iFraud Deep Dive
Welcome to iFraud Deep Dive, an official podcast series of the iFraud Foundation — where we tackle the toughest issues facing the property and casualty industry in the fight against fraud.
Each episode features in-depth conversations breaking down complex issues into easily consumable information that we can all understand. We explore the fraud landscape, expose emerging threats, and highlight actionable solutions. From staged accidents and collusive networks to litigation abuse and regulatory gaps, we go beyond the headlines to bring you the insights that matter.
Whether you’re a carrier, broker, employer, attorney, or regulator, if you’re committed to protecting the integrity of our industry then this podcast is for you.
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iFraud Deep Dive
S1 E52 GEICO Sues Alleged No Fault Fraud Ring
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Our Deep Dive today takes a look at a civil Complaint filed by GEICO against PULSE MEDICAL CARE, P.C., Dr. Adnan Qureshi, and Irshad Syed, alongside an exhibit cataloging the disputed bills. The insurance carrier alleges a protracted, multi-year scheme to defraud it of over $1.6 million by utilizing New York's No-Fault system through the submission of thousands of medically unnecessary claims via the mail. The core mechanism of the fraud allegedly involved illegal patient referral arrangements and the illegitimate operation of the medical practice by unlicensed individuals.
The lawsuit specifies that the billed services, documented in the accompanying schedule of claims, include exaggerated consultation complexity, medically unwarranted diagnostic ultrasounds (CPT 76881), and high-risk interventional procedures like Percutaneous Disc Decompressions performed by Qureshi, who allegedly lacked surgical qualifications.
Let's Dive In!