Refusal to Provide Workers’ Compensation is Expensive
Post 5240
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In Illinois Department of Insurance, Insurance Compliance Department v.USA Water And Fire Restoration, Inc., And Nicholas Pacella, Individually And As Officer, Nos. 23WC021808, 18INC00228, No. 25IWCC0467, the Illinois Department of Insurance (Petitioner) initiated an investigation after the Injured Workers’ Benefit Fund (IWBF) was added to a pending workers’ compensation claim. The claim alleged a work-related injury during employment with the Respondents who failed to maintain workers’ compensation Insurance.
Company Overview:
USA Water & Fire Restoration, Inc. was incorporated on January 17, 2014, and dissolved on June 14, 2019, for failure to file annual reports and pay franchise taxes. It then operated under assumed names including USA Board Up & Glass Co. and USA Plumbing and Sewer. The business involved rehabilitating structures damaged by fire or water (e.g., remodeling, repairs), subjecting it to automatic coverage under the Illinois Workers’ Compensation Act (Act).
Officers/Agents:
Tad Christensen (who was later identified as the true officer) had a history of fraud (e.g., 2005 insurance fraud charges under Action Fire Restoration; prior imprisonment). The Commission took judicial notice of Christensen’s criminal history.
Employee Evidence:
Illinois Department of Employment Security (IDES) quarterly wage reports showed employees (up to 6) from Feb. 2016–Aug. 2017 and Oct. 2017–Apr. 2018; zero reported in Sep. 2017. Illinois Department of Revenue records confirmed business activity (e.g., 2017 tax return signed by Christensen) but incomplete filings.
Violation Periods:
145 total days without coverage while doing business and employing workers.
Key Testimonies
Antonio Smith (Petitioner Investigator, 8 years experience) confirmed company’s subjection to Act; that there was no insurance during violation periods.
Summary of Law - Jurisdiction and Coverage
Section 3(1) of the Act (820 ILCS 305/3):
Automatically subjects employers to the Act if engaged in “erection, maintaining, removing, remodeling, altering or demolishing of any structure.” The company’s fire/water restoration (remodeling damaged structures) qualified.
Section 4(a) of the Act (820 ILCS 305/4(a)):
Requires all covered employers to secure workers’ compensation coverage via insurance or Commission-approved self-insurance.
Penalties and Culpability
Section 4(d) of the Act (820 ILCS 305/4(d)): For knowing/willful failure to comply with §4(a):
1. Civil penalty up to $500 per day per violation (post-1989 amendments).
2. Minimum $10,000.
3. Each day is a separate offense.
4. Personal liability for corporate officers/directors (e.g., Christensen) if they knowingly/willfully failed; primary liability on employer, secondary on officers if unpaid after 30 days.
Penalty Factors
1. Duration of violation (here: 145 days—significant but not continuous).
2. Number of claims (1 pending).
3. Prior awareness.
4. Number of employees (up to 6).
5. Ability to secure/pay coverage (no evidence of inability).
6. Mitigating circumstances (none alleged; intermittent prior coverage noted in mitigation).
7. Ability to pay penalty (no evidence presented).
Decision and Rationale
Findings:
The Company and Christensen knowingly/willfully violated §4(a) and Rule 9100.90 during 145 days (employees present, business active, no coverage/self-insurance). Violation was “knowing/willful” by inference from ignored notices, history of lapses, and non-appearance.
Penalty Assessed:
Maximum $500/day × 145 days = $72,500 against USA Water & Fire Restoration, Inc., and Tad Christensen (personally as officer). Exceeds minimum $10,000; justified by duration, claim, and awareness, tempered slightly by non-continuous lapses.
Enforcement:
Payable within 30 days by certified check/money order to Commission. Enforceable as circuit court judgment; judicial review per §19(f) of Act (bond fixed at $75,000). Debt owed to State.
ZALMA OPINION
Workers’ Compensation systems allow injured workers to obtain compensation for work related injuries without needing to prove anyone was responsible for the injury. It is a crime in almost every state to fail to report accurately employees for workers’ compensation insurance and a failure to provide any coverage requires punishment.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Formulaic Recitation Of The Elements Of Civil Conspiracy Are Insufficient
Post number 5320
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In Hassan Fayad v. Liberty Mutual Insurance Company, et al., No. 2:25-cv-10930, United States District Court, E.D. Michigan, Southern Division (March 24, 2026) Plaintiff Hassan Fayad, the owner of several businesses providing transportation, diagnostics, testing, and therapy services, regularly billed insurance companies for these services, was arrested and tried for fraud, convicted, had the conviction overruled and sued the insurers and prosecutors he found responsible.
FACTUAL BACKGROUND
By January 2020, Liberty Mutual, Progressive, Allstate, and Esurance suspected fraudulent activity and filed a complaint with the Michigan Department of Attorney General (MDAG). The insurers alleged that Fayad and others billed Michigan auto insurance policies for profit without actually providing medically ...
Federal Courts Have Limited Jurisdiction
When all Parties Refuse Removal There is No Jurisdiction
Post number 5319
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In Beth Mayhew and Matthew Mayhew v. Vladimir Sadovyh, et al., No. 2:26-CV-04029-WJE, United States District Court, W.D. Missouri (April 6, 2026) Mayhew was involved in a trailer-truck accident with Vladimir Sadovyh, who was employed by Nova First, LLC and Globex Transport, Inc. Both companies owned the tractor-trailer involved.
FACTUAL BACKGROUND
Chubb and Mohave Transportation Insurance Company jointly issued an insurance policy covering Nova First, Globex, and Sadovyh, with EMA Risk Services acting as a third-party administrator.
Beth Mayhew sued Nova First, Globex, and Sadovyh for negligence in Missouri state court, and following a jury trial, a nuclear judgment was awarded to the Mayhews totaling ...
Ordinary Negligence is What Medical Professi0nal Liability Insures
Post number 5319
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Sexual Conduct Exclusion Doesn’t Apply When Doctor Negligently Uses His Own Sperm
In Integris Insurance Company v. Narendra B. Tohan, No. AC 47222, Court of Appeals of Connecticut (April 7, 2026) Integris Insurance Company, a medical professional liability insurer, initiated a declaratory action to determine its duty to defend and indemnify Narendra B. Tohan, a physician licensed in Connecticut, in a separate negligence action alleging medical misconduct.
FACTUAL BACKGROUND
In 2019, Kayla Suprynowicz and Reilly Flaherty (civil action plaintiffs), who were strangers for most of their lives, discovered through a genetic testing company that they are half siblings.
INSURANCE POLICY
The policy defines “Professional Services” in relevant part as “any professional medical services within the ...
ZIFL – Volume 30, Issue 7 – April 1, 2026
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post number 5314
Posted on April 1, 2026 by Barry Zalma
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th 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/ This issue contains the following articles about insurance fraud:
No One is Above the Law – Not Even a Police Officer
Police Officer Convicted for Fraud in Reporting an Accident Affirmed
Police Officer Should never Lie about Results of Chase
In State Of Ohio v. Anthony Holmes, No. 115123, 2026-Ohio-736, Court of Appeals of Ohio, Eighth District, Cuyahoga (March 5, 2026) a police officer appealed criminal conviction as a result of lies about a high speed chase.
Read the following article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-04-01-2026-1.pdf...
ZIFL – Volume 30, Issue 7 – April 1, 2026
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post number 5314
Posted on April 1, 2026 by Barry Zalma
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th 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/ This issue contains the following articles about insurance fraud:
No One is Above the Law – Not Even a Police Officer
Police Officer Convicted for Fraud in Reporting an Accident Affirmed
Police Officer Should never Lie about Results of Chase
In State Of Ohio v. Anthony Holmes, No. 115123, 2026-Ohio-736, Court of Appeals of Ohio, Eighth District, Cuyahoga (March 5, 2026) a police officer appealed criminal conviction as a result of lies about a high speed chase.
Read the following article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-04-01-2026-1.pdf...
Posted on March 30, 2026 by Barry Zalma
Insurance Fraud, a Way to Reduce Violent Crime
Post number 5313
A Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story helps to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.
She Taught Her Customers The Swoop And Squat:
Recently the California Insurance Department’s Fraud Division arrested a young woman in Los Angeles County for operating an insurance fraud school. She advertised her classes in the “Penny Saver” an advertising sheet distributed free to the public and a print version of Facebook, X Craig’s list. She had operated for several years teaching methods of committing automobile insurance fraud. Only after a police officer enrolled in one of her classes was she arrested.
Her defense ...