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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 24, 2025
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 Hearsay Statements

The Government sought to preclude the defendant from introducing her own self-serving statements as inadmissible hearsay.
The Court deferred ruling on this request, requiring specific statements to be identified for admissibility assessment.

Use of Interview Reports to Impeach Government Witnesses

The Government requested to preclude the defendant from using interview reports to impeach witnesses unless the statements were verbatim or adopted by the witnesses.
The Court deferred ruling, requiring a factual determination on the nature of the statements.

Unopposed Motions in Limine

The Court granted several unopposed motions, including:

Exclusion of arguments suggesting selective prosecution.
Preclusion of comments on the Government’s failure to call a particular witness.
Exclusion of plea negotiations and related statements.
Exclusion of evidence blaming Medicare as the victim.
Exclusion of evidence related to harm or prejudice caused by the indictment.
Preclusion of arguments for acquittal based on reasons other than evidence and law.

DISCUSSION

Evidence And Argument Related To Specific Instances Of “Good Deeds” And “Law Abidingness”

The government argued that evidence and argument related to specific instances of “good deeds” and “law-abidingness,” including evidence of defendant’s legitimate billing or legitimate services, as circumstantial proof that she is not guilty, should be excluded. Defendant argued that honesty is a pertinent character trait to 18 U.S.C. § 1347, and defendant should not be precluded from introducing any character evidence.

Federal Rules of Evidence 404 states: “Evidence of a person’s character is not admissible to prove that on a particular occasion the person acted in accordance with the character or trait.”

Defendant was charged with six counts of health care fraud. Defendant’s character is not an essential element of the charges against her. Accordingly, the Court granted the government’s motion to exclude evidence and argument related to specific instances of “good deeds” and “law abidingness.”

Testimony About Defendant’s Own Hearsay Statements To Witnesses Or Other Third Parties

The government asked to preclude defendant from attempting to elicit or admit her own self-serving statements made to law enforcement agents, government investigators, or other witnesses as inadmissible hearsay. Defendant argued that granting the government’s motion would deny defendant the right to respond to inaccuracies, embellishments, and mischaracterizations introduced by the government through the defendant’s inculpatory statements.

Without viewing the statements that defendant seeks to admit, the Court could not rule on a blanket request to prohibit the introduction of defendant’s own statements.

Use Of Interview Reports Prepared By Law Enforcement Agents To Impeach Government Witnesses

The government sought to preclude defendant from introducing an interview report to impeach a witness as a prior inconsistent statement of anyone other than the report’s author. The Court could not issue a blanket ruling without first deciding whether the statements were verbatim, or whether the witnesses had subscribed to or otherwised adopted the statements as their own.

Evidence And Argument That The Defendant Should Be Acquitted For Reasons Other Than The Evidence And The Law

Jury nullification is not a right belonging to the defendant. Jury nullification is not desirable and that trial judges should exercise their power to prevent it when possible. The USDC categorically rejected the idea that, in a society, committed to the rule of law, jury nullification is desirable or that courts may permit it to occur when it is within their authority to prevent. Accordingly, the Court granted the government’s motion to preclude defendant from introducing evidence and argument that she should be acquitted for reasons other than the evidence and the law.

ZALMA OPINION

The government, faced with a well represented counsel seeking to avoid conviction for health insurance fraud, with evidence that is inappropriate. To protect the government’s case and to reduce irrelevant and useless testimony, the blanket motion in limine was partially successful and the trial judge will rule on other evidentiary attempts during trial when the evidence can be reviewed. The jury in the case will appreciate the limitations on presentation of inappropriate evidence by the defense.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:09:08
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September 18, 2026
Expert May Only Testify to What Experience Supports

Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.

Posted on September 18, 2026 by Barry Zalma

See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html

In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.

The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.

Law

The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution

Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

00:05:14
November 13, 2026
Habeas Relief Requires Cognizable Responses to State Defenses

Claims of Res Judicata and Procedural Default Defeats Habeas

Post 5543

Posted on November 13, 2026 by Barry Zalma

A Health Insurance Fraud Conviction Rested On Knowingly Submitting Materially False Or Misleading Claim Information With Specific Intent To Defraud.

A Health Insurance Fraud Conviction Rested On Knowingly Submitting Materially False Or Misleading Claim Information With Specific Intent To Defraud.

In Tariq Mustafa Abdulaziz v. Commissioner Of Correction, No. CV 26-5002432-S, Superior Court of Connecticut, Judicial District of Tolland, Habeas Docket (October 29, 2026) Tariq Mustafa Abdulaziz submitted 114 claims for in-home, face-to-face services purportedly provided to thirty program participants during four one-week periods. The department paid Neurostrategies, Inc., $13,650.

FACTS

The defendant waived his right to a jury trial and elected a trial to the court, D'Addabbo, J. Trial occurred over the course of eight days in August, 2022. The state presented testimony from ten witnesses and introduced thirty-three exhibits into ...

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November 12, 2026
Common Interest Doctrine Protects Confidentiality

Theft of Confidential Information

Post 4581

Posted on November 12, 2026 by Barry Zalma

In People Center, Inc. v. Deel, Inc., et al., No. 25-cv-02576-CRB (LJC), United States District Court, N.D. California (November 7, 2026) People Center, doing business as Rippling, and Deel compete in payroll and human-resource management software. Rippling alleges that Deel and its executives recruited Rippling employee Keith O’Brien, based in Ireland, to disclose confidential information and trade secrets.
THE IRISH SUIT

Rippling sued O’Brien in Ireland and Deel in the United States. O’Brien subsequently retained separate counsel, supplied an affidavit describing the alleged espionage, and entered into a Cooperation Agreement with Rippling. In exchange for his cooperation, Rippling agreed to provide financial assistance, indemnification, and conditional dismissal of the Irish proceedings. The agreement also permitted renewed proceedings or a monetary judgment upon a material breach.

The Irish proceedings against O’Brien were dismissed...

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November 11, 2026
After Dismissal Fraud Victim May Amend Complaint After Dismissal

A Proposed Amended Complaint That Includes New Factual Allegations to Remedy Pleading Deficiencies

Posted on November 11, 2026 by Barry Zalma
After Dismissal Fraud Victim May Amend Complaint After Dismissal
Post 4580

If A Proposed Amendment Is Not Clearly Futile, Then Denial Of Leave To Amend Is Improper

In John Hancock Life & Health Insurance Company v. Caring Connections LLC, Arthur Feldheim, and Blime a/k/a Vera Feldheim, Civ. No. 25-7574 (MAS)(JBD), United States District Court, D. New Jersey (November 6, 2026) John Hancock sued Caring Connections LLC, Arthur Feldheim, and Blime a/k/a Vera Feldheim on June 5, 2025, asserting thirteen claims, including fraud, breach of contract, and aiding and abetting fraud.

On March 26, 2026, this Court entered an order granting Caring Connections’ motion to dismiss and granting in part and denying in part the Feldheims’ motion to dismiss. The dismissed claims were dismissed without prejudice, and John Hancock timely sought leave to amend.

They also argued that the New ...

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