Here's How a Man From New Jersey Ran a Decade-Long No-Fault Insurance Scam Worth $60 Million

A man from New Jersey has pleaded guilty to a $60 million fraud targeting no-fault automobile insurance companies in New York. As per a Department of Justice release, U.S. Attorney Damian Williams reported that Bradley Pierre of Closter, New Jersey, led one of the largest no-fault insurance frauds in the history of New York, for over a decade.

Pierre bribed medical professionals and others to scam the insurance companies and defraud the IRS. His scheme led to the denial of fair and proper treatment to several accident victims as well.

What is a No-Fault Insurance?

As per the New York and New Jersey No-Fault insurance laws, a driver’s automobile insurance is required for a company to pay automobile insurance claims automatically for certain types of accidents, in cases where the claim is legitimate and below a fixed monetary threshold.

Insurance companies often pay medical service providers directly for the treatment they provide to automobile accident victims without billing the victims. Pierre took advantage of this feature of the laws and set up several clinics which defrauded insurance companies.

Here’s how the insurance fraud unfolded

From 2008 to 2021, Pierre along with other clinic controllers unlawfully owned and ran medical clinics in New York. These included Veda Medical, Sky Medical, Sun Medical, and Rutland Medical Clinics, as per the release.

Pierre conspired to submit fake bills to insurance companies falsely representing that the clinics were owned and operated by licensed doctors, and he coached doctors to lie during Examinations under Oath.

He also steered patients to seek MRIs at a medical facility and conspired with the owner of the MRI Facility to falsely report injuries in MRI reports. These falsified injuries allowed the clinics to bill insurance companies for additional, unnecessary medical services.

Pierre also sent prescriptions to pharmacies in return for over a million dollars in kickbacks. Further, he drove patients to seek legal representation from his wife’s law firm, the Law Firm of Nonna Shikh. The Shikh Firm then filed lawsuits against insurance companies to claim more money.

He used his control of the clinics for personal profit and took over $20 million from the clinics by either transferring the funds directly to his bank accounts or by using the clinics' bank accounts to pay for his personal expenses.

Pierre hid the fraud by using phony loan arrangements which claimed that he lent non-recourse loans to the Clinics and the MRI Facility, which would only have to be paid back if insurance companies paid the medical practices’ claims. However, he took almost $10,000,000 over what these purported loan agreements permitted.

He also paid bribes to hospital employees, 911 dispatchers, and others to fill the clinics and the MRI facility with patients. He paid to get the confidential names and numbers of motor vehicle accident victims and he along with Anthony Rose, a/k/a “Todd Chambers,” called the victims and lied to them so that they receive medical treatment at his Clinics and legal representation from the Shikh Firm.

As per the release he paid Rose over $800,000 in bribes. He further bribed Andrew Prime $800,000 as well, as Prime was bribing 911 operators and a hospital employee for confidential information. He also paid bribes to medical offices to send patients to the MRI Facility for MRIs. These facilities included Epione Medical Center and Modern Brooklyn Medical, according to the release.

Further, Pierre engaged in tax evasion through two companies, Medical Reimbursement Consultants (“MRC”) and Marketing 4 You (“M4Y”). He hid his income from the IRS by concealing multiple bank accounts for MRC and used check cashers for checks made out to MRC and M4Y.

He also layered the scheme by paying his expenses from MRC and M4Y’s bank accounts reporting them as “business expenses.” These payments for his wedding, home renovations, jewelry, furniture, luxury clothing, travel, and more reached over $4 million and stole about $1.5 million from the IRS.

Charges against Bradley Pierre

The original indictment stated counts of healthcare fraud, money laundering, bribery, identity theft, and fraud against the IRS. However, as per the release, Pierre pled guilty to one count of conspiracy to commit bribery, and one count of conspiracy to defraud the IRS, each of which carry a maximum sentence of 5 years in prison. His sentencing is scheduled for May 2024.