Purple Tab B001 — Insurance Fraud: Criminal Referral Package¶
GUARDRAIL: PURPLE — STRATEGIC INTEGRATION
Strategy, framework integration, and settlement positioning. References Blue/Red/Brown damages; does not duplicate calculations.
PART A — SCOPE & GUARDRAILS¶
A.1) Document Scope¶
What B001 Covers: - Insurance fraud / claim-phase conduct (Step 1) - December 2019 pre-inspection meetings and related communications - Claim submissions, supporting documentation, and representations to carriers - Interplay between Power Adjustment (Katz), American Package Co. (Kofman), and contractors
What B001 Does NOT Cover: - Court-facing misconduct (B004-B006, B010-B012) - Scope substitution / execution issues (B007-B009) - Bank fraud or OATH matters (pointer lanes B013-B018) - Damages calculations (Blue/Red/Pink sections)
A.2) Audience & Purpose¶
Primary Audiences: - Internal litigation team — to understand criminal exposure in Step 1 - Potential referral drafting — as structured starting point if counsel elects to pursue - Settlement team — as precise map of “what Step 1 looks like if a prosecutor ever cares”
Document Role: - This is an internal prosecution-readiness template - It organizes evidence to permit criminal/regulatory referral if counsel chooses - It does not direct or require any referral - All charging decisions remain with prosecutors; all referral decisions remain with counsel - This document is never handed directly to regulators or prosecutors without separate drafting
A.3) Language & Posture Guardrails¶
Preferred Terms: - “systematic misconduct,” “misrepresentation,” “exposure,” “potential criminal liability” - “coordinated conduct,” “pattern of activity,” “material false statement”
Prohibited Terms: - “criminal mastermind,” “destruction,” “annihilation,” “career death” - “devastating,” “explosive,” “guaranteed conviction”
Labeling Convention: - [Fact] — documented in White evidence - [Inference] — reasonable conclusion from facts - [Argument] — strategic or legal characterization (requires attorney approval)
A.4) Linkage Panel¶
Linkage → Yellow B002 (Method-2). Enterprise-liability framework (4x-8x court-credible band). Higher-ratio analyses, if needed, are implemented via Pink Vol 03 methodologies and reserved to Appendix/Authority in court-facing drafts.
WT-004 Chain Sources → Chain B (Pre-Insurance Inspection), Chain C (Insurance Coverage)
Evidence Compendium: WT-115 (Insurance Promise and Abandonment Sequence) — affidavit-ready chronology documenting promise → cooperation → abandonment pattern.
A.5) Relationship to P-203¶
[Argument] P-203 (Integrated Settlement Posture) sets the global framework: - 4-Phase Model: Evidence → Regulatory → Criminal → Settlement - Witness Sequencing: Rivera → Kowalewski → Coleman - Chain-Lane Mapping: Chains B and C feed B001-B003 - Anti-Fragmentation Rules: No settlement without evaluating remaining defendant impact
B001 is the Phase-3-ready backbone for Step 1: - Ensures that if counsel chooses criminal referrals, infrastructure is organized - Plugs into P-203’s witness order (Rivera first) and lane alignment (B001-B003) - Functions as the Step 1 X1 building block for any referral decision
PART B — REFERRAL OVERVIEW¶
B.1) Subject Matter¶
Alleged Conduct: Coordinated scheme involving property owner, public adjuster, and contractors to inflate insurance claim through fixture mischaracterization, non-disclosure of tenant ownership, and claim “padding”
Conduct Window: December 2019 through February 2020 (core fraud phase) Context Events: October 13, 2019 (flood) through May 26, 2021 (final declination)
Geographic Scope: Brooklyn, New York (G21 premises; meetings and inspections in NYC); carrier/adjuster communications likely via interstate mail and electronic systems
Estimated Fraud Amount: TBD pending claim file collection (P1 priority: 104-004)
B.2) Primary Subjects¶
| Subject | Role | Entity | Primary Conduct |
|---|---|---|---|
| Martin Kofman | Property Owner | American Package Co., Inc. | Non-disclosure instruction; staging coordination; scheme beneficiary |
| Evan Katz | Public Adjuster | Power Adjustment | Claim preparation; staging; “padded” admission |
| Chris Roussis | Contractor Rep | Total Restoration, Inc. | Staging participation; scope preparation |
| Julian Rivera | Contractor Rep | Total Restoration, Inc. | Claim disclosure; witness to admission (potential cooperator) |
B.3) Prosecution Venues Summary¶
| Agency | Jurisdiction | Primary Statutes | Status |
|---|---|---|---|
| Kings County DA | State | NY Penal §§ 176.05-176.25, 155.30 | Recommended Primary |
| NY Insurance Fraud Bureau | Administrative/Referral | NY Insurance Law § 403 | Parallel Notification |
| US Attorney EDNY | Federal | 18 USC §§ 1341, 1343, 371 | Reserved (pending amount) |
B.4) Evidence Strength Assessment¶
Current Position: Prima facie case supported by contemporaneous documentation and witness accounts
Strengths: - Contemporaneous email documenting non-disclosure instruction (Dec 3, 2019) - Multiple witnesses to staging activities and meetings (B.0-B.3) - Party admission (“padded the numbers”) from landlord’s own adjuster - Tenant’s documented refusal to participate in scheme - Neutral third-party witness (Master Adjuster) recognized professional studio - 15-day collapse sequence demonstrating knowledge and intent
Collection Dependencies: - Master Adjuster identity (P0 CRITICAL — 104-001) - Claim file with valuations (P1 — 104-003, 104-004) - Payout records quantifying fraud amount (P1 — 104-004)
PART C — CHRONOLOGICAL FACT PATTERN¶
C.1) Timeline Table (Step 1 Window)¶
| Date | Event | Source (White) | Chain |
|---|---|---|---|
| 2019-10-13 | Sprinkler/flood incident at G21; water damage to unit including studio build-out | WT-103 (background) | All |
| Late Nov 2019 | B.0: Initial visit by Roussis (TRI). Moisture testing performed; contractor recommends extensive demolition / full-gut scope | WT-104 (B.0); WT-203 | B |
| Late Nov 2019 | Landlord raises F1 housing concept (verbal); tenant told option may involve “taking the insurance money” | WT-102; WT-105 | C |
| 2019-12-03 | Tenant emails counsel documenting: (a) landlord statements about insurance; (b) instruction not to disclose tenant-built structures; (c) concern about non-disclosure | WT-102, §B; Bates G21-EVID-005-007 | B, C |
| 2019-12-11 | B.1: Staging/planning meeting at G21 with Kofman, Katz, and contractors. Scope, fixtures, and carrier presentation discussed | WT-104 (B.1); WT-201; WT-203 | B |
| 2019-12-18 | Great American E&S issues partial disclaimer / reservation of rights citing Exclusion j and Organic Pathogens | WT-103 (Letter 1); Bates G21-EVID-008-040 | C |
| Mid/Late Dec 2019 | B.2: Master Adjuster walkthrough at G21. Neutral adjuster recognizes professional studio; references Electric Ladyland inspection; states “no doubt” about professional character | WT-104 (B.2); Master Adjuster (TBD) | B |
| 2020-01-21 | Tenant emails counsel regarding case status and landlord/adjuster actions; confirms ongoing scope/insurance discussions | WT-102 (§C) | B, C |
| 2020-02-26 | B.3: Rivera informs tenant in hallway that carrier “approved” claim for Studios 1&2. Later, Katz reprimands Rivera and states in kitchen they “took your numbers and padded them” | WT-104 (B.3); WT-202; WT-201 | B |
| 2021-05-26 | Great American issues final declination / defense withdrawal effective June 25, 2021 | WT-103 (Letter 2) | C |
C.2) The “15-Day Collapse” Sequence (Dec 3-18, 2019)¶
[Inference] Chains B and C together reveal a compressed sequence with significant implications for intent and knowledge:
| Day | Date | Event | Significance |
|---|---|---|---|
| 0 | Dec 3, 2019 | Non-disclosure instruction documented; “take the insurance money” representation | Insurance-tied offer made; concealment instructed |
| 8 | Dec 11, 2019 | B.1 staging meeting (Kofman + Katz + contractors) | Claim-building in active progress |
| 15 | Dec 18, 2019 | Great American disclaims CGL coverage | Insurance money source collapses |
| ~25 | Mid/Late Dec | B.2 Master Adjuster walkthrough | POST-declination staging continues |
| ~90 | Feb 26, 2020 | B.3 claim approval reported; “padded” admission | Fraud completed |
[Argument] For criminal-referral analysis, this sequence establishes: - What Kofman and Katz understood about coverage when they continued claim-building - How they framed the claim to carriers despite knowing coverage was disputed - Continuing effort to shape claim narrative after written coverage warning
PART D — KEY STATEMENTS & EXHIBITS (Centerpiece Evidence)¶
D.1) Non-Disclosure Instruction (Dec 3, 2019)¶
Exhibit: E-001 (WT-102, §B; Bates G21-EVID-005-007)
Content: Tenant emails counsel documenting that landlord (Kofman) instructed tenant not to disclose that certain interior structures were built by tenant.
Exact Language (as reported): Landlord stated “damages would be covered by his insurance” and suggested tenant “take the insurance money and the buyout, move somewhere else.”
Strategic Value: - Contemporaneous documentation of fraudulent intent - Shows awareness that fixture origin/ownership matters to coverage - Indicates deliberate attempt to control narrative before insurer - Tenant’s documented refusal creates “proceeded despite objection” narrative
D.2) “Padded the Numbers” Admission (Feb 26, 2020)¶
Exhibits: E-004 (WT-104, B.3); WT-201 (Katz profile); WT-202 (Rivera profile)
Context: After B.3 hallway disclosure where Rivera mentioned claim approval, Katz reprimanded him. Subsequently, in the kitchen, Katz stated the numbers had been “padded.”
Exact Language (as reported): Katz told tenant they “took your numbers and padded them.”
Strategic Value: - Party admission from landlord’s own agent - Direct acknowledgment of claim inflation - Admissible under FRE 801(d)(2) / NY CPLR 4549 - Reprimand of Rivera indicates consciousness of guilt
Clarification Questions for Deposition: - What numbers? (TRI estimate? Tenant’s figures? Another source?) - How were they padded? (Markup? Inclusion of non-covered items?) - Were these padded numbers submitted to a carrier? Which one?
D.3) Master Adjuster Professional Recognition (Mid/Late Dec 2019)¶
Exhibit: E-004 (WT-104, B.2); Master Adjuster report (E-005, pending 104-001)
Content: Master Adjuster from carrier/IA firm examined G21 property and immediately recognized it as professional recording studio, referencing prior Electric Ladyland inspection. Stated “no doubt” about professional status.
Strategic Value: - Neutral third-party professional witness - Contradicts any “residential improvement” mischaracterization - Report + photos would document studio condition BEFORE alleged mischaracterization - Frames any later attempt to characterize space as purely residential as inconsistent
Collection Priority: P0 CRITICAL (104-001) — identity, report, photos
D.4) Great American Partial Disclaimer (Dec 18, 2019)¶
Exhibit: E-002 (WT-103, Letter 1; Bates G21-EVID-008-040)
Content: Great American E&S issues “Partial Disclaimer and Reservation of Rights” citing Exclusion j (Damage to Property) and Organic Pathogens exclusion. Letter references Western World Insurance Company as property carrier.
Strategic Value: - Shows timeline when landlord learned coverage was in dispute - Subsequent staging activities (B.2, B.3) must be considered against knowledge of this letter - Establishes dual-carrier routing (GA for CGL, Western World for property)
PART E — STATUTORY ELEMENTS → EVIDENCE TABLES¶
E.1) NY Penal Law § 176.05 — Insurance Fraud in the Fifth Degree¶
Classification: Class A Misdemeanor
Fraudulent Insurance Act Definition (NY Penal § 176.00): Knowingly and with intent to defraud presents or causes to be presented any written statement as part of an insurance transaction that contains materially false information or conceals material information.
| Element | Evidence | White Source | Status |
|---|---|---|---|
| Knowingly | Dec 3, 2019 non-disclosure instruction to tenant; post-declination activity continues | WT-102, §B; WT-104 B.2-B.3 | Documented |
| Intent to Defraud | Staging activities; fixture mischaracterization; continued post-declination | WT-104, B.1-B.3 | As Reported |
| Written Statement | Insurance claim submitted to carrier | Claim file (104-003) | Collection needed |
| Materially False | Fixture ownership/characterization misrepresented; “padded” admission | WT-104, B.3; claim file | As Reported |
| Insurance Transaction | Property damage claim following flood | WT-103 | Documented |
E.2) NY Penal Law § 176.10-176.25 — Aggravated Insurance Fraud¶
Grading by Value:
| Degree | Statute | Value Threshold | Classification |
|---|---|---|---|
| 4th | § 176.10 | Exceeds $1,000 | Class E Felony |
| 3rd | § 176.15 | Exceeds $3,000 | Class D Felony |
| 2nd | § 176.20 | Exceeds $50,000 | Class C Felony |
| 1st | § 176.25 | Exceeds $1,000,000 | Class B Felony |
Value Determination: Pending claim file collection (104-003, 104-004)
Anticipated Range: Based on professional recording studio fixture value and “padded” claim characterization, value likely exceeds $50,000 threshold for 2nd Degree (Class C Felony). For counsel to confirm upon claim file review.
| Element | Evidence | Status |
|---|---|---|
| Base Fraud Elements | See § 176.05 analysis above | Documented/As Reported |
| Value Exceeds Threshold | Claim file valuations; payout records | Collection needed (104-004) |
E.3) NY Penal Law § 155.30 — Grand Larceny in the Fourth Degree¶
Classification: Class E Felony (value exceeds $1,000)
| Element | Evidence | White Source | Status |
|---|---|---|---|
| Wrongful Taking | Insurance proceeds obtained through fraud | Payout records (104-004) | Collection needed |
| Property of Another | Insurance carrier funds | Claim file | Collection needed |
| Intent to Deprive | Scheme to inflate claim; “padded” admission | WT-104, B.3 | As Reported |
| Value Exceeds $1,000 | Professional studio fixtures; claim amount | Claim file (104-004) | Collection needed |
E.4) 18 USC § 1341 (Mail Fraud) / § 1343 (Wire Fraud)¶
Classification: Federal Felony (up to 20 years)
| Element | Evidence | White Source | Status |
|---|---|---|---|
| Scheme to Defraud | B.0-B.3 staging sequence; non-disclosure; mischaracterization | WT-104; WT-102 | Documented |
| Material Misrepresentation | Fixture ownership/characterization; claim valuations | WT-104; claim file | As Reported |
| Use of Mails/Wires | Claim submission; carrier correspondence; declination letters | WT-103; claim file | Likely (verification needed) |
| Intent to Defraud | Non-disclosure instruction; staging; continued post-declination | WT-102; WT-104 | Documented |
E.5) 18 USC § 371 — Conspiracy¶
Classification: Federal Felony (up to 5 years)
| Element | Evidence | White Source | Status |
|---|---|---|---|
| Agreement | B.1 staging meeting; coordination between Kofman/Katz/contractors | WT-104, B.1 | As Reported |
| Two or More Persons | Kofman, Katz, Roussis (confirmed participants) | WT-104; WT-201-203 | Documented |
| Unlawful Objective | Insurance fraud; mail/wire fraud | See above analyses | Documented |
| Overt Act | B.0 scope; B.1 staging; B.2 walkthrough; claim submission | WT-104 | Documented |
Co-Conspirators Identified:
| Name | Role | Overt Acts |
|---|---|---|
| Martin Kofman | Organizer | Non-disclosure instruction; meeting coordination; claim beneficiary |
| Evan Katz | Facilitator | Staging direction; claim preparation; “padded” admission |
| Chris Roussis | Participant | B.0 scope; B.1/B.2 staging activities |
| Julian Rivera | Participant | B.3 presence; claim knowledge (may qualify for cooperation) |
PART F — WITNESS MATRIX¶
F.1) Prosecution Witnesses (Priority 1A / 1B Structure)¶
For B001 (Insurance Fraud) specifically, there are two co‑primary factual anchors for Step 1:
- Priority 1A – Chris Roussis (TRI): establishes the starting point — what an honest, professional response to the loss looked like before any insurance staging or non‑disclosure.
- Priority 1B – Julian Rivera (TRI): establishes the end point of the fraud phase — confirmation that the claim was approved and that the numbers were “padded.”
Together, 1A/1B bracket the Step 1 misconduct: Roussis shows what should have happened; Rivera shows what actually did happen with the claim.
| Priority | Witness | Role | Key Testimony for B001 | White Profile / Source | Cooperation Likelihood |
|---|---|---|---|---|---|
| 1A | Chris Roussis | TRI contractor / estimator | B.0 initial inspection; moisture testing; full‑gut scope recommendation; early interaction with Kofman and Katz; what he understood the job to be before any insurance staging | WT‑203; WT‑104 (B.0, B.1, B.2) | [Inference] Moderate — professional contractor; may be cautious but has clean “baseline professional” story |
| 1B | Julian Rivera | TRI project manager / field lead | B.3 hallway disclosure that claim was approved; sequence of reprimand by Katz; kitchen “padded the numbers” statement; understanding of what was submitted vs. what was actually needed | WT‑202; WT‑104 (B.3) | [Inference] Moderate‑High — already broke script once by telling tenant about approval; natural cooperation candidate |
| 2 | Christian Gray | Victim / tenant | Receipt of non‑disclosure instruction; refusal to conceal tenant‑built structures; contemporaneous Dec 3, 2019 email; observations at B.1–B.3 | WT‑102; WT‑104 | High (complainant) |
| 3 | Master Adjuster | Carrier / IA | Recognition of space as professional recording studio; Electric Ladyland reference; “no doubt” about professional nature; pre‑fraud condition documentation | TBD (104‑001); WT‑104 (B.2) | [Inference] High — neutral professional, no apparent exposure |
| 4 | Carrier Representative(s) | GA / Western World claim personnel | What they were told about fixture ownership; how claim was presented; what documents were received; rationale for coverage positions and any fraud concerns | Claim files (103‑GA‑COV‑01; 103‑WW‑COV‑01) | Unknown — depends on employer posture and internal policies |
[Argument] For B001, any prosecution‑oriented presentation should treat Roussis and Rivera as co‑primary witnesses: one defines the professional baseline (what remediation should have been); the other defines the manipulated outcome (what was actually claimed and admitted). Christian Gray and the Master Adjuster then corroborate and contextualize that bracket, and carrier personnel authenticate how the claim was processed.
F.2) Subject Witnesses (Potential Defendants)¶
These are witnesses whose roles and documented conduct make them potential charging subjects in any insurance‑fraud or related prosecution.
| Subject | Role | Entity | Documented Conduct (B001 Scope) | Primary Exposure | Cooperation Assessment |
|---|---|---|---|---|---|
| Evan Katz | Public adjuster | Power Adjustment | Present at B.1 staging meeting; present at B.2 walkthrough; reprimanded Rivera after B.3 hallway disclosure; made “took your numbers and padded them” statement in kitchen | Direct exposure on insurance‑fraud and conspiracy theories; potential professional‑licensing consequences | [Inference] Low — central actor; party admission; strong incentive to contest narrative |
| Martin Kofman | Property owner / landlord | American Package Co., Inc. | Gave non‑disclosure instruction (Dec 3, 2019); coordinated staging meetings; scheme beneficiary via insurance proceeds | Organizer exposure; potential grand‑larceny / insurance‑fraud liability as beneficiary and director | [Inference] Low — primary civil defendant; strong incentive to deny coordination or intent |
These entries are framed as potential defendant profiles, not cooperation targets. Any cooperation consideration for these individuals would require separate attorney‑level strategy and is not assumed here.
F.3) Supporting / Context Witnesses¶
These witnesses are not primary anchors for the B001 theory, but they help authenticate documents, fill gaps, and provide professional context.
| Witness | Role | Entity | Relevance to B001 | White / Task Source | Notes |
|---|---|---|---|---|---|
| GA Claims Rep(s) | Claims handler(s) for CGL | Great American E&S | Testimony on what Great American was told about fixture ownership, valuations, and loss description; authentication of declination letters; internal fraud/coverage concerns | WT‑103; 103‑GA‑COV‑01 (P0) | May identify additional documents and internal notes relevant to intent/knowledge |
| Western World Claims Rep(s) | Property carrier claims | Western World Insurance | Testimony on which parts of studio build‑out were claimed under property policy; how values were presented; whether there were red flags | 103‑WW‑COV‑01 (P1) | Important for quantifying value and clarifying which carrier actually paid what |
| TRI Corporate Rep | Corporate designee | Total Restoration, Inc. | Authentication of TRI project files (estimates, scopes, invoices); internal understanding of the G21 job; relationship with Katz/Kofman | WT‑301; 104‑008 | Can confirm that Roussis/Rivera accounts match internal documentation |
| Tenant’s Counsel (Dec 2019) | Prior counsel | Law office (WT‑102 recipient) | Authentication of Dec 3, 2019 email and any follow‑up communications; may confirm contemporaneous concern about non‑disclosure instruction | WT‑102 | Limited role; primarily document authentication and context for complaint timing |
F.4) Witness Sequencing (P‑203 Alignment)¶
From P‑203 Part C (as modified by P‑203 v0.3 footnote):
- Global Priority 1 (case‑wide): Julian Rivera — frames “How the money fraud started” for the overall narrative and Phase‑model sequencing.
- Lane‑specific co‑primaries for B001: Roussis (1A) + Rivera (1B) — together, they bracket the Step 1 misconduct for the insurance‑fraud lane.
- Christian Gray and the Master Adjuster are then used to corroborate the bracket (non‑disclosure + neutral professional recognition), with carrier personnel providing claim‑file context.
[Argument] For any criminal‑referral concept on insurance fraud, B001 should be presented with Roussis and Rivera as the factual spine, and other witnesses arrayed around them by function: victim (Gray), neutral professional (Master Adjuster), and institutional actors (carrier representatives).
PART G — DOCUMENTARY EVIDENCE & COLLECTION PLAN¶
G.1) Currently Secured Evidence¶
| Exhibit | Description | White Source | Bates Range | Authentication |
|---|---|---|---|---|
| E-001 | Email to counsel (Dec 3, 2019) — non-disclosure instruction | WT-102, §B | G21-EVID-005-007 | Client records |
| E-002 | Great American Partial Disclaimer (Dec 18, 2019) | WT-103, §B | G21-EVID-008-040 | Carrier records |
| E-003 | Great American Final Declination (May 26, 2021) | WT-103, §C | TBD | Carrier records |
| E-004 | Pre-Insurance Inspection Meeting Evidence (B.0-B.3) | WT-104 | TBD | Client testimony |
G.2) Evidence To Be Collected¶
P0 CRITICAL (Immediate):
| Task ID | Target | Custodian | Method | Purpose |
|---|---|---|---|---|
| 104-001 | Master Adjuster identity, report, photos | Western World / Power Adjustment | Subpoena | Neutral witness; studio documentation |
| 103-GA-COV-01 | Great American claim/coverage file | Great American E&S | Subpoena | What GA was told; fraud risk evaluation |
P1 CRITICAL (~30 days):
| Task ID | Target | Custodian | Method | Purpose |
|---|---|---|---|---|
| 104-004 | Studios 1&2 approval record + payout ledger | Western World Insurance | Subpoena | Fraud quantification; carrier ID |
| 104-002 | Kofman-Katz communications (Nov-Dec 2019) | Power Adjustment / American Package | Subpoena | Pre-meeting coordination; premeditation |
| 104-003 | G21 claim file (fixture characterization, valuations) | Western World / Power Adjustment | Subpoena | Compare to “padded” admission |
| 103-WW-COV-01 | Western World Insurance file | Western World Insurance | Subpoena | Resolves which carrier approved B.3 claim |
P2 HIGH (~60 days):
| Task ID | Target | Custodian | Method | Purpose |
|---|---|---|---|---|
| 104-005 | Roussis formal statement | Via counsel | Interview/depo | Corroborate B.0 scope; B.2 staging |
| 104-006 | Rivera formal statement | Via counsel | Interview/depo | Lock B.3 disclosure sequence |
| 104-008 | TRI project files (estimates, scope, invoices) | Total Restoration, Inc. | Subpoena | Baseline numbers for “padded” comparison |
G.3) Evidence Gap Analysis¶
| Gap | Impact | Mitigation |
|---|---|---|
| Master Adjuster identity unknown | Lose neutral professional witness | P0 priority collection (104-001) |
| Claim valuations not yet obtained | Cannot quantify fraud amount for grading | P1 priority collection (104-003, 104-004) |
| Wire/mail use not confirmed | Federal jurisdiction uncertain | Subpoena claim submission records |
| Written claim document not reviewed | Cannot confirm specific misrepresentations | P1 priority collection (104-003) |
PART H — LEGAL AUTHORITY¶
H.1) NY Insurance Fraud Precedents¶
People v. Reyes, 180 A.D.3d 1148 (2d Dept. 2020): - Affirmed insurance fraud conviction based on staged accident and inflated claims - Relevant: Staging activities and claim inflation parallel to instant case
People v. Ramos, 178 A.D.3d 904 (2d Dept. 2019): - Insurance fraud conviction upheld where defendant submitted false claim documents - Relevant: Written false statements in insurance claim context
People v. Headley, 74 N.Y.2d 858 (1989): - Established that intent to defraud may be inferred from circumstances - Relevant: Non-disclosure instruction + staging activities support intent inference
H.2) Federal Mail/Wire Fraud Precedents¶
United States v. Weimert, 819 F.3d 351 (7th Cir. 2016): - Wire fraud conviction in insurance context; scheme need not succeed - Relevant: Even if claim partially legitimate, inflated portion constitutes fraud
United States v. Autuori, 212 F.3d 105 (2d Cir. 2000): - Conspiracy conviction requires only agreement and overt act - Relevant: B.1 meeting + subsequent activities satisfy conspiracy elements
H.3) Admission Evidence Authority¶
FRE 801(d)(2) — Opposing Party Statement: - Katz’s “padded the numbers” statement admissible against Katz - If Katz was agent of Kofman, statement may be admissible against Kofman under agency theory
NY CPLR 4549 — Admissions: - Party admissions admissible without hearsay objection - Katz admission usable in civil proceedings regardless of criminal outcome
PART I — PROSECUTION VENUES & AGENCY PROFILES¶
I.1) Kings County District Attorney¶
Bureau: Insurance Fraud Bureau / Economic Crimes
Jurisdiction: All NY Penal Law violations occurring in Kings County
Statutes of Interest: NY Penal §§ 176.05-176.25 (Insurance Fraud), §§ 155.30+ (Larceny)
Strengths: - Local jurisdiction; familiar with Brooklyn property matters - Insurance fraud is enforcement priority - Grand jury readily available - Multi-defendant conspiracy within scope
Considerations: - Resource constraints may affect complex case prioritization - May prefer referral to state-level Insurance Fraud Bureau for initial investigation
Contact Protocol: For counsel to determine — initial outreach via ADA intake or direct contact with Economic Crimes
I.2) NY State Insurance Fraud Bureau¶
Authority: NY Insurance Law § 403
Jurisdiction: Statewide; investigative and referral authority
Strengths: - Specialized insurance fraud expertise - Can coordinate with multiple DAs - Access to industry databases and carrier cooperation - May yield additional investigation resources
Considerations: - Investigative agency; prosecution via local DA - May take longer to develop case - Creates additional pressure on subjects even without prosecution
Contact Protocol: Online complaint submission or direct referral via counsel
I.3) NYS Department of Financial Services (DFS)¶
Authority: Licensing authority over public adjusters
Relevance: Any potential action regarding Evan Katz’s adjuster licensing
Note: License action is strictly within DFS discretion; separate from criminal prosecution
I.4) US Attorney — Eastern District of New York¶
Bureau: Civil Frauds / Criminal Division
Jurisdiction: Federal mail fraud, wire fraud, conspiracy
Statutes of Interest: 18 USC §§ 1341, 1343, 371
Strengths: - Greater resources for complex cases - Federal sentencing guidelines more severe - Can pursue RICO if pattern established
Considerations: - Higher threshold for prosecution acceptance - Must establish federal nexus (mail/wire use) - May decline absent significant dollar amount ($100K+) or broader pattern - Would assess whether mail/wire fraud or conspiracy interests are present
Contact Protocol: For counsel to determine — referral via FBI or direct AUSA contact
PART J — REFERRAL RECOMMENDATION¶
J.1) Recommended Approach¶
Primary Referral: Kings County DA — Insurance Fraud / Economic Crimes Bureau
Rationale: - State insurance fraud statutes directly applicable - Local jurisdiction; efficient prosecution - “Padded the numbers” admission provides compelling centerpiece - Contemporaneous documentation strengthens case
Parallel Action: Notify NY State Insurance Fraud Bureau
Rationale: - Creates additional pressure on subjects - May yield additional investigation resources - Industry databases may identify pattern behavior
Federal Referral: Reserve pending fraud amount quantification
Rationale: - Federal prosecution typically requires significant dollar threshold - Collection of claim file (104-003, 104-004) will establish amount - If amount exceeds $100,000+, federal referral becomes more viable
J.2) Timing Considerations¶
Pre-Referral Collection: - 104-001 (Master Adjuster) — Strengthens case significantly - 104-003/104-004 (Claim file/payout) — Required for grading and federal consideration
Optimal Referral Window: - After P0/P1 collection complete - Before civil settlement finalizes (preserve testimony cooperation) - Coordinated with P-203 Phase 3 (Criminal Readiness)
J.3) Attorney Decision Points¶
| Decision | Options | Recommendation |
|---|---|---|
| Referral timing | Pre-collection vs. post-collection | Post-P1 collection |
| Primary venue | State vs. federal | State primary; federal reserved |
| Subject prioritization | Katz vs. Kofman | Katz (direct admission); Kofman (organizer) |
| Cooperation approach | Rivera as cooperator? | Explore before referral |
| Civil coordination | Settlement before/after referral | Coordinate per P-203 |
PART K — P-203 INTEGRATION¶
K.1) Phase Model Alignment¶
Phase 1 — Evidence Foundation: - Lock Rivera, Katz, and Roussis testimony around B.0-B.3 - Secure claim files and Master Adjuster materials - Complete P0/P1 collection priorities
Phase 2 — Regulatory Pressure: - DFS / Insurance Fraud Bureau options as potential pathways - PA licensing review creates non-civil consequences - Industry notification may yield pattern evidence
Phase 3 — Criminal Readiness: - B001 functions as the Step 1 X1 building block - Referral packet assembly per Part G.1 guidance - Prosecution agency engagement per Part I profiles
Phase 4 — Settlement Window: - B003 uses same evidence for settlement framing - Criminal exposure creates leverage without requiring actual referral - Anti-fragmentation rules apply to any settlement coordination
K.2) Witness Sequencing Integration¶
From P-203 Part C: - Rivera is Priority 1 — anchor witness for Step 1 - His testimony frames “how the money fraud started” - Subsequent witnesses (Katz, Kofman) are framed against Rivera’s neutral account
K.3) Anti-Fragmentation Application¶
From P-203 Part A.4: - No settlement without evaluating impact on remaining defendants - Release language must preserve claims against non-settling parties - If Power Adjustment settles early, preserve claims against American Package - Criminal referral timing coordinated with civil settlement strategy
K.4) Chain-Lane Feed Matrix¶
Per P-203 Part D.3:
| Chain | B001-B003 Feed |
|---|---|
| Chain B (Pre-Insurance) | PRIMARY |
| Chain C (Insurance Coverage) | PRIMARY |
| Chain A (G21 Scope) | Context only |
| Chains D-G | Not applicable to this lane |
PART L — ATTORNEY REVIEW QUESTIONS¶
Before any external use of this package, counsel should consider:
L.1) Evidence Sufficiency¶
- Are there critical gaps (e.g., missing claim file, incomplete carrier communications) that must be filled before a referral is even considered?
- Is the “padded numbers” statement sufficiently documented for prosecutorial reliance?
- Do we have enough to establish the value threshold for felony grading?
L.2) Venue Strategy¶
- Does counsel view this primarily as civil leverage, or as a matter that should be brought to law enforcement attention?
- Is federal interest realistic given anticipated fraud amount?
- Should Insurance Fraud Bureau be engaged before or after DA contact?
L.3) Witness Readiness¶
- Are Rivera, Roussis, and tenant prepared for potential consequences of criminal involvement (timelines, discovery obligations, cross-examination)?
- Has Rivera been assessed for cooperation potential?
- Is Master Adjuster identity required before proceeding?
L.4) Civil Case Coordination¶
- Would a criminal or regulatory proceeding complicate or delay the civil matter?
- How does referral timing interact with settlement discussions?
- Should criminal leverage be deployed as threat or actuality?
L.5) Defendant-Specific Considerations¶
- Is Katz (smaller entity, direct admission) the optimal early target?
- Could Rivera cooperation offer reduce his exposure while strengthening case against Katz/Kofman?
- How does American Package’s deeper resources affect settlement vs. prosecution calculus?
PART M — APPENDICES¶
M.1) Exhibit Index¶
| Exhibit | Description | Source | Status |
|---|---|---|---|
| E-001 | Dec 3, 2019 Email (non-disclosure) | WT-102 | Secured |
| E-002 | Dec 18, 2019 Partial Disclaimer | WT-103 | Secured |
| E-003 | May 26, 2021 Final Declination | WT-103 | Secured |
| E-004 | B.0-B.3 Meeting Evidence | WT-104 | As Reported |
| E-005 | Master Adjuster Report | 104-001 | Collection Pending (P0) |
| E-006 | Claim File / Valuations | 104-003 | Collection Pending (P1) |
| E-007 | Payout Records | 104-004 | Collection Pending (P1) |
M.2) Subject Profile: Evan Katz¶
Name: Evan Katz Entity: Power Adjustment Role: Public Adjuster License: TBD (302-NYDFS-LIC-01) Contact: evan@poweradjustment.com; 526-633-0059 White Profile: WT-201
Documented Conduct: - Present at B.1 staging meeting (Dec 11, 2019) - Present at B.2 Master Adjuster walkthrough (mid/late Dec 2019) - Present at B.3 disclosure/admission (Feb 26, 2020) - Reprimanded Rivera for disclosure - Stated “padded the numbers” in kitchen
Exposure: Direct liability for insurance fraud; potential license revocation; party admission
M.3) Subject Profile: Martin Kofman¶
Name: Martin Kofman Entity: American Package Co., Inc. Role: Property Owner / Landlord Address: 97 Green Street, Brooklyn, NY 11222 White Profile: WT-301
Documented Conduct: - Gave non-disclosure instruction (Dec 3, 2019) - Coordinated staging meetings - Beneficiary of fraudulent insurance proceeds
Exposure: Organizer liability; scheme beneficiary
M.4) Entity Profile: Power Adjustment¶
Name: Power Adjustment Type: Public Adjuster Firm Principal: Evan Katz Status: TBD (302-DOS-ENT-01) White Profile: WT-302
Role in Scheme: Claim preparation; staging coordination; carrier interface
Discovery Targets: Engagement letter; claim file; carrier communications
M.5) Entity Profile: Total Restoration, Inc.¶
Name: Total Restoration, Inc. Type: Restoration Contractor Personnel: Chris Roussis, Julian Rivera White Profile: WT-301
Role in Scheme: Staging participation; scope preparation; claim support
Discovery Targets: Project files; B.0 scope documents; engagement records
PART N — DOCUMENT CONTROL¶
N.1) Cross-References¶
| Document | Relationship |
|---|---|
| Purple-B (Chain B) | Source — Pre-Insurance Inspection evidence |
| Purple-C (Chain C) | Source — Insurance Coverage context |
| P-203 | Coordination — Settlement/criminal integration |
| B002 | Companion — Courtroom Summary |
| B003 | Companion — Settlement Playbook |
| WT-102 | Evidence — Non-disclosure email |
| WT-103 | Evidence — Coverage declination |
| WT-104 | Evidence — B.0-B.3 meeting sequence |
| WT-201 | Witness — Evan Katz profile |
| WT-202 | Witness — Julian Rivera profile |
| WT-203 | Witness — Chris Roussis profile |
| WT-301 | Corporate — Total Restoration profile |
| WT-302 | Corporate — Power Adjustment profile |
N.4) Next Actions¶
- P0 Collection: Authorize 104-001 (Master Adjuster identity/report)
- P1 Collection: Authorize 104-003, 104-004 (claim file, payout records)
- Rivera Assessment: Evaluate cooperation potential before referral
- Attorney Review: Submit B001 v1.1 for checkpoint approval
- Venue Decision: Confirm state vs. federal prioritization
- B002 Development: Proceed to Courtroom Summary after B001 approval
END — Purple Tab B001 — Insurance Fraud: Criminal Referral Package v1.4