Zalma on Insurance
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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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April 13, 2022
True Crime of Insurance Fraud Video Number 54

High-Tech Fraud

Read the full article at https://lnkd.in/ga3wQsH5 and see the full video at https://lnkd.in/gTaFbheM and at https://lnkd.in/g8p4tE2Z and at https://zalma.com/blog plus more than 4150 posts.

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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Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog; daily articles are published at https://zalma.substack.com.

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He Who Acts as His Own Lawyer Has an Idiot for a Client

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Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.

Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed

In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.

FACTS

Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...

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May 11, 2026
Severe Punishment for Failure to Obey Court Orders

Foolish to Repeatedly Disobey Court Orders

All That Remains For Trial Is Plaintiff’s Damages On Each Of These Claims And Establishing Proximate Causation Of Those Damages.

Post number 5348

See the full video at and at and at https://zalma.com/blog plus 5300 posts.

In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).

FACTUAL BACKGROUND

This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...

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May 08, 2026
Ambiguous Contract to Repair not an Assignment

The Right to Negotiate with Insurer is Not an Assignment of Claims

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Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.

Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer

In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.

FACTUAL BACKGROUND

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12 hours ago
Insurer Contended it was not Defrauded

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Post number 5369

Read the full article at https://www.linkedin.com/pulse/qui-tam-insurer-contended-defrauded-barry-zalma-esq-cfe-pgfgc and at https://zalma.com/blog plus more than 5550 posts.

In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended parties in an automobile collision case involving a McLaren and a tour van. After that case settled for $25,000, the firm filed a qui tam action under California’s Insurance Frauds Prevention Act (IFPA) against Silver Bird Auto Leasing, LLC, X-Law Group, PC, and Filippo Marchino. The firm alleged three fraudulent acts in the underlying litigation:

1. the complaint falsely stated the McLaren was making a “legal turn,”
2. respondents produced a fraudulent repair bill/estimate, and
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12 hours ago
Default Judgment Must be Respected by Federal Court

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Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.

Posted on June 9, 2026 by Barry Zalma

Post number 5368

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In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.

After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...

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June 09, 2026
Default Judgment Must be Respected by Federal Court

Full Faith and Credit Act Controlled

Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.

Posted on June 9, 2026 by Barry Zalma

Post number 5368

Posted on June 9, 2026 by Barry Zalma

In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.

After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...

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