Lack of Standing Requires Dismissal
Post 5008
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Chutzpah: Attempt to Use Federal Court to Obtain a Share of the Proceeds of an Insurance Fraud
Tyanna Dodson is a chiropractor who sought compensation from ExamWorks, L.L.C.'s ("ExamWorks" ), a medical billing and scheduling provider. Dodson alleged that ExamWorks over-billed her patients' insurers for her services to insurers for independent medical exams (IME) she conducted.
In Tyanna Dodson, Doctor of Chiropractic v. ExamWorks, L.L.C., No. 24-50248, the United States Court of Appeals, Fifth Circuit (on February 28, 2025) Dodson contended that the IME's she conducted to help insurers defeat attempted insurance fraud were billed by ExamWorks fraudulently overcharging he insurer clients. She sued EamWorks for half of the excessive billing and damages because she faced discipline and charges of insurance fraud. The District Court found that she had no standing to bring the suit and ignored the fact that she sued in federal court to gain a share of the proceeds of a fraud.
FACTS
Dodson had entered into a contract with Landmark Exams in 2015, which was later acquired by ExamWorks. She terminated her agreement with ExamWorks in 2018, claiming mishandling of billing for over 80 IMEs (Independent Medical Examinations) she conducted in 2017 and 2018. Dodson sued ExamWorks for overbilling insurers and billing for services she did not perform, bringing claims for breach of contract, breach of fiduciary duty, constructive fraud, and declaratory judgment. She alleged injury from ExamWorks's failure to give her half of its allegedly ill-gotten gains and the risk of professional discipline and criminal liability.
ExamWorks moved to dismiss Dodson's First Amended Complaint for lack of standing and for judgment on the pleadings. The district court dismissed the case. Dodson's appeal contended that the district court erroneously concluded she lacked standing and abused its discretion by denying her motion to amend the judgment.
DECISION
The Fifth Circuit reviewed the case and found that Dodson failed to demonstrate a sufficient injury-in-fact. Dodson's claims of harm from ExamWorks withholding her cut of proceeds from fraudulent billing and the risk of future civil and criminal liability were deemed insufficient.
ANALYSIS
To satisfy Article III standing, a plaintiff must show that:
(1) she has suffered an "injury in fact,"
(2) that the injury "likely was caused or likely will be caused" by the defendant, and
(3) the injury is likely to be "redressed by the requested judicial relief."
Dodson presents a long list of purported injuries which essentially collapse into two for standing purposes: (1) ExamWorks withheld Dodson's cut of its proceeds from fraudulent billing, and (2) she now faces a risk of harm from potential future civil and criminal liability.
DEMAND FOR CUT OF FRAUDULENT CLAIMS
For her cut of the purportedly ill-gotten gains, Dodson alleged that she suffered "benefit of the bargain damages" from ExamWorks's alleged breach of contract. She stated that ExamWorks breached its contract when it "fraudulently billed and overbilled for [her IMEs] and related services without . . . providing [her] with the appropriate fee(s) which she was entitled to as per the parties' contract."
Dodson already received all the proceeds that she could legally receive under her contract. Even if Dodson had suffered such harm, it would not have been to a legally protected interest. To the extent that Dodson seeks to use federal courts to pursue her cut of allegedly illegally obtained funds, does not suffice for Article III standing.
ExamWorks observed that the time bar eliminates Dodson's risk of any professional discipline related to her allegations, which all allegedly occurred in 2018 and before. Any risk of injury that Dodson faces from potential future action by regulators is too speculative for Article III purposes.
Because she has not pleaded sufficient injury for Article III standing, the Fifth Circuit affirmed the district court's dismissal of this case and its denial of Dodson's motion to alter or amend the judgment.
ZALMA OPINION
"Chutzpah" is a Yiddish term that has found its way into the English language. It is defined as unmitigated gall and defined by the example of a person convicted of murdering his parents and seeking mercy from the court because he is an orphan. Dr. Dodson's claim for half of the illegally obtained fees by filing suit in the federal courts is, on its face, not only a claim without standing, it is conduct asking the court to assist her in obtaining "her share" of fraudulent billing.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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(c) 2025 Barry Zalma & ClaimSchool, Inc.
Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.
Subscribe to my substack at https://lnkd.in/gmmzUVBy
Go to X @bzalma; Go to the Insurance Claims Library – https://lnkd.in/gwEYk
Arsonist Tried To Represent Himself, Failed, and Sought Habeas Relief
Post number 5357
Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.
Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed
In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.
FACTS
Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...
Foolish to Repeatedly Disobey Court Orders
All That Remains For Trial Is Plaintiff’s Damages On Each Of These Claims And Establishing Proximate Causation Of Those Damages.
Post number 5348
See the full video at and at and at https://zalma.com/blog plus 5300 posts.
In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).
FACTUAL BACKGROUND
This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...
The Right to Negotiate with Insurer is Not an Assignment of Claims
Post number 5347
Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.
Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer
In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.
FACTUAL BACKGROUND
In ...
It is a Crime to Lie to Your Insurer That Accident Happened After Policy Inception
Post number 5386
Posted on July 3, 2026 by Barry Zalma
Conviction for Fraud Affirmed Because Evidence Overwhelming
In State Of Washington v. Saleem Mumin Robinson, No. 87244-3-I, Court of Appeals of Washington, Division 1 (June 29, 2026) Saleem Robinson was involved in an automobile collision on May 18, 2021. The other driver, Mohamed Waggeh, photographed Robinson’s documents and later reported the collision to GEICO, identifying the time as approximately 12:40 p.m.
That same day, at 6:06 p.m., more than five hours after the accident, Robinson purchased Progressive insurance for the vehicle involved in the collision.
The next morning, Robinson called Progressive to report the claim and stated that the accident occurred around 6:15 p.m. Progressive recorded that call without advising Robinson that it was being recorded. Progressive later conducted a special investigative unit investigation the claim because it was submitted shortly ...
Deprive Insurer of the Ability to Properly and Timely Investigate Claim & Recover Nothing
Posted on July 2, 2026 by Barry Zalma
Post number 5385
No Contract Claim No Bad Faith Claim
In South Alexander Development I, LLC v.Markel American Insurance Co., Civil Action No. 23-1436-JWD-SDJ, United States District Court, M.D. Louisiana (June 24, 2026) South Alexander Development I, LLC (SADI) owned and operated a solar farm in Springfield, Louisiana that allegedly sustained significant Hurricane Ida damage.
After SADI submitted a claim, MAIC ultimately paid $1,099,614.02 for undisputed physical damage plus the $210,000 income-loss policy limit. SADI later sued for breach of contract and statutory bad faith, contending MAIC failed to fully investigate and adjust the claim; MAIC sought summary judgment, arguing SADI failed to cooperate and withheld material repair-cost information.
LAW:
Louisiana insurance policies are interpreted as contracts according to their plain meaning, and the insured bears the burden ...
Deprive Insurer of the Ability to Properly and Timely Investigate Claim & Recover Nothing
Posted on July 2, 2026 by Barry Zalma
Post number 5385
No Contract Claim No Bad Faith Claim
In South Alexander Development I, LLC v.Markel American Insurance Co., Civil Action No. 23-1436-JWD-SDJ, United States District Court, M.D. Louisiana (June 24, 2026) South Alexander Development I, LLC (SADI) owned and operated a solar farm in Springfield, Louisiana that allegedly sustained significant Hurricane Ida damage.
After SADI submitted a claim, MAIC ultimately paid $1,099,614.02 for undisputed physical damage plus the $210,000 income-loss policy limit. SADI later sued for breach of contract and statutory bad faith, contending MAIC failed to fully investigate and adjust the claim; MAIC sought summary judgment, arguing SADI failed to cooperate and withheld material repair-cost information.
LAW:
Louisiana insurance policies are interpreted as contracts according to their plain meaning, and the insured bears the burden ...
