Insurance Fraud Conviction Upheld
Insurance fraud is a temptation difficult to resist, especially if you are a person with a history of criminal conduct. Even though insurance fraud is seldom prosecuted it is prosecuted and when it is, it is prosecuted with vigor.
One such temptation met its match in The People v. Deborah Carter, C083541, C084717, Court Of Appeal Of The State Of California Third Appellate District (Sacramento) (August 1, 2018) Deborah Carter was initially charged with several counts of insurance fraud and failing to appear. A jury found her guilty of the insurance fraud counts and the state eventually gave up the failure to appear charges.
Defendant was initially charged with five counts: three counts of insurance fraud (California Penal Code § 550, subds. (a)(1), (5), and (b)(1); counts 1-3); and two counts of failure to appear while released on bail (§ 1320.5; counts 4 & 5). The state dropped counts 4 & 5.
The insurance fraud counts arose from a car accident: a van hit a small sedan driven by defendant’s husband. Defendant claimed she was sitting in the front passenger seat at the time of the accident. As a result of the accident, defendant submitted an injury claim to the insurance company for the van. The sole contested issue was whether defendant was inside the sedan when it was hit. The accident occurred outside a day sanctuary for homeless people. Two witnesses testified to the accident: a security guard and a street monitor.
The security guard testified he was sitting on a front porch when he saw the sedan pull up in front of the women’s facility. He saw a “young lady” exit the sedan and walk into the women’s facility.
A van was also parked outside. The guard watched the van being loaded before it started to pull out. As the van moved, the sedan approached, stopping right behind the van. The van then backed into the sedan. After the accident, the security guard saw the same young lady come from the direction of the women’s facility and yell at the van driver.
At trial, the guard was asked if he saw the young lady in the courtroom and said, “It’s been so long, no.” The guard also testified he did not know how many people were in the sedan when he first saw it.
A street monitor also testified to seeing the accident. He saw the sedan parked in front of the women’s facility. Because the sedan was not supposed to be parked there, he approached and told the man in the driver’s seat to move the car. The monitor saw no one but the driver inside the sedan.
The street monitor then went into the kitchen. He recalled being in the kitchen for two minutes at most. When he came out, he saw a van had backed into the sedan — he did not see the actual collision.
He then saw a very upset woman coming out of the woman’s facility. She was yelling and waving her arms, saying the car was a rental.
Defendant was found guilty on all three insurance fraud counts. The trial court imposed a six-year aggregate term consisting of the five-year upper term on count one along with a one-year enhancement for defendant’s prior prison term.
The security guard’s description of the “young lady,” according to the Defendant, exiting the car did not match her description as she was 55 at the time. I don’t know how old the security guard was but I’m 76-years-old and, to me a woman only 55 is a “young lady.”
The basic substantial evidence test is well settled, requiring that ” ‘we review the whole record in the light most favorable to the judgment to determine whether it discloses substantial evidence—that is, evidence that is reasonable, credible, and of solid value—from which a reasonable trier of fact could find the defendant guilty beyond a reasonable doubt.’ ” (People v. Abilez (2007) 41 Cal.4th 472, 504; see People v. Raley (1992) 2 Cal.4th 870, 891 [substantial evidence ” ‘ “reasonably inspires confidence” ‘ “].)
The security guard saw a “young lady” exit the sedan for the women’s facility just before the accident. And just after the accident, he saw the same young lady walk to the van from the women’s facility. That testimony accords with the street monitor’s testimony that just before the accident, no one but the driver was inside the sedan. And just after the accident an upset woman came from the women’s facility.
From that, a jury could reasonably conclude defendant left the sedan just before the accident and returned just after. The fact that the security guard referred to the woman as a “young lady,” the fact he could not identify the woman in the courtroom, and the fact the street monitor was in the kitchen during the accident did not preclude a jury from reasonably concluding from the evidence as a whole that defendant was not in the sedan during the accident.
The U.S. is fast becoming a geriatric nation. People find it easy to steal from insurance companies. Judges, juries and seasoned citizens like your author, consider a 50 year old woman to be a “young lady.” Much to Ms. Carter’s surprise the insurance company and state investigated, found the two witnesses that established she was not in the car at the time of the accident, that her claimed injuries were false and fraudulent, and the state successfully prosecuted Ms. Carter who will serve six years in prison.
© 2018 – Barry Zalma
This article, and all of the blog posts on this site, digest and summarize cases published by courts of the various states and the United States. The court decisions have been modified from the actual language of the court decisions, were condensed for ease of reading, and convey the opinions of the author regarding each case.
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 50 years in the insurance business. He is available at http://www.zalma.com and firstname.lastname@example.org.
Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.
Books from Full Court Press
Insurance Law Deskbook: Learn the insurance basics that are essential to every civil practitioner. The Insurance Law Deskbook is intended to help law students, practitioners, insurance lawyers, professional claims personnel, insured persons, and anyone else involved in insurance. The book, published for the first time under Full Court Press, includes the full texts or digests of insurance-related decisions of the U.S. Supreme Court, the U.S. District Courts of Appeal, state appellate courts, and foreign courts that have molded the American insurance law, as well as vital explanatory chapters, historical context, form letters, and more.
California Insurance Law Deskbook: California has long led the way when it comes to insurance jurisprudence in the United States, and few know more about California insurance law than Barry Zalma. The California Insurance Law Deskbook is intended to help law students, practitioners, insurance lawyers, professional claims personnel, insured persons, and anyone else involved in insurance. Similar to Barry Zalma’s general Insurance Law Deskbook, this title focuses on the state where the author has long resided and practiced as an expert in California law. The book, published for the first time under Full Court Press, includes the full texts or digests of insurance-related decisions of the U.S. Supreme Court, the U.S. District Courts of Appeal, and California appellate courts, as well as vital explanatory chapters and historical context.
Insurance Bad Faith and Punitive Damages Deskbook: Understand the relationship between insurance, the tort of bad faith, and why punitive damages are awarded to punish insurers. Previously, a person suing an insurance company in the United States could only recover contract damages, but when the tort of bad faith was created by the courts contract law was enormously affected, allowing insureds to sue insurers for both contract and tort damages, including punitive damages. Read a thoughtful analysis of how punitive damages apply in the United States to insurance bad faith suits, and why some states allow judges and juries to award punitive damages against insurers in civil litigation.
Mr. Zalma’s books available as Kindle books or paperbacks at Amazon.com can be reached at http://zalma.com/zalma-books/
Mr. Zalma’s reports can be found on Tumbler at https://www.tumblr.com/search/bzalma on Facebook at https://www.facebook.com/barry.zalma and you can follow him on Twitter at https://twitter.com/bzalma
The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.