Biglaw

Biglaw Senior Associate Allegedly At Center Of Fraudulent Scheme

You know it's gonna be a fun case when the parties are already willing to take shots.

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A senior associate at Orrick, Herrington & Sutcliffe, David Ridenour, was sued this week by Cigna Insurance in a federal suit that claims the attorney committed fraud, conspiracy, and violations of the Employee Retirement Income Security Act.

The genesis of the suit was an incident in 2009, in which Ridenour’s son, an infant at the time, fell and suffered a head injury. As a result, according to the family, Ridenour’s son needs 35 hours of therapy a week to address physical and cognitive problems.

According to Cigna’s filing, the Ridenours paid a therapist that worked with their son $200 an hour — a $170 an hour raise from what the therapist had previously made for similar work — and used that money for a car and other perks not associated with their son’s care. According to Law360:

The Ridenour family used the [insurance] funds to pay Beatrice Bruno, a speech and occupational therapist, to live with them, purportedly providing a prescribed 35 hours a week of therapy to their son but actually performing nanny-like tasks, the insurer said. Bruno bought the family the SUV with the proceeds and moved Ridenour’s wife, Laura, and her four children to Hawaii, according to the suit.

“A significant portion of Ms. Bruno’s time that was included on these claims for reimbursement was not for occupational therapy services,” Cigna said in the suit. “The defendants knew that the reimbursement claims submitted to Cigna were false and misleading.”

According to Cigna (and the private investigator they hired), in addition to using the large amounts they received from their insurance claim to purchase an SUV and otherwise finance a lifestyle, the therapist billed for time spend babysitting the family’s other children and running errands.

But like all good legal dramas, it isn’t quite that simple. The Ridenours actually initiated the legal skirmish, suing the insurer in July for failing to timely pay over $300,000 in claims:

Ridenour accused the insurer of trying to dodge several rulings in Department of Insurance independent medical reviews finding that his son needs 35 hours of therapy after his brain injury, court records show. Cigna’s doctors, who aren’t pediatricians, have questioned the Ridenours’ pediatrician’s diagnosis several times and submitted papers to the DOI undermining the pediatrician’s work, according to Ridenour’s July suit.

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Cigna fired back:

As Mr. Ridenour knew, and at minimum should have known as a licensed attorney with over 10 years of experience, his allegations are without merit in light of the fraudulent scheme described above.

You know it’s gonna be a fun case when the parties are already willing to take shots like that.
Cigna Says Orrick Atty’s SUV Bought With False Claim Cash [Law360]

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