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Zalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - May 15, 2024ZIFL-05-15-2024Subscribe to ZIFL Here  Post 4801 Read the full 23 page issue here in Adobe pdf format. See the full video at  https://rumble.com/v4v566z-zalmas-insurance-fraud-letter-may-15-2024.html  and at https://youtu.be/r7TbELn-Si0 Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ This issue contains the fo...2024-05-2010 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - February 15, 2024ZIFL Volume 28, Issue 4 The Source for the Insurance Fraud Professional Subscribe here: Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma.  It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ The current issue can be read in full at http://zalma.com/blog/wp-content/uploads/2024/02/ZIFL-02-15-2024.pdf and includes the following articles: Do the Crime, Serve the Time Chutzpah: After Pleading Guilty Fraudster Tri...2024-02-1511 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter February 1, 2024ZIFL Volume 28 Issue 3 Post 4726Subscribe AT https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma.  It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ The current issue can be read in...2024-02-0908 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter February 1, 2024ZIFL Volume 28 Issue 3 Post 4726Subscribe AT https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma.  It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ The current issue can be read in...2024-02-0108 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - January 15, 2024ZIFL Volume 28, Issue 2 Read the full January 15, 2024 issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2024/01/ZIFL-01-15-2024.pdf Subscribe here: https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma.  It is provided FREE to...2024-01-1808 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – January 2, 2024Zalma’s Insurance Fraud Letter (ZIFL) continues its 25th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma.  It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ FREE subscriptions are provided to clients and friends of Barry Zalma, Inc., clients of ClaimSchool, Inc. Please feel free to forward ZIFL to anyone you know engaged in the efforts to reduce fraud. If you want to be on the free mailing list as...2024-01-0211 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - December 15, 2023Zalma's Insurance Fraud Letter - December 15, 2023 Merry Christmas,  Happy Hanukah, and May the Winter Solstice be Peaceful & Mild --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2023-12-1810 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - December 1, 2023ZIFL - Volume 27 Issue 23 The Resource for the Insurance Claims and Insurance Fraud Professionals This, the 22nd issue of the 27th Year of ZIFL includes articles and reports relating to insurance fraud, including: Some Red Flags of Insurance Fraud Over the last two centuries insurers, insurance investigators, Special Investigative Unit Investigators, insurance lawyers, and insurance management have developed lists of indicators of potential insurance fraud. The indicators are known as the Red Flags of Fraud and are used to determine if it is necessary to begin a thorough investigation of an insurance claim to determine if a fraud is...2023-12-0512 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - October 15, 2023ZIFL Volume 27, Issue 20 This, the twentieth 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. Man Bites Dog: GEICO Bites Fraudsters Don’t Ty to Defraud GEICO It Bites Back GEICO (collectively, “GEICO” or “Plaintiffs”) sued Defendants ALP Supply, Inc. (“ALP”), PV Supply, Inc. (“PV”), and Pal Vakula, alleging common law fraud and unjust enrichment claims. Read the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2023/10/ZIFL-10-15-2023.pdf McClenny Moseley & Associates Issues This is ZIFL’s sixteenth installment of the sag...2023-10-1611 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – October 1, 2023ZIFL – Volume 27, Issue 19, October 1, 2023 This, the nineteenth 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. Zalma’s Insurance Fraud Letter – October 1, 2023Volume 27, Issue 19, October 1, 2023Barry ZalmaOct 2, 2023 Share Leave a comment Read the full article at https://lnkd.in/gSwZcFtw, see the full video at https://lnkd.in/geXk8tvN and at https://lnkd.in/gyWx2-zm, Read the full article and the full 22 pages of ZIFL at https://lnkd.in...2023-10-0409 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter - September 15, 2023ZIFL Volume 27, Number 18 https://zalma.com/blog --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2023-09-1810 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - September 1, 2023ZIFL - 9/1/2023 - Volume 27, Issue 17 This, the seventeenth 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: Subscribe to Zalma's Insurance Fraud Letter The Source for Insurance Fraud Professional Allstate’s Qui Tam Actions Work to Take the Profit Out of Fraud Man Bites Dog Story – Allstate May Sue on Behalf of State for Insurance Fraud Allstate Insurance Company and several of its affiliates (collectively, Allstate) brought qui tam actions on behalf of the State of California alleging insura...2023-09-0410 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - August 15, 2023Issue 27 Number 16: ZIFL-08-15-2023 See the full video at  and at https://youtu.be/x0EJFKVdjwQ Lawyer Paying for Clients Guilty Experienced Lawyer Claiming Ignorance of Law Is No Defense Robert Irving Slater was a practicing worker’s compensation attorney when he entered into an agreement that cost him his freedom. Read the full article and the full ZIFL at http://zalma.com/blog/wp-content/uploads/2023/08/ZIFL-08-15-2023-1.pdf More McClenny Moseley & Associates Issues This is ZIFL’s Twelfth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in th...2023-08-1509 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - August 1, 2023ZIFL - 08/01/2023 https://zalma.com/blog --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2023-08-0311 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - June 15, 2023 ZIFL - 6-15-2023 - Volume 27, Issue 12 The Source For Insurance Fraud Professionals This, the Twelfth 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: Restitution Order Can’t Be Discharged in Bankruptcy After Frayba Tipton and William Tipton pled guilty to committing insurance fraud, they were ordered to pay victim restitution to Nationwide Insurance Company of America (Nationwide). The trial court granted Nationwide’s petition and entered civil judgments against the defendants. In Nationwide Insurance Company Of Americ...2023-06-1608 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter June 1, 2023The publication for insurance fraud professionals. --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2023-06-0508 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - May 1, 2023ZIFL 05-01-2023, Volume 27 Issue 9 Restitution Required John James Succi appealed pro se from the order dismissing his “Motion to Vacate Restitution/Sentencing.” In Commonwealth Of Pennsylvania v. John James Succi, No. 229 EDA 2022, No. J-S22022-22, Superior Court of Pennsylvania (February 28, 2023) the Superior Court gave consideration to the pro se motions of the convicted felon and ordered him to make restitution. Victims of crime must make certain that the state prosecutor, after convicting the criminal, like Succi, must demand restitution. The victims did so in this case and the prosecutor effectively obtained, at sentencing, an order of restitution. Succi, sent...2023-05-0111 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - April 15, 2023ZIFL - Volume 27, Issue 8 - The Source For Insurance Fraud Professionals Obesity, Diabetes and Covid Not Basis For Compassionate Release The US Congress, feeling sorry for federal prisoners, amended the law to create The First Step Act to allow a District Court to shorten a sentence when there exist extraordinary and compelling reasons to release the Prisoner.  Read the full issue of ZIFL-04-15-2023 at http://zalma.com/blog/wp-content/uploads/2023/04/ZIFL-04-15-2023-1.pdf The Special Investigative Unit Investigator The experienced claims investigator is usually a part of, or vendor to, a Special Investigative Unit (SIU) s...2023-04-1415 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - April 1, 202ZIFL Volume 27, Issue 7 The Source For Insurance Fraud professionals https://zalma.com/blog --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2023-04-0712 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - March 1, 2023ZIFL Volume 27, Issue Number 5   Read the full text of ZIFL at http://zalma.com/blog/wp-content/uplo....   McClenny Moseley & Associates & Insurance Fraud  The McClenny Moseley & Associates (MMA) series of lawsuits, court hearings and insurance department actions have brought about some very serious problems for MMA, including court orders, lawsuit dismissals, administrative cease and desist orders and litigation, all of which have created a poster child for Zalma’s Insurance Fraud Letter.  Since MMA has admitted that it reported a claim to various insurers, including Allied Insurance, that it was presenting claims against Allied and at least...2023-03-0715 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - January 15, 2023ZIFL - Volume 27, Issue 2 - The Source For Insurance Fraud Professionals --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2023-01-1912 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - January 1, 2023ZIFL January 1, 2023 - Volume 27, Issue 1   The Source for the Insurance Fraud Professional   Starting the 27th year of publication of Zalma's Insurance Fraud Letter,  ClaimSchool, Inc., Barry Zalma and the Zalma family wish you a happy  and prosperous new year.  Read the full pdf version of ZIFL at http://zalma.com/blog/wp-content/uploads/2022/12/ZIFL-01-01-2023.pdf  New Florida Statutes  The state of Florida proposed new statute to make insurance and insurance claims more fair is over 105 pages available at https://www.flsenate.gov/Session/Bill/2022A/2A/BillText/er/PDF.  Lawmakers in Florida passed legislatio...2023-01-0213 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - December 15, 2022ZIFL Volume 26 Number 24   Merry Christmas, Happy Hanukah & May The Winter Solstice be Peaceful  & Mild  Read the full Newsletter http://zalma.com/blog/wp-content/uploads/2022/12/ZIFL-12-15-2022-1.pdf.  A Christmas Fable of Fraud  ZIFL Publishes This Story At Christmas Time Every Year. I Hope You Like  It Again.  The story that follows is fiction based, in part, on a true case worked  on by me. Any similarity to real people is unintentional. It is meant  only to educate fraud professionals about how some unscrupulous people  use the crime of insurance fraud for...2022-12-1515 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - December 1, 2022ZIFL Volume 26, Issue 23  The December 1, 2022 issue contains articles and reports of insurance  fraud convictions for every insurance claims professional, SIU  investigators and everyone interested in the efforts to defeat or deter  insurance fraud. The December 1, 2022 issue includes:   It Doesn't Pay to Try to Cheat Your Insurance Company   Sigismondi Foreign Car Specialists, Inc. appealed the U. S. District  Court's summary judgment in favor of State Auto Property and Casualty  Insurance Company on State Auto's declaratory judgment action and  statutory insurance fraud claim.  In State Auto Property And Casualty Insurance Company v. Sigismondi  Foreign Car Specialists...2022-12-0115 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - November 1, 2022ZIFL - Volume 26 Issue 21   In this the 21st issue of the 26th year of publication of Zalma's  Insurance Fraud Letter you will find articles that discuss the following  insurance fraud issues:   When an Insured Lies to his Insurer the Claim May Be Denied  In Cesar Benitez v. Universal Property And Casualty Insurance Company,  No. 4D21-3281, Florida Court of Appeals, Fourth District (October 12,  2022) Cesar Benitez appealed the trial court’s entry of final summary  judgment in favor of Universal Property and Casualty Insurance Company  (“Insurer”) in a first-party property insurance dispute over a water  damage claim.  In his a...2022-11-0111 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - 10-15-2022ZIFL - 10/15/2022 available at  http://zalma.com/blog/wp-content/uploads/2022/10/ZIFL-10-15-2022-1.pdf   Short teases about the articles in this issue can be read at  ZIFL-10-15-2022   Ethics & Insurance Fraud  Insurance fraud is a crime in most jurisdictions. In California it is a  felony subject to five years in prison upon conviction. By definition a  person who commits the crime of insurance fraud is not acting ethically.  In State v. Whitaker, 175 P.3d 136, 117 Hawai'i 26 (Haw. App.  12/31/2007)  Whitaker, after presenting a claim to his insurer, was  indicted, convicted, and sentenced for Insurance Fraud in violation...2022-10-1410 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - October 1, 2022ZIFL - Volume 26 Issue 19   Read the full issue at http://zalma.com/blog/wp-content/uploads/2022/09/ZIFL-10-01-2022-1.pdf  Insurer Proactive Against Fraud CIGNA Obtains $14,371,384.95 Judgment Against Fraudulent Health Care  Provider  Since police, prosecutors and state insurance fraud investigators are  seldom willing to arrest or prosecute insurance fraud perpetrators it is  necessary for insurers to be proactive and sue those who attempt or  succeed in defrauding insurers.  In Connecticut General Life Insurance Company and CIGNA Health And Life  Insurance Company v. Mike Ogbebor and Stafford Renal LLC, No. 3:21-cv-00954  (JAM), United States District Court, D. C...2022-09-3011 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - Volume 26, Issue 17 - September 1, 2022A site for the insurance claims professional and anyone who wants to  know something about insurance, insurance claims, insurance fraud, insurance coverage,  and insurance law. --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2022-09-0513 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - July 15, 2022ZIFL – Volume 26, Number 14  THE COURTS ARE BACK CONVICTING FRAUD PERPETRATORS WITH VIGOR – READ  ABOUT THE CONVICTIONS IN THIS ISSUE OF ZIFL!   The July 15, 2022 issue contains articles available FREE at Subscribe to  e-mail Version of ZIFL, it’s Free!   Greg Lindberg Gets a New Trial  Jury Instruction Misled Jury by stating that an “Official Act” Existed  as a Matter of Law  Greg E. Lindberg and John D. Gray were convicted of honest services  fraud and federal funds bribery in connection with a series of payments  and offers of payment, in the form of campaign con...2022-07-1910 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - July 15, 2022ZIFL – Volume 26, Number 14  THE COURTS ARE BACK CONVICTING FRAUD PERPETRATORS WITH VIGOR – READ  ABOUT THE CONVICTIONS IN THIS ISSUE OF ZIFL!   The July 15, 2022 issue contains articles available FREE at Subscribe to  e-mail Version of ZIFL, it’s Free!  and  Read last two issues of ZIFL  here. Greg Lindberg Gets a New Trial  Jury Instruction Misled Jury by stating that an “Official Act” Existed  as a Matter of Law  Greg E. Lindberg and John D. Gray were convicted of honest services  fraud and federal funds bribery in connection with a series of payments  and offers of payment, in the form o...2022-07-1510 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - July 1, 2022ZIFL Volume 26 Number 13  ZIFL-07-01-2022.   The July 1, 2022 issue of Zalma's Insurance Fraud Letter you will be  able to read the full text of articles including:  Bases for Rescission   Rescission Is an Equitable Remedy First Created in The Ecclesiastical  Courts of Elizabethan England.  When the United States was conceived in 1776 the founders were concerned  with protecting their rights under British common law.   Common Law is a form of law developed by judges through tribunals and  decisions of courts rather than executive branch action and legislative  statutes.  Following the common law tradition, legal principles were referred to  ...2022-07-0108 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - June 1, 2022Zalma’s Insurance Fraud Letter   A ClaimSchool™ Publication © 2022, Barry Zalma & ClaimSchool, Inc.,  Go to my blog & Videos at: Zalma on Insurance, and at https://zalma.com/blog       The full issue in Adobe .pdf format is available here.  The following are summaries of some of the articles that can be found in  the current issue. Allianz Subsidiary Pleads Guilty to Defrauding Investors Prosecutors Also Brought Charges Against Three Former Allianz Employees,  With Two Agreeing to Plead Guilty  One of Allianz SE’s ALIZF investing divisions pleaded guilty to  securities fraud and agreed to pay about $6 billion in penalties and  r...2022-06-0212 minZalma on InsuranceZalma on InsuranceDisaster ScumTrue Crime of Insurance Fraud Number 37   Barry Zalma, Esq., CFE presents videos so you can learn how insurance  fraud is perpetrated and what is necessary to deter or defeat insurance  fraud. This Video Blog of True Crime Stories of Insurance Fraud with the  names and places changed to protect the guilty are all based upon  investigations conducted by me and fictionalized to create a learning  environment for claims personnel, SIU investigators, insurers, police,  and lawyers better understand insurance fraud and weapons that can be  used to deter or defeat a fraudulent insurance claim.   Disasters bring out the b...2022-03-1609 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - February 15, 2022Volume 26, Issue 4 – February 15, 2022 Go to Barry Zalma videos at Rumble.com at https://rumble.com/zalma A ClaimSchool™ Publication © 2022 Barry Zalma & ClaimSchool, Inc. Go to my blog & Videos at: Zalma on Insurance  And at https://zalma.com/blog   Go to the Insurance Claims Library Listen to the Podcast: Zalma on Insurance Videos from Zalma on Insurance Subscribe to Barry Zalma on Substack.com    Go Directly to Jail, Do Not Pass Go Chutzpah: Convicted of Insurance Fraud Appeals to Avoid Going to Jail Tarek Abou-Khatwa appealed his conviction of a complex, multi-yea...2022-02-1511 minZalma on InsuranceZalma on InsuranceTrue Crime Stories About How Insurance Fraud Costs EveryoneFictionalized True Crime Stories of Insurance Fraud from an Expert   https://zalma.com/blog Barry Zalma presents fictionalized True Crime Stories of Insurance Fraud  from an Expert who explains why Insurance Fraud is a “Heads I Win,  Tails You Lose” situation for Insurers.   The stories help to Understand How Insurance Fraud in America is Costing  Everyone who Buys Insurance Thousands of Dollars Every year and Why  Insurance Fraud is Safer and More Profitable for the ­­­Perpetrators  than any Other Crime.  This book started as a collection of columns I wrote and published in  the magazines “I...2022-01-1814 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - January 1, 2022Zalma's Insurance Fraud Letter Volume 26 Issue 1   https://zalma.com/blog The first issue of the twenty sixth year of publication is available as an Adobe .pdf document at  with this issue and the December 15, 2021  issues of ZIFL here. The issue includes the following articles but you  must go here  to read the full articles and the full 24 page issue of  Zalma's Insurance fraud Letter.   State Farm & Allstate Fight Fraudsters With Qui Tam Suits   It Is Essential That Insurers Are Proactive Against Insurance Fraud  Insurance companies are the victims of billions of dollars e...2022-01-0318 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - December 1, 2021ZIFL - Volume 25, Number 23   The full .pdf version is available here.    Admitted Crop Insurance Fraud Perpetrator Tries to ZIFL-12-01-2021 Limit  Restitution Crooked Farmer Goes to Jail and Must Pay $2.5 Million in Restitution  Defendant Ronnie Jolly pleaded guilty to crop insurance fraud, money  laundering, and conspiring to defraud the United States and to commit  mail or wire fraud. The Government sought restitution of monies paid by  the crop insurance program and Jolly moved to avoid or limit the orders  of restitution.   In United States of America v. Ronnie Jolly, CRIMINAL No. 5:18-32...2021-12-0118 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - November 1, 2021Description of Zalma’s Insurance Fraud Letter    https://zalma.com/blog Volume 25 Number 21 The Reason for the Examination Under Oath  Courts that construe submission to an EUO as a condition precedent to  recovery generally do not require the insurer to prove that it suffered  actual prejudice from an insured's unexcused refusal to submit to an  examination. Lorenzo–Martinez v. Safety Ins. Co., 58 Mass. App. Ct. 359,  790 N.E.2d 692, 695–96 (2003).  The EUO provides a mechanism for the  insurer to corroborate the claim by obtaining information that is  primarily or exclusively within the possession of the insured.  The ad...2021-11-0112 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – October 15, 2021Zalma’s Insurance Fraud Letter Volume 25, Number 20  https://zalma.com/blog Criminal Caused Suit on Policy to Drag on for More than Six Years Court Finally Stopped an Unconscionable Level of Overlitigation  United States District Judge Gary R. Brown was faced with a legal  dispute that, perhaps because the defendant was a criminal, went on for  years without a final disposition. In Principal Life Insurance Company  v. Jason P. Brand, No. CV 15-CV-3804, United States District Court, E.D.  New York (September 29, 2021) the case was reduced to seven years on  disputes that appeared to be relativel...2021-10-1518 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - October 1, 2021 - A VideoOctober 1, 1979 - 2021 – Another Anniversary – Thank You     https://zalma.com/blog Forty-one years ago today I left the world of the employed and became an  entrepreneur by opening my own law firm. The law practice was  incorporated shortly thereafter as Barry Zalma, Inc. When I opened for  business on October 1, 1979, I had no clients and no certainty that I  would have any in the future. I had borrowed money from the bank to  carry me through the first six months and was concerned about my ability  to pay the loan with my third child about to be born.  Muc...2021-10-0118 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - September 15, 2021A Video from ZIFL - 9/15/2021 -  https://zalma.com/blog New Articles on Insurance Fraud Cease And Desist Orders Issued to Four Companies Allegedly  Selling Home Warranties Without a License The California Department of  Insurance announced September 7, 2021 that it has issued Cease and  Desist Orders, effective immediately, to four companies who allegedly engaged in selling home  warranty contracts in California without proper authorization. Under the Orders, the companies must immediately stop selling the  contracts. To protect consumers from fraud, any company marketing and  selling home warranty contracts to California consumers must be licensed  by the Departme...2021-09-1618 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – September 1, 2021California Legislature Wants to Make Application Fraud a Crime   https://zalma.com/blog Application fraud in California is only recognized with regard to  workers’ compensation policies. The proposed new statute provides it  will be a crime for any fraud in any insurance application. Why it’s Difficult to Fire a Government Employee Insurance Fraud Conviction Requires Dismissal of Government Employee After Conviction for Fraud State Employee Demands Her Job  Fatu Rimbert appealed from a November 12, 2019 final administrative  decision of the Civil Service Commission (Commission) affirming her  removal as a family service worker for the County of Essex...2021-09-0118 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter August 15, 2021ZIFL 8/15/2021 -- Volume 25, Issue 16   https://zalma.com/blog and https://zalma.com/zalmas-insurance-fraud-letter-2/ Claim For Damage to Property That Existed Before Issuance of Policy Is  Fraud It Is a Crime to Claim Preexisting Damage as New Damage After accepting a Plea Agreement and having a judgment entered the  Defendant had no right to expunge his criminal record Vsevolod Sergee  Garanin appealed from the order, entered in the Court of Common Pleas of  Lackawanna County, denying his expungement petition. Commonwealth Of  Pennsylvania v. Vsevolod Sergee Garanin, No. 337 MDA 2020, Superior  Court of Pennsylvania (July 30, 2021)  Man Bites Dog Story: G...2021-08-1617 minZalma on InsuranceZalma on InsuranceThe Fortuity DoctrineExplaining "Fortuity" as an Unwritten Exclusion    https://zalma.com/blog Because the purpose of insurance is to protect insureds against unknown,  or fortuitous, risks, fortuity is an inherent requirement of all  insurance policies that take on the risk of loss accepted by the policy.  [Two Pesos, Inc. v. Gulf Ins. Co., 901 S.W. 2d 495, 502 (Tex. App.  Houston [14th Dist.] 1995, no writ)]. The fortuity doctrine precludes  coverage for both a “known loss” and a “loss in progress.” A “known  loss” is a loss the insured knew had occurred prior to making the  insurance contract. [Burch v. Commonwealth Mut. Ins...2021-08-0314 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - August 1, 2021Convicted Insurance Fraudster Appeals Finding She Breached Probation  https://zalma.com/blog Fraud Perpetrators Have Unmitigated Gall  Kristi Heffington appealed from the revocation of her probation. She  argued on appeal that the revocation court’s decision was error even  though it was proved that she had sent text messages to herself claiming  it came from her past employer dentist who fired her for stealing from  his practice and defrauding insurers. In Kristi Heffington v. State of  Maryland, No. 1899, Court of Special Appeals of Maryland (July 1, 2021)  the appellate court wasted much time dealing with her spurio...2021-08-0212 minZalma on InsuranceZalma on InsuranceInadequate Foundations & Shear WallsA Video Explaining Foundation & Shear Wall Defects    https://zalma.com/blog Foundation Defects   A foundation is the base upon which a structure stands. If a foundation  is inadequately engineered it will not properly hold a structure up and  will pose a hazard to the structure, to adjoining structures, and to  occupants of the building.  A foundation is the base upon which a structure stands. If a foundation  is inadequately engineered it will not properly hold a structure up and  will pose a hazard to the structure, to adjoining structures, and to  occupants of the buildi...2021-07-2616 minZalma on InsuranceZalma on InsuranceActual Cash Value Applied to Appraisal of Property LossesA Video Explaining the Interpretation of Actual Cash Value    https://zalma.com/blog Determining the actual cash value of an item of personal property is  often difficult and is subject to different interpretations across  multiple jurisdictions. When an insurer and insured cannot agree on the  amount of actual cash value loss they have the right to seek appraisal —  a limited form of arbitration that may only determine the amount of  actual cash value and loss.  Depending on the wording of the policy or local state law Actual Cash  Value (ACV) can be determined by subtracting from full r...2021-07-1516 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - July 15, 2021HTTPS://zalma.com/blog This fraud technique involves a loss at a time when an individual has no  or inadequate insurance. Following the loss, the individual applies for  insurance or increases the limits of existing coverage. After a period  of time (usually several days or weeks), a fraudulent claim is submitted  for a loss reported to have happened after the new policy came into  effect. Failure of the insurer, or its agent, to see the property  (especially if the insurer has included the items on its schedules)  before issuance of a policy is an invitation to this type of...2021-07-1514 minZalma on InsuranceZalma on InsuranceRescission of InsuranceExplaining The Equitable Remedy and Insurance  https://zalma.com/blog Rescission is an equitable remedy as ancient as the common law of  Britain.  When the United States was conceived in 1776 the founders were concerned  with protecting their rights under British common law. They adopted it  as the law of the new United States of America modified only by the  limitations placed on the central government by the U.S. Constitution  approved in 1789.  The viability and ability to enforce contracts was recognized as  essential to commerce. Courts of law were charged with enforcing  legitimate contracts. Courts of equity...2021-07-1418 minZalma on InsuranceZalma on InsuranceEthics and the AdjusterIndependent insurance adjusters serve insurance companies who do not  have sufficient claims staff to handle insurance claims on behalf of  those various insurers without staff in every jurisdiction where there  is property the risk of loss of which was insured.   https://zalma.com/blog The professional insurance adjuster recognizes that the work of  adjusting insurance claims is a profession of public trust. Independent  insurance adjusters should maintain a standard of integrity that will  promote the goal of building public confidence and trust in the  insurance industry.  Independent insurance adjusters, and company employed insurance  adjusters, should follow sta...2021-07-1317 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - July 1, 2021ZIFL - Volume 25, Issue 13    https://zalma.com/blog Attorneys Should Never Be Involved in Fraud with Clients The Crime Fraud Exception to The Attorney Client Privilege  In United States of America v. Aron Chervin, Et Al, No. 10 CR 918  (S.D.N.Y. 09/21/2011) an indictment involving multiple health insurance  fraud perpetrators attempted to keep from their criminal trial wiretap  conversations that seem to establish the crime.  By motion dated June 1, 2011, Defendant Michael Lamond (“Lamond”) moved  to suppress nineteen telephone conversations between himself and  Defendant Aron Chervin intercepted by the Federal Bureau of  Investigation (“FBI”) pursuant to court-authorized w...2021-07-0216 minZalma on InsuranceZalma on InsuranceHealth Insurance FraudExplaining Health Insurance Fraud    https://zalma.com/blog The nation’s bill for health care fraud is enormous  as large as $300  billion or more every year. Fraud takes place at many points in the  health care system, in hospitals, nursing homes, and diagnostic  facilities, by doctors, attorneys, health care providers, durable  equipment providers, and patients. One large area prone to fraud is the Medicare system. This system  processes more than 800 million claims a year with 70 different  contractors handling the claims that come from hundreds of thousands of  doctors, laboratories, and other health practitioners and facilities.    In 2012 Medicare...2021-06-2815 minZalma on InsuranceZalma on InsuranceIdentifying Insurance FraudA Video Explaining How to Discover and Defeat Insurance Fraud    https://zalma.com/blog Next to tax fraud, insurance fraud is the most practiced crime in the  world. It is perpetrated by members of every race, religion, sexual  orientation, and nationality. Insurance fraud is perpetrated by members  of every profession. The temptation to commit insurance fraud is great  because prosecutions are rare, convictions are rarer and the convicted  serve little or no time in prison. The possibility of a tax-free profit,  coupled with the commonly held belief that it is not a crime or morally  wrong to...2021-06-2516 minZalma on InsuranceZalma on InsuranceRetaining an Attorney to Defend an Insured Explaining How to Retain Defense Counsel   https://zalma.com/blog In instances where insurance claims may entail litigation, insurers must  move quickly to engage counsel. When an attorney is retained to defend a  person insured, the fact should be documented in writing by the  attorney, the adjuster, and the insured who is to be defended.  Before an insurer retains an attorney to represent an insured to defend  an insured who has been sued for a tort the claims person should be  certain the lawyer is competent to defend the insured. This can be  accomplished by attending...2021-06-2416 minZalma on InsuranceZalma on InsurancePreparation for Trial of an Insurance Tort Case & Use of ExpertsTrial Preparation   https://zalma.com/blog After completion of investigation, written discovery, oral depositions,  and retention of necessary expert witnesses, the trial preparation part  of the case begins.  The defense attorney’s response should include the settlement value, or  range of values, he or she places on the case.  After reviewing the report, the adjuster should confer with the attorney  to discuss strategy in depth. They should agree on the cost of a  potential settlement versus that of an actual trial. If they decide that  settlement should be attempted, the adjuster should give the attorney  settlement a...2021-06-2216 minZalma on InsuranceZalma on InsuranceEthics and the IMEExplaining The Ethical Obligations of the Claims Person when Retaining  an IME    HTTPS://zalma.com/blog Medical examiners have established their own codes of ethics with regard  to an IME and are obligated by those codes to report their findings  fairly and accurately. The American Board of Independent Medical  Examiners has published a code of Ethics.  The adjuster who follows the rules profiled by the American Board of  Independent Medical Examiners, which are similar to those posited by the  International Association of Special Investigation Units (IASIU),  should receive appropriate independent medical advice.  Insurance is a business of...2021-06-2115 minZalma on InsuranceZalma on InsuranceInsurance for Punitive DamagesExplaining Why Insurance for Punitive Damages is Against Public Policy   https://zalma.com/blog in Most States   Insurers generally argue that they cannot indemnify or insure for  punitive damage awards. Insurance carriers typically rely, in  California, on “public policy” and point to California Insurance Code  Section 533. Section 533 states:  An insurer is not liable for a loss caused by the willful act of the  insured; but he is not exonerated by the negligence of the insured, or  of the insured’s agents or others.  Insurance carriers frequently cite Peterson v. Superior Court, 31 Cal.3d  147 (1982), in support of their argument...2021-06-1615 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - June 15, 2021ZIFL - 06-15-2021  https://zalma.com/blog Quote of the Issue - “Learn from yesterday, live for today, hope for  tomorrow.” - Albert Einstein What Is Insurance Fraud?  When an insurer is asked to pay a fraudulent insurance claim it is the  victim of a tort, a civil wrong and in most states, a crime.  Black’s Law Dictionary, 6th Edition, defines fraud as: "An intentional  perversion of the truth for the purpose of inducing another in reliance  upon it to part with some valuable thing belonging to him or to  surrender a legal right; a false...2021-06-1517 minZalma on InsuranceZalma on InsuranceSome Grounds for Finding Bad FaithDescribing Grounds for the Tort of Bad Faith Unexplained Delays in Communication   https://zalma.com/blog When an insured asks a question of his or her insurer an answer is  expected. An insurer should respond to all inquiries promptly, and in no  event later than 15 days. If an insured submits a proof of loss to  which the insurer has agreed and asks “when can I expect to be paid?”  the insurer should respond with specificity, immediately. Most policies  and state regulations require payment within 30 calendar days of  agreement to the proof of loss. If the question is...2021-06-1417 minZalma on InsuranceZalma on InsuranceDefenses to Intentional TortsA Video Explaining Various Defenses to Intentional Torts    https://zalma.com/blog  Self-Defense and Defense of a Third Party  The California Civil Code states:  Any necessary force may be used to protect from wrongful injury the  person or property of oneself, or of a wife, husband, child, parent, or  other relative, or member of one’s family, or of a ward, servant, master  or guest. (California Civil Code § 50)  The person must reasonably believe that danger exists, and must use only  such force as is reasonably necessary.  Defenses to Battery—Use of Deadly Force  Deadly fo...2021-06-1115 minZalma on InsuranceZalma on InsuranceDefenses to Accidental Tort ClaimsA Video Explaining Defenses to Tort Claims    https://zalma.com/blog Contributory and Comparative Negligence  At one time, a plaintiff who contributed in any amount to his or her own  injury recovered nothing. The California Supreme Court thought the  result was harsh. A person 99% responsible for another’s injury would  have an absolute defense. The California Supreme Court decided that  almost all accidents, all negligent torts, were the result of negligent  actions of both parties.  The California Supreme Court enunciated in Li v. Yellow Cab, a system  known as comparative negligence where the jury was instructed t...2021-06-0917 minZalma on InsuranceZalma on InsuranceWater or Wind CoverageCatastrophes and Anti-Concurrent Cause Policy Language  https://zalma.com/blog The United States Court of Appeal, Fifth Circuit entered an important  decision with regard to water damage and insurance policy coverage for  claims resulting from water damage and catastrophe losses. In Leonard v.  Nationwide, 499 F.3d 419, 37 A.L.R. 6th 785 (2007) the first of the  Katrina cases to go to trial, found that  anti-concurrent-causation clause was not ambiguous; the clause was not invalid under Mississippi law; and water damages exclusion unambiguously excluded damage caused to  residence from storm surge.  The Leonards' home lies twelve feet above sea leve...2021-06-0812 minZalma on InsuranceZalma on InsuranceAn Occurrence Requires FortuityExplaining The Need to Prove an Occurrence   https://zalma.com/blog An “occurrence” is usually defined as accidental loss or damage which  results, during the policy period, in bodily injury or property damage.  In Green v. State Farm Fire & Casualty Co. 127 P.3d 1279, 2005 UT  App 564 (Utah App. 12/30/2005) a homeowner sued the insured developer  after he sustained property damages as a result of a landslide. At the  time of the landslide, the developer held a contractor/builder’s risk  insurance policy issued by State Farm. The developer initiated a  declaratory judgment action against State Farm, seeking defense and  i...2021-06-0718 minZalma on InsuranceZalma on InsuranceTime to Establish Excellence in Claims HandlingA Proposal to Create a Staff of Claims Professionals    https://zalma.com/blog To avoid claims of breach of contract, bad faith, punitive damages,  unresolved losses, and to make a profit, insurers must maintain a claims  staff dedicated to excellence in claims handling. That means they  recognize that they are obligated to assist the policyholder and the  insurer to fulfill all the promises made by the insurer in the wording  of the policy.  An insurer can create a claims staff dedicated to excellence in claims  handling by, at least:  Hiring insurance claims professionals. If claims profession...2021-06-0415 minZalma on InsuranceZalma on InsuranceAsking What is a Moral Hazard?Recognizing a Moral Hazard in the Underwriting of Insurance    https://zalma.com/blog The moral hazard is the increase in uncertainty caused by personal acts  of individuals. These acts may contribute to the probability or severity  of loss. The individual creating the problem may be the policyholder or  another person. In either case the chance of loss is increased. A moral  hazard may be present in every line of insurance. No underwriter can  ignore it without incurring an increased risk of substantial loss. The  moral hazard is very difficult to detect and therefore very dangerous to  the...2021-06-0317 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter June 1, 2021Do Insurers Get Their Money’s Worth from Fighting Fraud?    https://zalma.com/blog The Law of Unintended Consequences Strikes Again to Help Set Up a Bad  Faith Case   How a Statute to Protect Against Bad Faith Offers Created an Opposite  Result  In White v. Cheek, A21A0212, Court of Appeals of Georgia (May 21, 2021) a  personal injury action arising from an automobile accident involving  Stephan Duwayne White and Walter Cheek. White appealed from the trial  court’s denial of his motion to enforce a settlement. White contended  that the trial court erred by holding that oral communicat...2021-06-0117 minZalma on InsuranceZalma on InsuranceCasualty InsuranceA Video Explaining Casualty Insurance   https://zalma.com/blog  "Casualty insurance” is defined as an “agreement to indemnify against  loss resulting from a broad group of causes such as legal liability,  theft, accident, property damage, and workers' compensation.” Black's  Law Dictionary 871 (9th ed. 2009).  Liability insurance is part of the casualty line of insurance. A  “casualty” is an accidental injury, a fortuitous event.  For every such harm there is a law or legal principle that places the  burden of the consequences back on the finances of the initiator of the  harm. Applying the ancient maxim of the law that “for ev...2021-05-2715 minZalma on InsuranceZalma on InsuranceThe Unethical InsuredA Video Explaining Ethics and the Covenant of Good Faith & Fair  Dealing    https://zalma.com/blog On rare occasions, an insured will act unethically in his, her or its  relations with an insurer. When they do, if discovered by the insurer or  its claims person, the right to indemnity may be lost. As you read  about the decision from the United States Supreme Court below consider  how the insured acted unethically to the insurer and why the Supreme  Court decided to deprive the insured of his right to indemnity.  Although hoary with age this case still sta...2021-05-2615 minZalma on InsuranceZalma on InsuranceAppraisal of a Homeowners Policy ClaimA Video Explaining Appraisal in a Homeowners Claim   https://zalma.com/blog Almost all homeowners policies contain an “appraisal” clause similar to  that in the Standard Fire Insurance Policy.  Appraisal should be used as a last resort when all efforts to reach an  agreed amount of loss with the insured have failed. The appraisal  provision is optional, and neither the insured nor the insurer is  obligated to invoke that provision. [Overland Plumbing, Inc. v.  Transamerica Insurance Company, 119 Cal. App. 3d. 476, 174 Cal. Rptr. 1  (1981).]  Under civil practice rules, appraisal can be a formal proceeding at  which witnesses are subpoenaed...2021-05-2517 minZalma on InsuranceZalma on InsuranceAbout the Assault & Battery ExclusionIntentional Torts Should Never Be Insurable    https://zalma.com/blog Insurance against the liability that comes from an intentional tort is  said to be against “public policy.” Insurance companies are generally  forbidden to write liability insurance promising protection against the  consequences of an intentional tort since such activity would encourage  intentional torts.  Assault or battery is, by definition, intentional torts that should not  be insured. An assault is defined as:  An intentional, unlawful offer of corporal injury to another by force,  or force unlawfully directed toward person of another, under such  circumstances as create well-founded fear of imminen...2021-05-2115 minZalma on InsuranceZalma on InsuranceAbout More ExclusionsExclusions for Wear & Tear, Depletion, Deterioration, Rust,  Corrosion and Erosion, and Water Damage    https://zalma.com/blog  The wear and tear exclusion, perhaps because it is so obvious, has  seldom been the subject of appellate review. The exclusion for wear and  tear is not, however, as argued by the insured, limited to ‘abnormal  wear and tear,’ but rather encompasses all ‘wear and tear’. See Lovell  v. State Farm Mut. Auto. Ins. Co., 466 F.3d 893, 902 (10th Cir.2006)  Applying Colorado law and holding that when the language used in an  insurance contract is plain and its meaning is clear, the agre...2021-05-2016 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – May 15, 2021ZIFL – May 15, 2021    https://zalma.com/blog The May 15, 2021 issue of Zalma’s Insurance Fraud Letter Includes  articles on the following subjects:   EUO Is A Condition Precedent  People who commit insurance fraud tend to run from serious insurers who  deny claims for fraud, misrepresentation, concealment or failure to  fulfill conditions precedent. State Farm filed an unopposed motion for  summary judgment against defendants All Med Merchandise and Trading,  Inc., Haar Orthopedics & Sports Medicine, P.C., Park Avenue  Orthopedics, P.C., and Anthony Vigorito, D.C., probably because the  defendants knew they had no case and placed their efforts to colle...2021-05-1717 minZalma on InsuranceZalma on InsuranceAbout Care Needed to Elect RescissionRescission is an Important Remedy to Avoid Fraud    Never Rescind a Policy Without a Thorough Investigation and Advice of  Counsel  https://zalma.com/blog Insurers must use the rescission remedy with care. Insurers should never  assume that the promise to pay indemnity to the insured under a policy  of insurance can, with impunity, be broken by advising the insured that  the insurer has rescinded the policy.  Rescission without sufficient evidence is wrongful. Rescission without  the advice of competent counsel is a tactic fraught with peril.   Rescission without a thorough investigation is dangerous. Where no valid  g...2021-05-1218 minZalma on InsuranceZalma on InsuranceMOLD MYTHSInsurance Claims and Mold Reality  https://zalma.com/blog Get Rich Quick Thanks to Mold   Although there have been successful lawsuits, the days of multi-million  dollar verdicts in insurance mold claims are probably disappearing.  As for the get-rich-quick mold remediation companies, they are finding  that they must give real service or they will soon be visiting the  bankruptcy court.  "Killer Mold” Exists  Despite alarmist headlines that pronounce “Black mold can kill you!”  medical research has not been able to determine what amount of exposure  to “black mold,” if any, is toxic to a normally healthy ind...2021-05-1114 minZalma on InsuranceZalma on InsuranceFraud by Divine RightA Video True Crime Story of Insurance Fraud  https://zalma.com/blog They were All-American girls. Muffy and Buffy met each other as  cheerleaders in high school. They were best friends. They did everything  together. The two young women shared everything from clothes to  boyfriends. They decided to use insurance fraud to supplement their  income and allow them to continue to live with nothing but the best in  excess of their earnings.  Buffy and Muffy admitted to the adjuster that the watches were never  stolen in either claim. They withdrew the claim for the two watches...2021-05-1022 minZalma on InsuranceZalma on InsuranceThe Tort of Bad Faith's Unintended ConsequencesUnintended Consequences of the tort Bad Faith    https://zalma.com/blog  In a typical contract, one party has a duty to perform (construct a  building, deliver goods, convey real estate, pay indemnity) and the  other party has a duty to pay money or perform a task.  Breach by the  performer may take the form of nonperformance, defective performance, or  delay in performance. The primary purpose of damages for breach of a  contract is to protect the promisee’s expectation interest in the  promisor’s performance.  Damages should put the plaintiff in as good a  position as if the defend...2021-05-0716 minZalma on InsuranceZalma on InsuranceExplaining Construction Defects and Exclusions toIntentional Acts Exclusions and Fortuity    https://zalma.com/blog Implicit in the concept of insurance is that the loss occur as a result  of a fortuitous event not one planned, intended, or anticipated. Oddly,  the fortuity principle never appears in insurance contracts. The  principle is rooted in common law and in the statutes of at least six  states. The fortuity principle has the effect of an exclusion. That is,  an all-risk policy might provide coverage for all risks minus named  exclusions, but never provides coverage for non-fortuitous events, even  though non-fortuitous events are not named exclusion...2021-05-0416 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - May 1, 2021ZIFL - Volume 25, No. 9  https://zalma.com/blog & https://rumble.com/vgbcof-zalmas-insurance-fraud-letter-may-1-2021.html The May 1, 2021 issue of Zalma's Insurance Fraud Letter includes the  following articles and a video reporting on the key article about the  Examination Under Oath at  The Examination Under Oath is an Important Tool for Every Fraud  Investigation The EUO Is a Serious and Important Part of the Insurer’s Investigation  The attorney, insurance claims professional or investigator who conducts  the EUO can take a role similar to the role of a prosecutor without the  usual constitutional restraints controlling testimony at a depositi...2021-05-0216 minZalma on InsuranceZalma on InsuranceExplaining the Requirements of "Additional Insured""Additional Insured" Requirements of Construction Contracts and Policies     https://zalma.com/blog Although the “additional insured” requirement provides additional  security to the owner and architect, it can add to the cost of  insurance. Regardless, the requirement is often included in contract  documents and, if not carefully drafted, can result in multiple disputes  as to which insurer is required to defend which insured. Construction  contract language should be designed to avoid such disputes. An owner and a contractor should make every effort to obtain language in  their contract forms that will avoid ambiguous “additional insured”  endorsements. The form language...2021-04-2915 minZalma on InsuranceZalma on InsuranceExplaining the Construction ContractThe Construction Contract https://zalma.com/blog When a construction contract, like every other contract, is unambiguous,  the parties’ intent may be determined from the contract alone, and it  is the duty of the court—not the jury—to state its meaning.  Construction contracts are governed by the same rules as all other  contracts. When a court is called upon to interpret a construction  contract its terms are given their ordinary and generally accepted  meaning with the court working to give effect to the intent of the  parties to the contract unless the contract itself gives special...2021-04-2816 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - 04-15-2021ZIFL 4/15/2021 https://zalma.com/blog Zalma’s Insurance Fraud Letter,  in its 25th year is free to anyone who  subscribes or goes to the Mr. Zalma’s Website where you can Subscribe to  e-mail Version of ZIFL, it’s Free!  Read last two issues of ZIFL  here.  Go to the Barry Zalma, Inc. web site here Videos from “Barry Zalma on  YouTube”   Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921  See the full video at https://rumble.com/vfnvcj-a-video-from-zalmas-insurance-fraud-letter-april-15-2021.html and at https://youtu.be/zHkVc_ozTqs  Read the full issue of ZIF...2021-04-1519 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - April 1, 2021Not a Joke - Zalma's Insurance Fraud Letter Volume 25, Number 7    zalma.com/blog Arson for Profit Conviction Affirmed in Pennsylvania  John M. Sekerak appealed from the January 16, 2020 judgment of sentence  entered in the Court of Common Pleas of Berks County ("trial court"),  following his jury convictions for two counts of arson, recklessly  endangering another person ("REAP"), and insurance fraud. In  Commonwealth of Pennsylvania v. John M. Sekerak, J-S47005-20, No. 387  MDA 2020, Superior Court of Pennsylvania (March 15, 2021) the  Pennsylvania court considered the convicted arsonist’s claims of error  only to find that he was guilty beyond a reasonable...2021-04-0115 minZalma on InsuranceZalma on InsuranceA rue Crime Story from Barry Zalma's bookThe Real Cost of Fraud & the Largest Residential Burglary of All  Time   https://zalma.com/blog After twelve months trying to get insurance on over $3,000,000 in  jewelry and a like amount of fine arts, a Taiwanese man who was a wanted  criminal in his own country convinced two American insurers to agree to  insure him against the risk of loss to the contents of his home.  To obtain the insurance he concealed from the American insurers that he  was, at the time he purchased the insurance:  an alien a court had ordered deported; that in his home...2021-03-1815 minZalma on InsuranceZalma on InsuranceA Video About a New Book About Adjusting Property Claims"The Compact Book of Adjusting Property Claims - Third Edition"  https://zalma.com/blog The insurance adjuster is seldom, if ever, mentioned in a policy of  insurance. The strict wording of the first p arty property policy sets the obligation to investigate and prove a  claim on the insured.  Standard first party property insurance policies, based upon the New  York Standard Fire Insurance policy, contain conditions that require the  insured to, within sixty days of the loss, submit a sworn proof of loss  to prove to the insurer the facts and amount of loss. In general...2021-03-1615 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - March 15, 2021Proving Fraud by A Predetermined Treatment Protocol Articles in the March 15, 2021  Issue include the following:  RICO Action Against Medical Providers Raises Discovery Difficulties  Insurance companies who claim to be the victims of health care providers  operating in a no fault auto insurance state like 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 asserting 43 counts and attaching  more than 8,500 pages of spreadsheets as exhibits. Specifically,  Government Employees Insurance Co. (“Geico”) and related Ge...2021-03-1517 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - March 1, 2021Zalma's Insurance Fraud Letter Volume 25, No 5 Includes the Following Articles: https://zalma.com/blog  Insurance Fraud by Insurers Insurance fraud is not limited to fraud by insureds against their insurers. Much to the shame of the insurance industry, the reverse also happens. The poster child of fraud by an insurer was Martin Frankel who created a scheme he masterminded to “loot” more than $200 million from seven insurance companies that he controlled. Franklin American Corporation, and its wholly-owned subsidiary, Franklin American Life Insurance Company were controlled by another entity, a Tennessee trust named...2021-03-0113 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – February 15, 2021Convicted of Insurance Fraud In State of Delaware v. Paul Disabatino, ID No.: 1505000293, Superior Court of The State of Delaware (February 3, 2021) Health Insurance Fraud Convictions Videos on YouTube And Zalma On Insurance from Barry Zalma ­­­ Over 110 Videos describing important insurance  issues described by Barry Zalma and available to anyone who views or  subscribes to the YouTube account.  Issues include insurance fraud,  definition of insurance, insurance as a contract of personal indemnity,  millions for defense and not a dime for tribute and the tort of bad  faith. Please subscribe. There are 62 Videos are at ht...2021-02-1514 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - February 1, 2021See the full video at https://youtu.be/1Lvbxku45ho https://zalma.com/blog Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-barry-zalma-esq-cfe-17c/ a Quote of the Issue: “Man is only wise while he searches for wisdom; if he thinks he’s found it, he’s a fool.” - Rabbi Shlomo ibn Gavrioel Florida Insurers Actively Pursue Fraud Perpetrators in RICO Suits In a suit filed January 13, 2021, Heritage Property and Casualty Insurance Company...2021-02-0109 minZalma on InsuranceZalma on InsuranceExplaining Some Construction DefectsThe Defects HTTPS://zalma.com/blog Construction defects are any deficiencies in the performance or completion of the design, planning, supervision, inspection, or construction for any new building or structure that has been remodeled or undergone repairs. Understanding what a construction defect is has become so complex that states have begun to define them by statute. For example, construction defects are defined as a “violation of statutory performance standards for every building component in a dwelling” for any new residential construction sold after January 1, 2003, in California.   [California Civil Code § 895 et seq. “R...2021-01-2615 minZalma on InsuranceZalma on InsuranceZALMA’S INSURANCE FRAUD LETTER JANUARY 15, 2021ZALMA’S INSURANCE FRAUD LETTER JANUARY 15, 2021 https://zalma.com/blog Professional Insurance Adjusting and Insurance Fraud At the turn of the century, insurers, in a search for profit, decimated their professional claims staff. They laid off experienced personnel and replaced them with young, untrained and unprepared people. A virtual clerk replaced the old professional claims handler. Process and computers replaced skill and judgment. Insurers intentionally forgot that the promises made by an insurance policy are kept by th...2021-01-1516 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – January 1, 2021Zalma’s Insurance Fraud Letter January 1, 2021 https://zalma.com/blog Read last two issues of ZIFL at https://zalma.com/zalmas-insurance-fraud-letter-2/ Happy New Year – 2021 Must, and will be, Better than 2020 Guilty of Insurance Fraud People who commit insurance fraud think it is a crime without punishment or concern. When they are caught, prosecuted and convicted, the perpetrator is so amazed that he or she is one of the few unlucky ones who were caught that they use their ill-gotten gains to fund...2021-01-0405 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - Insurance Fraud Costs Everyone - 12-15-2020 - Listen to the Christmas Fable of FraudMerry Chirstmas – Happy Hanukah  & May the Winter Solstice be Peaceful & Mild https://zalma.com/blog A Christmas Fable of Insurance Fraud Most insurance criminals, unlike Raymond, know about the lack of staff, how overworked and underpaid adjusters are, and would never sign a release. The insurance criminal would either try to bribe the SIU investigator or sue the insurer for bad faith for having the gall to claim they caught them at their crime. Insurance fraud perpetrators do not give up a chance of easy money just because their scheme did...2020-12-1519 minZalma on InsuranceZalma on InsuranceZalma’s Insurance Fraud Letter – December 1, 2020ZALMA’S INSURANCE FRAUD LETTER DECEMBER 1, 2020 https://zalma.com/blog Read the full Zalma's Insurance Fraud Letter at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-december-1-2020-barry-zalma-esq-cfe-1c and see the full video at https://youtu.be/Phva0x6RNYQ and  at  https://rumble.com/c/c-262921  and at https://zalma.com/blog plus more than 3500 posts. Evidence of A Prior Fire Is Available to Prove Fraud 2020 Canadian Insurance Fraud Report Minnesota Fraud Bureau: Insurance Fraud Referrals Up In 2019 No Harm, No Foul When Instruction Error...2020-12-0116 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - November 1, 2020ZALMA’S INSURANCE FRAUD LETTER https://zalma.com/blog On or Before November 3, 2020 It is Imperative That Everyone Votes. I Have My Preferences and I Will Exercise the Right and Obligation to Vote. I Hope You All Will Do the Same. Volume 24, Issue 21 – November 1, 2020; Subscribe to e-mail Version of ZIFL, it’s Free! Read last two issues of ZIFL here. Go to the Barry Zalma, Inc. web site here Videos from “Barry Zalma on YouTube”  Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921A ClaimSchool...2020-11-0215 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - 10-15-2020Zalma's Insurance Fraud Letter See the full article, and the previous Fraud Letter, in Adobe pdf format at https://zalma.com/zalmas-insurance-fraud-letter-2/ On or Before November 3, 2020 It is Imperative That Everyone Votes.  Unlicensed Doctor Convicted of Insurance Fraud and Other Crimes After Patrick E. Usanga (Usanga) was convicted for many crimes of fraud he appealed his convictions unsuccessfully and then filed Post Conviction Relief Act motion to set aside the conviction in Commonwealth of Pennsylvania v.  Pa...2020-10-1512 minZalma on InsuranceZalma on InsuranceA Video Explaining What is Needed to Adjust the Commercial Property Loss Posted on October 8, 2020 by Barry ZalmaAdjusting the Commercial Property Loss https://zalma.com/blog The adjustment of a commercial loss is performed in the same manner  as any other property loss. The difference is one of tone rather than  substance. Adjusters  who usually deal with a business entity, and its officers or employees,  rather than an individual find claims handling is often, but not  necessarily always, easier. The experienced adjuster who deals with commercial claims usually has  knowledge of the business and the people who operate the business. Some  insurers even assign a single adjuster to a major...2020-10-0815 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - October 1, 2020October 1, 1979 – 2020 – Another Anniversary – Thank You Forty-one years ago today I left the world of the employed and became  an entrepreneur by opening my own law firm. The law practice was  incorporated shortly thereafter as Barry Zalma, Inc. When I opened for  business on October 1, 1979, I had no clients and no certainty that I  would have any in the future. I had borrowed money from the bank to  carry me through the first six months and was concerned about my ability  to pay the loan with my third child about to be born. Much  to my surprise and...2020-10-0115 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - September 15, 2020https://zalma.com/blog --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2020-09-1514 minZalma on InsuranceZalma on InsuranceZalma's Insurance Fraud Letter - July 15, 2020https://zalma.com/blog --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2020-07-1518 minZalma on InsuranceZalma on InsuranceGetting the Whole Truth - A New Book by Barry Zalma from the ABAhttps://zalma.com/blog --- Support this podcast: https://podcasters.spotify.com/pod/show/barry-zalma/support2020-06-3017 min