The anti-fraud voice to America’s courts
The Coalition files amicus curiae (“friend of the court”) briefs as a voice to federal and state courts on key anti-fraud issue. These decisions set national precedents. Important decisions greatly strengthen or damage how we combat fraud. Outcomes directly affect consumers and insurers alike.
Over more than 20 years the Coalition remains a highly credible voice to courts. Coalition amicus briefs carry great weight and impact decisions.
Our incisive briefs reflect our national leadership reputation — and the diverse voices of our members. Judges cite our arguments in landmark decisions supporting a stronger fraud fight. Courts listen when our nation’s anti-fraud leaders speak.
Cases are reviewed by our Amicus Committee using these standards:
- Issues: Are the facts and pleadings properly framed to address substantive anti-fraud issues? Both civil and criminal cases are appropriate for amicus brief filings.
- Implications: Does the case have national implications? Greater weight is given to cases where the decision will impact fraud laws nationally or in multiple states.
- Applicability: Does the issue further the Coalition’s mission by advancing the interests of all constituents?
- Timing: Sufficient research and drafting time are necessary to adequately prepare briefs for filing.
- Jurisdiction: What is the size of the jurisdiction and its potential impact on the anti-fraud fight.
- Judicial level: Normally filings are limited to state or federal courts of appeal or supreme courts.
Coalition amicus briefs
State of California v. Encino Hospital Medical Center (Los Angeles County Superior Court, 2022)
• Issue: Whether the California Insurance Fraud Prevention Act applies to fraudulent claims presented to HMOs and ERISA plans, which account for approximately 90% of the private health care market in California. The Coalition argues applying the IFPA to fraudulent claims made to HMOs and ERISA plans would be entirely consistent with the legislative purposes and public policies behind the law which is intended to combat all forms of insurance fraud including health care fraud, reduce the costs of insurance for consumers, and protect the fairness and integrity of the insurance system.
Astellas Holdings v. Federal Insurance v. Federal Insurance Company (U.S. 7th Circuit Court of Appeals, 2022)
• Issue: Decide whether insurers must indemnify a policyholder who agreed to a monetary settlement to resolve alleged federal False Claims Act violations.
Taqueria El Primo LLC et al v. Farmers Group, Inc. et al. (District Court of Minnesota, 2022)
• Issue: Deciding whether Farmers Insurance anti-fraud efforts identifying medical providers they allege are committing PIP billing improprieties and then entering into “billing moratorium” agreements with those clinics to stop billing the company, violates the state’s no-fault law.
Liberty Insurance v. Techdan (Supreme Court of New Jersey, 2021)
• Issue: Should those found liable for committing insurance fraud be subject to joint or several liability for awarded damages.
Keystone RX LLC v. Bureau of Workers' Compensation Fee Review Hearing Office (Pennsylvania Supreme Court, 2020)
• Issue: Right of providers to participate in review hearings/compound pharmaceutical fraud.
Illinois v. Family Vision Care (Illinois Supreme Court, 2020)
• Issue: State financial loss on citizen whistleblower actions.
Dr. Robert D. Haar, M.D. v. Nationwide Mutual (New York Court of Appeals, 2019)
• Issue: Immunity for good faith fraud reporting.
Keodalah v. Allstate Insurance Company (Supreme Court of Washington State, 2019)
• Issue: Personal liability in bad faith lawsuits.
Restoration 1 of Port St. Lucie v. Ark Royal Insurance (Florida Supreme Court, 2019)
• Issue: Assignment of benefits rights.
Andrew Carothers, MD, PC v. Progressive Insurance (New York Court of Appeals, 2019)
• Issue: Sham medical clinics.
Allstate v. Rehab Alliance of Texas (Supreme Court of Texas, 2016)
• Issue: Standards for pursuing recovery actions.
State Farm Mutual Automobile v. Roniesha Adams (Supreme Court of Kentucky, 2016)
• Issue: Examinations Under Oath.
Jocelyn Zolna Pitts. v. ATI Holdings (Appellate Court of Illinois, First Judicial District, 2014)
• Issue: Application of state whistleblower fraud law.
Hambarian vs. Orange County Superior Court (California Supreme Court, 2001)
Issue: victim participation in prosecution of insurance fraud
Commonwealth of Massachusetts v. James N. Ellis, Sr. (Massachusetts Supreme Court, 1998)
• Issue: insurer funding of state fraud bureaus.