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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.
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July 23, 2025
Unopposed Motion to Dismiss is Deemed Confessed

Act as Your Own Lawyer and Failure is Almost Certain

No Suit Can be Maintained if Claims are Facially Implausible
Post 5152

See the full video at https://lnkd.in/gJsqpbsj and at https://lnkd.in/gJsqpbsj, and at https://zalma.com/blog.

In Gabaryaahla Israel and Akiva Israel, Beneficiaries v. Caliber Home Loans, Inc., et al., No. CIV-24-1255-D, United States District Court, W.D. Oklahoma (July 11, 2025) Wells Fargo Bank, N.A.’s Moved to Dismiss Plaintiffs’ Complaint for Fraud, Quiet Title, Injunctive Relief, Breach of Contract, Declaratory Judgment, Damages, Racketeer Influenced Corrupt Organizations Act (RICO) Violations, and Trover and Midfirst Bank’s Rule 12(b)(6) Motion to Dismiss.

Plaintiffs, who are self-represented, failed to respond to the motions to dismiss within 21 days as required by LCvR7.1(g) (establishing a 21-day deadline, and noting that any motion that is not opposed within 21 days may, in the discretion of the court, be deemed confessed.

BACKGROUND:

The plaintiffs brought this action against the defendants alleging various claims such as fraud, trover, unjust enrichment, RICO violations, and violations of consumer protection statutes including the Truth in Lending Act and the Real Estate Settlement Procedures Act. They sought to enjoin a foreclosure action proceeding in Canadian County District Court, provide declaratory relief for fraudulent mortgage assignments, and award damages.

KEY ALLEGATIONS:
Securitization and Assignment:

Plaintiffs allege that the loan was securitized and assigned to MidFirst Bank, releasing them from their obligations .

Insurance Claim Payout:

Plaintiffs claim that the defendants received an insurance claim payout covering the value of the property but failed to disclose it.

COURT’S ANALYSIS:

The court found that the plaintiffs’ claims were facially implausible and failed to meet the pleading standards for fraud. The court also noted that the plaintiffs’ complaint did not comply with the requirements of Rules 8(a) and 9(b).

Rooker-Feldman Doctrine

In its motion Midfirst argued the Court lacks subject matter jurisdiction pursuant the Rooker-Feldman doctrine that precludes lower federal courts from effectively exercising appellate jurisdiction over claims actually decided by a state court and claims inextricably intertwined with a prior state-court judgment.

Standard of Decision

A complaint must contain a short and plain statement of the claim showing that the pleader is entitled to relief. The pleading standard for fraud is, however, higher. A party alleging fraud must state with particularity the circumstances constituting the fraud.

Although a pro se party’s pleadings must be liberally construed, the court cannot take on the responsibility of serving as the litigant’s attorney in constructing arguments and searching the record.

The Court found Plaintiffs’ complaint fails to state a claim for which relief can be granted. Plaintiffs’ theory that the loan was paid off via securitization is therefore facially implausible. Pro se status does not excuse the obligation of any litigant to comply with the fundamental requirements of the Federal Rules of Civil and Appellate Procedure.

A judgment has already been entered in a foreclosure action in Canadian County District Court between many, but not all, of the same parties.

CONCLUSION

The court dismissed the plaintiffs’ complaint in its entirety without prejudice and without leave to amend.

ZALMA OPINION

It is almost guaranteed that when a plaintiff represents his or her self and fails to comply with court rules the pro se plaintiff will lose. In this case the plaintiffs failed to represent their own interest, presented a inept complaint that exceeded the ability to sue in federal court, and lost their suit wasting the time of the court and the funds of the defendants to defend the spurious suit.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:06:32
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9 hours ago
Prosecutors Use Omnibus Motion in Limine to Limit Trial

The Need For and Application of a Motion in Limine

Post 5153

Lawyers Present & Argue Motions in Limine to Control Trial Excess

See the full video at https://lnkd.in/gBv_pukH and at https://lnkd.in/gnX4tyXK, and at https://zalma.com/blog plus 5100 posts.

In United States Of America v. Scharmaine Lawson Baker, Criminal Action No. 24-99, USDC, E.D. Louisiana (July 7, 2025) Scharmaine Lawson Baker was charged with six counts of health care fraud. She pled not guilty, and her trial was scheduled.

BACKGROUND

Government’s Omnibus Motion in Limine

The Government filed an omnibus motion in limine which included several requests to exclude certain types of evidence and arguments.

Exclusion of Evidence and Argument Related to Specific Instances of “Good Deeds” and “Law-Abidingness”

The Government argued that such evidence is irrelevant and improper character evidence.
The Court granted the motion, stating that the defendant’s character is not an essential element of the charges.

Testimony About Defendant’s Own ...

00:09:08
July 22, 2025
It’s Not Nice to Lie to Your Workers’ Compensation Insurer

See the full video at https://lnkd.in/gB5EKA9t and at https://lnkd.in/gBpMe7V2, and at https://zalma.com/blog plus more than 5100 posts.

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 ...

00:07:27
July 21, 2025
False Documentation to Obtain a Loan is a Crime

Arrest for False Impersonation Protected Property Owners from Losing Insurance

See the full video at https://lnkd.in/gYYWmkbQ and at https://lnkd.in/gEe2Wc86. and at https://zalma.com/blog plus more than 5100 posts.

In United States Of America v. Christopher J. Gallo and Mehmet Ali Elmas, No. 2:24-cr-00712 (BRM), USDC, D. New Jersey (July 16, 2025) Gallo and Elmas each filed Motions to Dismiss Count Eighteen which charges the CoDefendants with Aggravated Identity Theft.

BACKGROUND

Co-Defendants were charged in a criminal complaint (the “Complaint”) with conspiracy to commit bank fraud. Gallo, as a senior loan officer originated more than $1.4 billion in loans for the Financial Institution.

A grand jury returned an eighteen-count indictment charging Co-Defendants with Conspiracy to Commit Bank Fraud, False Statement to a Financial Institution and Aggravated Identity Theft.

LEGAL PROCEEDINGS

Motions to Dismiss

The court found that the identity theft was central to the fraudulent scheme, as the...

00:08:14
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 ...

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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 ...

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