The inclusion of pain-management specialists in multi-disciplinary clinics over the last several years in the no-fault claims industry has grown rapidly. Unfortunately, it has also opened the door to fraud.
More claims are being presented to auto insurance carriers for various types of pain management services, which has resulted in costly exposures related to first-party, no-fault claims and an increase in third-party claims settlement values and demands related to bodily injury.
The fraud is in overpricing and the unnecessary use of these items, so pricing and medical necessity are clear defenses to these claims.
Areas of pain management include opioid medications, compound creams, trigger-point injections, facet joint injections, and epidural injections.