Fullerton, CA asked in Insurance Bad Faith, Insurance Defense and Medical Malpractice for California

Q: is there a whistleblower reward available for reporting insurance fraud in california?

a business is allowing a doctors office to “recruit” patients on its premises. one of the managers is receiving a referral bonus (cash) for every employee that goes and has any procedure (bonus is from the dr office not from the employer). on top of that the doctors office offering new patients a “bonus” (cash) for having procedures done, apparently they are submitting false claims to insurance companies to get a higher payment and they split that amount with the patients, they also offer referral bonuses to anyone that brings them a new patient. i’m talking big bucks as these bonuses... my friend got $7,000 to have her nose surgery and she didn’t even need it, they basically talked her into having a surgery because she was offered the $7,000. i don’t want to disclose the company publicly

1 Lawyer Answer
William John Light
William John Light
Answered
  • Medical Malpractice Lawyer
  • Santa Ana, CA
  • Licensed in California

A: Insurance fraud is a crime, so contact the police. You can also contact the Medical Board, which licenses and disciplines physicians. dca.ca.gov/consumers/complaints/medbd.shtml

You can also retain an attorney to file your own lawsuit against the medical providers under the Insurance Fraud Prevention Act. The IFPA provides for fines against fraudsters ranging from $5,000 to $10,000 per violation in addition to damages of three times the amount of money the fraud cost its victims.

John Karas agrees with this answer

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