Allstate is taking two Florida chiropractic clinics to court, claiming they orchestrated a sweeping insurance fraud that cost the company hundreds of thousands of dollars.
Filed on August 15, 2025, in the US District Court for the Middle District of Florida, the lawsuit names Ortiz Health and Rehab Center, Inc., Align to Shine Chiropractic LLC, Orline Joseph, and Ricardo Bacallao, D.C., as defendants. Allstate alleges these clinics and individuals submitted and caused to be submitted false and fraudulent records, bills, and invoices through the US Mail and interstate faxes, seeking payment for chiropractic services that were not actually performed, were unnecessary, were fraudulently billed, and were not lawfully rendered.
According to the complaint, the defendants used predetermined treatment protocols that included excessive and unnecessary chiropractic services. Allstate claims that, regardless of a patient’s actual needs, the clinics billed for a set routine of services - sometimes for treatments that never occurred at all. The insurer alleges that the clinics used pre-printed forms that always claimed exactly fifteen minutes of treatment for each modality, a pattern Allstate says is not plausible. The complaint includes statements from a former chiropractor and patients, who reportedly described sessions that were rushed, unsupervised, or did not match the billing records.
Allstate also alleges that the clinics billed for experimental treatments, such as extracorporeal shockwave therapy, dry hydrotherapy, and low level laser therapy. The insurer claims these treatments were not medically necessary or approved for the conditions being treated, and that they were billed at high rates. The complaint describes instances where patients received both anti-inflammatory and pro-inflammatory treatments on the same day, a combination Allstate questions as medically reasonable.
A significant part of Allstate’s case is the alleged concealment of the clinics’ true ownership. The insurer claims that Orline Joseph, a layperson, actually controlled and oversaw all material aspects of the clinics’ operations, including patient care and billing, while licensed chiropractors were listed as owners in corporate documents. Allstate alleges this was intended to evade Florida’s licensing requirements and rendered every bill submitted to Allstate unlawful and non-compensable.
The complaint also details allegations of double billing, such as charging separately for services that should not be billed together, and billing for multiple initial evaluations for the same patient. Allstate claims the clinics provided bills and records to personal injury attorneys, knowing they would be submitted to Allstate as part of insurance claims and demands.
Allstate is seeking actual and consequential damages, treble damages under federal and Florida RICO statutes, attorney’s fees, costs, injunctive relief, and a declaration that it is not obligated to pay any pending or previously denied claims submitted by the defendants. The insurer also asks the court to declare that the defendants cannot seek payment from Allstate policyholders for the claims at issue.
As of the filing date, this case is at the complaint stage. The court has not made any findings, and the defendants have not yet responded to the allegations. All claims remain to be proven in court. The complaint references Florida’s Motor Vehicle No-Fault Law and the requirements for compensable claims but does not discuss specific insurance policy clauses beyond statutory references.
For insurance professionals, this case highlights the ongoing challenge of detecting and preventing fraudulent billing schemes. The details in the complaint serve as a reminder of the importance of careful claims review and monitoring of clinic ownership structures. As the case progresses, it may offer further insights into best practices for fraud prevention and compliance in the insurance industry.
