ZIFL -05-01-2023
Barry Zalma
May 1, 2023
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Happy Law Day!
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John James Succi appealed pro se from the order dismissing his “Motion to Vacate Restitution/Sentencing.” In Commonwealth Of Pennsylvania v. John James Succi, No. 229 EDA 2022, No. J-S22022-22, Superior Court of Pennsylvania (February 28, 2023) the Superior Court gave consideration to the pro se motions of the convicted felon and ordered him to make restitution. Victims of crime must make certain that the state prosecutor, after convicting the criminal, like Succi, must demand restitution. The victims did so in this case and the prosecutor effectively obtained, at sentencing, an order of restitution. Succi, sentenced to many years in prison, may never be able to pay the ordered restitution unless there are assets that could be taken to pay the restitution. Regardless, convicted felons have nothing but time so he wasted the appellate courts time by bringing this pro se motion which failed. He will remain in the Gray Bar Hotel for the next 15 to 30 years.
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McClenny Moseley & Associates Issues
This is ZIFL’s fifth installment of the saga of McClenny, Moseley & Associates (MMA) and its problems with the federal courts in the State of Louisiana and what appears to be an effort to profit from what some Magistrate and District judges indicate may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana. Since the last issue MMA’s originator have created a new professional corporation; McClenny was sued for damages due to a auto accident; MMA partners were ordered into court relating to Eldridge Smith becoming a client; more suits against MMA; Huye ignores suspension; MMA attempted to intervene in plaintiffs’ cases; a suit against MMA by Access Restoration Services US, Inc for a 572% return on its $3 million investment in MMA’s hurricane cases; and a suit by Global Estimating Services seeking $9,865,862.99 for estimating services provided to MMA.
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Another Florida Insurer Bites the Dust
Florida Commercial Insurer Capacity Insurance Company Now in Runoff.
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Chutzpah! Fraudster Sues Twice
Res Judicata Requires Fraudster to Lose Again After It Sues Again
Forcing Two Courts to Deal With a $366.64 Fraudulent Claim is Chutzpah
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Good News From the Coalition Against Insurance Fraud
More than 18 months after he pleaded guilty to absconding with almost $5M in premiums, a Florida insurance agent has been sentenced to 14 years in prison. John M. Thomas, 52, the former owner of Thomas Insurance Agency in Pensacola, also must pay more than $8M in restitution. A federal judge decided in March. For more than seven years, Thomas collected premium payments from at least 67 clients, then produced fraudulent policy documents and certificates purporting to show that clients were covered. Thomas used the money for personal gain, including an African safari, a Utah ski resort condominium, a Florida beach condo, a Lexus automobile, and restorations to a 45-year-old Jeep vehicle, according to his 2021 indictment. The independent agency sold homeowners, commercial property, commercial liability, auto, workers’ compensation, and other lines of insurance to some well-known commercial interests in Florida and Alabama before the fraud was discovered, attorneys said. Thomas was arrested and then unexpectedly pleaded guilty to the criminal charges in August of 2021. His sentencing was set for later that year. Prosecutors did not say why the sentencing had to wait another 18 months, but court records suggest that Thomas’ pro se filings with the court may have delayed the proceedings. Plus 9 more convictions.
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Investigation Into Misleading Home Warranty Mailers Results in Refunds to Consumers
California Insurance Commissioner Ricardo Lara announced that an insurance company offering home warranties will refund Californians deceived by a misleading mailer sent to hundreds of thousands of consumers. An investigation by the California Department of Insurance found that Response Indemnity Company of California worked with an unlicensed marketing company that mailed a “final notice” to consumers falsely warning that their home warranty was expiring. Because of the Department’s action, Response Indemnity will allow consumers to cancel the home warranty and receive a refund if the consumer purchased the warranty because of the mailer.
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Like Al Capone, Marlin Construction Avoided Insurance Fraud but was Convicted of Tax Fraud
David T. Aaron and Russell Ultes, co-owners of Marlin Construction Group LLC, cashed millions of dollars of customer checks at check-cashing businesses in order to underreport earnings and avoid federal taxes, federal prosecutors said last week. The men also used the cash to purchase luxury items for themselves, including jet skis and automobiles, according to the criminal complaint the owners of a Fort Myers roofing company, one that has been the subject of a number of complaints from consumers and which has filed multiple assignment-of-benefits lawsuits against property insurers, have pleaded guilty to more than $1 million in tax evasion.
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Health Insurance Fraud Convictions
The British Columbia, Canada Supreme Court ordered seven people and one company to pay $155,000 in punitive damages as a result of staged Surrey collisions designed to defraud ICBC.
Justice Jennifer Duncan said in an April 13 decision: “Those collisions were used by various of the parties to file personal injury tort actions.” And reports of dozens more convictions.
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Other Insurance Fraud Convictions
Jarod Hirbar, age 44, of Kellogg, pled guilty on April 17, 2023, to one count of Fraudulent Submission to Insurer (Class D Felony) following an investigation by the Iowa Insurance Division’s Fraud Bureau.
Latisha Hribar, age 42, of Kellogg, pled guilty on April 18, 2023, to one count of Fraudulent Submission to Insurer (Class D Felony) following an investigation by the Iowa Insurance Division’s Fraud Bureau. Plus many more convictions. Plus many more convictions.
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(c) 2023 Barry Zalma & ClaimSchool, Inc.
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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://podcasters.spotify.com/pod/show/barry-zalma/support; 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; https://creators.newsbreak.com/home/content/post; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library.
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Barry Zalma, Esq., CFE is available at http://www.zalma.com and [email protected]
Follow me on LinkedIn: https://lnkd.in/guWk7gfM
Go to the Insurance Claims Library – https://lnkd.in/gEabTFjz the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu
Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.
Lawyer Convicted of Workers’ Compensation Fraud
Post 5031
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In The People v. Jon Woods, G061948, California Court of Appeals, Fourth District, Third Division (March 18, 2025) a jury convicted Jon Woods of 37 felony counts of workers’ compensation fraud.
Woods was a worker’s compensation attorney who had made business arrangements that involved unlawful kickback and referral fees.
Woods contended that the Williamson rule (In re Williamson (1954) 43 Cal.2d 651, 276 P.2d 593) precluded convictions on counts 5 through 37. The Williamson rule states that where the Legislature has defined a specific crime with a lesser punishment, the conduct described by that crime may not be charged as a more general ...
Tortious Interference Requires Intent to Harm
Defamation is a Covered Personal Injury Tortious Interference with Business Is Not
Post 5031
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Robert Hole, M.D., appealed from the March 3, 2023 order granting plaintiff State Farm Fire and Casualty Company’s motion for summary judgment denying Dr. Hole coverage under the policy issued by State Farm.
In State Farm Fire And Casualty Company v. Dr. Robert Hole, M.D., and Dr. Michael Russonella, D.O., and North Jersey Orthopaedic And Sports Medicine Institute, LLC, No. A-2522-22, Superior Court of New Jersey, Appellate Division (March 21, 2025) a lawsuit filed against Dr. Hole by Michael Russonella, D.O. that alleged Dr. Hole made false statements regarding Dr. Russonella’s alleged misconduct at St. Mary’s Hospital in Passaic.
Dr. Hole sought coverage from his insurer, State Farm, to...
ACV, by Definition, Requires Depreciation from Replacement Cost
Post 5027
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This case is a putative class action concerning a commercial property insurance policy. Schoening Investment, LP alleges that The Cincinnati Casualty Company breached its insurance policy by undervaluing an actual cash value (ACV) payment for a covered partial structural loss to one of its properties in Schoening Investment, LP v. The Cincinnati Casualty Company, No. 1:24-cv-137, United States District Court, S.D. Ohio, Western Division (March 13, 2025)
Key Allegations:
Schoening contended that the policy does not allow Cincinnati Casualty to deduct any amount for depreciation from the ACV payments due for partial structural losses. Schoening specifically challenged whether the insurer is entitled to deduct depreciation from such payments at all.
Legal Standard:
This putative class action concerned a commercial...
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Duties and Liabilities of Insurance Brokers
Posted on March 12, 2025 by Barry Zalma
Excellence in Claims Handling
This blog post is just a taste of the full article that is only available to subscribers to Excellence in Claims Handling. Anyone can subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.
Cases in which insurance brokers’ liability is in question depend in part on whether brokers are seen to be serving a fiduciary role or simply acting as a conduit between the insured and the insurer.
A person or an entity is a fiduciary with respect to a plan to the extent:
he exercises any discretionary authority or discretionary control respecting management of such plan ...
Read the full article at https://www.linkedin.com/pulse/duties-liabilities-insurance-brokers-barry-zalma-esq-cfe-mmpbc, if you Subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.
Duties and Liabilities of Insurance Brokers
Posted on March 12, 2025 by Barry Zalma
Excellence in Claims Handling
This blog post is just a taste of the full article that is only available to subscribers to Excellence in Claims Handling. Anyone can subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.
Cases in which insurance brokers’ liability is in question depend in part on whether brokers are seen to be serving a fiduciary role or simply acting as a conduit between the insured and the insurer.
A person or an entity is a fiduciary with respect to a plan to the extent:
he exercises any discretionary authority or discretionary control respecting management of such plan ...
The Basics Needed by a Liability Adjuster
Post 5003
Posted on February 25, 2025 by Barry Zalma
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Adjusting liability insurance claims requires skill, patience, knowledge of insurance, basic knowledge of tort and contract law, and knowledge and experience as an investigator. The liability claims adjuster is faced with the following basic obligations:
- To understand the law of torts as applied in the state where the adjuster works.
- To understand the law of contracts as applied in the state where the adjuster works.
- To understand sufficient medical terminology to be able to evaluate claims of injury.
- To understand the costs to repair or replace damaged real or personal property.
- To understand how to read and apply the terms and conditions of a liability insurance policy.
- To understand how to thoroughly investigate all claims assigned.
- To conduct an investigation of every claim ...
