Feels like a Fraud: Fifth Circuit Rules in Favor of Insurer; Awards $6M in Fraudulent Claims Case

In Allstate Insurance Company et al. v. Michael Kent Plambeck, DC, et al. United States Court of Appeals for the Fifth Circuit, September 17, 2015, an insurer was awarded a $6 million verdict against a group of chiropractors, lawyers and telemarketers that coerced individuals into making fraudulent claims against the insurer. The District Court awarded the verdict based on the Racketeer Influenced and Corrupt Organizations Act (RICO). On September 17, 2015, the Fifth Circuit Court upheld the verdict.

The insurer accused the telemarketers of …

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Policyholder Required to Pay Back Insurer $900,000 Based on Misrepresentations

A Texas appellate court upheld a substantial jury award against a policyholder on fraud claims in Jackson Fulgham v. Allied Property and Casualty Ins. Co.. The insurer counter-sued the policyholder real estate firm over fraudulent claims it had made about hailstorm damage, resulting in a $900,000 jury award in favor of the insurer. The appellate court upheld the verdict claiming that the evidence supported such finding.

In 2009, the policyholder made a claim under its property insurance policy for damage to the roof of …

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Fraud Inducing Mass Mailings – One Event or Multiple Claims?

American Guar. & Liab. Ins. Co. v Chicago Ins. Co., 2013 N.Y. App. Div. LEXIS 2778 (N.Y. App. Div. 2013)

The New York state appeals court, first department reversed the trial court holding that an insurer is not obligated to cover defense costs for an attorney accused of selling estate planning services to senior citizens and then passing clients off to financial services representatives who swindled them because those claims arose outside policy period.

Attorney Roger A. Giuliani who is accused of engaging in a …

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Former NFL Linebacker Indicted for Insurance Fraud

United States of America v. Marcus Buckley and Kimberly Jones, United States District Court Eastern District of California, April 10, 2013
Marcus Buckley, a former linebacker for the New York Giants and Atlanta Falcons, was charged his involvement in a $1.5 million insurance fraud scheme. He is alleged to have filed fraudulent claims with the New York Giants’ workers’ compensation program. The adjuster on Buckley’s claims, Kimberly Jones, was also charged with fraud.

During the time period Buckley played for the Giants, the Giants …

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