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 22, 2022
True Crime of Insurance Fraud Video Number 60

My Paintings Were Stolen

Read the full article at https://lnkd.in/gnkSByzU and se the full video at https://lnkd.in/gG8NqmFm and at https://lnkd.in/gigi3kSc and at https://zalma.com/blog plus more than 4150 posts.

Posted on April 22, 2022 by Barry Zalma

See the full video at https://rumble.com/v11txwj-true-crime-of-insurance-fraud-video-number-60.html?mref=6zof&mrefc=2 and at

Lucky Ambrose was about to retire as a flight attendant with Italian International Airlines. His retirement pay would allow him to live — barely — in Barstow, California. On a layover in Rome, he found a means to retire in comfort while browsing the Vatican Art Museum.

He purchased a disposable flash camera at the souvenir shop and started snapping photographs of works of art in the museum. Of the twelve pictures he took two came out relatively clear, marred only by a blotch of white from the flash reflecting off the oils. They were pictures called:

“San Giorgio Che Occide Il Drago,”

Paris Bordone’s 1525 painting of St. George slaying the dragon, and

“Madonna Della Pera,” painted by Alessandro Buonvicino, known as Moretto Diana Brescia, in 1505.

Ambrose reported a burglary at his Barstow home and made claim for $555,000. Good Neighbor Insurance Company faced with a claimed loss of two Italian Renaissance paintings stolen from the bedroom of his California ranch house thought they had no choice but to pay the amount of the policy.

They were only suspicious since the claim contained multiple red flags of fraud, like:

The loss was within three weeks of the issuance of the policy;

There was no written evidence that the items were purchased by the insured;

The items were unusual and hard to market while his T.V., VCR and Stereo system were still in the house after the burglary; and

The only proof of ownership Ambrose offered when he insured the works were the two amateurish snapshots of the paintings.

Suspicions and red flags are not enough to deny a claim. Lucky Ambrose was paid what he asked and signed a subrogation and salvage agreement assigning all of his rights to the paintings to the insurance company.

The insurance agent who visited Ambrose’s house in Barstow testified he believed Ambrose when he was told that the paintings were inside the crates. “We are in a business of utmost good faith,” he said. “Why shouldn’t I believe him? He had paid his premiums regularly for the last five years.”

“If (the agent) had any questions about it, if he didn’t feel that everything was in line before he issued the insurance, we would have taken whatever steps needed to ensure it was genuine,” a Good Neighbor Spokesman testified. The Good Neighbor Spokesman also testified that when the paintings were reported stolen only three weeks after the policy was issued, they “had suspicions … but having no proof or anything to base an assumption that something was wrong, we had to go ahead and pay the claim.”

The jury returned a verdict in favor of Good Neighbor for the amount paid, interest at the legal rate, and attorneys fees.

The state of California investigated whether to arrest Ambrose but emulated the actions of the U.S. Attorney. He could go have gone to jail. His retirement plans could have been destroyed by an Italian cop who knows art better than the agents, underwriters and claims people at Good Neighbor Insurance Company.

He sold his house in Barstow and moved to Boise, Idaho before the state of California and the U.S. Attorney had time to change their mind. He now lives a quiet, and honest, life on his retirement pay in Boise and is trying to get used to snow in the winter.
ZALMA OPINION

Even a well trained, experienced fraud investigator, when saving some money for the insurer cannot help convince a prosecutor that a case can be proved of fraud beyond a reasonable doubt. To a prosecutor it is easier to convict a person accused of a violent crime against an innocent person with a three page police report rather than a detailed investigation establishing that a person is trying to steal from an insurance company.

(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.

Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

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November 07, 2025
Motion for Summary Judgment Fail Because Insurer Failed to Carry Burden

Motion for Summary Judgment Requires Evidence Establishing Defenses

Post 5223

Read the full article at https://www.linkedin.com/pulse/motion-summary-judgment-fail-because-insurer-failed-zalma-esq-cfe-jhfsc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

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 ...

00:07:26
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November 06, 2025
Man Bites Dog Story – Hertz Sues Alleged Fraudsters

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 ...

00:06:28
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November 06, 2025
Man Bites Dog Story – Hertz Sues Alleged Fraudsters

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...

00:06:28
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October 31, 2025
The Zalma Philosophy of Claims Handling – Part 9

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 ...

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October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

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 ...

post photo preview
October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

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 ...

post photo preview
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