Watch the full video at https://rumble.com/v2x0dna-zalmas-insurance-fraud-letter-july-1-2023.html and at https://youtu.be/yiSwfKAB7GM
The Source for Insurance Fraud Professionals
From https://zalma.com/blog, this, the thirteenth 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:
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Fraud at the outset is grounds for dismissal
No refund from defrauded insurer
Esurance Property & Casualty Insurance Company (Esurance) appealed the district court’s order granting summary disposition in favor of Nationwide Mutual Fire Insurance Company (Nationwide) and denying Esurance’s motion for summary disposition. IN Nationwide Mutual Fire Insurance Company v. Esurance Property & Casualty Insurance Company and Derek Allen Gregory and Blair Gregoryno. 361298, Court of Appeals of Michigan (June 15, 2023) Esurance argued that its insureds had defrauded them when they acquired the policy, and they were entitled to rescind the policy regardless of the trial court’s balancing of the equities.
Read the full ZIFL text in Adobe .pdf format at ZIFL-07-01-2023
More problems with McClenny Moseley & Associates
This is ZIFL’s ninth 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.
June 14, 2023
US Judge Michael North held a hearing to advise insurance companies on how to handle thousands of Hurricane Ida claims affected by alleged fraud by Texas law firm McClenny Moseley & Associates. It’s standing room only, more than 200 lawyers in court. One passed out.
Read the full ZIFL text in Adobe .pdf format at ZIFL-07-01-2023
Ethics and the public insurance adjuster
An example of a public insurance adjuster and the attorney who did not comply with the requirements of the National Association of Public Insurance Adjusters (NAPIA). Both represented the same client, involved in a claim resulting from the 1994 Northridge, California earthquake. The earthquake caused billions of dollars in damage in Southern California. It attracted lawyers and public adjusters who sought high fees like vultures flying over a dead antelope. As a result of the disaster, insurance companies’ investigations were limited due to the extent of losses caused by the earthquake and the need to quickly address their needs. Many unnecessary and false lawsuits were filed. Insurance fraud was rampant and insurance companies paid rather than fought because there were not enough staff available to deal with fraud and government agencies threatened insurance companies with large fines if they did not pay quickly.
Read the full ZIFL text in Adobe .pdf format at ZIFL-07-01-2023
Good news from the Coalition Against Insurance Fraud
When faced with a fraud conviction, this woman couldn’t stop herself from doing it again. Tanea Bouma, who had been ordered by the court not to obtain employment or a volunteer role involving financial authority.
Read the full text of ZIFL and many more conviction reports in Adobe .pdf format at ZIFL-07-01-2023
Order Limiting Cross-Examination Fair and Appropriate
IN The People v. Renae Louise Witt, G061305, California Court of Appeals, Fourth District, Third Division (June 5, 2023), a jury had convicted Renae Louise Witt of committing seven counts of health insurance fraud in violation of Penal Code section 550, subdivision (a)(6). The trial court suspended sentencing and placed Witt on two years of formal probation and ordered her to serve 364 days in jail, yet she appealed.
Read the full ZIFL text in Adobe .pdf format at ZIFL-07-01-2023
Health insurance fraud convictions
Gloucester County man pleads guilty to health care fraud
Christopher Gualtieri, 50, of Franklinville, New Jersey, pleaded guilty before US District Judge Robert B. Kugler to count one of an indictment charging him with conspiracy to commit health care and mail fraud and one count charging him with obtaining oxycodone by fraud. Gualtieri, a Gloucester County, New Jersey man, admitted on June 12, 2023 that he defrauded his employer’s health insurance plan of more than $4 million by submitting fraudulent claims for medically unnecessary compounded medications.
Read the full text of ZIFL and dozens of convictions in Adobe .pdf format at ZIFL-07-01-2023
Other insurance fraud
Clegg Gifford shuns fraudulent claims worth over £7m
Insurance broker Clegg Gifford (CG) has successfully identified and avoided fraudulent motoring claims worth over £7 million over a four-year period with the help of the anti-fraud team at law firm DAC Beachcroft (DACB).
Read the full text of ZIFL and more convictions in Adobe .pdf format at ZIFL-07-01-2023
Barry Zalma
Barry Zalma, Esq., CFE, now limits his practice to serving as an insurance consultant specializing in insurance coverage, insurance claims management, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance-related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims attorney and more than 54 years in the insurance industry. He can be reached at http://www.zalma.com and zalma@zalma.com
For the past 55 years, Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to enable insurers and their claims professionals to become professionals in insurance claims.
Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455; Subscribe to Zalma on Insurance at locals.com https://zalmaoninsurance.local.com/subscribe. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Go to the Zalma On Insurance podcast at https://podcasters.spotify.com/pod/show/barry-zalma/support Write to Mr Zalma at zalma@zalma.com; http://www.zalma.com; http://zalma.com/blog; I publish daily articles at https://zalma.substack.com, Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos on Rumble.com at https://rumble.com/c/c-262921; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ to consider more than 50 volumes written by Barry Zalma on insurance and insurance claims management.
