Long Island School District Sues Insurers Over Abuse Allegations
May 8, 2025 | JacobiJournal.com – Bay Shore, NY – Long Island School District: The Bay Shore Union Free School District has filed a federal lawsuit against Hartford Insurance Group and CNA Insurance, accusing the two insurers of refusing to defend and indemnify the district against a wave of sexual abuse lawsuits tied to a former elementary school teacher. Dozens of Claims Spark Legal Action The district faces 45 lawsuits filed by former students under New York’s Child Victims Act (CVA). The lawsuits allege sexual abuse by Thomas Bernagozzi, a teacher who worked from the 1970s through 2000 at Gardiner Manor and Mary G. Clarkson Elementary Schools. Long Island School District Bernagozzi was criminally charged in 2023 for allegedly abusing two students. He has pleaded not guilty. Roughly half of the civil suits have been settled. However, 18 cases remain unresolved—cases for which the district claims Hartford and CNA should provide insurance coverage under general liability policies issued between 1973 and 1982. $35 Million Bond, $25M Verdict Slashed In 2023, Bay Shore approved a $35 million bond to help fund settlements for 12 claims not covered by insurance. Meanwhile, one lawsuit that went to trial resulted in a $25 million jury award to a victim. A judge later reduced that award to $4 million, pending a new trial on damages unless the victim accepts the lower amount. Other claims have been paid through the New York State Insurance Reciprocal (NYSIR). Insurers Accused of Delay Tactics According to the lawsuit filed on May 2 in U.S. District Court for Eastern New York, the district alleges that both insurers have adopted a “wait-and-see” strategy in the wake of the CVA’s passage. The complaint argues that the insurers: Bay Shore contends that this conduct violates the terms of their contracts, as well as New York state insurance and consumer protection laws. Seeking Accountability and Coverage In its suit, Bay Shore requests a declaratory judgment affirming the insurers’ obligation to cover the remaining lawsuits. The district also seeks damages for breach of contract, bad faith, and violations of state business and insurance laws. Officials argue that the insurers are trying to evade financial responsibility despite issuing policies precisely to cover serious liabilities like those now unfolding. Source 📣 Districts and Institutions: Review Your Legacy Insurance Policies This case highlights the importance of reviewing decades-old liability policies and demanding accountability when insurers attempt to avoid responsibility under the CVA or similar survivor rights laws. 🔎 Read More from JacobiJournal.com: ⚖️ Subscribe to JacobiJournal.com for updates on high-stakes insurance litigation, institutional liability, and child protection laws.
North Carolina Man Faces 21 Felony Charges for ID Theft, Insurance Fraud
May 06, 2025 | JacobiJournal.com – Zebulon, NC – North Carolina Man: A 30-year-old man faces 21 felony charges after allegedly stealing multiple identities and filing fraudulent auto insurance claims with several major carriers. Fraud Spanned Six Months and Four Insurers According to the North Carolina Department of Insurance (NCDOI), Damain Rayshawn Cummings assumed the identities of at least six individuals between September 2024 and March 2025. During that time, he filed false auto claims with Progressive, State Farm, Liberty Mutual, and Allstate. North Carolina Man Investigation Led by NCDOI Authorities became aware of the scheme after suspicious activity flagged several claims. NCDOI investigators launched a full investigation and uncovered evidence suggesting that Cummings accessed victims’ personal data—potentially through birth certificates and email accounts. He was arrested and appeared in court on April 30, where he was later released on a $300,000 bond. Charges Include Insurance Fraud and Identity Theft The charges include multiple counts of insurance fraud, identity theft, and theft by deception. Officials said the case underscores the ongoing risk of identity-based insurance scams in North Carolina and across the country. Authorities Urge Vigilance State officials are encouraging residents to monitor their insurance records, review credit reports, and report any unauthorized claims immediately. The NCDOI continues to investigate whether additional individuals were affected. Source 🔎 Read More from JacobiJournal.com: 🕵️ Stay Alert with JacobiJournal.com Track major fraud cases, workers’ comp litigation, and insurance crime news at JacobiJournal.com — your trusted source for updates and expert insights.
Janitorial Services Owner Sentenced in $1.45M Fraud Case
Martha Toro Receives Jail Time for Insurance Fraud and Tax Evasion April 24, 2025 | JacobiJournal.com – Sacramento, CA — A Janitorial Services Owner Sentenced to 270 days in county jail and two years of formal probation after pleading no contest to insurance fraud and tax evasion. Martha Toro, who owns MT Janitorial Services, will also pay $1,454,130 in restitution, fines, and interest. Markel Insurance will receive $848,370, while $605,760 goes to the Franchise Tax Board (FTB). Years of Payroll Fraud Exposed Janitorial Services Owner Sentenced: Investigators began looking into Toro’s business in February 2020 after Markel Insurance raised concerns. They discovered Toro had intentionally underreported her number of employees from 2013 to 2020 to lower her workers’ compensation premiums. This fraud caused Markel Insurance to lose over $800,000. Meanwhile, Toro also falsified her state tax returns from 2016 to 2020, avoiding hundreds of thousands in taxes. Investigators Respond Swiftly The California Department of Insurance (CDI) led the investigation with assistance from the Franchise Tax Board. Their efforts confirmed that Toro misrepresented payroll information year after year. According to the CDI, underreporting payroll endangers workers, especially if they are injured on the job without proper insurance coverage. Tax Fraud Harms the Public Beyond insurance losses, Toro’s actions harmed California taxpayers. “Tax evasion threatens essential public services,” the FTB said. “By shutting down underground economic activity, we protect resources for education, healthcare, and infrastructure.” Fraud Creates Unfair Business Advantages Deputy District Attorney John MacKenzie, who prosecuted the case, highlighted how such fraud distorts the marketplace. “Toro gained an unfair edge by lowering her business costs illegally,” he said. “This hurts honest employers who follow the rules and puts customers at risk.” Because Toro’s business appeared cheaper, it won contracts at the expense of law-abiding competitors. Over time, this undermines trust and damages entire industries. Source: CDI 📚 Read More from JacobiJournal.com: 🕵️♂️ Stay informed on workers’ comp fraud, employer violations, and legal enforcement by visiting JacobiJournal.com for weekly updates.
Contractor Liable for Paralyzed Worker’s Injuries Under Statutory Employment Doctrine
Michigan Court of Appeals Upholds Contractor’s Liability for Worker’s Paralysis April 24, 2025 | JacobiJournal.com – Contractor Liable: The Michigan Court of Appeals recently ruled that a contractor is liable for the injuries sustained by a worker who was paralyzed after falling from a height on the job. The court’s decision relies on the statutory employment doctrine, which holds contractors responsible for workers under certain contractual agreements, even if they are not directly employed by the contractor. In this case, a worker employed by an uninsured subcontractor suffered life-changing injuries after a fall on a construction site. The worker’s direct employer lacked insurance. However, the court found that the contractor’s contract with the subcontractor’s agent made the contractor the worker’s statutory employer. As a result, the contractor had to cover the worker’s medical costs, lost wages, and additional benefits due to permanent paralysis. Statutory Employment Doctrine and Workers’ Compensation The statutory employment doctrine ensures workers can seek compensation from a general contractor if their direct employer lacks workers’ compensation coverage. This case emphasizes that contractors must take responsibility for workers’ safety and insurance, even if they don’t directly employ the worker, as long as a valid contract exists. The ruling underlines the importance of ensuring that everyone involved in a construction project is properly insured. Contractors must bear responsibility when subcontractors fail to meet insurance obligations. Contractors Must Prioritize Safety and Compliance This ruling sends a strong message to contractors about the need to prioritize safety compliance and insurance coverage. Contractors must ensure workers have the right insurance, especially after an accident. Failure to do so can lead to legal consequences, as this case shows. Contractors and subcontractors should carefully review contracts and ensure all parties have adequate insurance. Doing so protects workers and helps prevent financial liability. A Legal Reminder of Worker Protection The court’s decision highlights the worker’s right to fair compensation, even if the direct employer lacks insurance. It also reinforces contractors’ responsibility to provide workers’ compensation when needed. This case could set a significant legal precedent for similar claims in Michigan and other states. Source Read More from JacobiJournal.com: NY VA Firefighter Pleads Guilty to Workers’ Compensation Fraud Scheme Detroit CBP Director Charged in FEMA Fraud Scheme Employee Denied Workers’ Compensation for Topgolf Injury Healthcare Software Firm Pleads Guilty in $1B Medicare Fraud Scheme For more insights into workers’ compensation and liability claims, visit JacobiJournal.com.
Florida Insurance Broker Pleads Guilty ACA Fraud Scheme
April 22, 2025 | JacobiJournal.com – A South Florida insurance broker has pleaded guilty to orchestrating a $134 million Affordable Care Act (ACA) fraud scheme that exploited federal health subsidies and targeted society’s most vulnerable. Dafud Iza, 54, of Pembroke Pines, entered his guilty plea last Friday in federal court in the Southern District of Florida. He now awaits sentencing and could face up to 10 years in prison, along with a substantial restitution order. Broker Licenses Revoked After Years in the Industry Florida Insurance Broker: Iza previously held multiple insurance licenses in Florida, including property and casualty, temporary life, and health insurance credentials. However, the Florida Department of Financial Services confirmed all his licenses are now inactive. His appointment with Liberty Mutual Insurance expired in 2012. Although court records did not identify his most recent employer, Iza’s LinkedIn profile listed him as Director of Operations at Compass Health Insurance in Tequesta since May 2024. Before that, he spent nearly eight years as Executive Vice President at Fiorella Insurance Agency in Stuart, Florida. Scheme Targeted Vulnerable Populations According to the U.S. Department of Justice, Iza and his accomplices specifically targeted low-income individuals—including those facing homelessness, job loss, or mental health and substance abuse challenges. Street-level marketers, allegedly working under Iza’s direction, offered cash incentives to entice these individuals to enroll in ACA health plans. How the Fraud Worked The ACA, also known as ObamaCare, provides federal tax subsidies to insurers that enroll eligible consumers. Iza’s team manipulated this system by submitting falsified applications. They exaggerated applicants’ incomes to meet subsidy requirements and sold ACA plans to individuals who didn’t qualify. As a result, federal insurers disbursed $134 million in improper subsidies based on the false data. The scheme not only drained taxpayer funds but also compromised the integrity of a healthcare system designed to help those in genuine need. Upcoming Sentencing and Legal Fallout Iza pleaded guilty to felony charges related to health care fraud and could face up to a decade in prison. Federal prosecutors emphasized that restitution will be pursued, though the final amount remains undetermined. The case underscores the ongoing risks of fraud in publicly subsidized healthcare programs—and the importance of oversight in broker-led enrollments. Read More from JacobiJournal.com Stay informed on the latest developments in insurance fraud and healthcare regulation at JacobiJournal.com.
Former Texas Insurance Broker Charged in Alleged Fraud Scheme
April 17, 2025 | JacobiJournal.com – FRIENDSWOOD, TX – A former Texas insurance broker is facing felony theft charges after allegedly collecting payments from clients for policies he never purchased. Edgar Peralta, of Peralta Insurance Brokerage LLC, turned himself in to Friendswood Police on April 10, 2025. He is charged with theft, a state jail felony, filed by the Galveston County District Attorney’s Office. Fraud Uncovered After Traffic Stop Friendswood Police began investigating Peralta on March 3, 2025, after receiving a fraud complaint from a longtime client. The client had used Peralta for several years to secure homeowner, auto, and flood insurance policies. In May 2024, Peralta reportedly advised the client to prepay for policies covering the upcoming year, promising significant cost savings. However, after a January 2025 traffic stop, the client discovered their auto insurance was invalid. Upon contacting the insurer, they learned the policy had been canceled for non-payment. Further inquiries revealed the same issue with both the homeowners and flood policies. The client provided wire transfer records showing they had paid Peralta directly. However, investigators believe he never forwarded the funds to the insurance companies. License Revoked Months Earlier The situation escalated when the client discovered that Peralta’s insurance license was revoked in June 2024—months before he accepted their latest payments. Despite the revocation, he allegedly continued brokering policies under false pretenses. Former Texas Insurance Broker Ongoing Investigation Friendswood PD has referred the case to the Texas Department of Insurance, which has launched its own investigation. Additional charges may follow based on their findings. Peralta remains under investigation, and authorities urge any other potential victims to come forward. 🔗 Source: Friendswood Police Department Read More from JacobiJournal.com Stay ahead of insurance fraud news by following updates on JacobiJournal.com.
American Labor Alliance Execs Convicted in Multi-Million Dollar Fraud
April 15, 2025 | JacobiJournal.com – FRESNO, Calif. — American Labor Alliance Execs: After a 19-day trial, a federal jury convicted three Fresno defendants of orchestrating a sweeping fraud involving fake pension plans, bogus workers’ compensation coverage, and sham hardship exemptions. U.S. Attorney Phillip A. Talbert announced the verdict Tuesday. Marcus Asay, 68, Antonio Gastelum, 53, and their business—Agricultural Contracting Services Association, doing business as American Labor Alliance (ALA)—ran the schemes from 2011 through 2019, targeting thousands of workers and businesses across the country. Fraudulent Retirement Plan Misled Over 3,000 Workers Asay, founder and chairman of ALA, and Gastelum, who held multiple executive titles, convinced over 3,000 individuals to invest in a fake 401(k) retirement plan. Instead of managing the funds properly, the defendants funneled contributions into personal and business expenses. This included luxury dining, rare coins, online companion services, and rent for Asay’s lakefront home in Fresno. American Labor Alliance Execs To conceal the misappropriation, the defendants used funds from another fraudulent operation—fake workers’ compensation coverage—to cover supposed pension obligations. Losses from the retirement scheme exceeded $750,000. Workers’ Compensation Scam Involved Fake Insurance Certificates The second scheme involved false promises of workers’ compensation coverage. ALA told customers in California and other states that major national insurers backed their policies. In reality, those insurers were never involved. To maintain the illusion, ALA issued counterfeit certificates and policy declarations, allowing businesses to submit fraudulent documents to clients and regulators. When investigations began, ALA urged customers not to cooperate with authorities. The total fraud in this area exceeded $2.25 million. Hardship Exemptions Sold Under False Pretenses Asay and ALA also ran a third grift by charging individuals for bogus exemptions from the Affordable Care Act’s insurance mandate. While they promised to shield buyers from the ACA’s shared responsibility payment, the exemptions were neither valid nor legal. Only government agencies can issue such exemptions—and they’re free for qualified individuals. Sentencing and Potential Penalties The three defendants face sentencing on October 21, 2024, before U.S. District Judge Dale A. Drozd. Each fraud conviction carries up to 20 years in prison, with fines ranging from $250,000 to $500,000 per count. ALA could be fined up to $8.5 million. The case was investigated by multiple federal agencies, including the FBI, IRS Criminal Investigation, and Department of Labor, with prosecution led by Assistant U.S. Attorneys Michael Tierney, Joseph Barton, and Stephanie Stokman. 🔗 Source: U.S. Department of Justice – DOJ Press Release Read More from JacobiJournal.com 💼 Stay informed about major fraud cases and workers’ compensation enforcement at JacobiJournal.com.
Former Girardi Keese Accountant Sentenced for Fraud
Former Girardi Keese Accountant: Kamon ordered to pay nearly $9M in restitution for role in law firm’s collapse April 15, 2025 | JacobiJournal.com A former top accountant at the now-defunct Girardi Keese law firm has been sentenced to over 10 years in prison for defrauding both the firm and its clients. The ruling delivers a sharp blow to those involved in one of California’s most notorious legal scandals. Court Sentences Kamon to Over 10 Years Christopher Kazuo Kamon, 51, received a 121-month federal prison sentence from Judge Josephine L. Staton. The court also ordered him to pay nearly $9 million in restitution. Authorities arrested Kamon in The Bahamas in late 2022. He later pleaded guilty to two counts of wire fraud in October 2024. Judge Staton called Kamon a central player in a “web of deceit and manipulation.” She emphasized that his actions deepened the harm inflicted on vulnerable clients. Millions Stolen from Settlement Funds Kamon worked alongside Tom Girardi, 85, to steal from injured clients over a decade. One of the worst cases involved a burn victim from the 2010 San Bruno gas pipeline explosion. Girardi had secured a $53 million settlement. However, he told the client it was only $7 million. Rather than protect the client’s funds, Kamon helped reroute the money to cover law firm expenses. He and Girardi also used it to pay previous victims whose own settlements had already been misappropriated. To keep the deception going, they sent small “interest” checks and false updates about nonexistent accounts. Kamon Profited from the Scheme Kamon didn’t just help embezzle funds—he also used the firm’s money to enrich himself. He set up fake vendors and submitted fraudulent invoices to pay for renovations at his homes in Encino and Palos Verdes. In one outrageous move, he funneled hundreds of thousands of dollars to a female companion, including a $20,000 monthly stipend. She had no ties to the law firm. These payments came directly from the firm’s operating accounts. Kamon’s Actions Accelerated the Firm’s Collapse Federal officials said Kamon’s misconduct helped accelerate the law firm’s downfall. Girardi Keese filed for bankruptcy in December 2020 and dissolved by early 2021. The State Bar of California disbarred Girardi in July 2022. A jury recently found him guilty of multiple counts of wire fraud. Meanwhile, Kamon, Girardi, and former Girardi Keese lawyer David R. Lira now face a second criminal trial in Chicago this July. Federal Authorities Vow Continued Accountability U.S. Attorney Bill Essayli stated, “Kamon enabled Girardi’s scheme for nearly 20 years. Ironically, his own lies helped bring it to an end.” IRS Special Agent Tyler Hatcher added, “Kamon treated the firm’s finances like a personal piggy bank. Our teams traced every dollar and helped bring him to justice.” The IRS Criminal Investigation Division and the FBI led the investigation. Prosecutors continue to recover assets for victims of the scheme. 🔗 Source: U.S. Department of Justice Read More from JacobiJournal.com 💼 For ongoing legal coverage and insights, visit JacobiJournal.com
Labor Organization Owners Sentenced in Union Fraud Scheme
Labor Organization Owners Sentenced: Federal court sends clear message in white-collar embezzlement case April 14, 2025 | JacobiJournal.com – TTwo Southern California labor organization owners will serve time in federal prison after admitting to a fraud scheme that embezzled more than $500,000 in union funds. This case marks another aggressive move by federal authorities to confront white-collar corruption in labor institutions. Fraud Scheme Diverted Union Funds for Luxury and Travel According to the U.S. Department of Justice, the defendants ran a labor nonprofit allegedly dedicated to protecting workers’ rights. However, investigators uncovered that the organization was used as a front to finance personal luxuries. They diverted funds toward extravagant travel and high-end purchases, betraying the trust of union members in the process. Labor Organization Owners Sentenced Falsified Invoices and Shell Companies Used to Conceal Theft To mask the scheme, the pair falsified financial records, created fake invoices, and routed money through shell companies. These tactics were aimed at avoiding detection while continuing to misuse union funds. Prosecutors emphasized the significance of the betrayal, noting that such actions undermine confidence in legitimate labor movements. Federal Sentencing Underscores Severity Following a thorough investigation and prosecution, both individuals received multi-year federal prison terms and were ordered to pay restitution. The court’s decision sends a firm message: those who exploit positions of public trust, especially within labor organizations, will face serious consequences. Heightened Scrutiny for Union Oversight This case is part of a broader federal effort to increase oversight of labor organizations. As government agencies ramp up enforcement, unions are being urged to adopt tighter compliance measures and improve financial transparency. 📌 Employers and union representatives should review internal controls regularly to avoid costly liability or legal exposure. Read More from JacobiJournal.com: 🔍 Stay informed about union fraud, compliance enforcement, and insurance-related legal actions at JacobiJournal.com. Subscribe for updates that matter to employers, investigators, and compliance professionals.
Women Charged With Fraud After SUV Found in Mississippi River
VICKSBURG, MISSISSIPPI — Women Charged With Fraud: A routine stolen vehicle report took a surprising turn on March 21, when authorities discovered a partly submerged SUV in the Mississippi River—the same one reported stolen just moments earlier. Suspicious Discovery in the Water After receiving the initial 911 call about the stolen Ford Expedition, a second call came in about a vehicle found in the river near a landing. Local responders, including the Warren County Sheriff’s Office, fire-rescue crews, and search teams, rushed to the scene. Women Charged With Fraud Using a skiff launched from a nearby boat, authorities conducted a thorough search. However, they found no one inside the SUV or in the surrounding waters, according to the Vicksburg Daily News. Fraud Uncovered Soon after, investigators confirmed that the submerged Ford Expedition belonged to Heather Kay McCoy, the woman who had reported it stolen. On April 1, law enforcement arrested McCoy and charged her with insurance fraud. Authorities also arrested Amber Spencer, whom they identified as an alleged accomplice. She was charged with conspiracy to commit a felony. Next Steps in the Case Although officials did not release details on how they quickly uncovered the fraud attempt, both women posted bail. The case is now pending a grand jury review, expected in the coming weeks. 📚 Read More on Insurance Fraud Cases Stay updated with the latest cases at JacobiJournal.com.