High-Tech Fraud
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Dennis loved computers. He spoke their language fluently. He could converse as easily in Windows, Basic, COBOL, FORTRAN, machine language, UNIX and Linux as English. Basic and DOS were child’s play to Dennis.
Computers were his life. Whenever Intel marketed a new chip, Dennis was first in line to buy faster and more complex computers for his personal use.
Dennis could never afford every computer he wanted to buy. As a programmer for WYSIWYG Enterprises he earned only $60,000 a year. He lived near his work in San Jose. Dennis took the bus from his third floor walk-up apartment to his office. When he wasn’t working, he was modifying and upgrading his personal computers and editing software for his personal use.
Dennis loved working on his HP desktop running Windows 10 and UNIX. He had available for use a 1200 x 2400-dpi color scanner, a full color laser printer that printed at 1200 DPI and a 60 inch flat screen monitor. On the appropriate paper the printer produced photographic quality images.
“Dennis,” Alain exclaimed, “these are valuable antiques (not to mention your computer systems). How can you live in that miserable, cheap apartment without renters’ insurance to protect you against burglary?” “
Dennis took his photographs, which clearly fooled his computer-wise friend Alain and which he was certain would fool any fine arts appraiser, and opened the Yellow Pages under “A” for “Appraisers.” He found a listing of thirty five different names of fine arts and antique appraisers.
Since Dennis never owned any of the items of value depicted in the photographs, he was curious to see the true value of the items his photographs seemed to prove were in his house. He took the photographs to the first appraiser he found in the telephone book. That appraiser, Albert Aisensohn, was the owner of Antique Universe, a retail establishment selling antiques, used furniture and old estate jewelry.
Aisensohn took the photographs and said, “I can’t give you an appraisal from just photographs — when can I see the merchandise?”
When Dennis pulled out the five one hundred dollar bills he had in his wallet Aisensohn immediately sat at an old Underwood upright typewriter and began to type out an appraisal of the value of the various items depicted in the photographs Dennis provided to him. He made no comment, just silently put the bills in his pocket.
Because he only had photographs, Aisensohn estimated age, quality of craftsmanship and value. The appraiser, more often than not, could only provide a range of values such as: Chippendale chair, circa 1890, excellent physical condition, carved from mahogany and covered in a silk Jacquard print, valued between $30,000 and $40,000.
On the 310th day the policy was in effect, a Sunday morning, the day after Intel announced the shipment of 100,000 chips to Dell and HP, Dennis called the San Jose Police Department to report a burglary at his house. He informed the police officer that he left his home for only an hour and a half to walk down to the corner to get a cafe-laté and a sandwich. He drank the cafe-laté quietly at the coffee shop while reading his Sunday San Francisco Chronicle. On his return, he unlocked his front door and realized he had failed to lock the window beside his third floor fire escape. All his antiques were gone. His HP desktop was gone.
He gave the police officer the list of insured items and told him that he had no insurance on the computer work station. The police officer dutifully noted the descriptions from the insurance policy of each item and, from the invoice, the serial numbers of all of the components of the HP. Other valuable computer items were left in the apartment. Dennis and the police officer could only assume that the burglars heard him coming and were frightened away before they could take everything. Dennis was fortunate.
Dennis called up his friend Alain’s father, reported the burglary and after a visit by a claims representative the insurance company delivered a check for $420,000 to him in exchange for a signed proof of loss.
Dennis now knew that his fondest dream had come true. He deposited the check in his account and wired new Hewlett Packard and Dell computers together powered by 20 new dual core Intel chips chained together. His monitor was two sixty-inch screens putting out 2400 x 2400 pixels. He had 45 terabytes of internal hard drive, 5 terabytes of flash memory, and all was backed up with equal amounts of optical storage. His system rivaled those now used by NASA and the NSA.
Dennis lived happily ever after, occasionally creating new photographs as the computer industry created new toys.
ZALMA OPINION
If the insurer interviewed the appraiser they would have defeated the claim and Dennis would be in jail. The insurer did not. Dennis was a lucky criminal.
(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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Motion for Summary Judgment Requires Evidence Establishing Defenses
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In Michael Tillema, Kim Til- Lema v. Meridian Security Insurance Company, No. SA-24-CV-00661-JKP, United States District Court, W.D. Texas, San Antonio Division (October 7, 2025) Plaintiffs Michael Tillema and Kim Til-Lema claimed coverage from Meridian Security Insurance Company for benefits for alleged wind and hail damage from a storm on April 26, 2022.
Meridian Security Insurance Company denied the claim, citing inspection reports and weather data indicating no hail event occurred on the alleged date. Plaintiffs hired an independent contractor, who also found no hail within one mile of the property on the ...
Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers
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Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
Proactive Victim of Fraud Defeats Health Care Providers
In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.
FACTUAL BACKGROUND
Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.
Plaintiff also ...
Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers
Post 5222
Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
Proactive Victim of Fraud Defeats Health Care Providers
In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.
FACTUAL BACKGROUND
Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.
Plaintiff also moved...
The Professional Claims Handler
Post 5219
Posted on October 31, 2025 by Barry Zalma
An Insurance claims professionals should be a person who:
Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.
How to Create Claims Professionals
To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...