Allstate Ins. Co. v. Lopez

710 A.2d 1072, 311 N.J. Super. 660, 1998 N.J. Super. LEXIS 228
CourtNew Jersey Superior Court Appellate Division
DecidedFebruary 6, 1998
StatusPublished
Cited by11 cases

This text of 710 A.2d 1072 (Allstate Ins. Co. v. Lopez) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allstate Ins. Co. v. Lopez, 710 A.2d 1072, 311 N.J. Super. 660, 1998 N.J. Super. LEXIS 228 (N.J. Ct. App. 1998).

Opinion

710 A.2d 1072 (1998)
311 N.J. Super. 660

ALLSTATE INSURANCE COMPANY, Plaintiff,
v.
Idabells LOPEZ, et al., Defendants.

Superior Court of New Jersey, Law Division, Morris County.

Decided February 6, 1998.

*1073 Gordon Graber and Robyn Ann Valle, Morristown, for plaintiff (Sullivan & Graber, attorneys; Ms. Valle, on the brief).

Joseph A. Massood, Wayne, for defendants Melania Rodriguez, Yrsi Perez, Maria Rodriguez-Perez, Euclides DelRosario and Ana Benitez (Massood & Covello, attorneys; Mr. Massood, on the brief).

William Figundio III, for defendants Jose Bergos, Sandra Maria and Victor Pena (Weiner Ryan Brogan & Associates, attorneys, Passaic; Mr. Figundio, on the brief).

Jonathan G. Williams, Chatham, for defendant Clifton Medical Imaging Center (Epstein, Epstein, Brown & Bosek, attorneys; Mr. Williams, on the brief).

VILLANUEVA, J.A.D. (retired and temporarily assigned on recall).

Plaintiff, Allstate Insurance Company ("Allstate"), brings this declaratory judgment action against 434 defendants (insureds, drivers, passengers and health care providers) alleging insurance fraud. Allstate states that this case involves what is believed to be part of the largest automobile-accident fraud ring documented in United States history.[1] The alleged participants in this ring have instituted personal injury lawsuits and arbitration proceedings claiming damages for bodily injury, either individually or through assignees, for personal injury protection ("PIP") and other benefits and damages. Allstate seeks to stay all ongoing and future lawsuits in various counties and arbitration proceedings, but not discovery, involving these defendants, pending the resolution of this declaratory judgment action.

ALLSTATE'S ALLEGATIONS

The fraud ring operates primarily in the cities of Passaic and Paterson, New Jersey (Passaic-Paterson fraud ring). The ring members' purpose is to defraud Allstate and other automobile insurers. Allstate alleges that the members' method of achieving that purpose is to stage accidents involving major "players" or operatives, usually the owner and/or driver of the car who engage in frequent repeat performances, and bit players, the passengers, whose participation often is limited to a one-time appearance.[2]

The main players in the fraud ring are usually associated with four or more accidents in a relatively short period of time. Almost all of these alleged accidents involve two vehicles filled to capacity. The police are called to the scene in order to create a *1074 record of the incident. Generally, the vehicles appear to have minor damage; the driver or owner often attempts to offer preexisting damage as evidence to the responding officer, and later to the insurance company, that the accident occurred. The impact between the vehicles, to the extent that it occurred at all, occurs most often in a twenty-five mile-per-hour zone; frequently the drivers admit that one or the other vehicle was stopped or travelling at a minimal rate of speed.

Although the players often complain of pain at the accident scene, the responding police officer rarely discerns visible injuries. No one is bleeding, bruised or unconscious at the scene. None of the defendants named in this lawsuit sustained a fracture as a result of any of the alleged accidents. Rather, the participants, with the notable exception of the at-fault driver, file claims for extensive treatment and testing related to soft-tissue injuries. Due to the subjective nature of this type of injury, the players are able to feign injury without much risk of detection.

For the most part, Allstate alleges that the players design each accident to appear as if it were caused solely by the negligence of a single insured driver. Thus, ring members consistently employ predictable factual scenarios that serve as a blueprint and ensure: first, that the at-fault participant is easily recognizable, and, second, that the participants are not in danger of actual injury. These scenarios include: low-speed rear-end hits; intersection accidents caused by a driver's acknowledged failure to obey a stop sign; impacts caused by a driver's failure to yield when exiting from a parking lot, driveway or parking spot; and side-swipes of a stopped vehicle caused by the other driver's wide turn. These fact patterns generally foreclose liability questions and are allegedly designed to encourage insurance companies to settle claims quickly, without litigation.

SUMMARY OF FACTS

Because the facts in the original filed opinion are so detailed and lengthy, they have only been summarized for the purpose of the reported opinion.

The accidents that are at issue in this lawsuit can be analyzed most readily with reference to three alleged major players in the Passaic-Paterson fraud ring.

A. The Maria Vinales Connection

On July 26, 1995, Maria Vinales (also known as Maria Vinalls) was driving a car owned by Pablo Melendez when she rear-ended a car driven by Ysebia Reynoso. On August 14, 1995, defendant Vinales was driving a 1981 Buick when she rear-ended a 1992 Chevrolet driven by Elizabeth Escabi. On November 19, 1995, Vinales was driving Sonia Pabon's 1982 Plymouth when she rear-ended a car driven by Jose A. Maldonado. On December 18, 1995, Vinales was driving a car owned by Pedro Verdejo when she allegedly made a wide right turn and hit the oncoming vehicle driven by Nancy Jiminez. On January 31, 1996, Vinales was again driving Pabon's Plymouth when she rear-ended a vehicle driven by Melania Rodriguez and owned by Andy Catinchi. On February 17, 1996, Vinales was driving a car belonging to Ramon Hernandez when it was bumped by a car making a wide right-hand turn driven by Luis A. Vigo. On May 26, 1996, Vinales was driving a car owned by Joel Mendez when she rear-ended a car driven by Michele Romao. Therefore, Vinales apparently caused seven accidents within ten months.

Allstate contends that the drivers and passengers of the other cars involved in these incidents are not innocent victims; they, too, are active participants in the scheme to commit fraud.

Elizabeth Escabi (also known at Escabi-Townsend), who was involved in the August 14, 1995 incident with Vinales when she was rear-ended by the Vinales vehicle being driven by Angel R. Vasquez, is currently being investigated for that accident as well as two other accidents. Vasquez, himself, is under investigation for his involvement in five additional accidents.

Andy Catinchi, the owner of the car involved in the January 31, 1996 Vinales incident, is under investigation for losses sustained in twelve accidents that occurred between August 3, 1995 and April 1, 1996.

*1075 Joel Mendez, owner of the car driven by Vinales in the May 26, 1996 incident, is currently being investigated by Allstate for his involvement in twelve accidents that occurred between February 3, 1996 and July 21, 1996.

A familiar player involved with Mendez is Santos Gonzalez. Gonzalez was involved in three of the Mendez incidents while either Gonzalez was driving the Mendez vehicle or Mendez was driving the Gonzalez vehicle. Gonzalez is being investigated for his involvement in thirteen accidents that occurred between November 7, 1995 and August 10, 1996. In an accident which occurred on July 14, 1997, Gonzalez rear-ended a vehicle driven by Leonor Agosto. Agosto, herself, is currently under investigation by Allstate for her involvement in five accidents between February 25, 1996 and July 14, 1996.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Citizens United Reciprocal Exch. v. Meer
321 F. Supp. 3d 479 (D. New Jersey, 2018)
Garden State Equality v. Dow
79 A.3d 479 (New Jersey Superior Court App Division, 2013)
NJ MANUFACTURERS INS. v. Gonsalves
841 A.2d 512 (New Jersey Superior Court App Division, 2003)
Continental Ins. v. Simkins Indus., No. X01-Cv-01-0168422 (Dec. 20, 2001)
2001 Conn. Super. Ct. 16902 (Connecticut Superior Court, 2001)
State Farm Insurance v. Sabato
767 A.2d 485 (New Jersey Superior Court App Division, 2001)
Allstate Ins. Co. v. Lopez
738 A.2d 987 (New Jersey Superior Court App Division, 1999)

Cite This Page — Counsel Stack

Bluebook (online)
710 A.2d 1072, 311 N.J. Super. 660, 1998 N.J. Super. LEXIS 228, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allstate-ins-co-v-lopez-njsuperctappdiv-1998.