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Notable Cases

Insurance Fraud Jury Acquittal

Our client, a former soldier, had spent over a decade working for a disaster restoration company. When your house flooded, he was the person that knocked on your door at two in the morning with a crew waiting to help. But while our client was out working, the bosses were getting a little creative with the accounting.

You see, much like health care, disaster restoration is an industry that is built upon insurance claims. When your house floods, you call your insurance company and they recommend a restoration company to fix the problem. The restoration company comes out and does whatever work it can, and then subcontracts out the rest of the work. Once it is all said and done, the subcontractors bill the restoration company and the restoration company bills the insurance company for all the work both itself and the subcontractors did.

In this case, the bosses at the restoration company found a way to eek out a little extra from insurance companies by having subcontractors create two sets of bills: a high bill that would be sent on to the insurance company and a low bill that would actually be paid by the restoration company. Essentially, the insurance company thought that the restoration company was paying its subcontractors more than it actually was. The government argued that this misrepresentation constituted fraud because the insurance companies never would have paid the restoration companies as much money if they realized the restoration companies were paying less for the work done by the subcontractors. So, as is often the case, the government not only charged the bosses but also employees down the chain, hoping the defendants would turn on each other. Our client who had never submitted a bill in his life was caught in the government's wake.

In this ten-defendant case that spanned over eight years from beginning to end, our team employed a three-tiered approach to defend our client. First, we brought to the court's attention a rather incredible conflict of interest whereby an insurance industry-funded organization was essentially conducting the government's investigation (your tax dollars at work). Second, we brought in industry experts that showed the restoration company's conduct was within the normal course of business within the industry and that regardless of the information submitted by the restoration company, insurance companies performed their own, independent appraisals for any jobs they were paying on. Third, we showed that regardless of whether the alleged conduct was fraudulent, our client was never a decision-maker for the restoration company. He was a blue-collar guy just trying to get the job done quickly.

The jury agreed with us and our client was acquitted of all charges. His bosses, represented by other attorneys, were not so fortunate.

Related Media Coverage

Denver Business Journal, Disaster Restoration Executives Convicted of Fraud

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