Filing False Claims

Examples of false claims

A false claim is a form of fraud that involves promising services that either weren’t or can’t be provided. When someone suffers a personal injury filing false claims could occur if the medical provider bills the person’s insurance for tests they didn’t perform or treatments they didn’t provide. There are hundreds of healthcare fraud cases each year. 

Other examples of healthcare fraud involve the following:

• Inflating the costs of medication
• Misdiagnosing patients to sell medical devices or perform unnecessary treatments
• Paying kickbacks to medical professionals who support and prescribe a pharmaceutical company’s products

What is the Federal False Claims Act? 

The False Claims Act dates back to 1863. This federal law was introduced during the American Civil War to address false claims filed with the U.S. Government. This law introduced harsh financial penalties for anyone caught knowingly filing false claims.

The False Claims Act allows the government and private citizens to file false claim lawsuits. In 2022, judgments and settlements from false claim cases amounted to over $2.2 billion. 

What is a State False Claims Act? 

Some states have a False Claims Act through the Office of the Inspector General. These laws allow qualifying states to receive additional compensation from judgments or settlements.

The U.S. Department of Health and Human Services (HHS) recognizes False Claims Acts from 22 states, including California, Delaware, Hawaii, New York, and Texas. 

How could you be the victim of a false claim?

Suppose you’re in a car accident. A fake injury claim car accident case could involve someone with a prior injury filing a car accident claim blaming you for their injuries. They could seek compensation for medical treatment and specify the amount of damages they expect your insurance company to pay. A case like this can fall under the False Claims Act if the person tries to claim benefits, such as Social Security Disability Insurance (SSDI) benefits.

Suppose you hired a car accident lawyer to pursue a personal injury claim after sustaining injuries in a car accident. While preparing personal injury cases, lawyers review related costs, such as medical bills, car repair bills, and lost wages. If your attorney learns you were billed for medical services you didn’t receive, or that you received questionable treatments, it could indicate the medical provider or facility is filing false claims.

What are your options if you discover someone’s made a false claim? 

You can opt to pursue a false claim case yourself, or you can report the matter. You can choose one of the following options if you discover someone’s filed a false claim:

• Contact the agency involved – Suppose you learn someone’s filed a false SSDI claim. You can report the fraudulent filing to the Social Security Administration.
• File a complaint – This involves pursuing legal action yourself by filing a case in federal court.
• File a report with the Federal Bureau of Investigation (FBI) – The FBI investigates federal false claim cases.

Steps to take if you think you’ve discovered a false claim 

Collect the information you’ve discovered about the potential false claim. It’s a good idea to ensure you’re correct about a violation of the False Claims Act before taking further steps. 

Once you’re confident you’ve identified a potential false claim, you can initiate legal proceedings yourself or report the false claim to the affected government agency or the FBI. However, it’s a good idea to contact experienced personal injury attorneys to discuss the case before you decide how to proceed. A personal injury attorney can explain how the false claim could affect you and how reporting the claim or initiating a lawsuit will affect you in the coming months.

How a personal injury lawyer can help

A personal injury lawyer will protect your rights and ensure your insurance providers aren’t paying for false claims. Call 702.382.0000 to speak to one of the legal experts with Adam S. Kutner, Injury Attorneys, to learn about your legal options.