Liberty Mutual Insurance has brought a $17 million fraud lawsuit against a Chicago-based medical practice specializing in neck and back injuries, saying the practice billed for procedures and therapy they did not perform on worker’s comp patients and billed at inflated rates.
On Aug. 17, Liberty Mutual filed a complaint in Cook County
Circuit Court against Marque Medicos, a practice which provides care to
patients at several locations in Chicago and west suburban Aurora. According to
published reports about the practice, Marque Medicos specializes in neck and back
injuries generally payable under workers compensation claims. The practice also
was described in at least one report as catering particularly to Hispanic
The Aug. 17 lawsuit also named as defendants Derrick
Wallery, listed in the complaint as owner of Marque Medicos, as well as all of
Marque Medicos’ various other associated corporate entities.
Liberty Mutual was joined in the lawsuit by 17 other
affiliate insurance companies.
According to the lawsuit, Liberty Mutual, which provides
workers’ compensation insurance to many businesses in Illinois, has paid claims
to Marque Medicos for “treatment allegedly rendered to workers’ compensation
claimants who were employed by companies insured by Liberty Mutual.”
However, from 2008-2014, Liberty Mutual said it received
bills from Marque Medicos “for additional medical bills and charges … which
were denied and/or not paid.”
Those charges prompted Liberty Mutual to launch an
investigation into Marque Medicos’ claims, the lawsuit said, which “revealed …
fraudulent billing practices.”
Liberty Mutual alleged its investigation showed Marque
Medicos had billed at higher rates for such procedures as “attended electrical
stimulation when unattended electrical stimulation was actually performed” and
billing for “multiple units per visit of direct one-on-one” physical therapy,
when they actually allegedly performed “single-unit-per-visit group therapy.” The
lawsuit alleged the practice also billed for “hands-on therapy” when it was
never actually performed.
In all, Liberty Mutual alleged it had paid more than $2.5
million to Marque Medicos to satisfy those bills, and had received approximately
$5.1 million in additional bills from the practice.
The insurer alleged counts of insurance fraud and common law
fraud against Marque Medicos.
The lawsuit asked the court to award Liberty Mutual and its
affiliates three times the $2.5 million already paid, and two times the $5.1
million “wrongfully attempted to be obtained through the use of fraud.”
In all, Liberty Mutual has asked the court to order Marque
Medicos to pay out more than $17.7 million in damages, plus attorney fees.
Liberty Mutual is represented in the action by attorneys
John F. Boyle and Michael D. Spinazzola, of the Law Offices of Meachum, Starck,
Boyle & Trafman, of Chicago.