The False Claims Act of 1863 (FCA) is an American federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal government's primary litigation tool in combating fraud against the government. The law includes a qui tam provision that allows people who are not affiliated with the government, called "relators" under the law, to file actions on behalf of the government. This is informally called "whistleblowing", especially when the relator is employed by the organization accused in the suit. Persons filing actions under the Act stand to receive a portion of any recovered damages.
Barry Jay Minkow is a former American businessman, pastor, and convicted felon. While still in high school, Minkow founded ZZZZ Best, which appeared to be an immensely successful carpet-cleaning and restoration company. However, it was actually a front to attract investment for a massive Ponzi scheme. ZZZZ Best collapsed in 1987, costing investors and lenders $100 million in one of the largest investment frauds ever perpetrated by a single person, as well as one of the largest accounting frauds in history. The scheme is often used as a case study of accounting fraud.
Jeffrey Keith Skilling is an American businessman who in 2006 was convicted of federal felony charges relating the Enron scandal. Skilling, who was CEO of Enron during the company's collapse, was eventually sentenced to 24 years in prison, of which he served 12 after multiple appeals.
Insurance fraud is any act committed to defraud an insurance process. It occurs when a claimant attempts to obtain some benefit or advantage they are not entitled to, or when an insurer knowingly denies some benefit that is due. According to the United States Federal Bureau of Investigation, the most common schemes include premium diversion, fee churning, asset diversion, and workers compensation fraud. Perpetrators in the schemes can be insurance company employees or claimants. False insurance claims are insurance claims filed with the fraudulent intention towards an insurance provider.
The McCarran–Ferguson Act, 15 U.S.C. §§ 1011-1015, is a United States federal law that exempts the business of insurance from most federal regulation, including federal antitrust laws to a limited extent. The 79th Congress passed the McCarran–Ferguson Act in 1945 after the Supreme Court ruled in United States v. South-Eastern Underwriters Association that the federal government could regulate insurance companies under the authority of the Commerce Clause in the U.S. Constitution and that the federal antitrust laws applied to the insurance industry.
Life Partners, Inc. is a life settlement provider headquartered in Waco, Texas. LPI's parent company, Life Partners Holdings, Inc., delisted from the NASDAQ, currently trades on the OTCPK under the ticker LPHI.Q. This follows the company seeking Chapter 11 bankruptcy protection, resulting from a total of $46.9 million in penalties levied against the company and two of its officers.
Kyle Dustin "Dusty" Foggo, is a former American government intelligence officer. He was convicted of honest services fraud in the awarding of a government contract and sentenced to 37 months in the federal prison at Pine Knot, Kentucky.
Misclassification of employees as independent contractors is the way in which the United States and other countries classify the problem of false self-employment. In the U.S., it can occur with respect to tax treatment or the Fair Labor Standards Act.
Carol Chien-Hua Lam is a former United States Attorney for the Southern District of California. Lam was sworn into office on an interim basis on September 4, 2002. On November 12, 2002, Lam was further sworn in as a Senate confirmed presidential appointee. She oversaw the Rep. Randy "Duke" Cunningham military contracting corruption case. Lam was one of eight attorneys fired in the Dismissal of U.S. attorneys controversy.
Kerri Rigsby and Cori Rigsby (Moran) are the American sisters who worked for eight years at E.A. Renfroe Company and were managers overseeing catastrophe claims adjusters. Kerri and Cori Rigsby are also the whistleblowers who proved to a Mississippi jury that State Farm committed fraud against the U.S. government. The sisters claim State Farm ignored or minimized wind damage to avoid payments relating to Hurricane Katrina and instead attributed damage to flooding so that the National Flood Insurance Program would cover the claims. The jury verdict was upheld by the U.S. Court of Appeals for the Fifth Circuit, was then affirmed 8-0 by the United States Supreme Court. The Rigsbys were managers who worked in Gulfport, Mississippi for a subcontractor hired by State Farm to adjust wind and flood claims after Hurricane Katrina. They were the first to uncover a fraudulent scheme by State Farm to improperly categorize wind damage as flood damage. This mischaracterization was very important because State Farm had to pay for wind damage out of its own pocket under State Farm homeowner policies, while flood damage was paid by the federal government under FEMA's flood policies. Over the course of several months, the sisters amassed thousands of pages of documents related to State Farm's activities. The Rigsbys' landmark win was historic because they were the first to prove that an insurance company defrauded the government in FEMA's National Flood Insurance Program despite testimony by FEMA’s Executive Director that, after investigating the allegations, he personally didn’t believe that there was any fraud by State Farm, and he confirmed that FEMA had not asked State Farm to repay any money to the National Flood Insurance Program. However, according to court documents, the sisters took the documents without authorization. Their actions in regard to these documents is the subject of ongoing legal action. Eventually, their story went public when ABC's 20/20 show aired it in August 2006. In 2008, Judge Senter of the U.S. District Court of the Southern District of Mississippi found that the sisters and their attorneys had acted unethically when the Scruggs Katrina Group paid the sisters $150,000 per year each to testify, and barred them from testifying or using any of the documents that were taken. Scruggs was later forced to withdraw as their attorney because he improperly paid them for downloading and giving him the State Farm claims files and other documents to use in his lawsuits against State Farm. Scruggs also was later disbarred after pleading guilty to conspiracy to bribe a state circuit court judge in 2008 and separately, to improperly influence another state court circuit judge. He was sentenced to serve five years and seven years, to run concurrently, on the two guilty pleas.
Harris myCFO is the American wealth management unit of BMO Harris Bank serving high-net-worth individuals and families. In 2002, Harris acquired certain assets of myCFO, Inc., founded by James H. Clark, in a $30 million deal. Harris myCFO provides a variety of services including investment advisory and family office services. Harris myCFO managed over $18 billion in assets in 2011 and Forbes ranked the company seventh on a list of top fee-only investment advisors.
The Ohio Bureau of Workers' Compensation provides medical and compensation benefits for work-related injuries, diseases and deaths. It was founded in 1912. With assets under management of more than $29 billion, it is the largest state-operated and second largest overall provider of workers’ compensation insurance in the United States.
McNally v. United States, 483 U.S. 350 (1987), was a case in which the United States Supreme Court decided that the federal statute criminalizing mail fraud applied only to the schemes and artifices defrauding victims of money or property, as opposed to those defrauding citizens of their rights to good government. The case was superseded one year later when the United States Congress amended the law to specifically include honest services fraud in the mail and wire fraud statutes.
Happy's Pizza is an American regional chain of restaurants, serving pizza, ribs, chicken, seafood, sandwiches, pasta and salad.
5Linx is an American multi-level marketing company headquartered in Rochester, New York, which offers utility and telecommunication services, health insurance, nutritional supplements, and business services. It was founded in 2001. In 2017, the co-founders of 5LINX, Craig Jerabeck, Jeb Tyler, and Jason Guck, were indicted on multiple federal fraud charges, including wire fraud and money laundering. They admitted to defrauding $2.3 million from investors, illegally depositing company revenues into personal accounts, and failing to pay hundreds of thousands of dollars in taxes. Tyler and Jerabeck were sentenced to 14-month prison terms in December 2018.
Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare or equivalent State programs. The manner in which this is done varies, and persons engaging in fraud are always seeking new ways to circumvent the law. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).
Nikola Corporation is an American manufacturer of heavy-duty commercial battery-electric vehicles, fuel-cell electric vehicles, and energy solutions. It presented several concept vehicles from 2016 to 2020, the first of which was a natural gas fueled turbine-electric semi truck. The company went public on June 4, 2020. In February 2022, the company projected deliveries of between 300 and 500 of its first battery-electric semitrucks — known as the Nikola Tre — to customers. The company delivered its first two battery-electric trucks in December 2021. Like Tesla, Inc., the company is named in honor of Nikola Tesla, but these are not related to the inventor. Nikola Corporation is based in Phoenix, Arizona.
California Assembly Bill 5 or AB 5 is a state statute that expands a landmark Supreme Court of California case from 2018, Dynamex Operations West, Inc. v. Superior Court ("Dynamex"). In that case, the court held that most wage-earning workers are employees and ought to be classified as such, and that the burden of proof for classifying individuals as independent contractors belongs to the hiring entity. AB 5 extends that decision to all workers. It entitles them to be classified as employees with the usual labor protections, such as minimum wage laws, sick leave, and unemployment and workers' compensation benefits, which do not apply to independent contractors. Concerns over employee misclassification, especially in the gig economy, drove support for the bill, but it remains divisive.
Dynamex Operations W. v. Superior Court and Charles Lee, Real Party in Interest, 4 Cal.5th 903 was a landmark case handed down by the California Supreme Court on April 30, 2018. A class of drivers for a same-day delivery company, Dynamex, claimed that they were misclassified as independent contractors and thus unlawfully deprived of employment protections under California’s wage orders. Their claims raised the question of what the appropriate standard was to determine whether workers should be classified as employees or as independent contractors under California’s wage orders.
