News Summary
Allstate Insurance has filed a lawsuit against Ortiz Health and Rehab Center and Align to Shine Chiropractic, alleging extensive insurance fraud involving unnecessary services and misleading billing practices. The suit claims the clinics submitted false records and overbilled for treatments, including experimental therapies. Allstate seeks damages and relief from liability for disputed claims while highlighting the broader issues of fraudulent billing in healthcare. The case is currently at the complaint stage, with no responses from the defendants yet.
Florida – Allstate Insurance Company has launched a lawsuit against Ortiz Health and Rehab Center, Inc., Align to Shine Chiropractic LLC, and their operators, Orline Joseph and Ricardo Bacallao, D.C., alleging extensive insurance fraud amounting to hundreds of thousands of dollars. The legal action was filed on August 15, 2025, in the US District Court for the Middle District of Florida and claims that the defendants improperly billed for services that were either not performed, unnecessary, or fraudulently submitted.
According to the complaint, the clinics fraudulently submitted misleading records and invoices for chiropractic services that did not reflect actual patient care. Allstate stresses that the clinics adhered to predetermined treatment protocols that led to excessive provision of unnecessary services. Regardless of specific patient needs, the clinics reportedly billed for standardized treatment routines that included interventions purportedly never conducted.
The lawsuit outlines that Allstate observed a pattern in the clinics’ billing practices, highlighting the usage of pre-printed forms that noted precisely fifteen minutes of treatment for each service rendered, a claim that Allstate deems implausible. There are cited statements from a former chiropractor, along with accounts from patients, which indicate that treatment sessions were hurried and lacked supervision, contrasting sharply with the records submitted for billing purposes.
Moreover, Allstate accuses the clinics of providing experimental treatments, including extracorporeal shockwave therapy, dry hydrotherapy, and low-level laser therapy, which the lawsuit claims were neither medically necessary nor sanctioned for the conditions they addressed. The insurer noted several instances of billing for conflicting treatments, such as administering both anti-inflammatory and pro-inflammatory therapies within the same visit, raising doubts about the medical justification for such practices.
A significant claim made by Allstate involves the alleged concealment of the clinics’ true ownership structure. It is suggested that Orline Joseph, a layperson without a chiropractic license, actually controlled the operations of the clinics, while licensed chiropractors were listed as the formal owners. This arrangement, according to Allstate, was designed to avoid compliance with Florida’s licensing statutes, thereby rendering all submitted bills invalid and unenforceable.
The complaint also alleges multiple instances of double billing, including the improper separate charges for services that should not have been billed together and numerous bills for initial evaluations of the same patient. There are mentions of the clinics providing documentation and bills to personal injury attorneys, which Allstate claims were intended to be presented as part of insurance claims to the company.
In response to the alleged fraudulent practices, Allstate seeks actual and consequential damages, as well as treble damages pursuant to federal and Florida racketeering laws. The insurer has also requested attorney’s fees, cost recovery, and injunctive relief, alongside a declaration that would relieve Allstate from liability for any pending or previously denied claims related to the defendants. Additionally, the lawsuit aims to prohibit the defendants from requesting payment from Allstate policyholders for the disputed claims.
As of the filing date, the case remains at the complaint stage, meaning no court findings have been established yet, and the defendants have not publicly responded to the allegations made against them. All claims presented in the lawsuit still require proof in court. The suit references Florida’s Motor Vehicle No-Fault Law but does not specify particular clauses from the insurance policies involved.
This case underscores the ongoing challenges that insurance companies face in identifying and preventing fraudulent billing schemes, drawing attention to broader issues within the healthcare billing landscape.
Deeper Dive: News & Info About This Topic
- Insurance Business: Allstate Takes Florida Clinics to Court Over Sweeping Fraud Claims
- Wikipedia: Insurance Fraud
- Insurance Journal: News on Southeast Region
- Google Search: Insurance Fraud Florida
- Miami Herald: Florida State Politics
- Google Scholar: Florida Insurance Fraud
- NBC Miami: Man Accused of Insurance Fraud
- Encyclopedia Britannica: Insurance Fraud
- Newsweek: Florida Insurance Scandal
- Google News: Florida Insurance Lawsuit
Author: STAFF HERE ORLANDO WRITER
ORLANDO STAFF WRITER The ORLANDO STAFF WRITER represents the experienced team at HEREOrlando.com, your go-to source for actionable local news and information in Orlando, Orange County, and beyond. Specializing in "news you can use," we cover essential topics like product reviews for personal and business needs, local business directories, politics, real estate trends, neighborhood insights, and state news affecting the area—with deep expertise drawn from years of dedicated reporting and strong community input, including local press releases and business updates. We deliver top reporting on high-value events such as Orlando International Fringe Theatre Festival, Megacon Orlando, and Central Florida Fair. Our coverage extends to key organizations like the Orlando Economic Partnership and Hispanic Chamber of Commerce Metro Orlando, plus leading businesses in leisure and hospitality that power the local economy such as Walt Disney World Resort, AdventHealth, and Universal Orlando. As part of the broader HERE network, including HEREJacksonville.com, HEREPetersburg.com, HERETallahassee.com, and HERETampa.com, we provide comprehensive, credible insights into Florida's dynamic landscape.
