Zalma on Insurance
Education • Business
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.
Interested? Want to learn more about the community?
July 14, 2026
Suit Needs Article III Standing

Data Breach Requires Plaintiff’s Own Information was Missued

Post number 5394

The Dismissal Based on Lips’s Failure to Plead Injury in Fact,

Posted on July 14, 2026 by Barry Zalma

Read the full article at https://lnkd.in/gDQZc5vP and at https://zalma.com/blog plus more than 5350 posts.

In Danielle Lips, on behaf of hersef and all others similarly situated v. ACCU Reference Medical Lab, LLC, Civil Action No. 25-13642 (SDW) (CF), United States District Court, D. New Jersey (June 24, 2026) a data-breach class action, the District of New Jersey granted Accu Reference Medical Lab, LLC’s motion to dismiss because Plaintiff Danielle Lips failed to plead Article III standing.

FACTS:

Lips alleged that ACCU, a medical testing laboratory, obtained her personally identifiable information and protected health information through diagnostic testing ordered by her former physician. She claimed the Qilin ransomware group stole ACCU’s data and posted screenshots containing some patients’ unredacted information on the dark web. Lips alleged increased risk of identity theft, future mitigation expenses, lost time, annoyance, and diminution in the value of her information.

LAW:

A plaintiff must establish Article III standing by pleading injury in fact, causation, and redressability. In data-breach cases, courts assess whether the breach was intentional, whether the data was misused, and whether the type of information accessed could create a risk of identity theft. A plaintiff seeking damages based on future risk must allege not only a substantial risk of harm but also additional, currently felt concrete harms.

DISCUSSION:

Rule 12(b)(1) permits a party to bring a motion to dismiss for lack of subject matter jurisdiction. Fed.R.Civ.P. 12(b)(1). The Rule permits a party to assert either a facial or factual challenge. A facial attack challenges subject matter jurisdiction without disputing the facts alleged in the complaint, and it requires the court to consider the allegations of the complaint as true. A factual challenge attacks the factual allegations underlying the complaint’s assertion of jurisdiction, either through the filing of an answer or otherwise presenting competing facts.

The court found the attack was allegedly intentional because a known ransomware group exfiltrated data and posted screenshots, and the information allegedly exposed — such as Social Security numbers, dates of birth, insurance information, and health information — was sensitive enough to create identity-theft risk. However, the court held that Lips did not adequately plead misuse because she did not allege that her own information was posted on the dark web, identify which of her information was leaked, or allege fraudulent charges, unauthorized accounts, increased spam, or comparable misuse.

ANALYSIS:

An injury in fact is an invasion of a legally protected interest that is concrete and particularized, and actual or imminent, not conjectural or hypothetical. Where the threatened injury is certainly impending or there is a substantial risk that the harm will occur, allegations of future harm will suffice.

The court’s decision turned on the gap between a generalized breach allegation and a plaintiff-specific injury. The court treated the alleged posting of some patients’ data as insufficient without facts tying the disclosure or misuse to Lips personally.

Because Lips did not plead a substantial risk of future harm plus additional concrete present harms, she lacked standing for both injunctive relief and damages.

CONCLUSION:

The court granted Accu’s motion to dismiss under Rule 12(b)(1) for lack of subject-matter jurisdiction. The dismissal was based on Lips’s failure to plead injury in fact, and the court declined to reach Rule 12(b)(6) arguments. Because dismissals for lack of standing generally should not be with prejudice, the court allowed Lips an opportunity to amend.

ZALMA OPINION

Although the alleged ransomware attack was intentional and involved information that could create a risk of identity theft, the complaint did not allege that Lips’s own information was posted, misused, or tied to concrete present harms. Standing and an actual injury is required to sustain a law suit. There was clearly a potential of damage to Lips but it was only a potential. A potential for damage does not support litigation and the suit failed.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

Subscribe to my substack at https://gbarryzalma.substack.com/subscribe

Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://Cwww.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the InsuranceClaims Library – https://lnkd.in/gwEYk.

post photo preview
Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
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
23 hours ago
Restitution Sentence Affirmed

Psychiatrist Who Was Convicted of Fraud Asked the First Circuit to Reduce his Punishment
Post 4851

Posted on September 24, 2026 by Barry Zalma

Fraud to Private and Public Health Insurers Doesn’t Pay

In United States v. Gustavo Kinrys, Nos. 24-1592, 24-1716, United States Court of Appeals, First Circuit (September 21, 2026) Gustavo Kinrys, a Massachusetts psychiatrist, submitted fraudulent claims to private and public health insurers from 2015 through 2018, including bills for more than 1,000 sessions when he or the purported patient was outside the country. When insurers requested supporting records, he delayed through a fictitious office manager and created false documentation.

A jury convicted Kinrys on fourteen counts. The district court imposed a 99-month sentence, calculated intended loss at slightly more than $19 million based on billed amounts, ordered $6,537,309.59 in restitution, and ordered $6,527,391.19 in forfeiture.

At sentencing, the district court calculated Kinrys’s base offense level to be ...

post photo preview
September 23, 2026
Payment and Performance Bonds Are Not Designed to Profit from Failure to Perform

The Collateral-Source Rule is a Narrow Exception to the Prohibition Against Double Recovery

Post 4850

Posted on September 23, 2026 by Barry Zalma

A Surety Stands In The Principal’s Shoes And May Assert The Principal’s Defenses.

In Hudson Insurance Company v. Archer Western Federal, JV, No. 1:24-cv-544 (PTG/IDD), United States District Court, E.D. Virginia, Alexandria Division (September 18, 2026) Archer Western Federal, JV (“AWF”), the prime contractor for a new fire station at Marine Corps Base Quantico, subcontracted roofing work to Eastern General Contractor, Inc. (“EGC”) for $456,330.

Hudson Insurance Company (“Hudson”) issued payment and performance bonds, each with a $456,330 penal sum.

AWF later sought recovery under both bonds.

LAW

Under Virginia law, the collateral-source rule is a narrow exception to the prohibition against double recovery. A surety stands in the principal’s shoes and may assert the principal’s defenses. Liability under the bonds required EGC’s ...

post photo preview
September 22, 2026
Fraudsters May Not Enjoin Suit Alleging Fraudulent PIP Claims

Defendants May Not Enjoin a Suit Alleging They Defrauded the Plaintiffs

Plaintiffs, automobile insurers, sued medical professionals and healthcare entities, alleging a scheme to submit fraudulent personal injury protection (PIP) bills and supporting documentation for services that were not performed or were medically unnecessary. The complaint asserted common-law fraud, violations of the New Jersey Insurance Fraud Prevention Act (IFPA), aiding and abetting fraud, unjust enrichment, and declaratory relief.

While the action was pending, Plaintiffs moved to stay and enjoin related PIP arbitrations. A magistrate judge recommended denial. in State Farm Guaranty Insurance Company v. Tri-County Chiropractic And Rehabilitation Center P.C., Civil Action No. 22-4852, United States District Court, D. New Jersey (September 15, 2026)

After the New Jersey Supreme Court decided Allstate New Jersey Insurance Company v. Carteret Comprehensive Medical Care, P.C., the federal court reopened the case and considered the parties’ supplemental...

post photo preview
See More
Available on mobile and TV devices
google store google store app store app store
google store google store app tv store app tv store amazon store amazon store roku store roku store
Powered by Locals