Photo 1: Pacific Mutual Life & Accident Co., California; Library of Congress, LC-DIG-det-4a25756, between 1900 and 1920.

Photo 2: Pacific Life Foundation, licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license, 2007.

Service Details

Special Investigations Unit / Insurance Fraud Litigation

The submission of false claims to insurers is epidemic. Insurance fraud rings are highly organized into networks of interlocking cappers, attorneys, doctors and medical clinics. The fight against insurance fraud should feature not only the defense of false insurance claims, but affirmative litigation against those who submit fraudulent claims.

At Manning & Kass, our Special Investigations Unit / Insurance Fraud Litigation Team is led by Dennis B. Kass, a founding partner in the firm. Mr. Kass has been featured in The New York Times, Los Angeles Times, Daily Journal, and scores of other periodicals, and on television and radio for his role as lead counsel in numerous “whistle-blower” actions where insurance companies have sued professionals, including attorneys and doctors, for their role in large fraud rings.

Insurance Code 1871.7 Actions and Other Affirmative Litigation
Insurance Code section 1871.7, the "Organized Crime Prevention and Victim Protection Act," enables insurers to recover money and acquire court orders barring future bad acts by those who submit false, fraudulent, or capped claims. This statute is an effective tool in the battle against fraud. Our team of seasoned trial attorneys have filed more than one hundred Insurance Code Section 1871.7 actions. The resulting verdicts and settlements exceed one hundred million dollars.

Dennis Kass helped draft two bills revising Insurance Code 1871.7:  AB 1050 and SB 799. Dennis testified at the related committee hearings in the state assembly and senate, leading to their passage. The team’s work in the area of 1871.7 is also reflected at the appellate level. In ex rel. Allstate v. Weitzman (2003) 132 Cal.Rptr.2d 165, the California Appellate Court determined that the "original source" rule did not bar our client Allstate's action. In ex. rel. Allstate v. Muhyeldin (2003) 112 Cal.App.4th 604) the California Supreme Court upheld an $8.2 million verdict in our client's favor, finding CPT upcoding a correct basis for the verdict. Our firm's Strategy, Writs, and Appeals Team worked hand-in-hand with our Special Investigations Unit / Insurance Fraud Litigation Team in those appeals and have numerous appellate decisions in the 1871.7 arena.

Subject areas routinely handled include actions against health care providers, body shops, law offices, tow truck operators, suspected cappers and stagers of automobile accidents, and public adjusters. The types of claims involved include automobile collisions, medical reports and CPT upcoding, MRI and other film facilities, wildfire smoke damage claims, and durable medical equipment claims and more.

The effective fight against insurance fraud requires creativity and use of all available tools. In addition to actions under Insurance Code 1871.7, we also bring actions under Business and Professions Code 17200, pursue declaratory relief actions, intervention actions, and at the Workers' Compensation Appeals Board (WCAB), we pursue lien consolidations. We have vast experience in each area and can assist our clients in choosing the best tool or tools to fight false claims.

Special Investigation Unit Cases
The Special Investigations Unit / Insurance Fraud Litigation Team handles both 1st and 3rd party Special Investigation Unit cases. Our team cumulatively has more than one hundred years of experience in this area and has tried scores of SIU cases. Dennis Kass is co-counsel at the national level to the International Association of Special Investigation Units (IASIU), and is Southern California Chapter counsel. Dennis is also a member of the Claims and Litigation Management Alliance (CLM) Fraud Committee.

This specialty area requires a unique combination of experience, knowledge, and tenacity in correctly assessing, investigating, litigating, and resolving these matters. Subject areas include first and third party bodily injury, medical payments, total vehicle theft, commercial and home arson, commercial and home burglary, and water loss claims.

Our ongoing handling of affirmative litigation and the defense of false claims provides our team with special insight into the most successful and cost-effective ways to fight these claims.