The Story That Wrote Itself Video Number 51
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Posted on April 8, 2022 by Barry Zalma
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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.
On February 27, 1995 the District Attorney filed the following In the Superior Court of the State of California for the County of San Diego that writes this chapter for me. The District Attorney stated, as part of the criminal Information (the charge) as follows:
“COUNT — 1 CONSPIRACY TO COMMIT A CRIME “On or about December 10, 1991 JORGE NOREN HOLLAND did willfully and unlawfully conspire together and with another person (Armen Al Zennedjian) and persons whose identity is unknown to commit the crime of Arson of an Inhabited Structure or Inhabited Property, Penal Code § 451 (b), in violation of Penal Code Section 182 (a) (1).
“The object of the conspiracy was to set fire to and burn the house located at 3030 Shelby Drive, in the County of San Diego, which belonged to and was occupied by JORGE NOREN HOLLAND in an effort for JORGE NOREN HOLLAND to collect the insurance proceeds as a result of the fire “Thereafter, in the County of San Diego, State of California, pursuant to the above conspiracy and in furtherance of the objects thereof:
“OVERT ACT NO. (01): On or about December 10, 1991, at the house located at 3030 Shelby Drive, JORGE NOREN HOLLAND showed Armen Al Zennedjian where the house key to 3030 Shelby Drive was located.
“OVERT ACT NO. (02): ……entered the house with Armen Al Zennedjian.
“OVERT ACT NO. (03):…at the house HOLLAND showed …Zennedjian around the interior of the house.
“OVERT ACT NO. (04): On or about December 11, 1991, …Zennedjian telephoned …HOLLAND to inform him that …Zennedjian would go to the house …on December 12, 1991 to cause the house to catch fire and burn.
“OVERT ACT NO. (05): On or about December 11, 1991, …HOLLAND had a telephone conversation with …Zennedjian about …Zennedjian going to the house …on December 12, 1991 to cause the house to catch fire and burn.
“OVERT ACT NO. (06): On or about December 12, 1991, at his residence in the City of El Cajon, …Zennedjian obtained gasoline cans which he placed into his pickup truck.
“OVERT ACT NO. (07): On or about December 12, 1991, at a gas station near his residence in the City of El Cajon, …Zennedjian purchased gasoline, and filled the gas cans that he had obtained from his residence with the gasoline.
“OVERT ACT NO. (08): On or about December 12, 1991, …Zennedjian drove his pickup truck from the gas station near his residence in the City of El Cajon with the gas cans filled with gasoline to the house located at 3030 Shelby Drive.
“OVERT ACT NO. (09): On or about December 12, 1991, at 3030 Shelby Drive, …Zennedjian obtained the house key shown to him by …HOLLAND at the house…
“OVERT ACT NO. (10): On or about December 12, 1991, …Zennedjian used the house key shown to him by …HOLLAND to unlock the door to the house…
“OVERT ACT NO. (11): On or about December 12, 1991, …Zennedjian entered the house at 3030 Shelby Drive. “OVERT ACT NO. (12): On or about December 12, 1991, …Zennedjian while inside the house
…opened the sliding glass porch door and exited the house…
“OVERT ACT NO. (13): …Zennedjian reentered the house … and carried the gas cans filled with gasoline that he had brought with him, into the house…
“COUNT — 2 ARSON OF AN INHABITED STRUCTURE OR PROPERTY “On or about December 12, 1991 JORGE NOREN HOLLAND did willfully, unlawfully, and maliciously set fire to and burn and cause to be burned an inhabited structure and inhabited property, in violation of PENAL CODE SECTION 451(b). “And, it is further alleged that in the commission and attempted commission of the above offense, the said defendant, JORGE NOREN HOLLAND did take, damage, and destroy property, with the intent to cause such taking, damage, and destruction, and the loss exceeds one hundred thousand dollars ($100,000), within the meaning of Penal Code section 12022.6(b).
“COUNT — 3 FALSE OR FRAUDULENT INSURANCE CLAIM “On or about March 27, 1992 JORGE NOREN HOLLAND did knowingly and unlawfully present or cause to be presented a false or fraudulent claim for the payment of loss under a contract of insurance, in violation of INSURANCE CODE SECTION 1871.1.” The only oddity about the Information quoted above is its rarity. Those of us involved with the Insurance industry should cheer the actions of the San Diego District Attorney and the insurers who refused to pay to avoid litigation with the two individuals alleged by the Information to have committed the crimes of arson and insurance fraud.
Mr. Holland Pleaded guilty to insurance fraud and was sentenced to make restitution to the insurance company and placed on probation. He, in fact made full restitution to the insurance company to avoid immediate incarceration and a copy of that check is hanging on my office wall.
Zalma Opinion
American States Insurance Company (the victim) and its investigator Steve Thompson should be honored for its efforts to defeat this fraud and help the state of California to bring the arsonist to justice.
(c) 2022 Barry Zalma & ClaimSchool, Inc.
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and [email protected].
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Jury’s Findings Interpreting Insurance Contract Affirmed
Post 5105
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Madelaine Chocolate Novelties, Inc. (“Madelaine Chocolate”) appealed the district court’s judgment following a jury verdict in favor of Great Northern Insurance Company (“Great Northern”) concerning storm-surge damage caused by “Superstorm Sandy” to Madelaine Chocolate’s production facilities.
In Madelaine Chocolate Novelties, Inc., d.b.a. The Madelaine Chocolate Company v. Great Northern Insurance Company, No. 23-212, United States Court of Appeals, Second Circuit (June 20, 2025) affirmed the trial court ruling in favor of the insurer.
BACKGROUND
Great Northern refused to pay the full claim amount and paid Madelaine Chocolate only about $4 million. In disclaiming coverage, Great Northern invoked the Policy’s flood-exclusion provision, which excludes, in relevant part, “loss or damage caused by ....
Failure to Name a Party as an Additional Insured Defeats Claim
Post 5104
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Contract Interpretation is Based on the Clear and Unambiguous Language of the Policy
In Associated Industries Insurance Company, Inc. v. Sentinel Insurance Company, Ltd., No. 23-CV-10400 (MMG), United States District Court, S.D. New York (June 16, 2025) an insurance coverage dispute arising from a personal injury action in New York State Supreme Court.
The underlying action, Eduardo Molina v. Venchi 2, LLC, et al., concerned injuries allegedly resulting from a construction accident at premises owned by Central Area Equities Associates LLC (CAEA) and leased by Venchi 2 LLC with the USDC required to determine who was entitled to a defense from which insurer.
KEY POINTS
Parties Involved:
CAEA is insured by Associated Industries Insurance Company, Inc. ...
Exclusion Establishes that There is No Duty to Defend Off Site Injuries
Post 5103
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Attack by Vicious Dog Excluded
In Foremost Insurance Company, Grand Rapids, Michigan v. Michael B. Steele and Sarah Brown and Kevin Lee Price, Civil Action No. 3:24-CV-00684, United States District Court, M.D. Pennsylvania (June 16, 2025)
Foremost Insurance Company (“Foremost”) sued Michael B. Steele (“Steele”), Sarah Brown (“Brown”), and Kevin Lee Price (“Price”) (collectively, “Defendants”). Foremost sought declaratory relief in the form of a declaration that
1. it owes no insurance coverage to Steele and has no duty to defend or indemnify Steele in an underlying tort action and
2. defense counsel that Foremost has assigned to Steele in the underlying action may withdraw his appearance.
Presently before the Court are two ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
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Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th 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/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
A Heads I Win, Tails You Lose Story
Post 5062
Posted on April 30, 2025 by Barry Zalma
"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone 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."
Immigrant Criminals Attempt to Profit From Insurance Fraud
People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.
The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...
