Lack of Standing Requires Dismissal
Post 5008
Read the full article at https://lnkd.in/gvSemwVK, See the full video at https://lnkd.in/gcH7RrhH and at https://lnkd.in/gqmF2Jqi, and at https://zalma.com/blog plus more than 5000 posts.
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.
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://barryzalma.substack.com/subscribe
Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg
Go to the Insurance Claims Library – https://lnkd.in/gwEYk
(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 ...
Qui Tam Case Without Evidence to Prove Fraud Fails
Post number 5369
Read the full article at https://www.linkedin.com/pulse/qui-tam-insurer-contended-defrauded-barry-zalma-esq-cfe-pgfgc and at https://zalma.com/blog plus more than 5550 posts.
In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended parties in an automobile collision case involving a McLaren and a tour van. After that case settled for $25,000, the firm filed a qui tam action under California’s Insurance Frauds Prevention Act (IFPA) against Silver Bird Auto Leasing, LLC, X-Law Group, PC, and Filippo Marchino. The firm alleged three fraudulent acts in the underlying litigation:
1. the complaint falsely stated the McLaren was making a “legal turn,”
2. respondents produced a fraudulent repair bill/estimate, and
3. respondents failed to disclose Marchino’s GEICO insurance and its payment for repairs....
Full Faith and Credit Act Controlled
Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.
Posted on June 9, 2026 by Barry Zalma
Post number 5368
Posted on June 9, 2026 by Barry Zalma
In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.
After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...
Full Faith and Credit Act Controlled
Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.
Posted on June 9, 2026 by Barry Zalma
Post number 5368
Posted on June 9, 2026 by Barry Zalma
In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.
After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...
