Watch the full video at https://rumble.com/v2u5x6o-zalmas-insurance-fraud-letter-june-15-2023.html and at https://youtu.be/ftQmCWmT-gE
From https://zalma.com/blog, this, the twelfth issue of the 27th year of publication, Zalma’s Insurance Fraud Letter contains several articles on how to deal with insurance fraud in the United States. The question starts with:
Repayment decisions cannot be resolved in bankruptcy
After Frayba Tipton and William Tipton pleaded guilty to insurance fraud, they were ordered to pay restitution to Nationwide Insurance Company of America (Nationwide). Nationwide obtained a civil judgment and award of over $1,200,000 in civil litigation against Tipton’s only to have the judgment vacated in bankruptcy. Nationwide then petitioned the trial court to convert the criminal restitution orders into civil judgments against both defendants. The district court granted Nationwide’s motion and entered civil judgments against the defendants.
IN Nationwide Insurance Company Of America v. Frayba Tipton et all., C095606, California Court of Appeals, Third District, San Joaquin (May 26, 2023), the court agreed that the restitution order could be made enforceable as a civil judgment and not subject to discharge in bankruptcy.
See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
More problems with McClenny Moseley & Associates
This is ZIFL’s eighth installment in the saga of McClenny, Moseley & Associates and its problems with the federal courts in the state of Louisiana and what appears to be an attempt to capitalize on what some judges and district judges indicate may be criminal behavior to capitalize on . insurance claims related to hurricane damage to the public in the state of Louisiana.
See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
Another insurer bites the dust
Nevada Insurance Commissioner petitions to place Friday Health in receivership
Friday Health Plans in Nevada has clashed with Nevada Insurance Commissioner Scott Kipper who filed legal action in Nevada District Court to place it under supervision.
See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
Bad news from the public
A new survey shows that it’s totally cool to exaggerate the damages on an insurance claim or, like, totally awesome to say you hurt yourself at work when you didn’t.
See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
Health insurance fraud convictions
Fifteen years in prison in $134 million Covid-19 health care fraud and money laundering scheme
Billy Joe Taylor, 44, pleaded guilty to conspiracy to commit health care fraud and money laundering on October 27, 2022. According to court documents, Taylor and his co-conspirators submitted more than $134 million in false and fraudulent claims to Medicare related to diagnostic laboratory tests, including urine drug tests and tests for respiratory diseases during the covid-19 pandemic, which were medically unnecessary, not ordered by medical providers and not provided as represented. Taylor and his co-conspirators obtained medical information and private personal information of Medicare beneficiaries and then misused the confidential information to repeatedly submit claims to Medicare for diagnostic testing. According to court documents, Taylor and his co-conspirators received more than $38 million from Medicare on these fraudulent claims.
See the full issue and dozens more convictions at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
Florida judge slams SFR contractor for misrepresentation, fraud in Tower Hill case
SFR servicesa Florida restoration company made famous by its volume of litigation and its allegations that United Property & Casualty Insurance Co. had instructed desk adjusters to change their estimates, now finds itself in some legal trouble of its own.
See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
Other insurance fraud
Man sentenced to prison for staged arson and insurance fraud
Denis Vladmirovich Molla falsely reported to the Brooklyn Center Police Department that his mobile home had been intentionally set on fire. The 30-year-old Minnesota resident has been sentenced to 30 months in prison, followed by one year of supervised release, for filing fraudulent insurance claims related to a staged arson.
See the full issue and more convictions at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
Baseball card scam
This is a fictional insurance fraud story from my experience as an insurance fraud expert and is provided to explain why insurance fraud is a “Heads I Win, Tails You Lose” situation for insurers. The story is true, only the names and locations were changed to protect the guilty.
See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
Qui Tam and Insurance Fraud
The qui tam part of the California Insurance Frauds Prevention Act, as in many other states, has a qui tam provision.
See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
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See the full issue at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-06-15-2023.pdf
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