Source: http://slabbed.org/2010/09/23/breaking-news-new-katrina-qui-tam-unsealed-ex-rel-denena-v-allstate/
Timestamp: 2019-08-20 07:17:33
Document Index: 641503730

Matched Legal Cases: ['§ 3729', '§ 3729', '§ 3729', '§ 3729', '§ 3729', '§ 3729', 'art 62', 'art 62']

BREAKING NEWS - new Katrina qui tam unsealed: ex rel Denenea v Allstate - Slabbed
In adjusting and settling the claims of the Weisses, Majoue, Shearman, Whelan, and Richardson under their respective homeowners policies and Standard Flood Insurance Policies for combined wind and flood damage to their respective insured properties, Allstate, unbeknownst to the insureds, knowingly and systematically fabricated and falsified documents including but not limited to proof of loss forms, flood narrative forms, WYO flood processing request forms, NFIP preliminary report forms, property loss worksheets, and/or other documents, forms, and/or information which substantially inflated the amounts of these insureds’ flood insurance claims at the expense of the Government, while at the same time enriching Allstate by substantially deflating the amounts of these insureds’ homeowners insurance claims.
In adjusting and settling Smith’s claims under his homeowners policy and Standard Flood Insurance Policy for combined wind and flood damage to his insured property at 1546 Marina Drive, and Johnson’s claims under his homeowners policy and Standard Flood Insurance Policy for combined wind and flood damage to his insured property at 286 Marina Drive, Allstate, unbeknownst to Smith and Johnson, knowingly estimated Smith’s and Johnson’s losses utilizing substantially inflated replacement cost values for items comprising their flood insurance claims at the expense of the Government, while at the same time enriching Allstate by substantially deflating replacement cost values for identical items comprising their homeowners insurance claims.
Allstate’s actions described herein and in Denenea’s original complaint comprised an overall system and process of fabricating data and information necessary to obtain federal flood benefits, including but not limited to a pattern and practice of knowingly and systematically fabricating water line measurements on and in homes that no longer existed, all unbeknownst to the Weisses, Majoue, Shearman, Whelan, Richardson, Smith, and Johnson.
Allstate thus engaged in a fraudulent scheme to submit and to cause to be submitted to the Government a series of false claims, records, and statements fabricating flood losses where none existed and substantially inflating the amounts of its insureds’ flood insurance claims at the expense of the Government, while at the same time enriching Allstate by eliminating or substantially deflating its insureds’ private homeowners wind insurance claims, all in violation of 31 U.S.c. § 3729(a)(1) and (2) and unbeknownst to the Weisses, Majoue, Shearman, Whelan, Richardson, Smith, and Johnson.
Allstate thus knowingly and systematically presented, or caused to be presented, to the Administrator of the FIA and other officers and employees of the Government, unbeknownst to the Weisses, Majoue, Shearman, Whelan, Richardson, Smith, and Johnson, false and fraudulent laims for substantially inflated flood insurance benefits under these insureds’ Standard Flood Insurance Policies in violation of 31 U.S.C. § 3729(a)(1).
Unbeknownst to the Weisses, Majoue, Shearman, Whelan, Richardson, Smith, and Johnson, Allstate also thus knowingly and systematically made, used, and caused to be made and used, false records and statements to get false and fraudulent claims for substantially inflated flood insurance benefits under these and other insureds’ Standard Flood Insurance Policies paid and approved by the Government in violation of 31 U.S.c. § 3729(a)(2).
As a result of Allstate’s violations of 31 U.s.c. § 3729(a)(1) and (2), the Government has been damaged because Allstate, unbeknownst to the Weisses, Majoue, Shearman, Whelan, Richardson, Smith, and Johnson, knowingly and systematically utilized Federal funds to pay false and fraudulent claims for substantially inflated flood insurance benefits under these and other insureds’ Standard Flood Insurance Policies, and those payments are binding on the FIA.
On information and belief, Allstate, unbeknownst to its insureds, knowingly and systematically has engaged and engages in the practice of paying false and fraudulent claims for substantially inflated flood insurance benefits under Standard Flood Insurance Polices it sold to policyholders in addition to the Weisses, Majoue, Shearman, Whelan, Richardson, Smith, and Johnson who were also insured by Allstate under its property business lines of insurance and whose insured properties sustained catastrophic combined wind and flood damage in 2005, but Denenea presently has no means of ascertaining the full extent to which Allstate has engaged and engages in this practice in violation of 31 U.S.c. § 3729(a)(I) and (2) except through the production of evidence thereof now in Allstate’s possession and control.
The Government presently has means of ascertaining the full extent of Allstate’s violations of 31 U.S.C. § 3729(a)(1) and (2) pursuant to the FASA, which provides: “The PIA and the Comptroller General of The United States, or their duly authorized representatives, for the purpose of investigation, audit, and examination shall have access to any books, documents, papers and records of the Company that are pertinent to this Arrangement,” including records of “claims paid or payable under policies issued pursuant to this Arrangement.” 44 CFR, Part 62, Appendix A, Art. XIV.
The FASA further provides: “Inasmuch as the Federal Government is a guarantor hereunder, the primary relationship between the Company and the Federal Government is one of a fiduciary nature, i.e., to assure that any taxpayer funds are accounted for and appropriately expended.” 44 CFR, Part 62, Appendix A, Art. XVI.
SLABBED previously reported Weiss v Allstate in Please Release Me, Let Me Go – all but certain to now be the Company’s theme song!
Author Posted on September 23, 2010 Categories NowdoucitTags Claims Dumping, ex rel Denenea v Allstate, Katrina qui tam litigation
4 thoughts on “BREAKING NEWS – new Katrina qui tam unsealed: ex rel Denenea v Allstate”
Great lawyers and great lead plaintiff! Go get’em guys.
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I’m not an attorney, and I’m probably completely wrong on this, but I think there may be something called an exception or something like that. If an attorney learns of someting during litigation, the information is public, and he can’t be a relator.
from one “not an attorney” to another, NAAS, I know of no statutory “exception” that would preclude an attorney Relator. Not only is there no statutory exclusion, the recently amended FCA relaxed the standard for public disclosure and put the emphasis on the claim itself in an effort to encourage Relators to come forward. In Denenea v Allstate, it appears the Relator’s allegations are based on a pattern he discovered in the multiple exemplar claims and not a single case. That said – and given the response of insurers to both the Branch and Rigsby qui tam cases – I would expect Allstate to come up with all sorts of distorted citations and attempt to wiggle away.
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