In a newly filed New York action New York Marine & General Insurance Company v. Subin, et al., an insurer describes what it calls a “deceitful, collusive” operation built around a “legal-driven medical engine.” At the center is a mentally ill man who, according to the complaint, was “involuntarily committed just 3 weeks before a medically unjustified spinal fusion.”

Three weeks after that commitment, a surgeon “removed the C6-7 intervertebral disc from a mentally ill man. …and inserted a titanium plate and screws into his neck,” claiming “weakness on examination and MRI demonstrating posterior disk herniation correlating with symptoms.” The complaint cites how this surgery was completed while, “no MRI was ever done, and the CT… demonstrated. …no stenosis, no instability, and no other findings, whatsoever.” 

To make matters worse, “no guardian, proxy, or other surrogate decision-maker provided consent.” The filing calls this conduct a “blueprint. … “of the exploitative, legal-driven medical engine”. …”exceeding all marks of fraud.” 

But the surgery did not happen in isolation: this was a blueprint for these personal injury lawyers and doctors, something they had done time and time again. On “the very same day,” the same surgeon allegedly performed a spinal fusion procedure on “the purported witness to Aquino’s accident,” who was also represented by the same firm and treated by the same providers. The complaint states the surgeon received “$15,000 upfront” in both cases and later asserted six-figure liens. The client, in this case, was not aware they agreed to any lien-based treatment.

According to the insurer, this is not a single bad case. It alleges a “chronic and extreme pattern,” referencing at least 28 claimants who allegedly followed the same pathway: law firm, same clinics, same imaging centers, same surgeons, same lien-based treatment.

The complaint frames the issue clearly: “When an attorney commences, or maintains, an action grounded in material misrepresentation of fact, the opposing party is obligated to defend or default and necessarily incurs legal expenses.”

But the larger concern is not just defense costs. The filing argues that this conduct “has dramatic and widespread effects on consumers,” including “clogged Court dockets” and “wrongfully driving up the cost of legitimate insurance business operations, resulting in needlessly escalating premiums.”

At its core, the lawsuit alleges a breakdown of boundaries:  lawyers, doctors, and financial incentives allegedly operating in a closed loop. The court filing warns that the system depends on “the integrity of attorneys who fulfill the role of officers of the court,” and accuses the defendants of subverting that “truth-seeking function.”

If the allegations are proven, the case would not be about aggressive advocacy. It would be about whether litigation became the driver of medicine and these schemes, and whether vulnerable consumers became the product.