Miscarriage Manipulation for Money
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Posted on May 11, 2022 by Barry Zalma
Posted on May 11, 2022 by Barry Zalma
See the full video at https://rumble.com/v147vii-true-crime-of-insurance-fraud-video-number-71.html and at https://zalma.com/blog plus more than 4200 posts.
Rita was five months’ pregnant. Her entire family greeted her condition as an opportunity to make sufficient money for a happy Christmas in sunny Hawaii.
For four generations Rita’s family has lived luxuriously on insurance claims. Their last names changed more often than their underwear. Wherever they go, they carry a small plastic valve of soapy liquid and a small razor. Depending on the size of the town they are visiting, they stay a week, a month or a year. One member of the family will claim to have slipped and fallen in a restaurant or grocery store. With the razor they will induce bleeding at their hairline or on an arm or leg. They will be pleasant victims with no interest in profit. Grocers, and their insurers, rapidly and fairly settle their claims in fear that their injuries will increase.
Rita had been a professional claimant since she was eight. She fell in the most luxurious restaurants in Las Vegas, New York City, Baltimore, Washington, D.C., St. Louis, Missouri, and Beverly Hills, California. Shortly after she began to walk, her family taught her how to slip and look like she was hurt without actually causing any physical damage. By the time she was five she could limp on either leg, hold one arm limp, wince with pain when touched and give all the symptoms of a severely injured person.
By the time she was ten she had a clear knowledge of anatomy and knew all of the symptoms of soft tissue injury. Now, at 22, pregnant with the child of a sailor she met in San Diego whose name she does not remember, Rita is ready to move into major, profit making scams. Her brother Aaron would pose as her husband as they worked the major hotels and restaurants of Sacramento, California. At the Holiday Inn, she fell in a puddle of water in the lobby restroom where two innocent women ran to her assistance.
“Oh, my God!” Rita moaned. “Did I hurt the baby.”
Rita rode to the hospital with her “husband” sitting in the ambulance beside her, wringing his hands. They left their name, a mail drop address and a telephone number which connected to the family cellular telephone, with the hotel. She and the baby were found healthy and allowed to leave, although the doctor, because of the family history of miscarriage, noted on the hospital record that here condition was “guarded” and that she should cautiously watch for any spotting or other indication of a potential miscarriage.
In the next four days Rita fell in five hotels, two department stores and three restaurants in greater Sacramento. She rode to the hospital in an ambulance twice and visited a local chiropractor known to her family four times.
The family lived, and traveled, in three sixty-foot motor homes equipped with cellular telephones, a computer and all the comforts of a luxurious home. The family knew better than to be greedy. They never presented more than 10 claims each in any one city.
Rita and Aaron were reasonable people. They told the adjusters they did not wish to hire a lawyer. Although they were afraid they might lose the baby, the doctors had assured them that the baby was unhurt by the fall.
The adjusters, sensing an ability to settle the claim quickly before the baby was born, with possible extra damage, worked quickly to gain the confidence of Rita and Aaron. They wanted a release that would protect their clients.
They had no knowledge of Rita’s family history. Liability was clear. Independent witnesses observed a slick, soapy substance on the floor and on Rita after she fell.
Rita and Aaron were professional claims presenters. They played upon the innocence and good faith of the insurance adjusters. They would tell the adjusters:
“We don’t want money. We just can’t afford to pay the doctors’ bills. Please pay those for us and we’ll be happy.”
The adjusters, knowing the law and knowing that if litigation was filed Rita would be entitled to money for her pain and suffering, insisted that Rita take more money than the medical bills. Most of the claims were settled for between $6,000 and $25,000, depending on the generosity or gullibility of the individual adjusters.
Rita’s potential miscarriage brought her family over $100,000 for their stay in Sacramento. Her brothers, sisters, cousins and nephews falling all over the city generated another $100,000 in claims payments.
Their welcome in Sacramento worn thin, the family motor homes traveled west to San Francisco.
The motor homes were parked in a long term secure parking lot and the entire family boarded airplanes for a three week holiday in Maui.
ZALMA OPINION
The reason why a group of professional slip and fall claimants can succeed is due to the failure of insurers to conduct a full and thorough investigation of a claim presented. Had the adjuster’s investigated Rita’s claims and had they checked the All Claims Data Base the crime would have failed.
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(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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Concurrent Cause Doctrine Does Not Apply When all Causes are Excluded
Post 5119
Death by Drug Overdose is Excluded
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Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.
KEY POINTS
1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
3. Duty to Indemnify: The court could not determine at this stage whether the Plaintiff had a duty to ...
GEICO Sued Fraudulent Health Care Providers Under RICO and Settled with the Defendants Who Failed to Pay Settlement
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Post 5119
Default of Settlement Agreement Reduced to Judgment
In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)
Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...
ZIFL – Volume 29, Issue 14
Post 5118
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You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
This issue contains the following articles about insurance fraud:
The Historical Basis of Punitive Damages
It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.
The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.
You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf
Insurer Refuses to Submit to No Fault Insurance Fraud
...
Rulings on Motions Reduced the Issues to be Presented at Trial
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CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
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 ...