Settlement over a False Claims Act Allegations against Progressive announced.
San Diego, CA -- (SBWIRE) -- 05/14/2018 -- The Whistleblower Institute announces that Progressive Casualty Insurance Company, and Progressive Garden State Insurance Company reached a $2 million settlement in a whistleblower lawsuit over violating the False Claims Act by causing Medicare and Medicaid to pay for claims for which the companies were responsible for.
Those who have a similar case or experienced a similar situation or any other wrongdoing within a corporation have certain options and should contact the Whistleblower Institute at email@example.com or call: 619-452–1218. There are no costs or obligations to you.
A settlement has been reached to resolve False Claims Act allegations against Progressive Casualty Insurance Company and Progressive Garden State Insurance Company.
The allegations arose from a lawsuit that claimed Progressive Casualty Insurance Company, and Progressive Garden State Insurance Company, both part of the Progressive Group of Insurance Companies, violated the False Claims Act by causing Medicare and Medicaid to pay for claims for which the companies were responsible for.
If an individual has Medicare or Medicaid and other private health insurance coverage, each type of coverage constitutes a "payer." The insurance coverage that pays first, referred to as the "primary payer," typically pays to the limits of its coverage for an individual's health care claims. Generally, if there are health care costs that the primary payer does not cover, these costs may then be paid by the individual's other insurance coverage, referred to as the "secondary payer."
Under federal and New Jersey state law, if an individual has both private insurance and Medicare or Medicaid, neither Medicare nor Medicaid may serve as the primary payer for certain claims and the private insurer must remain as the primary payer.
According to the government, allegedly under "health first" automobile insurance policies that it offered, Progressive designated the policyholder's health insurance carrier as the primary payer for medical claims that arose in connection with an automobile accident. Even though, under the law, Progressive could not decline to make primary payment to Medicare or Medicaid beneficiaries, the company permitted Medicare and Medicaid beneficiaries to elect a "health first" policy. Many of these policyholders in New Jersey who were Medicare or Medicaid beneficiaries incurred medical claims in connection with an automobile accident. Because Progressive's "health first" policies designated the company as the secondary payer, Medicare and Medicaid improperly paid for claims that Progressive should have paid. The United States and New Jersey alleged that this conduct violated the Medicare Secondary Payer Act and Medicaid regulations and, as a result, Progressive caused false claims to be submitted to Medicare and Medicaid.
The whistleblowers' share of the settlement will be more than $600,000 of the more than $2 million that the United States and New Jersey recovered.
Progressive Corporation is one of the largest providers of car insurance in the United States. The company also insures motorcycles, boats, RVs and commercial vehicles, and provides home insurance through select companies.
The Whistleblower Institute is an information portal for current or former employees and other people having insight information about wrongdoing and other illegal activities by individuals either individually or within corporations, through company culture and or within international affairs. Whistleblowers should keep in mind that under the Dodd-Frank Act any person who provides the Securities and Exchange Commission ("SEC") with original information that leads to a successful enforcement action with over $1 million recovered must be awarded between 10%-30% of the total amount recovered. In order to determine the total amount of the reward there are numerous factors that need to be considered. Whistleblower actions are complex and our goal is to guide any whistleblower every step of the way. The Whistleblower Institute is dedicated to partnering with any individual who have information about fraud and we work with many of the best law firms worldwide.
Those who have a similar case or experienced a similar situation or any other wrongdoing within a corporation have certain options and should contact the Whistleblower Institute.
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The material was prepared by the Whistleblower Institute for informational purposes only and is not legal or financial advice. The information is provided only as general information which may or may not reflect the most currently available public information, is not provided as a basis for any established or existing relationship, and is not intended to constitute legal or financial advice, or to substitute for obtaining such advice from an attorney or other advisor licensed in your state.
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