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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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August 11, 2025
Sovereign Immunity Prevents Suit Against USA

Chutzpah: After Criminal Prosecution Defendant Sues USA
Post 5164

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Dr. Segun Patrick Adeoye, a medical doctor, filed a lawsuit against the United States of America, seeking damages for alleged violations during his criminal prosecution. He was acquitted by a jury but claims to have suffered significant harm, including financial losses, damage to his professional reputation, and personal distress.

In Dr. Segun Patrick Adeoye v. The United States Of America, Civil Action No. 4:25-cv-83, United States District Court, E.D. Texas, Sherman Division (July 23, 2025) the USDC dismissed Adeoye’s suit.

FACTUAL BACKGROUND

Dr. Adeoye was indicted on charges of conspiracy to commit wire fraud and money laundering. The indictment alleged that he and his co-conspirators obtained at least seventeen million dollars through various fraudulent schemes. Despite being acquitted, Dr. Adeoye claims that his prosecution caused him ongoing harm.

PROCEDURAL BACKGROUND

Dr. Adeoye’s complaint asserts three causes of action:

1. Violation of Due Process: Adeoye claims his due process rights were violated due to wrongful detention, lack of legal safeguards, and delays in his trial.

2. Violation of the Speedy Trial Act: Adeoye alleges unnecessary procedural delays caused by the government’s failure to advance the case.

3. Negligence: Adeoye asserts that the government was negligent in investigating the charges, delaying access to legal counsel, and not advancing the case in a reasonable time frame.

ANALYSIS

The court’s analysis focused on the government’s motion to dismiss, arguing that Dr. Adeoye’s claims were barred by sovereign immunity. The court agreed with the government, stating that the United States had not consented to being sued for the type of constitutional tort claims Dr. Adeoye seeks. The court also found that Dr. Adeoye’s claims under the Speedy Trial Act and negligence are not cognizable under the Federal Tort Claims Act (FTCA) due to lack of exhaustion of administrative remedies.

A Rule 12(b)(6) motion allows a party to move for dismissal of an action when the complaint fails to state a claim upon which relief can be granted. When considering a motion to dismiss under Rule 12(b)(6), the Court must accept as true all well-pleaded facts in the plaintiff’s complaint and view those facts in the light most favorable to the plaintiff. The Court may consider the complaint, any documents attached to the complaint, and any documents attached to the motion to dismiss that are central to the claim and referenced by the complaint. The Court must then determine whether the complaint states a claim for relief that is plausible on its face.

The Government argues that Rule 12(b)(1) bars Plaintiff’s claims. That is because, according to the Government, each of Plaintiff’s claims are barred under sovereign immunity. Before the Court can proceed any further, it must ensure that sovereign immunity does not prevent it from presiding over the case.

Because Plaintiff’s Complaint seeks to assert a claim under the civil rights statutes and the United States has not consented to suits for such claims, Plaintiff’s claim here is barred by sovereign immunity.

Fundamentally, Plaintiff’s Complaint is also deficient because it mentioned no individual connected to the conduct complained of at all.

Plaintiff’s Speedy Trial Act Claim

The only remedy for a violation of the STA is dismissal of an indictment. Plaintiff’s Complaint does not present any theory of recovery under the STA that would allow the Court to engage with it any further. Plaintiff has not carried his burden here. He has not even attempted to demonstrate that his STA cause of action is in exact compliance with the terms of a statute under which the sovereign has consented to be sued. Thus, Plaintiff’s STA claim must be dismissed.

Even if sovereign immunity did not apply, the Court would nonetheless dismiss each of Plaintiff’s claims under Rule 12(b)(6). Plaintiff’s Complaint is wholly deficient and borders on frivolous.

CONCLUSION

The court granted the United States’ motion to dismiss, dismissing Dr. Adeoye’s § 1983 and Speedy Trial Act claims with prejudice and his FTCA claim without prejudice.

ZALMA OPINION

Health insurance fraud is a serious crime. Dr. Adeoye was indicted as part of a multi-million dollar fraud scheme. The case went to trial and Dr. Adeoye was acquitted because the USA failed to convince the jury of his crimes beyond a reasonable doubt. Dr. Adeoye sued the government without first presenting the claim and without complying with the tort claims act resulting in the government’s motion to dismiss the suit based on sovereign immunity.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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9 hours ago
Duty to Defend is Broad but not Unlimited

Exclusions Defeat Claim for Defense & Indemnity

Genuine Dispute Dispels Claim of Bad Faith

Post 5167

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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
August 12, 2025
Fraud Cannot Obtain Insurance to Pay the Victims

Coverage for Fraud Encourages Crime

Post 5166

Posted on August 12, 2025 by Barry Zalma

See the full video at and at

Tandem Fund II, L.P. (“Tandem”) a venture capital firm, provided loans to Cuff, Inc. (“Cuff”), a startup company. Cuff failed as a business, and Tandem was never repaid on the loans. Tandem assigned the loans to Bijoux Corp. (“Bijoux”), which then initiated arbitration against Cuff and its CEO, Deepa Sood, for intentional misrepresentation and fraudulent concealment. The arbitration panel ruled in favor of Bijoux, awarding damages against Cuff and Sood.

In Tandem Fund II, L.P. v. Scottsdale Insurance Company, No. 23-16187, United States Court of Appeals, Ninth Circuit (August 4, 2025) Scottsdale argued that the award was uninsurable under California law, which prohibits insurance coverage for restitution of wrongfully acquired funds. The district court agreed with ...

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August 11, 2025
Piecemeal Litigation is Inefficient and Risks Inconsistent Judgments

Interrelated Acts Constitute a Single Claim
Post 5165

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In Yonah Rothman v. Complete Packaging & Shipping Supplies, Inc. and Mitchell Mankosa, Complete Packaging & Shipping Supplies, Inc. v. Arch Insurance Company, No. 22-CV-2821-SJB-ST, United States District Court, E.D. New York (August 4, 2025) dealt with the issue of parties seeking a partial judgment to be resolved on appeal.

Complete Packaging & Shipping Supplies, Inc. (“Complete”) and Arch Insurance Company (“Arch”) litigated disputes about coverage in relation to the Rothman employment discrimination action.

THE KEY ISSUES

Background:

Yonah Rothman filed a lawsuit against Complete and Mitchell Mankosa, alleging employment discrimination, underpayment, and wrongful termination. Rothman claims he was retaliated against for participating in a separate lawsuit brought by another employee.
Insurance Coverage Dispute:

Complete ...

00:08:27
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

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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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