Insurers catch NJ doctor in $2 million fraud scheme
ISO ClaimSearch® and NetMap® products helped New Jersey insurers unlock the door to a widespread fraud scheme involving top automobile insurance companies. The case focused on Dr. Juan Carlos Fischberg, who was sentenced in August to three years in prison. Fischberg billed 20 insurers more than $2 million for tests he never performed.
In May, the New Jersey Office of the Insurance Fraud Prosecutor announced that Fischberg pled guilty to second-degree health claims fraud.
- Fischberg owned Hudson Rehabilitation and Medical Center of West New York, New Jersey.
- At his hearing, Fischberg admitted to billing for electrodiagnostic services that he hadn’t performed.
- Fischberg surrendered his medical license in 2004.
- Fischberg had been wiring money to South America and Delaware to cover his tracks.
The court ordered Fischberg to pay $2,126,243 in restitution and a $50,000 civil insurance fraud fine. The state has already seized:
- bank accounts totaling $64,000
- property that sold at auction for $452,000
ISO ClaimSearch and NetMap connect the dots
Tom Mulvey is ISO’s national director of Claim and SIU Services. Before joining ISO, Mr. Mulvey was director of the special investigation unit at Prudential Property & Casualty Company, where he was directly involved in the Fischberg investigation.
“When we uncovered the initial misrepresentations, our investigators and analysts used ISO ClaimSearch and NetMap to expose the associations leading to claims at other carriers,” Mulvey notes. “We were able to connect the dots quickly and avoid further payment of questionable pending claims.”