2d Circuit Majority and Concurring Opinions of Fraud and Sentencing

In United States v. Corsey , ___ F.3d ___, 2013 U.S. App. LEXIS 14897 (2d Cir. 2013), here free version , [ enhanced version available to lexis.com subscribers ], a per curiam decision, the Second Circuit opens its opinion: This appeal principally raises two issues: (1) whether the misrepresentations...

Health Insurance Fraud – Conviction Affirmed

Health Insurance Fraud is rampant. Most people convicted of health insurance fraud are doctors and other health care providers. Where most of the money goes, however, is to people taking advantage of free or subsidized health care benefits when they are not entitled to receive the benefits because there...

jail businessman cash in hand

Georgia Court Holds No Coverage For Embezzlement By Employee

In its recent decision in National Reimbursement Group Inc. v. Gemini Ins. Co ., 2013 U.S. Dist. LEXIS 118435 (M.D. Ga. Aug. 21, 2013) [ enhanced version available to lexis.com subscribers ], the United States District Court for the Middle District of Georgia had occasion to consider whether a company...

Caution: When State Corruption Becomes a Federal Crime

BY: CHARLES E. "CHUCK" JAMES, JR. With multiple state and federal investigations ongoing, all eyes are on Richmond, Virginia. Meanwhile, the Department of Justice continues to devote considerable resources to other allegations of bribery, corruption and fraud in local, state and federal...

Knowingly, Willfully and Materiality

In United States v. Phillips , ___ F.3d ___, 2013 U.S. App. LEXIS 18430 (7th Cir. 2013) (en banc), here , the Seventh Circuit reversed convictions under "18 U.S.C. § 1014 [ enhanced version available to lexis.com subscribers ], which criminalizes 'knowingly mak[ing] any false statement...

Insurance Fraud “Chutzpah” – No Mercy for Insurance Criminal

This case concerns the criminal conduct of the owner of an insurance business, formerly known as Associates Insurance Agency, Inc., owned and operated by the Defendant-Appellant, Tina Woods Butler , in Dyersburg, Tennessee. On February 13, 2012, the Dyer County Grand Jury returned a seventeen-count indictment...

Florida Court Holds Criminal Conduct Exclusion In E&O Policy Applicable

In its recent decision in Certain Interested Underwriters at Lloyd’s v. AXA Equitable Life Insurance Company , 2013 U.S. Dist. LEXIS 159639 (S.D. Fla. Nov. 7, 2013) [ enhanced version available to lexis.com subscribers ], the United States District Court for the Southern District of Florida had...

Orlando Attorney Charged With Stealing Personal Injury Settlement Money

Orlando Attorney Raymond (Ramon) Ismael Melendez of the Melendez Law Firm, P.A.has been arrested for allegedly stealing insurance settlement proceeds totaling nearly $80,000 from three personal injury clients. The charges allege that between February 2011 and June 2012, Melendez withheld notification...

Fraud Proved – Lie About Cause Of Fire Sufficient to Support Guilty Verdict

Arson for profit is a difficult crime to prove. The prosecution must both prove that the fire was intentionally set and that the owner and person insured caused the fire with the intent to defraud the insurer. Insurance fraud, on the other hand, is fairly easy to prove. The case below is evidence that...

California Attorney Convicted of Using Paid Recruiters to Prey on Accident Victims

Attorney Walter Martinez has pled guilty to 43 felony counts of using cappers (recruiters paid from victims' insurance settlement) to get clients for his practice. Martinez ran this scheme with at least three cappers. Martinez was sentenced to 365 days in jail on December 19, 2013, followed by three...

Real Estate Business Owners And Title Company Executive Indicted In Multi-Million Dollar Mortgage Fraud Scheme

Federal authorities have arrested three business owners and a title company executive in connection with a mortgage fraud scheme that involved approximately 800 real estate properties and about $45 million in loans. The two-count indictment charges 58–year-old Stephen Mark Hilliard, owner of...

Corporate Corruption Case Charged With Swiss Bank Accounts to Hide the Loot

According to a DOJ press release here (emphasis supplied by JAT): Asem Elgawhary, the former principal vice president of Bechtel Corporation and general manager of the Power Generation Engineering and Services Company (PGESCo), was indicted by a grand jury in Maryland on charges that he defrauded...

Contractor's Construction Fraud Implied

It is not unusual for a contractor to obtain an advance for construction work or materials. While that is done more often with residential construction, it is also done on some commercial projects or with individual subcontractors. What if they don't then follow through? Virginia makes "construction...

Jail for False Health Insurance Claims – Health Insurance Fraud Conviction Stands

Because Medicare and Medicaid pay health care providers promptly and without any inquiry into the probity of the claim health insurance fraud is a fairly easy crime to commit with little chance of being arrested or convicted. Perhaps that is the reason why the extent of health insurance fraud is counted...

Convicted Politician Did Not Lay a Proper Foundation For Proffered Indirect Testimony of Lack of Intent

In United States v. Beavers , ___ F.3d ___, 2014 U.S. App. LEXIS 12469 (7th Cir. 2014), here , the defendant was convicted of multiple counts of tax fraud. The facts are within a range of what might be expected given his profession -- money flowed to him and he did not report or pay tax on it. The...