Thomas E. Fraysse

Thomas Fraysse

Thomas E. Fraysse specializes in prosecuting high exposure and complex cases in the areas of fraud, unfair business practices, personal injury, wrongful death, mass tort and insurance bad faith.  As a trial lawyer, he has litigated more than two thousand matters over the past thirty-five years, including participating in more than one hundred trials, representing parties in numerous arbitrations and mediations, and successfully trying more than thirty jury trials to verdict.  His skill in trying a case has led to many successful outcomes. San Francisco Superior Court Judge Ernest H. Goldsmith commented on his trial skills in a written decision and order on the recovery of attorney’s fees: “… lead counsel for Plaintiff, Mr. Thomas Fraysse, has extensive experience and expertise in insurance law and bad faith litigation, and has demonstrated the highest level of professional skill in the instant case.”  With a deep sense of justice, Mr. Fraysse has had the honor to represent a wide variety of litigants, from individuals to Fortune 500 companies.  He enjoys trying civil cases before juries and has a deep belief that our traditional jury system is essential to concept of justice for all.

For most of his career, he has represented victims of fraudulent practices and schemes in common law fraud, unfair business practices, California Insurance Code section 1871.7 (“qui tam”), state and federal False Claim Act, and civil RICO cases against a wide spectrum of defendants – corporations, LLCs, officers, directors, doctors, lawyers, hospitals, clinics, health management organizations, chiropractors, medical device manufacturers, medical device distributors, pharmacists, pharmaceutical companies, and automotive repair shops, among others.

He files lawsuits for insurance companies against defendants for making false, fraudulent or misleading insurance claims that are prohibited by California Penal Code sections 549 and 550 (California’s criminal insurance fraud statutes) and California’s insurance qui tam statute (California Insurance Code section 1871.7); for engaging in prohibited self-referral of patients to entities in which a doctor has a financial interest; for paying monetary kickbacks in exchange for the referral of clients or patients; for violating the Moscone-Knox Professional Corporation Act (California Corporations Code section 13400 et seq.), including participating in schemes in which unlicensed lay persons own, operate and control “sham” law offices or medical corporations; for billing for health care treatment or services that were not rendered; for the illegal and improper use of Current Procedural Terminology (CPT) codes on billing statements and CMS-1500 forms, including up-coding and unbundling; for falsifying medical records as part of a fraud scheme; for providing unnecessary medical services or diagnostic procedures; and for employing cappers, runners or steerers to secure patients, among other prohibited practices.

Mr. Fraysse and the Knox Ricksen LLP health care fraud group have secured a string of large judgments under California’s insurance qui tam or “whistleblower” statute (California Insurance Code Section 1871.7), including a $11,544,037 judgment and a permanent injunction in the matter of People of the State of California ex rel. Allstate Insurance Company v. Wonguen Chang et al. (Los Angeles County Superior Court , Case No. BC541476), which involved claims made by a phony or “sham” law firm owned and operated by non-professionals, and a $7,010,668.40 judgment in the matter of People of the State of California ex rel. Allstate Insurance Company v. Daniel H. Dahan and Progressive Diagnostic Imaging, Inc. (Los Angeles County Superior Court, Case No. BC-397695 and 3 Cal.App.5th 372; 207 Cal.Rptr.3d 569), which arose out of the production of false, fraudulent or misleading x-ray reports to support fraudulent claims against insurance companies.  In addition to the string of judgments, Mr. Fraysse and the Knox Ricksen LLP health care fraud group have obtained permanent injunctions to prevent the resumption of fraudulent activities and to protect the public.

In addition to his work on health care and other fraud matters, Mr. Fraysse has handled numerous personal injury and wrongful death claims and actions, representing both plaintiffs and defendants, including representing persons and entities in claims and actions based on injury or death due to exposure to asbestos-containing products, product liability, negligence, premises liability and dangerous condition of public property.

Mr. Fraysse also represents totally disabled individuals in insurance “bad faith” cases against disability insurers for wrongfully withholding payment of insurance benefits.  In 1993, he and Steven R. Anthony of Knox Ricksen LLP secured a $9.2 million jury verdict, including punitive damages, against a disability carrier, The Equitable Life Assurance Society of the United States, in Los Angeles County Superior Court, on behalf of a totally disabled U.S. Postal Service employee and, subsequently, represented numerous disabled insureds, securing many multi-million dollar settlements.

He has been recognized by his peers as a Northern California Super Lawyer from 2005 to the present and holds and AV rating (“Preeminent”) from Martindale Hubbell – “a testament to the fact that a lawyer’s peers rank him or her at the highest level of professional excellence.”

Mr. Fraysse practices in both the Oakland and Los Angeles offices of Knox Ricksen LLP.  He is the Managing Partner of Knox Ricksen LLP.

925.433.2500

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Education

  • J.D. University of the Pacific, McGeorge School of Law (1982)
  • B.A. University of California, Berkeley (1978)

Admitted to Practice

  • State Bar of California (1982)
  • U.S. District Court, Northern and Central Districts of California (1982)

Professional Activities

  • Conference Chair, 24th Annual Anti-Fraud Conference, presented by NCFIA/AFA, California District Attorneys Association, California Department of Insurance and National Insurance Crime Bureau, Hyatt Regency Monterey, Monterey, California (March 2013)
  • President, NCFIA/AFA (2004- 2005, 2016-2018), Member of the Board of Directors (2002-2004, 2005-2006, 2015-2017), Counsel to the Association (2010 to present), Life Member
  • Member, Alameda County Bar Association (1983 to present)
  • Member, Contra Costa County Bar Association (2000 to 2009)
  • Member, Association of Defense Counsel of Northern California and Nevada (1984 to 2009)
  • Member, Defense Research Institute (DRI) (2000 to 2009)
  • Associate, American Board of Trial Advocates – ABOTA (2013)
  • Member, International Association of Special Investigations Units – IASIU (2013 to present)

Publications & Speeches

  • Instructor, “Ethics” with Eric von Geldern of the Alameda County District Attorney’s Office; 26th Annual Anti-Fraud Conference presented by NCFIA/AFA, California District Attorneys Association, the California Department of Insurance and the National Insurance Crime Bureau, Monterey, California (April 2015)
  • Instructor, “From Inside Clinic Walls” with Gordon Oard, Berkshire Hathaway Homestate Companies and Eric J. Danowitz of Knox Ricksen LLP; 26th Annual Anti-Fraud Conference presented by NCFIA/AFA, California District Attorneys Association, the California Department of Insurance and the National Insurance Crime Bureau, Monterey, California (April 2015)
  • Instructor, “Workers’ Compensation Health Care Fraud Investigations ” with Gordon Oard, Berkshire Hathaway Homestate Companies; 25th Annual Anti-Fraud Conference presented by NCFIA\AFA, California District Attorneys Association, the California Department of Insurance and the National Insurance Crime Bureau, Monterey, California (April 2014)
  • Instructor, “Two Case Studies: The Anatomy of Eleven Million Dollars in Civil Insurance Fraud Judgments” with Thomas J. Hall of Pringle, Quinn, Anzano, P.C.; 24th Annual Anti-Fraud Conference presented by NCFIA, California District Attorneys Association, the California Department of Insurance and the National Insurance Crime Bureau, Monterey, California (March 2013)
  • Instructor, “The ABC’s of MD/DC, Investigation and Legal Options Associated with the MD/DC Business Model” with Gordon Oard, Berkshire Hathaway Homestate Companies; Northern California Fraud Investigators Association Fall Quarterly Meeting, Lafayette, California (December 2012)
  • Instructor, “Investigating and Legal Options Associated with the MD/DC Model” with Gordon Oard, Berkshire Hathaway Homestate Companies; International Association of Special Investigation Units 27th Annual Seminar, Palm Desert, California (September 2012)
  • Instructor, “Ethics in the Fight Against Fraud” with Eric von Geldern, Deputy District Attorney, Alameda County; at the 23rd Annual Anti-Fraud Training Conference presented by the Northern California Fraud Investigators Association, California District Attorneys Association, California Department of Insurance and the National Insurance Crime Bureau, Monterey, California (April 2012)
  • Instructor, “Preparing California Insurance Code Section 1871.7, California Business and Professions Code Section 17200, RICO and Common Law Fraud Actions for Civil Prosecution” with David Kassabian, Esq. of Kassabian, Doyle & Weatherford, P.C., Arlington, Texas and Joe Rocha, Allstate Insurance Company; at the 21st Annual Anti-Fraud Training conference presented by the Northern California Fraud Investigators Association, California District Attorneys Association, California Department of Insurance and the National Insurance Crime Bureau, Monterey, California (March 2010)
  • Instructor, “Illegal Ownership of Clinics” with Astrid G. Meghrigian, Esq. of the California Medical Association and Michael J. Stahl, D.C.; at the 2009 Northern California Fraud Investigators Association/California Department of Insurance/California District Attorneys Association 20th Annual Training Conference, Monterey, California (April 2009)
  • Instructor, “Interview Techniques, Examinations Under Oath and Depositions: How to Get to the Truth and Prepare a Case“with Christina Smith and Eric Winkler of the California Department of Insurance; at the California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference North, Pleasanton, California (January 2008) and the California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference South, Riverside, California (February 2008)
  • Panelist, “Status of California Silica Litigation” California Silica Litigation 2006: For The Defense, Toxic Tort Committee of the Association of Defense Counsel of Northern California and Nevada, Westin St. Francis, San Francisco, California (February 2006)
  • Speaker, “Overview of Silica Litigation” California Silica Litigation 2006: For The Defense, Toxic Tort Committee of the Association of Defense Counsel of Northern California and Nevada, Westin St. Francis, San Francisco, California (February 2006)
  • Speaker, “Accident Investigation – Practical Suggestions for Safety Personnel Investigating Construction Zone Accidents” for a client at the Embassy Suites Hotel, Monterey, California (January 2005)
  • Speaker, “Silica Litigation” for a client at the Embassy Suites Hotel, Monterey, California (January 2005)
  • Speaker, “Use of the California Qui Tam Statute, the Unfair Competition Act, and Common Law Fraud in Fighting Auto Insurance Fraud in California” for a client at the Hyatt Regency Monterey, Monterey, California (December 2005)
  • Speaker, “Essentials of Best Practices – A Collaborative and Tactical Strategy for Combating Fraud – The Role of SIU Counsel” with Craig Pusser and James Durkee of California State Automobile Association Inter-Insurance Bureau; John Standish, Bureau Chief, and Moses Gomez, Division Chief of the California Department of Insurance; and Eric von Geldern and George Wood of the Alameda County District Attorney’s Office; at the California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference, San Diego, California (November 2004); California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference, Berkeley, California (March 2005); the Northern California Fraud Investigators Association 16th Annual Training Conference, Monterey, California (March 2005); the Sacramento Claims Association Luncheon, Rancho Cordova, California (May 2005) and the Claims Conference of Northern California Annual Meeting, Oakland, California (September 2005)
  • Speaker, “Silica Litigation Update” 2005 Annual E&C Risk Management Group Conference, Gleneden Beach, Oregon (June 2005)
  • Speaker, “Unfair Business Practice or Unfair Claim? Fraud in Motion” Wheels, Water & Vertical Carriers – Merging Themes in California Transportation Law, Association of Defense Counsel of Northern California and Nevada, Sacramento, California (May 2004)

Reported Decisions

  • People ex rel. Allstate Ins. Co. v. Dahan (2016) 3 Cal.App.5th 372; 207 Cal.Rptr.3d 569