State Farm Mutual Automobile Insurance v. Giventer

212 F. Supp. 2d 639, 2002 U.S. Dist. LEXIS 9952, 2002 WL 1596504
CourtDistrict Court, N.D. Texas
DecidedApril 30, 2002
Docket3:98-cv-02918
StatusPublished
Cited by7 cases

This text of 212 F. Supp. 2d 639 (State Farm Mutual Automobile Insurance v. Giventer) is published on Counsel Stack Legal Research, covering District Court, N.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Farm Mutual Automobile Insurance v. Giventer, 212 F. Supp. 2d 639, 2002 U.S. Dist. LEXIS 9952, 2002 WL 1596504 (N.D. Tex. 2002).

Opinion

FINDINGS OF FACT AND CONCLUSIONS OF LAW

LINDSAY, District Judge.

Plaintiff State Farm Mutual Automobile Insurance Company (“State Farm”) filed this lawsuit on December 14, 1998, asserting claims against Defendants Alexander Giventer (“Giventer”), Michael Merlin (“Merlin”) and other individuals and entities, 1 for alleged violations of the Racketeer Influenced and Corrupt Organizations Act (“RICO”), 18 U.S.C. § 1961 et seq., and for common law fraud. This case was scheduled to begin trial on February 20, 2002. On February 15, 2002, the court held a pretrial conference. Giventer and Merlin failed to appear either personally or by counsel, and did not obtain the court’s consent for their nonappearance. At the pretrial conference, State Farm made an oral motion for entry of default against Giventer and Merlin based on their failure to appear at the pretrial conference or otherwise defend. On February 21, 2002, the court issued an order granting State Farm’s motion for entry of default, and entered default against Giventer and Merlin. A prove-up hearing on the remaining issue of damages was held on February 26, 2002. The court now files its findings of fact and conclusions of law as to Defendants Alexander Giventer and Michael Merlin pursuant to Fed.R.CivP. 52(a).

I. Contentions of the Parties 2

A. State Farm’s Contentions

State Farm contends that Giventer and Merlin were participants in a conspiracy to present fraudulent insurance claims based on intentionally caused automobile collisions. Specifically, State Farm alleges that, from 1993 through 1996, Giventer and Merlin and other individuals, owned, operated, and/or controlled law offices and chiropractic clinics in Dallas County, Texas, through which they submitted fraudulent insurance claims arising out of at least 153 deliberately caused automobile collisions. State Farm contends that these staged accidents typically involved participant drivers, as well as phony passenger victims, who were recruited by street level organizers known as “cappers” or “runners.” According to State Farm, the scheme operated in this manner. Participant drivers caused “Sudden Stop Collisions” by intentionally maneuvering their vehicles in front of non-suspecting motor *642 ists and then deliberately slamming on the brakes to cause rear-end collisions. After the deliberately caused collision, cappers would take participant drivers and their passengers, if any, to a law firm and chiropractic clinic also involved in the scheme. The chiropractic clinics provided the law firms with fraudulent documents that misrepresented the nature and extent of the alleged injuries suffered by the participant drivers and/or their phony victims to substantiate bodily injury claims. The manufactured billing statements were then used by the participating law firm to make fraudulent settlement demands of insurance companies through the mail. State Farm contends that Giventer and Merlin, through the operation of two chiropractic clinics, namely Greenville Health Care and Pain Control Clinic (“Greenville Health Care”) and Forest Health Care Clinic (“Forest Health Care”), participated in the conspiracy by providing to participating law firms fraudulent documents regarding the nature and extent of bodily injuries allegedly sustained by participant “victims.” State Farm contends that these fraudulent documents were submitted by the participating law firms to substantiate fraudulent bodily injury claims that were presented and subsequently paid by State Farm. State Farm asserts claims against Giventer and Merlin under RICO, specifically, 18 U.S.C. §§ 1962(c) and (d).

State Farm also asserts a claim for common law fraud, contending that Giventer and Merlin made false and fraudulent misrepresentations of fact to it and other insurance companies regarding the facts and circumstances of the Sudden Stop Collisions; the existence, nature, and severity of the fraudulent soft tissue injures allegedly caused by those collisions; and the reasonableness and necessity of examinations, consultations, treatments, and testing procedures purportedly provided to the participants. State Farm contends that Giventer and Merlin intentionally concealed and failed to disclose material facts within their knowledge knowing that State Farm was ignorant of those facts. In particular, State Farm contends that Giv-enter and Merlin concealed and failed to disclose that the Sudden Stop Collisions were intentionally caused to manufacture fraudulent personal injury and property damage claims, the purported injuries of participants were fraudulent, and medical bills and related records reflected services that either never occurred or were not reasonably necessary.

State Farm seeks to recover $2,135,968.13 in actual damages as a result of the fraudulent bodily injury and property damage claims arising from the Sudden Stop Collisions, as well as statutory treble damages pursuant to 18 U.S.C. § 1964(c), and punitive damages under common law.

B. Giventer’s Contentions

Defendant Giventer denies State Farm’s allegations, contending that he has no personal knowledge of the facts upon which State Farm’s Complaint is based. Given-ter contends that although he owned the chiropractic clinics in question, he lived and worked in California during their periods of operation and relied on Merlin, the office manager, and other staff members to handle the day-to-day management and operation of the clinics. Giventer contends that he did not enter into any agreements or understandings with respect to the referral of patients or payment of persons or entities for the referral of patients, and that he did not enter into any agreement as to the matters alleged to constitute a conspiracy. Giventer contends that he was misled by members of his staff regarding the management and operation of the clinics, including the source of income received by the clinics. Giventer therefore contends that he is not liable to State Farm under RICO or for common law fraud, and that he is not responsible for any of the claimed monetary damages.

*643 Giventer also contends that State Farm’s claims are barred or reduced in whole or in part by the applicable statute of limitations, assumption of risk or negligence of its employees, managing directors and agents, and by the conduct or negligence of the other named defendants in this action, which he contends are superseding causes to any conduct allegedly attributable to him. Giventer also contends that State Farm’s claims are barred in whole or in part by its failure to mitigate damages, laches and estoppel. 3

II. Findings of Fact 4

A. Findings 5

1.

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Bluebook (online)
212 F. Supp. 2d 639, 2002 U.S. Dist. LEXIS 9952, 2002 WL 1596504, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-mutual-automobile-insurance-v-giventer-txnd-2002.