Settlement of Fraud Suit Does not Give Doc Suit Against Insurers

0
3K

SLAPP Motion Appropriate When Fraud Perpetrators Sue Insurers and Their Lawyers


Read the full article at https://www.linkedin.com/pulse/settlement-fraud-suit-does-allow-doc-sue-insurers-zalma-esq-cfe and at https://zalma.com/blog plus more than 4150 posts.


Nine insurers sued Ajay Mohabeer for fraudulently billing them for medical treatment never provided nor provided in the amounts charged. The insurers sued, lost a partial summary judgment, and rather than go on to trial on other causes of fraud, settled the suit with Dr. Mohabeer. Unhappy with the settlement Dr. Mohabeer sued the insurers and their lawyers for wrongful use of civil proceedings and damages (called malicious prosecution in other jurisdictions) 

The allegations of plaintiffs claim are based solely on written statements and documents provided to the federal court in the context of the underlying action. The only dispute on appeal concerns whether plaintiff has met his burden to present prima facie evidence as to each element of his claim of wrongful use of civil proceedings.


ANALYSIS


One element of the claim of wrongful use of civil proceedings is an absence of probable cause to prosecute the underlying action. In the context of the special motion to strike, however, the existence of prima facie proof of the elements of the claim being challenged by the motion is something that the court determines as a matter of law, based on the pleadings and supporting and opposing affidavits stating the facts upon which the liability or defense is based.


The court agreed with defendants’ argument that that is evidence that the claims brought by defendants in the underlying action were objectively reasonable and based on probable cause.


ZALMA OPINION


Farmers and the other insurers defendant should be honored for proactively working to defeat a fraudulent claims. By not taking the case to trial after losing a partial summary judgment motion and stipulating that the case was resolved in the favor of the plaintiff they invited his suit. The lesson learned by the insurers was that they should have taken Dr. Mohabeer to trial on the causes that they could have proved were fraudulent. Settlement is not appropriate when evidence of fraud exists.


(c) 2022 Barry Zalma & ClaimSchool, Inc.


Subscribe to Zalma on Insurance at locals.com https://zalmaoninsurance.local.com/subscribe. 


Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. 


Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog. 


Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ Read posts from Barry Zalma at Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

 

 

Sponsorizzato

We are 100% funded for October.

Thanks to everyone who helped out. 🥰

Xephula monthly operating expenses for 2024 - Server: $143/month - Backup Software: $6/month - Object Storage: $6/month - SMTP Service: $10/month - Stripe Processing Fees: ~$10/month - Total: $175/month

Xephula Funding Meter

Please Donate Here

Cerca
Categorie
Leggi tutto
Politics
Cuomo the little mafiosi uses lies to frame restrictions on Jews... nice, limp wrist...
The USA says: "We'll never be like Nazi Germany... Never..." WANNA BET? Try this headline sports...
By Scarecrow III 2020-10-08 05:06:46 0 6K
Literature
The Roast of Mark Zuckerberg by his own AI creation.
Carefully counting at the meticulous copies of code, spreadsheets, and mud from the dirty...
By Rock IXOYE 2020-01-17 17:22:32 1 6K
SyFy
THE SOULSTONE | Forum
What is the soulstone? It's a microchip that can hold a flawed recording of someone's...
By Rock IXOYE 2020-01-20 03:59:50 0 7K
Health
Insurer Sues Fraudsters
Health Care Providers Created Fraudulent Billing for Covid Instant Tests Read the full article at...
By Barry Zalma 2022-09-26 13:43:14 0 5K