Zalma on Insurance
Education • Business
Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
Interested? Want to learn more about the community?
June 09, 2025
Guilty Pleas of Some Defendants Not Enough for Disclosure

Prosecutors Have the Right to Keep Some Secrets
Post 5093

Application of New York's Freedom of Information Law (FOIL)

See the full video at https://lnkd.in/g5FHC3bf and at https://lnkd.in/gNt6447Q, and at https://zalma.com/blog plus more than 5050 posts.

James M. Haddad sought to compel Alvin L Bragg  (Bragg) to produce certain material seized pursuant to a search warrant executed in connection with a now-completed criminal matter.

In James M. Haddad v.  Alvin L Bragg, in his official capacity as District Attorney of the County of New York, 2025 NY Slip Op 31779(U), Index No. 158493/2023, Supreme Court, New York County (May 15, 2025) the court resolved the dispute.

FACTUAL BACKGROUND

OneTeam Restoration, Inc., its owner and president, Mario Rojas, Jr., and certified public accountant Steven Lyon were charged with three counts of Insurance Fraud in the First Degree and Falsifying Business Records in the First Degree based on allegations that Lyon, Rojas, and OneTeam engaged in a scheme to defraud the New York State Insurance Fund.

On April 26, 2023, petitioner submitted a Freedom of Information Law (FOIL) request to Bragg, the New York County District Attorney's Office. The FOIL sought the original rap sheets, warrants and corporate summons, production log and a thumb drive containing the discovery materials.  The "discovery materials" on the thumb drive were, at least in part, thousands of pages of these defendants' business and financial records seized pursuant to a search warrant.

Bragg's Records Access Officer ("RAO" ) Corey S. Shoock denied petitioner's request on the grounds that disclosure would "interfere with the criminal judicial process, as well as with any further investigation and future judicial proceedings that might be necessary." Petitioner appealed the denial of his FOIL request.

Shortly thereafter, Rojas and OneTeam pled guilty to one count each of First Degree Falsifying Business Records and were sentenced that day.

Because the third defendant, Steven Lyon, remained open the appeal affirmed the RAO's determination and denial on pending judicial proceeding grounds and incorporate by reference his reasoning and cited authority.

In a post-remand decision on June 16, 2023, RAO Shoock wrote: “[P]ursuant to that portion of the AO's decision granting your appeal, you will be provided access to the following thirty-three (33) pages of material ... [but] [i]nsofar as criminal charges remain pending against defendant Steven Lyon, Omnibus Motion papers relating to defendant Lyon, discovery produced in the criminal prosecution against defendant Lyon, together with email correspondence between opposing counsel and with the Court, is exempt from production on the grounds that disclosure of such records would interfere with three pending prosecutions conducted by this Office against this defendant ...” [emphasis added]).

DISCUSSION

FOIL imposes a broad duty on government to make its records available to the public and all government records are thus presumptively open for public inspection and copying unless they fall within an enumerated statutory exemption contained in Public Officers Law § 87(2). The burden rests on the agency to establish that requested material qualifies for any of the exemptions, which must be narrowly construed.

Bragg met the burden by establishing that the requested records fell "squarely" within an exemption to disclosure. The statute exempts from disclosure records or portions thereof that are compiled for law enforcement purposes and which, if disclosed, would interfere with law enforcement investigations or judicial proceedings.

The petition was denied and this special proceeding dismissed.

ZALMA OPINION

FOIL limits the freedom of information available to criminal litigants and the public if it has an effect on the prosecution to disclose that information. Even after some defendants pleaded guilty to insurance fraud, others did not, so the FOIL request stayed refused. Regardless of the need for information to be freely available from prosecutors like Bragg, that freedom is not unlimited and the prosecutor may keep the evidence private for the purposes of trial.

(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 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.

00:07:49
Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
1 hour ago
Crime Doesn’t Pay – Allstate to Have Judgment Against Fraudsters

Fraud Perpetrators Will Have Judgment Entered in Favor of Insurer They Defrauded
Post 5155

See the full video at https://lnkd.in/gGP7BYSU and at https://lnkd.in/gi4GEGeG, and at https://zalma.com/blog plus more than 5150 posts.

Allstate Effectively Proactive Against Insurance Fraud

Plaintiffs Allstate Insurance Company and other Allstate companies (collectively, “Plaintiffs”) sued seeking redress for losses incurred due to an alleged insurance fraud scheme. Plaintiffs alleged that Defendants Toshner, Lacey Davies, Michael Trinh, Roadside Response, LLC, and Responsible Billing, LLC’s (collectively, “Defendants”) submitted false reimbursement claims for hazardous material cleanups that were never actually performed, were unnecessary, or did not involve an Allstate insured.

In Allstate Insurance Company, et al. v. Daniel Toshner, et al., No. 1:24-CV-27-RP, United States District Court, W.D. Texas, Austin Division (July 9, 2025) Allstate moved for default to be entered against the defendants.

...

00:06:02
1 hour ago
Plaintiff Must be an Insured to Sue Insurance Company

When Plaintiff Gives Up Court Must Grant Summary Judgment

Post 5154

It is Contumacious to Sue an Insurer if You are Not Insured

See the full video at https://lnkd.in/ggmMWkcN and at https://lnkd.in/gJXMDYxG, and at https://zalma.com/blog plus more than 5100 posts.

Defendant American National filed a motion for summary judgment because Plaintiff is not a named or third-party beneficiary of the Policy. Defendant contends that because Plaintiff is not covered by the Policy, Plaintiff cannot prove that Defendant breached the Policy or demonstrated bad faith under La. R.S. 22:1973 and 22:1892. In support of this contention, Defendant argued that the Policy only covers the “Named Insured/Mortgagee” of the property, Magee Holdings, LLC, and that the Policy does not name Plaintiff as an insured or a third-party beneficiary.

In Hannah Guillotte v. American National Property And Casualty Company, Civil Action No. 23-00931-BAJ-RLB, United States District Court, M.D. Louisiana (July 16, 2025) Plaintiff, the ...

00:06:32
July 25, 2025
Plaintiff Must be an Insured to Sue Insurance Company

When Plaintiff Gives Up Court Must Grant Summary Judgment

Post 5154

It is Contumacious to Sue an Insurer if You are Not Insured

See the full video at https://lnkd.in/ggmMWkcN and at https://lnkd.in/gJXMDYxG, and at https://zalma.com/blog plus more than 5100 posts.

Defendant American National filed a motion for summary judgment because Plaintiff is not a named or third-party beneficiary of the Policy. Defendant contends that because Plaintiff is not covered by the Policy, Plaintiff cannot prove that Defendant breached the Policy or demonstrated bad faith under La. R.S. 22:1973 and 22:1892. In support of this contention, Defendant argued that the Policy only covers the “Named Insured/Mortgagee” of the property, Magee Holdings, LLC, and that the Policy does not name Plaintiff as an insured or a third-party beneficiary.

In Hannah Guillotte v. American National Property And Casualty Company, Civil Action No. 23-00931-BAJ-RLB, United States District Court, M.D. Louisiana (July 16, 2025) Plaintiff, the ...

00:06:32
July 16, 2025
There is no Tort of Negligent Claims handling in Alaska

Rulings on Motions Reduced the Issues to be Presented at Trial

Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.

CASE OVERVIEW

In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.

FACTS

Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.

Prior to trial Bernier had three remaining claims against State Farm:

1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.

Both Bernier and State Farm dispositive motions before ...

post photo preview
May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

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 ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

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 ...

See More
Available on mobile and TV devices
google store google store app store app store
google store google store app tv store app tv store amazon store amazon store roku store roku store
Powered by Locals