Plude v. Adams

100 F. Supp. 3d 172, 2015 U.S. Dist. LEXIS 28337, 2015 WL 1014526
CourtDistrict Court, D. Connecticut
DecidedMarch 9, 2015
DocketCivil No. 3:12-cv-0069 (AWT)
StatusPublished

This text of 100 F. Supp. 3d 172 (Plude v. Adams) is published on Counsel Stack Legal Research, covering District Court, D. Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Plude v. Adams, 100 F. Supp. 3d 172, 2015 U.S. Dist. LEXIS 28337, 2015 WL 1014526 (D. Conn. 2015).

Opinion

RULING ON MOTION FOR SUMMARY JUDGMENT

ALVIN W. THOMPSON, District Judge.

The plaintiff, Michael Plude (“Plude”), brought this action against Officer John T. Petrillo, Jr. of the Shelton Police Department (“Petrillo”), Rebecca Adams (“Adams”), David L. Guay, Thomas Reynolds and the Connecticut State Board of Accountancy. The court has dismissed all claims against Adams, David L. Guay, Thomas Reynolds and the Connecticut State Board of Accountancy. As to Petril-lo, Plude brings a claim for false arrest pursuant to 42 U.S.C. § 1983 and a common law claim for malicious prosecution. Petrillo moves for summary judgment on both claims. For the reasons set forth below, Petrillo’s motion for summary judgment is being granted.

I. FACTUAL BACKGROUND

Plude is a certified public accountant and a partner in an accounting firm. From 1999 until July 2008, he provided accounting services to Pioneer Gas & Appliance Inc. (“Pioneer”).

This action arises out the Shelton Police Department’s investigation and arrest of Plude, pursuant to a warrant, for health insurance fraud in violation of Connecticut General Statutes § 53-442 and conspiracy to commit health insurance fraud in violation of Connecticut General Statutes § 53a-48.

Under Connecticut General Statutes § 53-442, a person is guilty of health insurance fraud if he:

with the intent to defraud or deceive any insurer ... presents or causes to be presented to any insurer or any agent thereof any written ... statement as part of ... an application for any policy of insurance ... knowing that such statement contains any false, incomplete, deceptive or misleading information concerning any fact or thing material to such claim or application, or omits information concerning any fact or thing material to such claim or application....

As discussed below, Petrillo conducted the investigation of Plude, which revealed, among other things, that: (a) Plude had submitted an application for health insurance with Anthem Blue Cross Blue Shield Insurance (“Anthem”) through Pioneer, which stated that he worked 40 hours per week for Pioneer as its Treasurer and his date of full-time hire was December 17, 2006; and (b) Pioneer denied that it ever employed Plude. Plude was arrested for the charges described above pursuant to an arrest warrant on June 25, 2009.1

Petrillo’s investigation of Plude began on July 22, 2008, when Pioneer asked the Shelton Police Department to help retrieve certain company records from Plude, whose relationship with Pioneer had been terminated because he was suspected of fraudulently using the company’s money. [175]*175Petrillo subsequently learned that Anthem, Pioneer’s medical insurance carrier, had filed an Insurance Fraud Report -with the Connecticut Insurance Department against Plude for fraudulently receiving medical benefits through Pioneer during the period from September 1, 2007 through August 1, 2008 (the “Anthem Insurance Fraud Report”). Petrillo received a copy the Anthem Insurance Fraud Report, dated September 16,- 2008, which described the following “suspected fraudulent activity” by Plude:

[Pioneer’s] “Corporate Secretary” Lorraine Tirella [told Anthem that Plude] had himself added to Pioneer’s Anthem group insurance coverage without authorization to do so; he was never an employee of the company. Plude, it is believed, also managed to get himself designated in State of [Connecticut] filings as the “treasurer” for Pioneer. Plude and his family ... had health insurance coverage with Anthem, through Pioneer, from 09/01/2007 through 08/01/2008 (when Pioneer had Plude’s family coverage cancelled).... It is believed that Plude dealt directly with [insurance agent] Fredrick Serra ... to get himself added to the Pioneer Gas health plan with Anthem.... [A]ll documents specific to Anthem coverage for any Pioneer employee had traditionally been sent to Serra from Pioneer; the documents for ... Plude and his family were between Plude, from his office at [his accounting firm], and Serra, and appear to have bypassed involvement from Pioneer. It is believed that [Pioneer’st former bookkeeper, Joanne Wilson,] devised a plan to cut Pioneer payroll checks for Plude, in an amount ... that would cover the usual payroll deductions and leave just enough “net” to cover the cost for Plude’s family health insurance coverage.... Joanne Wilson was fired by Pioneer Gas when this scheme came to light and Pioneer’s relationship with Plude was severed as well_ [Serra] stated that “as a vendor” he was led to believe (but did not say by whom) that Plude had a very active role at Pioneer and was doing more things “strategically” for the company. Serra claims that if he spoke with Plude about Pioneer’s health benefits, he was always referred back to Joanne Wilson. [Serra] never questioned Plude’s coverage because he was of the belief that Plude was actively managing Pioneer business and that arrangements were made for said coverage. Serra was asked about what he thought when Plude, who is a partner in his own [accounting] firm, asked him to cancel the health coverage he had with [the Connecticut Business and Industry Association] and put him on Pioneer’s plan with Anthem. He said he didn’t question it because he’s seen similar situations in the past and he was under the belief that Plude was “actively involved in Pioneer company management.”

(56(a)2 Stmt., Ex. 6 at 1-2.)

Over the course of the investigation that followed, Petrillo obtained, among other things, records related to Plude’s health insurance coverage and professional relationship with Pioneer, and statements and reports from Pioneer employees and others.

On February 25, 2009, Petrillo interviewed Pioneer’s insurance agent, Fredrick Serra (“Serra”). According to Pe-trillo’s case/incident report, Plude told Serra in August 2007 that he “was now running Pioneer”, and shortly thereafter he applied to receive benefits through Pioneer, which Tirella and Joanne Wilson (Pioneer’s former bookkeeper) (‘Wilson”), “would also approve.” (56(a)2 Stmt., Ex. 7 at 1.) During the interview Adams indicated that her agency, the State Board of [176]*176Accountancy, was also investigating Plude’s conduct.

On April 30, 2009, Petrillo obtained a copy of Plude’s insurance application, which stated that his employer was Pioneer, his occupation was Treasurer, he worked 40 hours per week, and his date of full time hire was December 7, 2006. Health insurance benefits through Pioneer were limited to Pioneer employees who worked 30 hours or more per week.

On May 6, 2009, Pioneer’s Vice President, Ralph Tirella (“Tirella”), provided Petrillo a written statement that contradicted material information in Plude’s health insurance application. Tirella stated that he had been in charge of hiring at Pioneer since March 2005, Plude was never an employee of Pioneer, Plude was an independent contractor who performed accounting services for Pioneer through his accounting firm, Plude was not authorized to add himself to the Pioneer medical insurance plan because he was never an employee, and Tirella was not aware that Plude enrolled himself on Pioneer’s insurance plan until several months after he had done so.

Petrillo received a number of documents from Pioneer that were inconsistent with information in Plude’s health insurance application.

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Bluebook (online)
100 F. Supp. 3d 172, 2015 U.S. Dist. LEXIS 28337, 2015 WL 1014526, Counsel Stack Legal Research, https://law.counselstack.com/opinion/plude-v-adams-ctd-2015.