iFraud Deep Dive
Welcome to iFraud Deep Dive, an official podcast series of the iFraud Foundation — where we tackle the toughest issues facing the property and casualty industry in the fight against fraud.
Each episode features in-depth conversations breaking down complex issues into easily consumable information that we can all understand. We explore the fraud landscape, expose emerging threats, and highlight actionable solutions. From staged accidents and collusive networks to litigation abuse and regulatory gaps, we go beyond the headlines to bring you the insights that matter.
Whether you’re a carrier, broker, employer, attorney, or regulator, if you’re committed to protecting the integrity of our industry then this podcast is for you.
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iFraud Deep Dive
S2 E29 Union Mutual vs CitiMed Moves to Round 2
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In this episode of Deep Dive, we break down a significant court ruling that keeps a high-stakes insurance fraud case alive in New York.
At the center is a lawsuit brought by Union Mutual Fire Insurance Company against Citimed Complete Medical Care and Dr. Regina Moshe—alleging a coordinated scheme built on falsified medical reports, engineered to drive insurance payouts and sustain a pipeline of patient referrals. The defendants pushed to have the case dismissed. But the court said not so fast.
Judge Natasha C. Merle ruled that the fraud allegations were detailed enough—and serious enough—to move forward into discovery, signaling that the claims warrant a closer, evidence-driven examination. At the same time, the court trimmed the case, dismissing claims for unjust enrichment and declaratory judgment as duplicative of the core fraud allegations.
What remains is the heart of the dispute: whether there was a deliberate pattern of misrepresentation—and how much financial damage it caused.
This is exactly the kind of case that sits at the intersection of medical billing, litigation strategy, and the broader “Fraudemic” impacting the insurance ecosystem.
Let’s dive into it.