Jul 26th, 2016

FKB’s Andrew R. Jones and Jessica Serrano obtain dismissal of a fraud and negligent misrepresentation action against an Insurance Agent in connection with an alleged “illegal” Healthcare Group workers compensation insurance scheme

FKB successfully obtained pre-answer dismissal on a motion to dismiss from Justice Knipel in New York State Supreme Court, Kings County. FKB’s pre-answer motion to dismiss pursuant to CPLR §§ 3211(a)(1) and (a)(7) argued, inter alia, that the complaint failed to state a cause of action. FKB’s client, a senior, experienced insurance agent assisted in procuring group workers compensation insurance for what was, essentially, a conglomerate of healthcare organizations.

As set forth in greater detail in the Motion to Dismiss, FKB argued that the Court was presented with a conglomeration of Plaintiffs which: (a) used their own, self-created, complex structure to obtain a benefit, in the form of reduced insurance premiums; then (b) when premium payments eventually, rightfully, became due, sought to avoid making payments owed, claiming that Plaintiffs did not understand what they had contracted for, despite being highly sophisticated and having their own team of consultants and advisors.

FKB argued that after a Federal Court correctly held (in a prior action) that the Plaintiffs properly owed premiums under obligations Plaintiffs knowingly contracted into, Plaintiffs commenced the instant action seeking to: (i) collaterally attack the Federal Action settlement; and/or (ii) improperly blame anyone remotely connected to the underlying transactions for Plaintiffs essentially “getting caught” trying to beat the system.

FKB argued – and Justice Knipel agreed – that critically, Plaintiffs set forth inadequately pled, conclusory “claims” of fraud and negligent misrepresentation.

The full decision can be found by clicking here. See in particular, pp. 29-34.

If you have any questions about this decision, or the defense of insurance agents and practitioners in general, please contact Andrew R. Jones or Jessica Serrano.