TAMPA - State Farm is swinging hard at one of its biggest foes, the founder of the 1-800-ASK-GARY hotline, claiming he has conducted a "massive fraud scheme" to obtain no-fault insurance benefits, according to a new federal lawsuit.
In a lengthy complaint filed Friday, the company alleges that Sarasota businessman Gary Kompothecras masterminded a scheme to steer unwitting 1-800-ASK-GARY callers to Kompothecras' own chain of accident clinics, called Physicians Group. He also steered callers to personal injury attorneys who pay fees to the hotline.
At least some of those attorneys secretly agreed to refer their legal clients back to Kompothecras' clinics for medical care, most prominently the Tampa-based law firm Winters & Yonker, according to State Farm's complaint.
State Farm has paid the clinics more than $19 million since 2005, a substantial portion of which may have been based on fraudulent charges, the company says. However, it asks the court only for $480,000 in damages and to void any pending bills it has received from Physicians Group.
In its defense, Physicians Group attorney Greg Zitani called State Farm's lawsuit "frivolous and malicious" and said neither the Florida Bar nor any medical board have ever found that Physicians Group did anything unlawful.
"This suit is a desperate act by State Farm, one of the largest and most profitable insurance companies, who owes Physicians Group over $9 million by its failure to pay over 1,000 claims for medical costs incurred by its policy holders," Zitani said in a prepared statement.
Kompothecras is a chiropractor who founded the 1-800-ASK-GARY referral service in 2005 and used it steer auto accident victims to his Sarasota-based chain of clinics. Many of his commercials have featured an iconic spokeswoman named Roz telling accident victims not to be "scared and confused" and to call 1-800-ASK-GARY for a lawyer or doctor.
The ads apparently brought in enough business that Physicians Group expanded to more than 40 locations in Florida, Kentucky and Minnesota.
Kompothecras grew in prominence around Florida, becoming a major fundraiser for former Gov. Charlie Crist and becoming a target of insurance companies, who accused his clinics of milking his clients' personal injury protection (PIP) insurance policies.
State Farms' lawsuit may be the culmination of these insurance companies' frustrations. In its suit, the insurer draws heavily from an affidavit from a former Winters & Yonker attorney named Anthony Gadlage from Kentucky. Gadlage describes in his affidavit a cross-referral arrangement between Winters & Yonker and a Kentucky clinic chain owned by Kompothecras, called Kentucky Spine and Rehab.
For example, Gadlage was to designate a client with a number 1 if the client came to Winters & Yonker though its own advertising. He was to write a number 2 if the referral came from the ASK GARY hotline. Gadlage testified that supervisors directed him and other firm lawyers to send as many clients as possible to Kompothecras' clinics, because of the referrals Kompothecras sent to the law firm.
Gadlage said his Winters & Yonkers supervisors fired him when he refused to send clients solely to Kentucky Spine & Rehab. He later sued Winters & Yonker alleging wrongful termination, but a judge dismissed his case on a technicality, saying Gadlage couldn't bring such a lawsuit based on a violation of legal ethics.
Winters and Yonker has since been disbanded, according to the State Farm suit. Partners Bill Winters and Marc Yonker could not be reached for comment Monday.
State Farm claims that such cross-referral arrangements are unlawful and violate the state's anti-kickback statute.
In another allegation, the insurance company claims Physicians Group violated Florida law by referring patients to another business entity in which it had an investment. For example, its 1-800-ASK-GARY call center operators referred callers to related Physicians Group clinics.
In fact, Kompothecras and his business entities "have never identified a single patient who was referred from the ASK GARY referral service to any health care provider other than Physicians Group," the complaint says.
Kompothecras created shell companies to make it seem as if the 1-800-ASK-GARY hotline and Physicians Group clinics were separate. For example, Kompothecras installed his cousin, William Sigelakis, as the named owner of a company called W.S. Marketing that owned the ASK GARY name, the lawsuit says.
In reality, Kompothecras controlled W.S. Marketing, and Sigelakis' true job was driver and delivery person for the accident clinic chain, the lawsuit says.
Zitani, Physicians Group's attorney, wouldn't answer questions Monday, but he sent the Tribune a prepared statement that rebutted some of State Farm's claims.
Contrary to the lawsuit's claims, a great number of 1-800-ASK-GARY callers are not referred to Physicians Group for treatment. Secondly, attorneys who are in the 1-800-ASK-GARY network are not required to refer clients to the clinic chain, Zitani says.
"State Farm will be exposed to claims for malicious prosecution by pursuing this absurd action to attempt to avoid paying the millions of dollars it owes to the defendants," his statement reads. "This is not the first, or the last time an insurance company acts in bad faith exposing it to significant liability."
Carl Hinson, a personal injury lawyer unaffiliated with either party, said insurance companies and accident lawyers alike will closely watch the lawsuit. He said State Farm appears to be hanging much of the case on the affidavit of a single person, Gadlage, the former Winters & Yonker lawyer.
Gadlage's statement might have carried more weight if it had come from an accident victim, who was improperly steered to one of Kompothecras' clinics. As it stands, it's coming from a lawyer who was fired by Winters & Yonker and may have a bias in the matter, Hinson said.