Allstate Claims $1M for Fraud - Analyst Blog
June 24 2011 - 1:43PM
Zacks
In an effort to recoup over $1 million paid in personal injury
protection benefits, Allstate Corp. (ALL) has
filed a lawsuit against 10 New York area defendants.
According to the complaint filed by Allstate under the Racketeer
Influenced and Corrupt Organizations Act (RICO) and New York common
law, four professional service corporations, a licensed
psychologist and five laypersons unlawfully owned and controlled
the professional corporations.
The Allegation
Allstate alleged that HK Psychological, P.C., Kingshwy
Psychological, P.C., Omega Psychological, P.C. and Jay
Psychological, P.C. were illegally incorporated through a scheme
using the name of licensed psychologists. However, in reality, Ben
L. Adler, Alex Gormakh, Milana Gormakh, Peter Kerner and Shari
Matatov, none of whom were licensed practitioners, secretly owned
and controlled the professional service corporations.
The Allstate lawsuit alleges that the defendants had submitted
or aided in submitting claims for psychological services through
the professional corporations. But these corporations were not
eligible to collect insurance benefits as they were not controlled
by licensed professionals.
This represents the third insurance fraud lawsuit in 2011. In
May, Allstate filed two insurance fraud lawsuits. In the first
fraud lawsuit, the company sought to recover $4 million against 20
New York area defendants. In the lawsuit, Allstate had alleged six
physicians, eight medical professional corporations, and lay-owned
companies of controlling medical professional corporations.
In the second fraud lawsuit, Allstate sought to recoup $2.1
million against 37 New York area defendants. It alleged that the
defendants engaged in a scheme in which fraudulent and misleading
bills were submitted to Allstate for durable medical equipment,
medical supplies and orthotic devices.
Since 2003, Allstate has filed 30 fraud lawsuits in New York,
seeking nearly $169 million in damages. If the money is recovered,
it would add to the company’s financials.
In the News Recently…
Allstate was in the news late last week, after it made an upward
revision to its preliminary estimate of catastrophe losses (cat
losses) from property damages owing to adverse weather conditions
that continued into May.
After the revision, the company expects pre-tax cat losses of
around $2 billion, up $600 million from $1.4 billion that was
announced during April, for the storms in the southern states of
the U.S. In May, Allstate was affected by unprecedented
tornadoes.
Allstate’s expected second quarter loss of $2 billion is
considerably higher in magnitude as against $2.21 billion incurred
for the whole of 2010. Its peer Travelers Companies
Inc. (TRV) estimates April and May cat losses to cost
between $1 billion to $1.05 billion.
Following years of sharp price declines, we believe that a hard
market might return as the disasters caused by severe
weather-related events this year are pushing prices higher in the
insurance industry.
Going forward, we believe Allstate’s excellent underwriting
margins, prudent capital management and strong liquidity will
continue to impress results. Further, the ongoing agency expansion
plan explains Allstate’s strategy to revitalize its distribution
channel by increasing its market presence.
Though continued synergies are expected from the company’s
industry-leading position, diversification and pricing discipline,
we believe that the current volatile economy will continue to
impact its premiums until the markets regain momentum.
Shares of Allstate currently retain the Zacks #3 Rank, which
translates into a short-term ‘Hold’ rating.
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