No-Fault Insurance Anti-Fraud Litigation: A Practitioner's Guide

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No-fault insurance fraud amounts to a significant fraud tax on consumers, estimated at billions of dollars each year. Residents in states where no-fault insurance fraud is endemic have experienced large increases in their automobile insurance premiums. For example, in 2011, Florida residents paid nearly $58 per vehicle as the result of no-fault insurance fraud, and in New York, policyholders paid the equivalent of $229,000,000 in increased automobile insurance policies due to this fraud. Currently, twelve states have a no-fault law (FL, HI, KS, KN, MA, MI, MN, ND, NJ, NY, PA, and UT), and while there are considerable variations among the no-fault laws in each of these states, they can broadly be classified by the degree to which the respective systems permit or abolish tort liability, and the type of threshold an injured party must meet before tort liability is permitted.

Against this backdrop, automobile insurance companies have been the primary actors in the fight against no-fault fraud, engaging in civil litigation against no-fault insurance fraud rings. Written by practitioners who have litigated hundreds of no-fault anti-fraud cases, this is a practice-focused, general guide to no-fault insurance anti-fraud litigation from the perspective of a plaintiff-insurer, from inception of the case through to summary judgment.

Although most lawsuits are resolved through settlement or dispositive motion practice, thorough preparation of the case for trial is critical. The authors provide clear guidance on how to identify corporate structure fraud as well as fraud involving medically unnecessary services, kickbacks, or illusory services. Further chapters address the critical issues involved once an anti-fraud insurance case is initiated, including selecting the defendants and the venue, preparing the complaint, motions to dismiss, counterclaims, discovery, provisional remedies, and settlements, summary judgments, and trial.

Author Bio

Max Gershenoff is a partner at the law firm of Rivkin Radler, LLP located in Uniondale, New York. Mr. Gershenoff specializes in complex insurance fraud litigation and helps automobile insurers prosecute and defend civil lawsuits under the federal Racketeer Influenced and Corrupt Organizations (RICO) Act in courts throughout the 2nd and 3rd Circuits. Mr. Gershenoff prosecutes affirmative actions to recover insurer claim payments to physicians, medical clinics, attorneys, public adjusters, and others involved in complex, large scale insurance fraud schemes. He also represents insurers in the defense of litigation challenging claims-handling practices, counsels insurers on claims-handling practices and investigation techniques, and works with insurers to develop fraud prevention, detection, and recovery plans. His efforts have helped create a significant body of legal authority supporting the use of civil RICO to combat insurance fraud. In addition, Mr. Gershenoff has published several articles on civil RICO pleading requirements and on privacy issues in the context of insurer record retention requirements. Most recently, he co-authored No-Fault Insurance Anti-Fraud Litigation: A Practitioners Guide which was published by the American Bar Association in 2017. http://www.rivkinradler.com/attorneys/max-gershenoff/ Barry I. Levy, Esq., has been lead counsel in hundreds of complexinsurance fraud cases, including many suits to recover claim paymentsto physicians, medical clinics, attorneys, public adjusters, and othersinvolved in insurance fraud schemes. Mr. Levy also counsels healthcare,automobile, property, fidelity, and life insurers on claims handlingpractices and investigation techniques and the development of ffraud prevention, detection, and recovery plans. He also representsinsurers in the defense of litigation challenging claims-handlingpractices. Mr. Levy received his B.A. degree from the Ohio State Universityand his law degree from the Ohio State University Collegeof Law.