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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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Zalma’s Insurance Fraud Letter – August 15, 2025

Zalma’s Insurance Fraud Letter – August 15, 2025
Posted on August 15, 2025 by Barry Zalma

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

ZIFL Volume 29, Issue 16

Post 5169

Read the full article at https://lnkd.in/gRvKMemX, See the full video at https://lnkd.in/gKmEeN7f and at https://lnkd.in/gV687Vt9, at https://zalma.com/blog and at at https://lnkd.in/g-VHDaev.

See the full video at https://lnkd.in/gKmEeN7f and at https://lnkd.in/gV687Vt9

Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication. It is provided FREE to anyone who visits the site at https://lnkd.in/gVT5G9s

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

Subscribe to the e-mail Version of ZIFL, it’s Free!
Post 5169

See the full video at and at

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...

00:10:37
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August 14, 2025
Appraisal Award Sets Amount of Loss

Award Signed by Two of Three Appraisers Binding on Insured and Insurer

Post 5168

See the full video at https://rumble.com/v6xj16m-appraisal-award-sets-amount-of-loss.html and at https://youtu.be/XBy4m31c0AM, and at https://zalma.com/blog plus more than 5150 posts.Dispute Over Extent of Damages is not Bad Faith

Kelly Mallady filed a lawsuit against Homeowners of America Insurance Company due to damages sustained from a nearby explosion in January 2020 that the insurer rejected in part.

In Kelly Mallady v. Homeowners Of America Insurance Company, No. 14-24-00147-CV, Court of Appeals of Texas, Fourteenth District (August 7, 2025) resolution was obtained of the disputes.

CASE BACKGROUND:

1 Mallady’s homeowners insurance policy was effective from September 15, 2019, to September 15, 2020 .
2 The initial claim was acknowledged, and an independent adjuster estimated the property damage to be $13,014.79, covering only the dwelling and fence.
3 Mallady invoked appraisal, demanding $247,860.40 for property and contents damages, plus...

00:07:13
August 13, 2025
Duty to Defend is Broad but not Unlimited

Exclusions Defeat Claim for Defense & Indemnity

Genuine Dispute Dispels Claim of Bad Faith

Post 5167

See the full video at https://lnkd.in/gvGAeT7t and at https://lnkd.in/gh67UEyB.

In Diversified Restaurant Group, LLC, et al. v. Houston Casualty Company, et al., No. 25-cv-02344-EMC, United States District Court, N.D. California (July 31, 2025) Diversified Restaurant Group, LLC (DRG) and Golden Gate Bell, LLC (GGB) sued Houston Casualty Company (HCC), Pennsylvania Manufacturers Indemnity Company (PMIC), and Manufacturer’s Alliance Insurance Company (MAIC) around the denial of insurance coverage for a lawsuit filed by a former employee who alleged sexual harassment and assault by a supervisor.
Insurance Policies and Denial of Coverage:

DRG and GGB had insurance policies with PMIC and MAIC, which included general liability, workers’ compensation, and employer’s liability coverage. Both PMIC and MAIC denied coverage for the underlying lawsuit, citing various exclusions in their policies.

Exclusions:

The PMIC policy ...

00:08:51
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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