Healthcare Insurance Fraud Defense Philadelphia

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Insurance & Healthcare Fraud Litigation

Provider and claimant EUOs
SIU defense
Affirmative actions on behalf of insurers

GMR has become the premier law firm in the region specializing in healthcare insurance fraud litigation. With over 40 years of experience, we are recognized for our ability to identify patterns in claims and medical records, along with analyzing data, in order to help our clients resist making payments on fraudulent claims. Regardless of the venue, the GMR team consistently wins trials and helps our clients resist settling non-meritorious claims based on exaggerated or even fraudulent evidence. Not only do we use these tools to defend claims, but we provide consulting services to eliminate the costs caused by fraud and prosecute civil remedies against those who defraud our clients. These affirmative litigation actions may include claims under the federal RICO statute and state insurance fraud statutes, which both allow for the recovery of attorney fees.

Our team is one of the few in the country that has successfully secured trial victories against attorneys, physicians, chiropractors, diagnostic testing centers, pharmacies, and medical facilities engaged in healthcare insurance fraud. These successes include:

Jury verdict of more than 15 million dollars against a group of physicians, chiropractors, an MRI center, and a pharmacy for fabricating patient records and billing for unnecessary treatment, testing, and pharmaceuticals. The jury verdict not only included insurance benefits paid in PIP claims, but included payments made in third party, personal injury matters. The jury verdict was upheld by a federal appellate court.
Jury verdict of more than 7 million dollars against a chiropractic office, a chiropractor, and laypersons who owned and controlled the practice and submitted fraudulent bills and records. On the eve of trial, one of the defendants filed for bankruptcy in order to delay the matter. Our team successfully obtained an emergency dismissal of the bankruptcy. The jury’s verdict on damages included all PIP payments as well as payments made in the settlement of third party, personal injury matters.
Jury verdict of 1.5 million dollars against an attorney and a medical office for submitting fraudulent claims.

Armed with these victories, we achieve meaningful results for our clients by way of substantial settlements often without stepping foot into the courtroom. Additionally, through our forward-thinking consulting services, we help our clients limit their exposure on questionable claims and ensure that they are not damaged by fraudulent practices in the future.

Our insurance and healthcare fraud team assists insurers, and their special investigation units, in defending their policyholders in all forms of actions and proceedings including third party personal injury matters, declaratory judgment actions, and arbitration disputes. We also provide coverage opinions, conduct examinations under oath, and defend carriers in PIP, fire, property, theft, and UM/UIM matters.

Our team, co-chaired by Richard Castagna and Matthew Moroney, is committed to providing the highest quality legal representation in a results-oriented and cost-effective way. We invite you to learn more about our team by reaching out to Rich or Matt.

Practicing Attorneys

View entire team

Richard Castagna

Matthew Moroney

Warren Holland

Dana M. Koos

Harlan R. Schreiber

Samantha Pullman

Benjamin Bagenski

Sarah V. Cohenson

Garrett Rigby

Nikita Desai

Rich has dedicated his career to helping his clients combat health care fraud. He counsels his clients on both routine and complex matters associated with healthcare fraud as well as those areas that parallel and intersect with this complex area of the law. He works tirelessly to assist his clients in uncovering and ending abusive and fraudulent activities, while at the same time helping to ensure that his clients avoid the legal and financial pitfalls that often accompany such complex investigations. Under Rich’s leadership, the GMR team of trial attorneys has counseled clients regarding large and complex fraud investigations in various jurisdictions including Pennsylvania, New Jersey, New York, Delaware, and Maryland.

Matt regularly counsels insurance carriers on multi-claim investigations involving healthcare providers located in New York, New Jersey, Pennsylvania, Delaware, and Maryland. Matt and his team regularly analyze complex data, including medical records and billing, on an individual and multi-claim basis to identify questionable patterns and to assess potential fraud. Matt has successfully litigated large scale affirmative actions with fraud, RICO, and declaratory judgment claims, which recouped millions of dollars for his clients.

Warren has litigated cases in several state and federal jurisdictions, including Pennsylvania, New York, and New Jersey with over 100 defense verdicts at trial. Over the course of his career, Warren has gained extensive experience in the field of insurance and healthcare fraud. He has helped his corporate clients investigate and prosecute fraud on numerous occasions, and has served as counsel in several complex insurance fraud and civil RICO cases which have resulted in substantial verdicts or settlements in his clients’ favor.

Dana is a partner with Goldberg, Miller & Rubin, P.C., managing our New York City office since 2013. Dana oversees the daily operations of all New York litigation for the firm and counsels associates in the defense of automotive negligence and other personal injury matters. Her expertise in third-party and first-party no-fault litigation has been a contributing factor in her victories in countless arbitrations and at trial.

Harlan is a partner with Goldberg, Miller & Rubin, P.C. in our New York City office. Harlan focuses his practice primarily on first-party coverage, claim investigations, and no-fault litigation and arbitration. For the past 15 years, he has developed an expertise in affirmative litigation, proactively enforcing valid insurer disclaimers of coverage.

Samantha is a partner in Goldberg, Miller & Rubin’s New York office. She concentrates her practice on defending automotive negligence and other personal injury claims and also assists with insurance and healthcare fraud claims. Samantha is known as a zealous advocate and concentrates on all phases of litigation, both inside and outside of the courtroom.

Benjamin Bagenski is an associate attorney at Goldberg, Miller & Rubin's New York office. His practice focuses on insurance coverage matters, including first-party coverage, claim investigation, and no-fault litigation and arbitration.

Sarah Cohenson is a senior associate at Goldberg, Miller & Rubin’s New York office. Her practice focuses on insurance coverage matters, including first-party coverage, claim investigation, and no-fault litigation and arbitration. Sarah has been practicing no-fault litigation at both the Civil Court and Appellate levels for over five years. She regularly takes examinations under oath, argues motions, and tries cases. She has expertise in affirmative insurer litigation and declaratory actions relating to coverage.

Garrett Rigby is a senior associate at Goldberg, Miller & Rubin’s New York office. His practice focuses on insurance coverage matters, along with no-fault litigation and arbitration matters.

Nikita (“Niki”) Desai is an associate in GMR’s Philadelphia office, focusing her practice on motor vehicle, premises, general liability, and personal injury.