BIO
Thomas Fraysse represents victims of fraudulent practices and schemes in actions based on common law fraud, California’s Insurance Frauds Prevention Act, qui tam or whistleblower cases, and state and federal False Claims Acts. His cases have involved a broad spectrum of defendants, including doctors, chiropractors, corporate officers and directors, lawyers, hospitals, clinics, management companies, medical device manufacturers, distributors, pharmacists, pharmaceutical companies, and automotive repair shops, among others. His favorite quote on fraud comes from a California Supreme Court case, which, ironically, did not involve fraud: “When profit is involved, the ingenuity of man spawns limitless varieties of unfairness.”
He files lawsuits for insurance companies and union health and welfare trusts against those engaging in fraudulent activities, including:
Healthcare providers billing for treatment or services that were not rendered
Doctors and lawyers paying cappers, runners or steerers for the referral of patients or clients
Persons falsifying medical records
Healthcare providers improperly using billing codes to falsely increase revenue
Persons making false, fraudulent or misleading insurance claims
Persons illegally owning, operating and controlling professional practices, such as medical facilities, clinics and law offices
Healthcare providers, lawyers or others paying monetary kickbacks for the referral of patients or clients
Healthcare providers rendering unnecessary medical services or diagnostic procedures
Physicians prescribing unnecessary drugs, including compounded drugs
Physicians engaging in prohibited self-referral
Representing clients in high exposure and complex civil litigation cases in the areas of fraud, unfair business practices, catastrophic personal injury, wrongful death, and mass tort, Tom’s clients range from individuals to Fortune 500 companies. He believes in the concept of justice for all and strives to ensure that everyone has access to our court system.
With more than three decades of trial experience, Tom maximizes recovery for clients through pragmatic and strategically planned litigation. He enjoys trying civil cases before juries and firmly believes that our imperiled jury system is essential to the concept of justice for all.
Tom has litigated more than 2,000 matters, represented parties and witnesses in more than 100 trials, and has handled hundreds of arbitrations and mediations. His experience and skill in trying cases has resulted in successful outcomes. Judge Ernest H. Goldsmith of the San Francisco Superior Court observed in a written decision and order on a post-trial motion, “Mr. Fraysse has extensive experience and expertise in insurance law and bad faith litigation” and “has demonstrated the highest level of professional skill.”
While he focuses on healthcare fraud, Tom has successfully handled numerous catastrophic personal injury and wrongful death claims and actions, actions based on injury or death due to exposure to asbestos-containing products, and product liability, negligence, premises liability and dangerous condition of public property cases. In addition, he represents totally disabled individuals in insurance bad faith cases against disability insurers for wrongfully withholding payment of insurance benefits.
EDUCATION
University of the Pacific, McGeorge School of Law, J.D., 1982
University of California, Berkeley, B.A., 1978
BAR AND COURT ADMISSIONS
State of California
U.S. District Court, Northern and Central Districts of California
U.S. Court of Appeals for the Ninth Circuit
REPRESENTATIVE MATTERS
Secured $9.2 million insurance bad faith jury verdict, including punitive damages, against a disability insurance company on behalf of a totally disabled U.S. Postal Service employee and, thereafter, represented disabled persons, securing numerous multi-million dollar settlements.
Secured $11.5 million qui tam judgment and a permanent injunction after a jury trial in the matter of People of the State of California ex rel. Allstate Insurance Company v. Wonguen Chang et al., which involved claims made by a phony or “sham” law firm owned and operated by non-professionals; prevailed on appeal.
Secured $7 million judgment after a seven-week court trial in a qui tam case in the matter of People of the State of California ex rel. Allstate Insurance Company v. Daniel H. Dahan and Progressive Diagnostic Imaging, Inc., which arose out of the production of false, fraudulent or misleading x-ray reports to support fraudulent claims against insurance companies; prevailed on appeal.
Represent insurance carriers and 160 victims of a fraud scheme involving implanting counterfeit medical devices into victims, paying kickbacks to physicians and fraudulently billing insurance companies.
Represent a major union health plan in a qui tam case in which a single doctor allegedly prescribed $55 million of bogus compounded medication over 13 months, and a pharmacist reaped $43 million in illicit gains.
Settled a premises liability slip-and-fall personal injury case against City College of San Francisco and the City and County of San Francisco for a seriously injured aeronautics instructor for $6.5 million.
Secured a $48 million qui tam judgment for a union welfare trust plan based on false and fraudulent billings.
PUBLISHED OPINIONS
People ex rel. Allstate Ins. Co. v. Dahan (2016) 3 Cal.App.5th 372
People ex rel. TIG Ins. Co. v. Culpepper (2018) 720 Fed.Appx. 884; 83 Cal. Comp Cases 886
People ex rel. Allstate Ins. Co. v. Suh (2019) 37 Cal.App.5th 253
PUBLICATIONS AND SPEAKING ENGAGEMENTS
Workshop speaker, “Ethics for Prosecutors, Civil Attorneys, Special Investigation Units and Other Investigators Handling Fraud Matters,” 30th Annual Anti-Fraud Conference, Monterey, CA (April 2019)
Workshop speaker, “Strategies and Approaches in the Trial of Complex Criminal and Civil Insurance Fraud Actions Against Medical Providers,” 29th Annual Anti-Fraud Conference, Monterey, CA (April 2018)
Workshop speaker, “The Investigation and Civil Prosecution of Lay Persons Owning, Operating and Controlling ‘Sham’ Law Offices,” 27th Annual Anti-Fraud Conference, Monterey, CA (April 2017)
Workshop speaker, “Ethics,” 26thAnnual Anti-Fraud Conference, Monterey, CA (April 2015)
Workshop speaker, “From Inside Clinic Walls,” 26thAnnual Anti-Fraud Conference, Monterey, CA (April 2015)
Workshop speaker, “Workers’ Compensation Health Care Fraud Investigations,” 25th Annual Anti-Fraud Conference, Monterey, CA (April 2014)
Workshop speaker, “Two Case Studies: The Anatomy of Eleven Million Dollars in Civil Insurance Fraud Judgments,” 24th Annual Anti-Fraud Conference, Monterey, CA (March 2013)
Workshop speaker, “The ABC’s of MD/DC, Investigation and Legal Options Associated with the MD/DC Business Model,” AFA Fall Quarterly Meeting, Lafayette, CA (December 2012)
Workshop speaker, “Investigating and Legal Options Associated with the MD/DC Model,” International Association of Special Investigation Units (IASIU) 27th Annual Seminar, Palm Desert, CA (September 2012)
Workshop speaker, “Ethics in the Fight Against Fraud,” 23rd Annual Anti-Fraud Training Conference, Monterey, CA (April 2012)
Workshop speaker, “Preparing California Insurance Code Section 1871.7, California Business and Professions Code Section 17200, RICO and Common Law Fraud Actions for Civil Prosecution,” 21st Annual Anti-Fraud Training Conference, Monterey, CA (March 2010)
Workshop speaker, “Illegal Ownership of Clinics,” Northern California Fraud Investigators Association/California Department of Insurance/California District Attorneys Association 20th Annual Training Conference, Monterey, CA (April 2009)
Workshop speaker, “Interview Techniques, Examinations Under Oath and Depositions: How to Get to the Truth and Prepare a Case,“ California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference South, Riverside, CA (February 2008)
Workshop speaker, “Interview Techniques, Examinations Under Oath and Depositions: How to Get to the Truth and Prepare a Case,“ California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference North, Pleasanton, CA (January 2008)
Panelist, “Status of California Silica Litigation,” California Silica Litigation 2006: For The Defense, Toxic Torts Committee of the Association of Defense Counsel of Northern California and Nevada, San Francisco, CA (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, San Francisco, CA (February 2006)
Speaker, “Essentials of Best Practices A Collaborative and Tactical Strategy for Combating Fraud The Role of SIU Counsel,” Claims Conference of Northern California Annual Meeting, Oakland, CA (September 2005)
Speaker, “Silica Litigation Update,” 2005 Annual E&C Risk Management Group Conference, Gleneden Beach, OR (June 2005)
Speaker, “Essentials of Best Practices A Collaborative and Tactical Strategy for Combating Fraud The Role of SIU Counsel,” Sacramento Claims Association Luncheon, Rancho Cordova, CA (May 2005)
Speaker, “Essentials of Best Practices A Collaborative and Tactical Strategy for Combating Fraud The Role of SIU Counsel,” California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference, Berkeley, CA (March 2005)
Speaker, “Essentials of Best Practices A Collaborative and Tactical Strategy for Combating Fraud The Role of SIU Counsel,” Northern California Fraud Investigators Association 16th Annual Training Conference, Monterey, CA (March 2005)
Speaker, “Use of the California Qui Tam Statute, the Unfair Competition Act, and Common Law Fraud in Fighting Auto Insurance Fraud in California,” Monterey, CA (December 2005)
Speaker, “Accident Investigation Practical Suggestions for Safety Personnel Investigating Construction Zone Accidents,” Monterey, CA (January 2005)
Speaker, “Silica Litigation,” Monterey, CA (January 2005)
Speaker, “Essentials of Best Practices A Collaborative and Tactical Strategy for Combating Fraud The Role of SIU Counsel,” California District Attorneys Association Insurance Fraud SIU Multi-Agency Conference, San Diego, CA (November 2004)
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, CA (May 2004)
PROFESSIONAL ACTIVITIES
Member, Anti-Fraud Alliance
President (2004-2005, 2016-2018)
Member of the Board of Directors (2002-2004, 2005-2006, 2018-2020)
Associate, American Board of Trial Advocates—ABOTA
HONORS AND AWARDS
AV® rating with Martindale-Hubbell
Selected to the Super Lawyers list in Northern California (2005-present)
COMMUNITY INVOLVEMENT
Tom believes in taking matters pro bono for individuals who have little or no ability to access the legal system.
