Court Restrains Health Care Providers Attempts at Fraud
Post 5080
See the full video at https://lnkd.in/g9_M6Zx9 and at https://lnkd.in/g_gv5gaY, and at https://zalma.com/blog plus more than 5050 posts.
USDC Holds Fraud in Abeyance
Illegal Financial Arrangements Between Health Care Professionals Stopped
In Government Employees Insurance Company, GEICO Indemnity Company, GEICO General Insurance Company and GEICO Casualty Company v. Akiva Imaging Inc., Rashbi Diagnostics Imaging Inc., et. al, No. 1:24-CV-6549 (FB) (JAM), United States District Court, E.D. New York (May 19, 2025)
Plaintiffs:
GEICO companies collectively referred to as “Plaintiffs” or “GEICO” .
Defendants:
Akiva Imaging Inc., Rashbi Diagnostics Imaging Inc., and other health care providers “Defendants.”
Massiveness Of Fraudulent Scheme:
Defendants contend that the scheme here does not reach the size and complexity required by the Circuit in Tri-Borough to find serious questions going to the merits and to apply the exceptions to the FAA and AIA. Serious questions exist by virtue of the scheme’s complexity the complaint “describes a web of interconnected relationships among the various Defendants, and illegal financial arrangements tying many of the Defendants together,” among other things.
Allegations:
GEICO alleges that Defendants committed civil violations under the Racketeer Influenced and Corrupt Organizations Act (RICO), common law fraud, unjust enrichment, and aiding and abetting fraud. GEICO sought a declaratory judgment that Defendants may not recover on any of the outstanding bills submitted to it .
Court’s Decision:
GEICO’s motion was granted and Defendants’ motions are denied. The court found irreparable harm that warrants injunctive relief given the global and intertwined nature of the fraud. The balance of hardships tipped decidedly in GEICO’S favor.
Bond:
The court waived the Rule 65(c) bond requirement.
Conclusion:
Plaintiffs’ motion was granted and Defendants’ motions were denied. Defendants were enjoined from initiating new or proceeding with ongoing collections arbitrations and state-court suits.
ZALMA OPINION
This is a man bites dog story. GEICO as the victim of no fault insurance fraud by various health care providers scheming to present fraudulent health insurance claims to no fault auto insurers when, in fact, the patients were neither injured nor were they treated, just billed. The court stopped the bleeding. The trial would be very interesting where the victim of a fraud seeks indemnity from the alleged fraudsters.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.
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Post 5397
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See the video and at https://lnkd.in/gNUs2XzT and at https://lnkd.in/g2MawyzX
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Post 5396
See the video and at https://rumble.com/v7ctgmq-the-great-jewel-theft.html at https://youtu.be/aRbQ2sJfGwA
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.
The Insured purchased, for the first time in his life, a policy of Personal Articles Floater Insurance (PAF) scheduling $125,000 worth of ladies jewelry. He advised the insurer that the jewelry was always kept in a class E safe at his residence. He also told the insurer that he was employed full time as the owner of a gasoline service station and that he had never been canceled or suffered a previous loss.
One month after the policy was ...
Day Care Owner Loses Subsidies Because She Criticized State
Post 5421
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Rescission for Material Misrepresentation
Post 5418
Posted on August 5, 2026 by Barry Zalma
An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.
In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units. After an underlying personal injury action was filed, Union Mutual determined that the property actually contained three apartment units and rescinded the policies on the ground that the defendants had made a material misrepresentation in the applications.
LAW:
A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true ...
Rescission for Material Misrepresentation
Post 5418
Posted on August 5, 2026 by Barry Zalma
An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.
In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units.
LAW:
A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true facts been disclosed. To establish materiality as a matter of law, the insurer must submit documentation of its underwriting practices, such as manuals, guidelines, bulletins, or rules addressing similar risks.
DISCUSSION/ANALYSIS:
As a result, the...
