By KJ Singh
As we have seen in recent weeks and months, NYC TLC drivers and those in the NYC TLC Auto Insurance industry have little protection from those that abuse NY insurance regulations. Why does this matter? Because it results in significant costs being passed down to honest hardworking drivers, like you.
Should drivers bail out private insurance companies? No. Should drivers protect their livelihoods and have options to obtain insurance to protect themselves? Absolutely. Why does it matter? Because without proper auto insurance, one cannot drive a car in NY, let alone work as a taxi/livery driver.
Claims, Claims and More Abusive Claims
- As stated in part 1 of this series, NY State Regulation 68 was created to help the public, passengers and claimants in the case of an accident. Unfortunately, at the same time it allows for significant abuse with regards to alleged medical treatment, after an alleged accident. Key word: Alleged. Reason being, there are many targeted and staged accidents like the recent viral Tik Tok video recorded in NY.
- After such an alleged accident, people can claim injuries and start medical treatment immediately. It is at this point, the very start of a claim, the abuse starts. With no treatment plan, no guidelines, no short-term or long-term health goals and no need to follow any standard medical guidelines, excessive and abusive bills are submitted to auto insurance companies, immediately. Recent trends are that medical bills come before phone calls, police reports or any validation of an accident.
Insurance vs Insurance
- If any of these bills were submitted to a health insurance company, or Medicare/Medicaid, they would have the ability to be reviewed, cross referenced with standard medical guidelines and then processed.
- Under Regulation 68, auto insurance companies have no such ability to review treatment and/or reference bills to existing guidelines. As a result, alleged “soft tissue” injuries such as sore backs, necks and ankles can be billed in equivalence to heart and brain surgeries.
- Unfortunately, the costs to pay and defend are being passed down to honest hardworking drivers, like you.
- There are rare, and legitimate, claims where significant injuries occur. These are usually handled by Hospitals and their associated Emergency Rooms. However, they follow existing medical guidelines and do not submit excessive and abusive bills. As a result, they get processed and paid promptly.
- This is the intent of Regulation 68, to provide emergency and basic treatment for the benefit of the public, passengers and claimants.
It is Not Fraud if it’s Allowed
- Only in NY, can abusive billing and alleged treatment be submitted to auto insurance companies, with no consequences.
- Ironically, if the same abusive medical bills are submitted to Medicare/Medicaid or the Federal Government, they might get paid, but Federal Investigators will come knocking, quickly. In that regard, there are many cases in NY where medical providers have been fined, suspended and/or arrested for Medicare/Medicaid abuse.
- Recently, three licensed professionals in NY were found guilty of a $31 million dollar insurance scheme. Two of the individuals were sentenced to over eight years in jail, while the third defendant was sentenced to two years in jail.
- Over the course of several years, these licensed physicians and attorneys performed over 300 medically unnecessary surgeries and filed over 200 fraudulent lawsuits to obtain additional fees among other illegal activities.
- The Federal Government and the FBI prosecuted the case in NY. This is the norm, not the exception. (Reference: https://www.justice.gov/usao-sdny/pr/new-york-lawyers-and-doctor-sentenced-defrauding-new-york-city-area-businesses-and)
- It is in this regard, American Transit Insurance Company, the largest insurance company in the NYC TLC, filed a Federal lawsuit against 180 defendants for $450M under the federal Racketeer Influenced and Corrupt Organizations Act. More commonly known as RICO.
Protect Yourself
- It is a serious problem so protect yourself at all times. Take and send pictures of accidents immediately. If you suspect a setup or a staged accident, call the police immediately to make a statement. Also, utilize technology, install and test dashcams for your protection.
- At the end of the day, it is a fight between honest hardworking TLC drivers and abusive claimants.
KJ Singh is the President/COO of the Maya Assurance Company.
