Two orthopedic surgeons will have to face a lawsuit from Geico that alleged they worked with a personal injury attorney to submit false insurance claims.
Erik Bendiks, MD, and Sonia Pasi, MD, of Apex Spine & Orthopaedics allegedly conspired with attorney Ronald Shane Smith to maximize payments for themselves, according to a June 3 order from the U.S. District Court for Western North Carolina. According to a lawsuit filed by Geico, they submitted fraudulent invoices for medical services that weren't performed, unwarranted or unrelated to the corresponding insurance claim. Based on the false medical documents, they reached settlements in automobile claims.
Geico filed their lawsuit in 2023 alleging that the surgeons and attorney violated the Racketeer Influenced and Corrupt Organizations Act. In December the surgeons moved to dismiss the lawsuit for "lack of jurisdiction and failure to state a claim."
The surgeons' motions were denied on grounds including the fact that Geico alleged "specific, discrete, fraudulent acts which include details such as the who, what, when, where, and why for multiple patient-specific examples." Geico will have to prove the extent of damages from the scheme but allegedly incurred a more than $2.8 million loss.
Apex Spine & Orthopaedics didn't immediately respond to a request for comment.
Editor's note: This article was updated June 6 at 11:32 a.m. CT.