Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-barry-zalma-esq-cfe-19c, see the full video at https: // rumble .com / vekstj-zalmas-insurance-fraud-letter-march-15-2021.html and at https://youtu.be/tkhTUJSIa5I and at https://zalma.com/blog plus more than 3600 posts.
Articles in the March 15, 2021 issue include the following:
RICO Action Against Medical Providers Raises Discovery Problems
Insurance companies claiming to be victims of caregivers working in a car-free insurance state Florida. In Government Employees Insurance Co., et al. v. Mark A. Cereceda, et al ., CASE NO. 19-22206-CIV-ALTONAGA / GOODMAN, United States District Court Southern District of Florida Miami Division (January 15, 2021) where plaintiffs filed a 406-page complaint claiming 43 bills and attaching more than 8,500 pages of spreadsheets as exhibits. More specifically, government employees sued Insurance Co. ("Geico") and related Geico entities ("Geico", together) chiropractor (Mark A. Cereceda), other caregivers and myriad LLC who are alleged to provide fraudulent healthcare services. Geico claims that Cereceda is a leading member and owner of LLCs.
An insurance company claiming fraud based on a predetermined treatment protocol should not have to prove that every claim in a vacuum is fraudulent. A court-accepted middle ground allows insurers to rely on unreliable patterns in supplier bills and documentation to explain globally why groups of claims are fraudulent, provided the insurer adequately identifies the claims in question. It can also use specific cases to prove the pattern or fraud, but then it must respond in detail to discovery requests. In that respect, I have in my practice seen medical billing and reporting that was identical to several patients except for the name of the patient. If Geico can demonstrate that type of fraud, it will have no problem with RICO's security of action and will not have to respond to interrogations of thousands of fraudulent allegations.
When you do the crime you have to do the time  The doctor successfully claimed he was a "patsy" who was talked about helping a criminal
Insurance fraud should not be a pension plan
Insurance fraud gives you three boxes and a cot
Good news from the Coalition Against Insurance Fraud
Taking an insurance check and making money twice is fraud
Insurance fraud and thief appeals conviction requiring a 35-page opinion that confirms ] Other Insurance Fraud
© 2021 – Barry Zalma
Barry Zalma, Esq., CFE, now limits his practice to working as an insurance consultant specializing in insurance coverage, insurance claims management, unfaithful and near-insurance insurance fraud . He also acts 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 lawyer and more than 52 years in the insurance industry. He is available at http://www.zalma.com and firstname.lastname@example.org.
Mr. Zalma is the first recipient of the first annual Claims Magazine / ACE Legend Award.
For the past 53 years, Barry Zalma has devoted his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following libraries with books and other materials to enable insurers and their claims staff to become insured.
Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow 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 Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ Read posts from Barry Zalma at https://parler.com/profile/Zalma/ posts; and Read the last two issues of ZIFL here.