Tag Archives: Fraud

Cell Phone Records Support Insurer’s Denial Based on Fraud

When insurers investigate insurance claims and suspect that something about the claim is not quite right, they often assign special investigation units evaluate whether the claim lacks merit or is otherwise fraudulent. In Young v. Progressive Casualty Insurance Company,1 a federal district court in California recently upheld an insurer’s denial of its insured’s claim for … Continue Reading

Using a Motion in Limine to Exclude Evidence of Prior Fires or Prior Insurance Claims

Motions in limine are commonly used to seek a pre-trial ruling regarding excluding inadmissible or prejudicial evidence. At the federal level, Federal Rules of Evidence (“FRE”) 103(d) and 104(c),1 402,2 403,3 and 611(a)4 and Federal Rule of Civil Procedure (“FRCP”) 16(c)5 provide the underlying bases for in limine motions, though the power to rule on … Continue Reading

Former Director of Hi-Rise Engineering is Indicted in New York

Former director of Hi-Rise Engineering, Matthew Pappalardo was indicted on a 50-count indictment stemming from Hi-Rise’s role in altering their engineering reports to defraud policyholders from monies owed due to Superstorm Sandy damage. Contained within the indictment were 25 counts of Forgery in the second degree, in violation of Penal Law Sect. 170.10(1) and 25 … Continue Reading

Here we go again …

Since the Florida Legislature is currently in session, we are being inundated with insurance industry talking points in the media. The most consistent talking point, and the one that frustrates me the most, is that we need to eradicate “fraud” because it is costing consumers money.… Continue Reading

New Jersey Independent Adjuster Sentenced to 32-Months in Prison for Defrauding the New Jersey Turnpike Authority

On January 8, 2015, Robert Napolitano, of Clifton, New Jersey was sentenced to thirty-two (32) months in prison and three years supervised release1 after pleading guilty to “charges that he defrauded the [New Jersey Turnpike Authority (“NJTA”)] out of insurance money meant to cover the cost of repairs to turnpike property,” totaling approximately $900,000.00.2… Continue Reading

New Jersey Senator Menendez Calls for Investigation into Manipulated Expert Reports

United States Senator Robert Menendez – the senior senator from New Jersey, today issued a letter seeking a full investigation into the fraudulent altering of reports by carrier friendly experts. Followers of our blog know that this has risen to the forefront of Superstorm Sandy flood litigation. Essentially, carriers and their experts are accused of … Continue Reading

Fraudulent Superstorm Sandy Flood Expert Reports

An engineering firm has produced an alleged fraudulent report of an engineer’s opinion in a Superstorm Sandy flood lawsuit. Outcome oriented vendor firms providing outcome oriented reports is a big problem for consumers of insurance after a loss occurs. Reports can be altered and language changed which can be disastrous for insurance customers and save … Continue Reading

Texas Appellate Court: Alleged Fabrication of Photographs Did Not Warrant Million Dollar and “Death Penalty” Sanctions Against Insured

Regardless of whether you’re the plaintiff or defendant in an insurance dispute, fabricating or otherwise altering evidence can have some very serious consequences. Earlier this summer, the Sixth District Texas Court of Appeals issued a memorandum opinion involving two of the most severe sanctions parties can face under Texas law for such misconduct – monetary … Continue Reading

Florida Updates Website for Reporting Suspected Insurance Fraud

When a policyholder disputes a property damage claim, insurance company representatives often dig in their heels and try to stand firm on the denial or the low valuation. Insurance companies frequently allege various unsupported reasons and defenses to avoid paying what is due. Some insurance companies accuse consumers of insurance fraud even when the facts … Continue Reading

Insurance Policy Conditions (a/k/a/ Land Mines): Part 21 – “Intent” and the Fraud Condition

Most policies contain a “Concealment or Fraud” condition that reads along these lines: “With respect to all persons insured under this policy, we provide no coverage for loss if, whether before or after a loss, one or more persons insured under this policy have: a. Intentionally concealed or misrepresented any material fact or circumstance; b. … Continue Reading

Insurance Policy Conditions (a/k/a/ Land Mines): Part 16 – Specificity of Fraud-Based Claim Denial

Most policies contain a “Concealment or Fraud” condition that reads along these lines: With respect to all persons insured under this policy, we provide no coverage for loss if, whether before or after a loss, one or more persons insured under this policy have: a. Intentionally concealed or misrepresented any material fact or circumstance; b. … Continue Reading

Is Insurance Fraud As Rampant As Insurers Rampantly Contend?

Insurers often employ the phrase “insurance fraud” in conjunction with claim denial, legislative lobbying, and premium increase requests. But does the usage rate of this phrase correlate with the rate at which insurance fraud is actually committed? Put differently, is insurance fraud as rampant as insurers rampantly contend? Nope! A renowned, well-respected claims practice expert … Continue Reading
LexBlog