Double Jeopardy Claims Fails Because There was no Second Prosecution for the Same Offense
Post 5057
See the full video at https://lnkd.in/dHta_-yp and at https://lnkd.in/ddck47wm and at https://zalma.com/blog plus more than 5050 posts.
Posted on April 24, 2025 by Barry Zalma
Tariq M. Abdulaziz was charged with larceny in the first degree by defrauding a public community, health insurance fraud, and failure to appear. The charges of larceny and health insurance fraud were tried to the court, and Abdulaziz was found guilty of health insurance fraud.
In State Of Connecticut v. Tariq M. Abdulaziz, No. AC 45916, Court of Appeals of Connecticut (April 8, 2025) the Court of Appeals found that Abdulaziz had submitted false claims for face-to-face services to the Department of Social Services’ Medicaid program while he was in Texas.
The trial court acquitted him of larceny in the first degree due to the state’s failure to prove the value of the wrongfully obtained property exceeded $2000 and the court found him guilty of health insurance fraud, as he had presented false statements to the insurer with the intent to defraud.
The court sentenced Abdulaziz to three months of incarceration, execution suspended, and eighteen months of probation. The state filed a motion to correct an illegal sentence, arguing that the court should apply the sentencing provisions for larceny in the second degree. The court partially granted the motion and resentenced Abdulaziz to three months of incarceration, execution suspended, and one year of probation.
The defendant claimed that the trial court violated the double jeopardy clause and his constitutional right to due process. The court rejected these claims and affirmed the conviction of health insurance fraud.
ANALYSIS
The United States Supreme Court has explained that the fifth amendment guarantee against double jeopardy gives rise to three separate constitutional protections.
It protects against:
1. a second prosecution for the same offense after acquittal.
2. a second prosecution for the same offense after conviction.
3. multiple punishments for the same offense.
The defendant’s present claim invokes the first of these protections under the collateral estoppel branch of double jeopardy jurisprudence.
The defendant contends that the court’s findings on the ”intent to defraud or deceive” and the ”material[ity]” elements of health insurance fraud cannot be reconciled with his acquittal on the larceny charge because these elements both require that the ”alleged fraud concern something of value.”
The Court of Appeals concluded that the trial court did not, as the defendant claims, find ”that no value . . . was proven.” In fact, the court expressly found that ”some value [was] proven,” which is precisely what the defendant claims the court was required to do.
The nature of the services the defendant and the recipients’ other providers and supporters were offering were supposed to be home and community based. It simply is not reasonable or logical to conclude that they could, or would, be offering these types of services from Texas, on 114 separate occasions, particularly when in-person, face-to-face meetings without the service recipient present are ”highly unusual.”
Instead, the reasonable and logical view of the evidence presented supports the court’s finding that at least some of the face-to-face services for which payment was sought and obtained were not performed at all, and thus the defendant was properly convicted of health insurance fraud.
The judgment was affirmed.
ZALMA OPINION
It takes a great amount of Chutzpah to claim that a health care provider in Texas did “face to face” treatment with a patient in Connecticut. It is not ”highly unusual” as the defendant claimed, it is impossible. He was convicted of insurance fraud for claiming face to face treatment and had the unmitigated gall to claim he did the impossible and the court was wrong because he was acquitted of a similar, but different crime. The Court of Appeals took dozens of pages to explain why it affirmed the trial court who was kind enough to keep the defendant out of jail. I would hope more insurance fraud perpetrators are sentenced to serve a long time in prison.
(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
Subscribe to my substack at https://lnkd.in/gmmzUVBy
Go to X @bzalma; Go to the Insurance Claims Library – https://lnkd.in/gwEYk
Notice of Claim Later than 60 Days After Expiration is Too Late
Post 5089
Injury at Massage Causes Suit Against Therapist
Read the full article at https://lnkd.in/gziRzFV8, see the full video at https://lnkd.in/gF4aYrQ2 and at https://lnkd.in/gqShuGs9, and at https://zalma.com/blog plus more than 5050 posts.
Hiscox Insurance Company (“Hiscox”) moved the USDC to Dismiss a suit for failure to state a claim because the insured reported its claim more than 60 days after expiration of the policy.
In Mluxe Williamsburg, LLC v. Hiscox Insurance Company, Inc., et al., No. 4:25-cv-00002, United States District Court, E.D. Missouri, Eastern Division (May 22, 2025) the trial court’s judgment was affirmed.
FACTUAL BACKGROUND
Plaintiff, the operator of a massage spa franchise, entered into a commercial insurance agreement with Hiscox that provided liability insurance coverage from July 25, 2019, to July 25, 2020. On or about June 03, 2019, a customer alleged that one of Plaintiff’s employees engaged in tortious ...
ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Posted on June 2, 2025 by Barry Zalma
Post 5087
See the full video at and at
Read the full article and the full issue of ZIFL June 1, 2025 at https://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-06-01-2025.pdf
Zalma’s Insurance Fraud Letter – June 1, 2025
See the full video at https://lnkd.in/gw-Hgww9 and at https://lnkd.in/gF8QAq4d, and at https://zalma.com/blog plus more than 5050 posts.
ZIFL – Volume 29, Issue 11
The Source for the Insurance Fraud Professional
Read the full article and the full issue of ZIFL June 1, 2025 at https://lnkd.in/gTWZUnnF
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at ...
No Coverage if Home Vacant for More Than 60 Days
Failure to Respond To Counterclaim is an Admission of All Allegations
Post 5085
See the full video at https://lnkd.in/gbWPjHub and at https://lnkd.in/gZ9ztA-P, and at https://zalma.com/blog plus more than 5050 posts.
In Nationwide Mutual Insurance Company v. Rebecca Massey, Civil Action No. 2:25-cv-00124, United States District Court, S.D. West Virginia, Charleston Division (May 22, 2025) Defendant Nationwide Mutual Insurance Company's (“Nationwide”) motion for Default Judgment against Plaintiff Rebecca Massey (“Plaintiff”) for failure to respond to a counterclaim and because the claim was excluded by the policy.
BACKGROUND
On February 26, 2022, Plaintiff's home was destroyed by a fire. At the time of this accident, Plaintiff had a home insurance policy with Nationwide. Plaintiff reported the fire loss to Nationwide, which refused to pay for the damages under the policy because the home had been vacant for more than 60 days.
Plaintiff filed suit ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.
This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
A Heads I Win, Tails You Lose Story
Post 5062
Posted on April 30, 2025 by Barry Zalma
"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime."
Immigrant Criminals Attempt to Profit From Insurance Fraud
People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.
The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...
