Evan H Krinick

January 05, 2017 | New York Law Journal

In his Insurance Fraud column, Evan H. Krinick discusses new tools such as social media and data analytics that insurance companies are using to help stop fraudulent policies from being issued or renewed based on false representations of fact and to block false, inflated, or otherwise fraudulent claims from being paid.

By Evan H. Krinick

14 minute read

November 16, 2016 | FC&S Insurance

The federal False Claims Act (FCA)1 is a powerful tool in the fight against fraud involving federal health insurance programs such as Medicare and…

By Evan H. Krinick

9 minute read

November 03, 2016 | New York Law Journal

Insurance Fraud columnist Evan H. Krinick discusses ways in which whistleblowers, in actions brought under the False Claims Act, play a vital role in the fight against fraud involving federal health insurance programs such as Medicare and Medicaid. Of the $48 billion recovered by the federal government under the FCA from 1987 to 2015 (including health-care-related recoveries), over $33 billion resulted from whistleblower-initiated litigation, also known as "qui tam" lawsuits.

By Evan H. Krinick

17 minute read

September 01, 2016 | New York Law Journal

Evan Krinick takes note in his Insurance Fraud column of a ruling in July that a fact-finder in a criminal case may go beyond the formal indicia of ownership in determining the actual ownership of a medical services professional corporation (PC) for purposes of examining the PC's entitlement to payment from an insurance carrier of claims assigned to the PC by a patient under New York's no-fault insurance law. Going forward, he writes the decision will make it easier for the government to criminally prosecute cases of no-fault insurance fraud in this state.

By Evan H. Krinick

18 minute read

July 01, 2016 | New York Law Journal

In his Insurance Fraud column, Evan Krinick discusses the recent case 'Iowa v. Rimmer,' and writes: "Defendants will bemoan the ruling, but prosecutors and courts in other states undoubtedly will rely on its analysis when considering whether they may prosecute a multistate criminal insurance fraud action in their own courts."

By Evan H. Krinick

23 minute read

May 06, 2016 | New York Law Journal

In his Insurance Fraud column, Evan H. Krinick writes: Generally speaking, once a prison sentence for insurance fraud is imposed, everyone moves on. Everyone, that is, except the defendant, who is tarred with the conviction forever. In an unusual and rare case decided by U.S. District Judge John Gleeson just days before leaving the bench, Judge Gleeson refused to simply "move on," instead fashioning a creative remedy to address the situation.

By Evan H. Krinick

12 minute read

March 04, 2016 | New York Law Journal

In his Insurance Fraud column, Evan H. Krinick writes that examinations under oath are an important investigative tool used by insurance carriers to uncover fraudulently filed claims and to commit claimants to their story on the record. EUOs look like depositions but the consequences for failing to answer a question are more severe.

By Evan H. Krinick

13 minute read

January 08, 2016 | New York Law Journal

In his Insurance Fraud column, Evan H. Krinick analyzes a case, soon to be heard by the New Jersey Supreme Court, that raises the important issue of the liability of those who devise a fraudulent scheme intended to avoid the prohibition on the corporate practice of medicine, and market it to practitioners, but who never actually participate in the enterprise themselves.

By Evan H. Krinick

10 minute read

January 07, 2016 | New York Law Journal

In his Insurance Fraud column, Evan H. Krinick analyzes a case, soon to be heard by the New Jersey Supreme Court, that raises the important issue of the liability of those who devise a fraudulent scheme intended to avoid the prohibition on the corporate practice of medicine, and market it to practitioners, but who never actually participate in the enterprise themselves.

By Evan H. Krinick

10 minute read

November 06, 2015 | New York Law Journal

In his Insurance Fraud column, Evan H. Krinick reviews recent decisions by the U.S. District Court for the Western District of New York and the U.S. Court of Appeals for the Fifth Circuit and their explorations of how sentencing and restitution should be calculated in insurance fraud cases.

By Evan H. Krinick

11 minute read