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Workers’ Compensation Insurer Sues to Collect Premiums Avoided by Fraud
It’s Fraud to Lie on Application for Insurance
Post 5121
In The Commissioners Of The State Insurance Fund v. Capcon Construction Industries Corp., Capcon Construction Supply Corp., Jab Masonry Corp., Agra Masonry Inc., Agra Industries Usa Corp, A&A Masonry Corp., Alexander Shvartsberg, Darren Caputo, Maryann Furman, 2025 NY Slip Op 32359(U), Index No. 452680/2024, Motion Seq. No. 002, Supreme Court, New York County (July 2, 2025) the court dealt with a fraudulent application for workers’ compensation insurance.
BACKGROUND
On March 3, 2015, A&A Masonry Corp. applied for workers’ compensation insurance coverage from the New York State Insurance Fund (SIF).
On January 15, 2016, Agra Masonry Inc. was incorporated with Maryann Furman as the sole shareholder and President.
On January 4, 2018, SIF canceled the A&A Policy for non-payment.
On March 6, 2018, Masonry applied for workers’ compensation and employer’s liability insurance from SIF.
On November 29, 2018, SIF commenced an action against A&A seeking to recover unpaid insurance premiums.
On October 3, 2019, SIF sent Masonry a notice of cancellation.
On October 9, 2019, the Masonry Policy was reinstated after Masonry paid $6,286.47.
On February 21, 2019, SIF obtained a judgment against A&A for $333,301.65.
On June 30, 2020, Agra Industries USA Corp. was incorporated.
On October 27, 2021, SIF commenced an action against Masonry seeking recovery of unpaid insurance premiums.
On January 12, 2022, SIF obtained a judgment against Masonry in the amount of $5,398,564.69.
On September 27, 2024, SIF commenced the instant action seeking $15,521,316.45 in damages.
DISCUSSION
Insurance Fraud WCL §§ 96(2) And 93
Pursuant to WCL § 96(1), any “person who knowingly … conceals any material fact or engages in any other fraudulent scheme or device for the purpose of obtaining, maintaining or renewing insurance in the state insurance fund … shall be guilty of a class E felony.” Violations of WCL § 96(1) entitle SIF to treble damages, “or five thousand dollars, whichever is greater.” WCL § 96(2).
Here, plaintiff has provided documentary evidence and pled with sufficient particularity that Shvartsberg’s role at Masonry was omitted on the Masonry Application’s question six for the purpose of obtaining insurance, as Shvartsberg was barred from obtaining policies from the SIF Fund due to the A&A judgment under WCL § 93. Thus, defendant’s motion to dismiss the sixth cause of action should be denied.
CONCLUSIONS
Alter Ego Liability: Plaintiff has presented evidence that Masonry’s funds were diverted to make it judgment-proof.
1. Successor Liability: Plaintiff has sufficiently pled that Industries could be liable for the Masonry Judgment as the successor of Masonry.
2. DCL §273: Plaintiff has pled a voidable transfer pursuant to DCL § 273(a)(1).
3. DCL § 274: Plaintiff has alleged that Masonry’s judgment rendered it insolvent.
4. Attorney’s Fees Pursuant to DCL § 276-a: Plaintiff has sufficiently pled the prior DCL causes of action.
5. Insurance Fraud WCL §§ 96(2) and 93: Plaintiff has provided documentary evidence and pled with sufficient particularity that Shvartsberg’s role at Masonry was omitted on the Masonry Application.
ZALMA OPINION
Insurance fraud is a crime in almost every state, including the state of New York. Lying about the management of a company to hide the fact it is controlled by a person who was ineligible for insurance voids the insurance and can be criminal and, at the least, will void the insurance and holds the owners responsible for the premium charged to the various entities. Hiding behind new corporate entities to avoid premium payments is fraud in the inducement the insurer to rescind and obtain a judgment for earned premium.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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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).
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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.
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Post number 5369
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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...