His amended pleading comes greater than eight months after the insurers sued him and his medical apply for allegedly performing pointless and costly spinal surgical procedures and procedures on sufferers injured in auto accidents to inflate the worth of their insurance coverage claims. He has denied the allegations within the go well with filed in San Antonio federal court docket.
Of their causes of motion, the insurers cite a federal legislation typically related to prosecutions of mob bosses — the Racketeer Influenced and Corrupt Group Act, or RICO.
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Submitting fraudulent payments by way of the U.S. mail quantities to a “sample of racketeering exercise” meant to defraud the insurers, they alleged of their July grievance.
The Texas Medical Board web site reveals Misra, who has been licensed for 3 a long time, has no prison historical past and no disciplinary actions in opposition to him.
The insurers are utilizing their lawsuit to “squeeze” him — “a well-regarded physician and professional witness” — “out of enterprise to restrict how a lot State Farm has and doubtlessly pays sooner or later to correctly settle and litigate claims,” Misra says in his countersuit.
Additionally they try to recoup cash from authorized circumstances beforehand settled and/or litigated with 335 sufferers Misra handled for neck and/or again ache, he says. The businesses say they paid greater than $6.5 million to settle claims.
“State Farm is partaking in a concerted litigation technique designed to harass, intimidate, and dissuade physicians like (Misra) from treating car accident victims who assert claims in opposition to these insured by State Farm,” Misra’s countersuit says.
He really useful or carried out spinal injections on the sufferers, with about half suggested to endure spinal surgical procedure, the insurers allege. When the injections don’t resolve sufferers’ complaints, they are saying, the physician recommends “costly, medically pointless surgical procedures” that price greater than $50,000.
Throughout a court docket listening to within the case final month, State Farm legal professional Jared Heck informed a decide what Misra allegedly mentioned when a affected person suggested him the affected person didn’t need an injection.
The physician “informed them, ‘No shot, no cash,’ ” Heck mentioned through the listening to earlier than U.S. Justice of the Peace Decide Henry Bemporad.
The assertion drew an instantaneous objection from Ricardo Cedillo, a lawyer for Misra. Cedillo known as the assertion an “unsubstantiated allegation.”
“I look very a lot ahead to confronting the one that mentioned it, and I can inform you it’s going to be a present as a result of I do know I can discredit that particular person,” Cedillo mentioned to the decide.
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In his countersuit, Misra says the insurers “improperly miscast” their “underlying Medical Legal responsibility claims as a RICO motion,” Misra says.
The insurers sued lower than every week after they obtained an opposed verdict in a case determined by a Bexar County jury, he says. The plaintiff who prevailed was a Misra affected person. The physician additionally testified concerning the affected person’s remedy. The plaintiff was amongst these recognized in court docket displays which can be a part of the insurers’ grievance, he notes in his countersuit.
Misra’s claims in opposition to the insurers are for negligence and “tortious interference with potential enterprise relations.” In his authentic motion, he additionally sued for defamation and enterprise disparagement. He and his apply had suffered “a downturn of enterprise alternatives” due to “State Farm’s smear marketing campaign.” It couldn’t be decided why these claims have been dropped.
Cedillo couldn’t be reached Friday however beforehand declined to touch upon the unique countersuit after its submitting final month.
The State Farm firms “look ahead to making our case in court docket,” a spokesman has mentioned.
