Qualified not Absolute Privilege

Published: April 23, 2023, 2:51 p.m.

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Reporting Suspected Insurance Fraud is Subject to a Qualified Privilege \\nin Oklahoma\\n\\nSue Chimento sued claiming defamation, negligence, intentional \\ninterference with business relations, false representation, constructive\\n fraud, and conspiracy against Gallagher Benefit Services, Inc., and \\nScott McCoy, based on allegations they made to the Tulsa Police \\nDepartment, Tulsa County District Attorney\'s Office, and the Oklahoma \\nInsurance Department that she had embezzled money while under their \\nemployment. The trial court granted partial summary judgment to \\nDefendants, finding that their statements to the police and district \\nattorney were subject to an absolute privilege and their statements to \\nOklahoma Insurance Department were subject to a qualified privilege \\nunder 36 O.S. \\xa7 363.\\n\\nIn Sue Chimento v. Gallagher Benefit Services, Inc., and Scott Mccoy, \\nIndividually, Nos. 120089, 120101, 2023 OK 22, Supreme Court of Oklahoma\\n (March 21, 2023) resolved the dispute.\\n\\nBACKGROUND\\n\\nPetitioner, Sue Chimento would pay individual premiums on behalf of the \\nclient Native American Tribes\' employees out of the Tribal Account. \\nGiven how the Tribal Account was utilized, it was typical for the Tribal\\n Account to have a zero balance.\\n\\nIn March 2017, Midfirst Bank found that the Tribal Account was \\noverdrafted. Shortly after management\'s Mr. McCoy inquired of Chimento \\nas to why the account was overdrafted, Chimento resigned her employment \\nwith AJG. McCoy then filed a report with the Tulsa Police Department \\n("TPD") alleging that Chimento embezzled approximately fifty-one \\nthousand dollars ($51,000.00).\\n\\nShortly thereafter the Tulsa County District Attorney filed a criminal \\ninformation charging Chimento with one count of felony embezzlement. The\\n District Attorney later dismissed the charges against Chimento for \\ninsufficient evidence.\\n\\nIMMUNITY DEFENSES\\n\\nDefendants asserted that any of their statements to TPD, the District \\nAttorney\'s Office, and the OID were subject to an absolute privilege, \\nand thus, to the extent any of Chimento\'s claims were based on these \\nstatements, the claims must fail. The trial court granted summary \\njudgment to AJG/GBS on all of Chimento\'s remaining claims. The trial \\ncourt found that Defendants\' statements to TPD and to the District \\nAttorney\'s office were subject to an absolute privilege under 12 O.S. \\xa7 \\n1443.1 and their statements to the OID were subject to a qualified \\nprivilege under 36 O.S. \\xa7 363.\\n\\nDISCUSSION\\n\\nThe Supreme Court concluded that Defendants\' statements to law \\nenforcement were entitled to a qualified privilege.\\n\\nStatements to law enforcement are entitled to a qualified privilege.\\n\\nAny statements Defendants made to TPD and the District Attorney\'s Office\\n only enjoy a qualified privilege.\\n\\nDefendants\' Statements To The Oklahoma Insurance Department Are Entitled\\n To A Qualified Privilege.\\n\\nThe Supreme Court concluded that the clear and unambiguous intent of \\xa7 \\n363 is to provide qualified immunity from civil actions for individuals \\nwho furnish information to the OID regarding fraudulent insurance \\nactivity.\\n\\nTherefore, Defendants statements to TPD and the District Attorney\'s \\nOffice are entitled to a qualified privilege. Likewise, Defendants \\nstatements to the Oklahoma Insurance Department are entitled to a \\nqualified privilege under 36 O.S.Supp.2012 \\xa7 363.\\n\\nZALMA OPINION\\n\\nState law requires insurers to report to the Oklahoma Department of \\nInsurance (OID) suspected insurance fraud and by statute an insurer is \\nprovided an immunity from certain suits like those made by the Plaintiff\\n if the suit is based upon the report to the OID. The report to police, \\nif made in good faith, usually provides an absolute immunity but \\nOklahoma no makes the immunity qualified. Whether qualified or absolute \\nthe immunity protects the defendants.

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