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Hospitals Committing Insurance Fraud

Posted by Sami Thalji | Oct 07, 2021

As we continue to represent clients injured in auto accidents we continue to find more and more examples of hospitals committing insurance fraud. There are two main strategies we continue to see hospitals employ. First, hospitals often times "balance bill." Balance billing occurs when a hospital bills and is paid the full amount allowed by Florida law. Once they receive that payment the law requires them to waive the remaining balance. Instead, we continue to find numerous instances of hospitals billing the remaining balances to the patients. This is illegal. Second, we continue to find instances of hospitals accepting double payments for emergency services. Double payments occur when hospitals simultaneously bill your personal injury protection auto insurance and your health insurance at the same time. Hospitals are supposed to bill your personal injury protection auto insurance for emergency services. However, many hospitals send bills out to all known sources of insurance. The problem occurs when they start receiving payments from all the sources who are unaware that the other source has made a payment. In our experience the hospitals don't return the health insurance payments, instead they keep both payments and collect a windfall. This is also illegal and a terrible result for the patient as the patient is forced to pay back their health insurance carrier from any settlement proceeds they may receive from an auto accident claim. 

This continues to occur because the only enforcement mechanism are attorneys that recognize these illegal billing practices and take action by bringing claims under Florida's Consumer Collections Practices Act (FCCPA) or the Fair Debt Collections Practices Act (FDCPA). Unfortunately, this doesn't occur often because most auto accident lawyers do not understand consumer finance laws and also don't have a real grasp of insurance laws and regulations. Any lawsuits brought are not of high enough value to deter these billion dollar hospital conglomerates from these illegal activities. However, you can make sure this doesn't happen to you by hiring a firm like Florida Consumer Lawyers that practices in the areas of auto accident claims as well as consumer protection such as FCCPA and FDCPA lawsuits. 

About the Author

Sami Thalji

Sami Thalji is a native Floridian, born in Clearwater and raised in St. Petersburg, Florida. Sami graduated from Osceola High School in Seminole, Florida before attending and receiving both his Bachelor of Science and Juris Doctor from the University of Florida in Ga...


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