By Forum Staff
A New Jersey man has been sentenced to 10 years in prison for conspiracy to commit bribery and conspiracy to defraud the Internal Revenue Service in connection with his orchestration of a $60 million fraud targeting No-Fault automobile insurance companies, federal prosecutors recently announced.
According to the Indictment, the plea agreement, and statements made in court:
New York and New Jersey No-Fault insurance laws require a driver’s automobile insurance company to pay automobile insurance claims automatically for certain types of motor vehicle accidents, provided that the claim is legitimate and below a particular monetary threshold. Pursuant to these requirements, insurance companies will often pay medical service providers directly for the treatment they provide to automobile accident victims without the need to bill the victims themselves. This process resolves automobile claims without apportioning blame or fault for the accident, thereby avoiding protracted disputes and the costs associated with an extended investigation of the accident.
From at least in or about 2008 through in or about 2021, Bradley Pierre, 41, agreed with others to unlawfully own and run medical clinics located in the New York area, including, among others, Veda Medical, Sky Medical, Sun Medical, and Rutland Medical. Pierre knew that clinics are unable to bill insurance companies for No-Fault benefits if the medical facilities are controlled by non-physicians. Pierre nonetheless agreed with others, including doctors, to submit bills to insurance companies falsely representing that the clinics were owned and operated by licensed doctors and to direct doctors to lie under oath during Examinations under Oath about the ownership, control, and finances of the clinics. Pierre personally coached doctors to lie under oath in these EUOs.
Pierre used his control of the clinics for personal profit. Between 2008 and 2021, Pierre took over $20,000,000 from the clinics by either transferring the funds directly to bank accounts under his control or using the clinics’ bank accounts to pay his personal finances. Pierre also used his control of the clinics to steer prescriptions to pharmacies in return for over a million dollars in kickbacks and to steer patients to seek legal representation from his wife’s law firm, the Law Firm of Nonna Shikh. The Shikh Firm, which has an office on Queens Boulevard in Elmhurst, then filed lawsuits against insurance companies on these patients’ behalf. Pierre maintained an office at the Shikh Firm and was actively involved in the legal practice as a “manager.” The Shikh Firm made millions of dollars from the scheme and transferred over $4 million of illegal proceeds to Pierre through a “marketing” arrangement between Pierre’s shell companies and the Shikh Firm.
Pierre used his control of the clinics and his managerial role at the Shikh Firm to also steer patients to seek MRIs at a medical facility over which he exercised substantial control. Pierre also agreed with the purported sole owner of the MRI facility, who was a doctor, that the doctor would falsely report injuries in MRI reports. These falsified injuries allowed the clinics to bill insurance companies for additional, unnecessary medical services and allowed attorneys to falsely claim injuries in lawsuits against insurance companies. Pierre and the doctor agreed that the doctor would lie to insurance companies during EUOs about Pierre’s role in the MRI facility.
