总检察长因州保险欺诈局资助和联系而对律师事务所提起汽车保险欺诈诉讼并非不当或违宪

ATTORNEY GENERAL'S PROSECUTION OF LAW FIRM FOR AUTO INSURANCE FRAUD NOT IMPROPER OR UNCONSTITUTIONAL BECAUSE OF FUNDING BY AND CONTACT WITH STATE INSURANCE FRAUD BUREAU

Journal of Risk & Insurance · 1999
被引 0
ABS 3

中文导读

马萨诸塞州最高司法法院裁定,总检察长办公室的保险欺诈部门由保险公司资助并不违宪,驳回了被告关于利益冲突的挑战。

Abstract

Commonwealth v. Ellis, 429 Mass. 362, 708 N.E.2d 644 (Supreme Judicial Court of Massachusetts, April 14, 1999). Massachusetts, like many states, operates an insurance fraud division of its Attorney General's office and an insurance fraud bureau. These entities focus on investigating and prosecuting insurance fraud. The antifraud bureau is funded by statutorily established procedure in which insurers doing business in Massachusetts fund the division. As a result, insurance fraud defendants recently challenged their convictions as tainted by improper conflict of interest. The Massachusetts Supreme Judicial Court rejected the challenge, ruling that the funding system for the antifraud division did not violate the constitution. Although the Court did not expressly address the issue of any violation of the rules of lawyer professional responsibility, or other laws, the Court implicitly found no other legal infirmity with the system, although it did raise public policy concerns as to the wisdom of the system's operation. The Insurance Fraud Bureau (IFB) of the Attorney General's office is charged with investigating any claims of fraudulent insurance transactions and referring any infraction to the appropriate prosecutor. Instances of alleged fraud are brought to the attention of the IFB by insurers who have been victimized by the fraud. A state statute in fact requires insurers to report any instances of suspected fraud. Where the IFB is satisfied that fraud has taken place, it is required to refer the matter to the AG, the appropriate state district attorney, or the United States Attorney for Massachusetts. In addition to any other applicable criminal penalties, those committing fraud, if successfully prosecuted shall be ordered to make restitution to the insurer for any financial loss sustained because of the fraud. The AG has historically appointed a half-dozen or more assistant AG's who work full time with the IFB. The IFB is governed by a board of 15 members, five from the Automobile Insurance rating bureau, five from the Workers' Compensation rating bureau, and five public officials. An executive director presides over the IFB. The IFB is funded by the two rating bureaus, who are assessed an amount determined by the Commissioner of Insurance based on actual costs of operating the IFB and conducting the investigations. During fiscal 1999, these amounts were over $1 million. The Court observed: There is no authority bearing on whether a prosecutor, acting pursuant to authorizing legislation, may properly prosecute a class of crimes involving an industry that indirectly provides funds to support those prosecutions. There is considerable authority concerning the impropriety of a prosecutor, or a prosecutor's client, having a substantial interest in the outcome of the criminal proceedings. Much of that authority is not based on constitutional considerations. In the cases before us, however, the defendants must rest their main argument on constitutional grounds because the structure of the process that they challenge is prescribed by statute.... [T]he circumstances of this case are unique. See 429 Mass. at 366-67, 708 N.E.2d at 647-48. Despite the unique nature of the challenge to the Massachusetts anti-fraud bureau, the Court considered the potentially analogous impact of cases such as Young v. United States ex rel Vuitton et Fils, S.A., 481 U.S. 787, 107 S.Ct. 2124, 95 L.Ed. 2d 740 (1987), in which the U.S. Supreme Court found a violation of due process when a civil litigant was appointed by the trial court to prosecute criminal contempt charges against its opponent. In Vuitton, there was simply too much incentive for the prosecutor to litigate the case in a manner that would provide it advantages in the related civil case. By contrast, in Ellis and other insurance fraud prosecutions, the affected insurer is funding the prosecutor in only an indirect and attenuated manner. …

保险法法律伦理宪法保险欺诈