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Insurance Fraud/Examinations Under Oath

By January 3, 2012Insurance



  • Based on its expertise in insurance coverage and taking examinations under oath, Cummins & White, LLP, assisted an insurance carrier in its arson investigation of a claim for fire damage to a residence.
  • During examinations under oath, attorney Melody Mosley elicited misrepresentations from the homeowners, which in combination with additional evidence led the carrier to deny the claim.
  • The fire department utilized information from the insurance carrier’s file as part of a separate criminal investigation which culminated with the insureds receiving lengthy prison sentences for involuntary manslaughter, conspiracy to commit arson, and insurance fraud.


Case Study

Cummins & White, LLP, assisted a major insurance carrier in an insurance fraud investigation following a suspicious residential fire.  Despite a fire department determination that the blaze was intentionally set, the homeowners submitted a claim, triggering an investigation.  Additionally, the homeowners’ handyman died as a result of being burned in the fire.  As part of the investigation, Cummins & White attorney Melody Mosley conducted examinations under oath, during which the homeowners misrepresented and concealed information about the condition of the home, their financial situation, and their relationship and recent contact with the handyman. It appeared likely that the husband had hired the handyman to set the fire, and based on all the information, the claim was denied. Additionally, the police used information from the insurance inquiry to supplement their criminal investigation, which ended with significant prison sentences for the homeowners.

Background/Legal Strategy

In 2007, a vacant home in Long Beach, Calif., was destroyed by fire.  Neighbors heard an explosion and saw a man in flames run from the home.  He rolled in gutter water and left before firefighters arrived.  An investigation determined that the fire was intentionally set with gasoline, and that an explosion had occurred.

Following the fire, the homeowners (a husband and wife) filed a claim, and the carrier began its own arson investigation. Cummins & White attorney Melody Mosley was retained to conduct examinations under oath.


The initial investigation revealed that:

  • The homeowners’ handyman died as a result of being burned in the fire.  According to the handyman’s wife, he called to say there had been an explosion and he was heading to the hospital.  She intercepted him and helped him to the hospital.  He died later that day.
  • The handyman had been paid by the homeowner husband to burn the house. This information was revealed by the handyman’s wife during police interviews and was relayed to the insurance investigative team. The second phase of the investigation included examinations under oath. Ms. Mosley took sworn statements from the homeowners. During their testimony, the couple misrepresented critical facts, stating that:
    • The house was ready to be rented.  This was disputed by a city building inspector, who said a recent home inspection showed several items requiring repair.
    • The handyman had last worked at the property two to three weeks before the fire, and they had not recently been in touch with him. The homeowners changed their testimony when asked to produce cellphone bills but still did not provide accurate dates for the phone calls.  Phone records later indicated a number of recent calls to and from the handyman to the insureds’ cell phones, including calls to the homeowner husband on the day of the fire.

Based on the facts uncovered as part of the investigation and the sworn testimony of the homeowners, the claim was denied. Importantly, the fire department, which was conducting a separate inquiry, obtained a copy of the insurance company’s file, and with the additional information, filed charges against the homeowner husband.  His wife was subsequently arrested and charged when the judge at her husband’s preliminary hearing found that there was sufficient evidence implicating her as well. (She had been in court as an observer). The criminal case ended when the homeowner husband pleaded no contest to involuntary manslaughter, conspiracy to commit arson, and insurance fraud.  He was sentenced to more than 14 years in prison.  His wife pleaded no contest to insurance fraud and was sentenced to six years in prison.

Ms. Mosley said the final outcome reflected a group effort, including insurance carrier staff members who recognized that the claim required further review and a private investigator who conducted interviews and uncovered key facts.