largest insurance fraud actions filed under the Racketeer Influenced and Corrupt Organizations Act (RICO) in New York. ATIC is pursuing a substantial $153 million in compensatory damages ($459 million in trebled damages) plus punitive damages, etc. 

The complaint presents serious allegations against the defendants, including Surgicore, LLC. It claims they engaged in improper licensing practices, billed for unnecessary services, paid illegal kickbacks, and charged amounts that exceed what is allowed under New York’s No-Fault law. This law mandates that insurance companies reimburse their policyholders for necessary and properly documented medical care up to $50,000 for personal or private passenger vehicles, and $200,000 for taxis and for-hire vehicles in New York City, for injuries sustained in an accident regardless of fault. Such significant potential recoveries under the no-fault system can tempt unscrupulous providers to over-diagnose, over-treat, and inflate bills in order to maximize their profits.

ATIC provides insurance for approximately 60% of the over 117,000 commercial taxis, livery cabs, black cars, and rideshare vehicles in New York City. ATIC has reported a dire financial situation, claiming insolvency with over $700 million in losses.