ZIFL - Volume 27, Issue 13 - http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-07-01-2023-1.pdf
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 provides multiple
articles on how to deal with insurance fraud in the United States. The
issue begins with:
Fraud in Inception is Ground for Rescission
No Restitution from Defrauded Insurer
Esurance Property & Casualty Insurance Company (Esurance) appealed
the trial court’s order granting summary disposition in favor of
Nationwide Mutual Fire Insurance Company (Nationwide) and denying
Esurance’s request for summary disposition. In Nationwide Mutual Fire
Insurance Company v. Esurance Property & Casualty Insurance Company,
and Derek Allen Gregory and Blair Gregory, No. 361298, Court of Appeals
of Michigan (June 15, 2023)
Read the full text of ZIFL in Adobe .pdf format at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-07-01-2023-1.pdf
More McClenny Moseley & Associates Issues
This is ZIFL’s ninth installment of the saga of McClenny, Moseley &
Associates.
June 14, 2023
US Magistrate Judge Michael North held a hearing to advise insurers 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 fainted.
Read the full text of ZIFL in Adobe .pdf format at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-07-01-2023-1.pdf
Ethics And the Public Insurance Adjuster
An example of a public insurance adjuster and the lawyer who failed to
follow the requirements set out by National Association of Public
Insurance Adjusters (NAPIA).
Read the full text of ZIFL in Adobe .pdf format at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-07-01-2023-1.pdf
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 court-ordered not to
obtain employment or a volunteer role involving financial authority.
Read the full text of ZIFL and many more reports of convictions in Adobe
.pdf format at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-07-01-2023-1.pdf
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 medical
insurance fraud in violation of Penal Code section 550, subdivision
(a)(6). The trial court suspended imposition of sentence and placed Witt
on two years of formal probation and ordered her to serve 364 days in
jail and yet, she appealed.
Read the full text of ZIFL in Adobe .pdf format at http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-07-01-2023-1.pdf
Health Insurance Fraud Convictions
Gloucester County Man Admits Healthcare Fraud
Christopher Gualtieri, 50, of Franklinville, New Jersey, pleaded guilty
before U.S. District Judge Robert B. Kugler to one count of an
indictment charging him with conspiracy to commit health care and mail
fraud and one count charging him with obtaining oxycodone through fraud.
Gualtieri, a Gloucester County, New Jersey, man on June 12, 2023
admitted defrauding his employer’s health insurance plan out of more
than $4 million by submitting fraudulent claims for medically
unnecessary compounded medications.
Other Insurance Fraud Convictions
Clegg Gifford Shuns Over £7 Million Worth of Fraudulent Claims
Insurance broker Clegg Gifford (CG) has successfully identified and
avoided more than £7 million worth of fraudulent motor trade claims over a period of four years with the help of the counter-fraud team at law firm DAC Beachcroft (DACB).
