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Fraud/Special Investigation

In response to the high demand for aggressive trial attorneys to defend against insurance fraud, Marshall Dennehey Warner Coleman & Goggin has significantly expanded its Fraud/Special Investigation Practice Group.
 
Insurance fraud is, understandably, no longer tolerated or in any way compromised by insurance companies and self-insureds. We work very closely with our clients in furtherance of that philosophy through relentless investigation, aggressive defense and prosecution in response to false and inflated insurance claims.
 
Our members supplement their litigation experience with up-to-date knowledge of the current trends in insurance fraud detection and prosecution areas by regularly attending and participating in seminars given by such educational agencies as the National Insurance Crime Bureau, International Association of Special Investigation Units and Certified Fraud Examiners. In addition, they also attend numerous local conferences and association meetings throughout Pennsylvania, New Jersey, Delaware, Ohio, Florida and New York.
 
Aggressive Fraud Defense
 
As a part of an overall aggressive fraud defense, the members of the Fraud/Special Investigation Practice Group believe that the "best defense is a good offense." Our trial attorneys are quite experienced in the investigation, defense and affirmative prosecution of fraudulent claims. The scope of their practice is focused on the individual claimant as well as organized groups or "rings." We routinely file suits and collect judgments against perpetrators of insurance fraud including both insureds and medical providers.
 
We have considerable experience with cases involving:

  • Medical provider fraud
  • Claimant fraud
  • Insurance claim inflation
  • Staged accidents
  • Application/rate evasion fraud
  • Workers' compensation fraud
  • Vehicle "give ups"
  • Suspicious jewelry losses and arsons

 
We maintain a centralized "fraud library" of fraud scams, investigations and perpetrators. Dissemination of this information to the group members, as well as a constant dialogue between attorneys, allows them to immediately incorporate current law and recent events in the fraud industry into defense strategies. We, in turn, enable our clients to incorporate this knowledge and experience into investigations by providing them with updates concerning recent developments in the industry. Our clients greatly appreciate the fact that we collaborate with them in the course of investigations in order to coordinate efforts and ensure that the goals of fighting fraud are met.
 
We would welcome the opportunity to work with you in vigorously defending against insurance fraud claims. Members of our practice group are also available to give presentations at your location or in one of our offices.

Jun 20, 2011
Attorneys obtained a defense verdict in a binding fire loss arbitration. Plaintiff claimed water damage resulting from three fires that occurred at our clients' investment property. Plaintiff occupied the home adjacent to our clients' rental...
Mar 1, 2010
Attorney was involved in the initiation of a Fraud investigation eventually resulting in the recent arrest of a local chiropractor, and 15 others . The fraudulent operation stemmed from phony treatment by the chiropractor and staged accidents. While...
Mar 23, 2009
Attorney was able to get Plaintiff's sole claim against our attorney client dismissed by way of Preliminary Objections filed in the Philadelphia County Court of Common Pleas. In this case, the Plaintiff brought a fraud claim against our client,...
Jul 7, 2008
Attorney obtained a voluntary withdraw on behalf of defendant insurance company on a fraudulent homeowner claim. The claim involved water and structural damages to the insured's home subsequent to a hail storm. The insured retained a public...
Jul 7, 2008
Attorney obtained a voluntary withdraw on behalf of defendant insurance company on a residency fraud claim. The claim involved PIP benefits for a seriously injured plaintiff who needed shoulder surgery. The insured's attorney voluntarily withdrew...

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Law Alerts January 11, 2013
New Jersey Appellate Division determination involving an appeal of a Superior Court finding in favor of Nelson. This case stemmed from an automobile accident which occurred in 2006 while Mr. Martino, Ms. Nelson's live-in boyfriend and the father..., Case Law Alerts - 1st Quarter 2013
Law Alerts October 1, 2012
In this New Jersey Supreme Court action, the court affirmed, on different grounds, the Appellate Division's determination in Selective Ins. Co. of Am. V. Hudson E. Pain Mgmt., 416 N.J. Super. 418 (App. Div. 2010). The Court held that an..., Case Law Alert - 4th Qtr 2012
Law Alerts October 1, 2012
In this New Jersey Supreme Court action, the Court affirmed the Appellate Division's determination in Selective Ins. Co. of Am. v. Rothman, 414 N.J. Super. 331 (App. Div. 2010). In affirming the Appellate Division, the Supreme Court essentially..., Case Law Alert - 4th Qtr 2012
Law Alerts July 1, 2012
The plaintiff filed a federal civil RICO action against the defendants, a series of allegedly interconnected professional corporations (medical providers and diagnostic testing facilities). The plaintiff alleged the defendants billed Allstate via..., Case Law Alert - 3rd Qtr 2012
Law Alerts July 1, 2012
Subsequent to Nunez, Florida enacted a significant overhaul of its PIP statute, amending Fla. Stat. § 627.736 to provide, in pertinent part, that under Fla. Stat. § 627.736(6)(g), "[a]n insured seeking benefits…must comply with..., Case Law Alert - 3rd Qtr 2012
Law Alerts July 1, 2012
The plaintiff, a State Farm insured, brought an action against the defendant claiming that State Farm breached the insurance contract and failed to act in good faith in denying his homeowner's claim (pertaining to a house fire). State Farm..., Case Law Alert - 3rd Qtr 2012
Law Alerts July 1, 2012
In this United States District Court matter wherein the federal court interpreted New Jersey law in a diversity action brought by Certain Underwriters at Lloyds of London against its insured, Salvatore Alesia, alleging violations of the New Jersey..., Case Law Alert - 3rd Qtr 2012
Law Alerts July 1, 2012
The Appeals Court certified question to Florida Supreme Court: "[w]hether, under Fla. Stat. § 627.736, an insurer can require an insured to attend an EUO as a condition precedent to recovery of PIP benefits?" The plaintiff, a claimant..., Case Law Alert - 3rd Qtr 2012
Defense Digest Article December 1, 2011
Florida – SIU/Fraud , Key Points: The court's misinterpretation of a carrier's policy language will be short lived based upon past precedents from across the country. The best advice is to wait and see before engaging in a protocol revision...., Defense Digest, Vol. 17, No. 4, December 2011
Law Alerts April 1, 2011
The Appellate Division concluded that judicial review of an intermediate ruling is not one of the APDRA procedures the Commissioner has made "applicable" to PIP arbitration proceedings. In further support of this position, the Appellate Division..., Case Law Alert - 2nd Qtr 2011

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Conference Nov 14, 2012
Join our distinguished panel for lunch and a discussion on issues relating to fraud.  

Chair

James H. Cole
Chair, Fraud/Special Investigation Practice Group; Chair, Property Litigation Practice Group
(267) 880-2026
jhcole@mdwcg.com

Additional Contacts

Jeffrey G. Rapattoni
Shareholder
(856) 414-6076
jgrapattoni@mdwcg.com

Related Practice Areas

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