The Only Solution to Fraud is to Take the Profit Out of the Crime
It Takes Courage to Fight the Fraudster
Post number 5395
Posted on July 16, 2026 by Barry Zalma
In Vivian Maritza Triana Marin, Sebastian Arroyave Penagos, and Daniel Arroyave Penagos v. Marc J. Paynter and Transport Marc Paynter Inc., No. 23-CV-6498, United States District Court, E.D. New York (July 10, 2026) Plaintiffs sued Defendants in diversity after a rear-end collision on the Whitestone Expressway in Queens, New York. Plaintiffs were in a Subaru driven by Vivian Maritza Triana Marin, while Defendant Marc J. Paynter drove a Transport Marc Paynter Inc. tractor-trailer.
Facts:
Dashcam footage from Defendants’ vehicle showed Plaintiffs’ vehicle braking suddenly in the left lane despite an open roadway ahead. Marin could not identify a specific reason for braking, the passenger plaintiffs did not know why she braked, and a non-party witness testified that Plaintiffs’ vehicle stopped abruptly for no apparent reason.
The Accident occurred when Defendants’ vehicle contacted the rear bumper of Plaintiffs’ vehicle. Marin testified that she was traveling at the posted speed limit of fifty-five miles per hour prior to the Accident, and that she decelerated by removing her foot from the accelerator prior to impact. Plaintiffs allege that Defendants’ vehicle was “overtaking cars on the right while remaining in the left lane. Defendants acknowledge that Defendants’ vehicle was in the left lane but contend that the Video shows that other vehicles were passing Defendants’ vehicle on the right.
On March 21, 2024, Plaintiffs’ no-fault insurance carrier, LM General Insurance Company, also known as “Liberty Mutual,” filed an action in the Supreme Court of the State of New York, Nassau County, against Plaintiffs and Plaintiffs’ healthcare providers, seeking a declaratory judgment that the Accident was “not the product of a covered event as it was the product of staged and/or intentional event,” which was “perpetrated by [Plaintiffs] with the intent to obtain insurance benefits that [Plaintiffs] would not otherwise be entitled to receive.”
The prior no-fault litigation and arbitration proceedings involved allegations that the accident was staged, even though Plaintiffs were discontinued from the state action without prejudice and were not parties to the arbitrations.
LAW:
Summary judgment is proper where there is no genuine dispute of material fact and the movant is entitled to judgment as a matter of law. Reliable video evidence may control over a party’s contrary version of events when the recording blatantly contradicts that version. For fraud under New York law, Defendants had to establish material misrepresentation or omission, knowledge of falsity, intent to induce reliance, justifiable reliance, and damages by clear and convincing evidence.
DISCUSSION:
The court found the dashcam video dispositive on liability.
It showed Defendants’ tractor-trailer maintaining a steady and safe distance for approximately thirty-five seconds before Plaintiffs’ vehicle suddenly braked with no vehicle, obstruction, pothole, construction, or other hazard ahead.
Plaintiffs’ explanations were speculative, while the video and witness testimony supported Defendants’ position that the unexplained stop caused the accident. The court rejected Plaintiffs’ arguments that Defendants failed to maintain a safe distance or improperly used the left lane, finding no causal violation sufficient to impose liability on Defendants.
ANALYSIS:
Because the undisputed video evidence eliminated any reasonable inference that Defendants caused the collision, the court held that Plaintiffs’ vehicle was the sole proximate cause of the accident.
Liability was resolved in Defendants’ favor and made it unnecessary to address Defendants’ alternative argument that Plaintiffs failed to satisfy New York’s serious-injury threshold. However, the fraud counterclaim survived because the prior state action and no-fault arbitration decisions had no preclusive effect against Plaintiffs, and Defendants did not adequately establish each fraud element on summary judgment.
CONCLUSION:
Plaintiffs’ motion for summary judgment on liability was denied. Defendants’ motion for summary judgment on liability was granted.
Defendants’ motion for summary judgment on the fraud counterclaim was denied, leaving that counterclaim for trial.
ZALMA OPINION
The swoop and squat is a type of insurance fraud where the driver of the fraudster’s car stops suddenly in front of an 18 Wheeler assuming it is insured and then making fake bodily injury claims. Plaintiffs sued Defendants in diversity after a rear-end collision on the Whitestone Expressway in Queens, New York. Plaintiffs attempted fraud by stopping in the middle of a highway in front of Marc J. Paynter’stractor-trailer. He fought and counterclaimed for damages. The trial will decide if Paynter can prove the fraud and get damages from the criminals.
(c) 2026 Barry Zalma & ClaimSchool, Inc.
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Policy Limits Demand Accepted Settles Claim
Post 5434
Posted on August 26, 2026 by Barry Zalma
See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute
In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange, The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.
FACTUAL BACKGROUND
Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.
Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...
Policy Limits Demand Accepted Settles Claim
Post 5434
Posted on August 26, 2026 by Barry Zalma
See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute
In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange, The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.
FACTUAL BACKGROUND
Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.
Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...
The Largest Residential Burglary of All Time
Post 5407
Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma
See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.
This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.
After ...
Insurance Requires Fortuity to be an Insured Risk
Post 5485
Posted on September 8, 2026 by Barry Zalma
In Industrial Park Center, LLC, doing business as Mainspring Capital Group v. Great Northern Insurance Company, a foreign insurer, No. CV-25-0330-CQ, Supreme Court of Arizona (September 1, 2026).
The United States Court of Appeals for the Ninth Circuit certified the following question to this Court:
"Is damage to property a “fortuitous” loss when, based on the insured’s knowledge at the time the insurance policy issued, it was reasonably foreseeable that such damage was almost certain to occur if certain preventative measures were not taken?"
FACTUAL BACKGROUND
Mainspring owned commercial property leased to Star Fisheries for decades. Star Fisheries’ use of water and salt allegedly caused structural damage over time. In 2010, Mainspring learned of damage and made some repairs but did not implement all recommended preventive measures. In 2021–2022, additional similar structural damage was discovered, and ...
Qui Tam Relators are not officers of the United States
Posted on September 4, 2026 by Barry Zalma
Attempt to use Constitution to Stop a Qui Tam False Claims Act Case
Post 5486
FCA’s Qui Tam Provisions do not Violate the Appointments Clause.
In United States Of America, Clarissa Zafirov, ex rel; Dr. v. Florida Medical Associates, LLC, d.b.a. Vipcare, Physician Partners, LLC, Anion Technologies, LLC, Freedom Health, Inc., Optimum Healthcare, Inc., Physician Partners Specialty Services, LLC, et al., No. 24-13581, United States Court of Appeals, Eleventh Circuit (September 1, 2026).
The False Claims Act (“FCA”) allows the Attorney General to bring civil suits against perpetrators of fraud against the government. This case involves another portion of the FCA-the qui tam provisions-which allow people, called relators, who have knowledge about fraud against the government to pursue a case against the perpetrator of the fraud.
Dr. Clarissa Zafirov filed a qui tam action under the False Claims Act on behalf of...
Posted on September 3, 2026 by Barry Zalma
You Only Get One Chance to Sue
Post 5484
In David Cromp v. Johnny Harkrider, Monique Harkrider, and their Marital Community, dba Able Plumbing Plus, No. 61678-5-II, Court of Appeals of Washington, Division 2 (August 25, 2026) David Cromp hired Able Plumbing Plus in 2018 to install plumbing, including two toilets, at his residence. In 2019, both toilets allegedly leaked, causing damage. Insurance claims were submitted through Able’s contractor policy, but the insurer eventually denied the claims.
Cromp sued Able in 2022 for breach of contract based on the allegedly defective toilet installation. During that case, Cromp attempted to add claims related to Able’s conduct during the insurance claim process, including fraud, bad faith, tortious conduct, and bond-related claims, but the superior court denied leave to amend. The 2022 breach-of-contract claim was later dismissed with prejudice on summary judgment as time-barred.
On the same day the 2022 case was dismissed, Cromp filed a ...
