GEICO is taking legal action against a Brooklyn pharmacy, claiming it submitted over $3.5 million in fraudulent claims related to New York’s No-Fault auto insurance system. The lawsuit, filed on July 22 in the U.S. District Court for the Eastern District of New York, names Best Care Pharmacy and its owners, Maksym Fedotov and Ilya Bronstein, along with several unidentified individuals.
The complaint alleges that Best Care Pharmacy exploited the No-Fault system, which offers up to $50,000 in personal injury benefits per accident, regardless of fault. GEICO claims the pharmacy targeted expensive topical medications like Lidocaine ointment and Diclofenac gel, billing for them in high volumes without medical necessity. The insurer argues that these prescriptions were chosen for profit rather than patient care.
Additionally, GEICO suggests that the pharmacy collaborated with healthcare providers and unlicensed clinic operators associated with No-Fault clinics. This partnership allegedly led to the use of preprinted prescription forms and the repeated prescribing of the same medications. The lawsuit also highlights concerns about “therapeutic duplication,” where patients received multiple medications from the same class, potentially raising safety issues and increasing costs.
The financial stakes are significant. GEICO has already paid around $1.18 million on the claims and is seeking a court ruling to avoid paying another $1.4 million in pending bills from Best Care Pharmacy. The complaint notes that Fedotov had previously been banned from submitting any billing to GEICO due to a permanent injunction, which the insurer claims has been violated.
The lawsuit includes serious allegations under the federal Racketeer Influenced and Corrupt Organizations (RICO) Act, as well as claims of common law fraud and unjust enrichment. It also references New York’s insurance regulations that prohibit reimbursement to providers who do not meet licensing requirements.
While these are serious allegations, it’s important to remember they are not yet proven in court. This lawsuit reflects GEICO’s efforts to combat what it describes as a coordinated scheme that could impact how insurers manage disputed pharmacy claims within New York’s No-Fault insurance framework.