By Dr. Tom Rhudy
When assessing the true cost of healthcare fraud, one must fairly assess efforts expended to breach a fiduciary duty incumbent upon any entity upon which the State bestows its imprimatur, granting a "quasi-governmental" status (e.g., Allstate Insurance, National Insurance Crime Bureau, etc.).
Were competent Healthcare Compliance training to be implemented for all Allstate employees, and a bona fide Healthcare Compliance Officer given authority to enact applicable policies and procedures, one cannot help but wonder, "How much fraud is transacted each and every day, and neither recognized nor reported?" As Goethe said, "The eye only sees what the mind knows."
Date: 12-11-2008
Case Style: Fred Klecka v. Allstate Insurance Company
Case Number:
Judge:
Court: 150th District Court, Bexar County, Texas
Plaintiff's Attorney: Gravely & Pearson LLP, San Antonio, Texas
Defendant's Attorney:
Description: A San Antonio jury awarded almost a $1 million verdict against Allstate Insurance Company in what attorney Matthew Pearson termed a case where his client was forced to choose between his freedom or his job.
Fred Klecka, a former Allstate special investigation unit (SIU) adjuster uncovered fraudulent claims handling by a co-worker that occurred over six years and involved more than $1.3 million. The fraudulent activities led to a criminal investigation conducted by the FBI."
Our client was told not to cooperate with the FBI or he could lose his job. He chose to disregard the illegal instruction and continued to assist the FBI," Attorney Marc Gravely, Pearson's partner, said after Monday's verdict in the 150th District Court of Bexar County.
Klecka helped the FBI with their investigations of Roland Villarreal, an Allstate contractor, and Chandler Bruton, a claims adjuster. Both were convicted two years ago in federal courts for insurance fraud."
I appreciate the fact that the jury recognized that our client was wrongfully terminated. However, I am especially gratified that the jury decided to punish Allstate for their conduct," Pearson said. " Hopefully, this will prevent another Allstate employee from being placed in the same dilemma."
The jury awarded Klecka $373 thousand in compensatory damages and another $500 thousand in punitive damages.
SOURCE: Gravely & Pearson LLPfor Gravely & Pearson LLP Matt Scherer, 210-325-4130 mattscherer@gmail.com
Outcome: Plaintiff's verdict for $1 million.
Sadly, $1 million is chump-change to Allstate. After spending three more years to have the Appeal heard, and spending hundreds of thousands of dollars on additional legal-fees, the Decsion loses its luster. Nevertheless, Fred Klecka is an individual worthy of our respect and admiration if, as is suggested by this Decsion, he refused to bow to Allstate's efforts to interfere with a lawful investigation into Allstate's activities.
There can be little doubt that the "Good Hands People" will crush any individual who interferes with its bottom-line. Congratulations, Mr. Klecka!
About the Author:Dr. Tom Rhudy is licensed as both an Attorney and Doctor of Chiropractic in the states of Texas and Missouri. While serving as both an Attorney and Doctor of Chiropractic, he has worked closely with law enforcement, insurance carriers, administrative agencies, the FBI, US Attorney's Office, the US Postal Inspector's Office, and healthcare providers in the prevention, investigation, and prosecution of healthcare fraud. For the past 20+ years he has devoted most of his efforts toward educating and assisting providers in the development of healthcare treatment and compliance programs and prevention of healthcare fraud and abuse, making every effort to improve the quality of care and representation provided to patients.
Now you may receive his FREE 10-STEP QUICK-START COMPLIANCE GUIDE created to minimize healthcare fraud and abuse my completing the form below:
