A former Virginia insurance agent pled guilty last week to wire fraud related to a scheme to pocket the premiums he was paid for policies he sold.
According to court documents, Thomas Robert Hoyt, of Melfa, told certain clients to pay premiums to him and that he would forward the payments to the insurance carriers for which he was an agent.
In response to complaints, the Virginia Bureau of Insurance opened an investigation in June 2021. In September 2021, Hoyt agreed to the permanent revocation of the insurance licenses for himself and Hoyt Insurance.
According to court documents, Hoyt then sold his book of business to another independent insurance agency. Hoyt falsely represented that all premiums due on policies that were part of the purchase had been paid to the respective insurers and that there were no pending investigations.
The acquiring agency provided Hoyt with a $27,282.28 down payment. However, the agency soon discovered that a “significant number had lapsed or were never in place because Hoyt had failed to pay the insurance carriers” the required premiums, according to the U.S. Attorney for the Eastern District of Virginia.
In August 2022, the insurance regulator referred the matter to the U.S. Postal Inspection Service (USPIS), which found that Hoyt had repeatedly assured his clients they had a valid insurance policy, collected premium payments from them, and then used the payments for personal use rather than forwarding them to the insurance companies.
At best, the judge wrote, facts presented by Uber show that the doctors received benefits “incidental to an ordinary and lawful client-referral relationship and third-party litigation financing of medical treatment,” but they do not permit a plausible inference that the doctors shared the common purpose to engage in fraudulent conduct to extract claims from Uber and others.
The court found that beyond its conclusory statements, Uber’s factual allegations supported “only an inference of independent relationships” involving different sets of defendants. Uber alleged “at least 17 different schemes involving different amalgamations of different defendants engaged to allegedly defraud Uber in a variety of ways.” But each scheme only involved sub-groups of defendants, never all defendants. Such allegations of “various defendants and subgroups agreeing at different times to engage in various fraudulent schemes” does not plausibly support an inference of common purpose, the judge concluded.
Furthermore, in six of the 17 cases Uber relies on, only one law firm defendant is alleged to have directed passengers to a doctor, without participation from another law firm or doctor.
Also, the allegations by Uber of lawyers’ referrals of passengers to the doctors and receipt of causation statements fail to show common purpose and “nothing suggests anything more than routine medical referrals and medical declarations.”