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June 02, 2022
Convicted of Insurance Fraud Still Entitled to a Legal Sentence

Pennsylvania Requires Court to Announce a Convicted Defendant’s Recidivism Risk Reduction Incentive

Read the full article at https://lnkd.in/gADDr_7v and at https://zalma.com/blog plus more than 4200 posts.

Posted on June 2, 2022 by Barry Zalma

Claire A. Risoldi, in a second try appealed from the Judgment of Sentence, entered after remand for resentencing on the restitution portion of her sentence. Risoldi challenged the legality of her sentence. In Commonwealth Of Pennsylvania v. Claire A. Risoldi, 2022 PA Super 94, No. 1382 EDA 2021, J-A07001-22, Superior Court of Pennsylvania (May 24, 2022) Risoldi’s second appeal requires a finding from the trial court of whether she was entitled to a finding of a recidivism risk reduction incentive (RRRI) finding.
FACTS

On February 5, 2019, a jury convicted Risoldi of various offenses related to her participation in an insurance fraud scheme. On May 17, 2019, the court sentenced Risoldi to an aggregate term of 11½ to 23 months’ incarceration and over $10 million in restitution. On review, this Court vacated the restitution portion of Risoldi’s sentence, remanded for resentencing solely on that issue, and affirmed all other aspects of Risoldi’s sentence. [Commonwealth v. Risoldi, 238 A.3d 434, 465 (Pa. Super. 2020)] The Pennsylvania Supreme Court denied allowance of a further appeal [Commonwealth v. Risoldi, 244 A.3d 1230 (Pa. 2021)].

On June 25, 2021, the court resentenced Risoldi only on the restitution portion of her sentence. At no point in Risoldi’s initial sentencing or resentencing did the court state whether Risoldi is eligible to participate in a reentry plan. Risoldi timely filed a Notice of Appeal and both she and the trial court complied with Pa.R.A.P. 1925.

Risoldi argued only that the sentencing court imposed an illegal sentence on May 17, 2019, and reimposed an illegal sentence on June 25, 2021, because it did not determine her reentry plan eligibility on the record as required by the Sentencing Code.

The court reviewed the implications of a sentencing court’s failure to state on the record if a defendant is eligible for RRRI minimum sentence under a different subsection of the same statute which states, in relevant part, that “[t]he court shall determine if the defendant is eligible for a recidivism risk reduction incentive minimum sentence[.]” 42 Pa.C.S. § 9756(b.1) (emphasis added).
ANALYSIS

The Appellate Court concluded that the legislature’s use of the term “shall” in the statute a sentencing court’s failure to determine on the record if a defendant is RRRI eligible results in the imposition of an illegal sentence. The legislature’s use of the term “shall” confers on the sentencing court the requirement that it determine a defendant’s RRRI eligibility at sentencing, and failure to do so results in the imposition of an illegal sentence.

In the instant case, the trial court did not state on the record at sentencing if Risoldi is eligible to participate in a reentry plan. That aspect of Risoldi’s sentence is, therefore, illegal and subject to correction. The appellate court remanded solely for the sentencing court to determine Risoldi’s eligibility to participate in a reentry plan pursuant to 42 Pa.C.S. § 9756(b)(3).
ZALMA OPINION

It amazes me how many times a person convicted of insurance fraud is able to appeal the sentence imposed. In this case the trial court failed to do what it was required to do and the appellate court sent it back for a re-sentence regarding RRRI. Hopefully the trial court will find she is not eligible.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and [email protected].

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March 11, 2026
Public Adjusters Attempt to Represent an Insured Subject to APA Clause

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Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster

In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.

FACTS

NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...

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March 11, 2026
Public Adjusters Attempt to Represent an Insured Subject to APA Clause

Anti-Public Adjuster Clause Is Effective in New York

Post number 5301

Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster

In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.

FACTS

NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...

00:08:05
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March 10, 2026
Acting as Your Own Lawyer is Foolish

Proof of Highly Contaminated Water is Required for Extra Payments

Post number 5300

Read the full article at https://www.linkedin.com/pulse/acting-your-own-lawyer-foolish-barry-zalma-esq-cfe-mbg0c, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

Acting as Your Own Lawyer is Foolish

Evidence of Breach of Contract Survives Dismissal of All Other Charges

In Lee Lifeng Hsu and Jane Yuchen Hsu v. State Farm Fire And Casualty Company, C. A. No. N24C-09-020 CLS, Superior Court of Delaware (February 27, 2026) a claim to State Farm who paid approximately $61,000 after assessments but denied coverage for additional items including ceramic tiles, the kitchen floor ceiling, underlayment plywood, and numerous personal property items resulted in suit by the Hsu’s acting in pro per.
Facts

Lee Lifeng Hsu and Jane Yuchen Hsu (“Plaintiffs”) purchased a homeowners’ insurance policy from State Farm Fire...

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13 hours ago
Portable Storage Containers are not Buildings

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Post number 5307

Principles of Contract Interpretation Compels Reading Contract as Written

Read the full article at https://www.linkedin.com/pulse/portable-storage-containers-buildings-barry-zalma-esq-cfe-fkg1c and at https://zalma.com/blog.

In Eastside Floor Supplies, Ltd. v. SCS Agency, Inc., Hanover Insurance Company, et al., No. 2024-01501, Index No. 609883/19, 2026 NY Slip Op 01488, Supreme Court of New York, Second Department (March 18, 2026)

In May 2019, a fire damaged business personal property belonging to the plaintiffs, which was stored in portable storage containers at their Manhattan premises. At the time of the fire, the plaintiffs were insured under a businessowners insurance policy (BOP) issued by the defendant Hanover Insurance Company which provided general coverage for business personal property, and which included a specific extension for “Business Personal Property Temporarily in Portable Storage Units” (the portable storage ...

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Failure to Provide Well-Pled Facts Defeats Most of Action

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Post number 5306

Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.

Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity

In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.

FACTUAL BACKGROUND

United and Oxford, who administer both ERISA and ...

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March 19, 2026
Failure to Provide Well-Pled Facts Defeats Most of Action

ERISA Saves Fraudulent Claims Suit

Post number 5306

Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.

Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity

In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.

FACTUAL BACKGROUND

United and Oxford, who administer both ERISA and ...

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