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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May 01, 2023
Zalma’s Insurance Fraud Letter – May 1, 2023

ZIFL -05-01-2023
Barry Zalma
May 1, 2023

Read the full article at https://lnkd.in/gkfAtmwU and see the full video at https://lnkd.in/gydB3cYU and at https://lnkd.in/gAbPNpth and at https://zalma.com/blog plus more than 4500 posts.

Happy Law Day!

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.

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.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.

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.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.

Another Florida Insurer Bites the Dust

Florida Commercial Insurer Capacity Insurance Company Now in Runoff.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.
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

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.

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.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.
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.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.

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.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.

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.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.
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.

Read the full 22 page issue in Adobe pdf format at https://lnkd.in/gFjTSvnu.

(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]

Follow me on LinkedIn: www.linkedin.com/comm/mynetwork/discovery-see-all?usecase=PEOPLE_FOLLOWS&followMember=barry-zalma-esq-cfe-a6b5257

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.

Subscribe and receive videos limited to subscribers of Excellence in Claims Handling at locals.com https://lnkd.in/gfFKUaTf.

Consider subscribing to my publications at substack at https://lnkd.in/gcZKhG6g

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.

00:11:37
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7 hours ago
When You File Suit Late You Lose

Private Limitation of Action Provision Defeats Suit Against Insurer
Post 5072

See the full video at https://lnkd.in/g_8AU-NK and at https://lnkd.in/gWzCpUZB, and at https://zalma.com/blog plus more than 5050 posts.

In Vishnudut Ramyead et al. v. State Farm General Insurance Company, B329614, California Court of Appeals, Second District, Second Division (April 29, 2025) resolved a purported class action suit because it was filed late.

After their personal property suffered water damage, plaintiffs and appellants Vishnudut and Teika Ramyead (collectively, plaintiffs) submitted a claim to their property insurer, defendant and respondent State Farm General Insurance Company (State Farm). State Farm paid plaintiffs a total of $750.75. Dissatisfied with State Farm’s handling of their claim, plaintiffs filed a class action lawsuit against State Farm, bringing causes of action for alleged violations of the unfair competition law and declaratory relief.

The trial court granted State Farm’s motion for summary judgment.

FACTS AND PROCEDURAL ...

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May 12, 2025
Insurance Fraudsters are not Nice – They Are Criminals

Lawyers Attempt to Protect Assets of their Clients Charged with Insurance Fraud From Seizure by State Fails

Post 5071

See the full video at and at and at https://zalma.com/blog plus more than 5050 posts.

In The People v. David M. Browne et al., B332304, California Court of Appeals, Second District, Seventh Division (May 6, 2025) find criminal defense lawyers in contempt.

Attorneys David M. Browne and George A. Shohet appeal from the trial court's denial of their special motion to strike (Code of Civ. Proc., § 425.16, subd. (b)(1)) an affidavit filed by the Los Angeles County District Attorney's office on behalf of the People of the State of California to initiate a civil contempt proceeding against Browne, Shohet, their clients, and others based on alleged violations of three temporary restraining orders that barred the transfer or encumbrance of specified properties and assets. The trial court issued the ...

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May 09, 2025
Pro Se Plaintiff’s Frivolous Suit Dismissed

Suit Claiming Ex-President Attempted to Kill Plaintiff for Profit, Insurance Fraud, Assaults, Battery, and False Imprisonment Dismissed

Post 5070

See the full video at https://lnkd.in/gJ-rDMa8 and at https://lnkd.in/gG3ERkXB, and at https://zalma.com/blog plus more than 5050 posts.

In a suit entitled Ivette T Echenidue v. President Biden, et al., Civil Action No. 1:25-cv-00517 (UNA), Judge Chutkan of the United States District Court, District of Columbia (April 17, 2025) refused to acknowledge the claims of the plaintiff.

Judge Chutkan explained that Echenidue’s suit was before the court on its initial review of plaintiff’s pro se complaint. The court granted the in forma pauperis application and, for the reasons explained below, dismissed the case pursuant to 28 U.S.C. § 1915(e)(2)(B)(i), by which the court is required to dismiss a case “at any time” it determines that the action is frivolous.

IS THE ACTION FRIVOLOUS?

Judge Chutkan noted that “A complaint must contain sufficient factual matter,...

00:09:00
April 30, 2025
The Devil’s in The Details

A Heads I Win, Tails You Lose Story
Post 5062

Posted on April 30, 2025 by Barry Zalma

"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ­­­Perpetrators than any Other Crime."

Immigrant Criminals Attempt to Profit From Insurance Fraud

People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.

The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...

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April 18, 2025
When a Plaintiff in an Insurance Bad Faith Case Seeks Punitive Damages The Plaintiff and Counsel Must Consider the Effect of State and Federal Income Taxes

Punitive Damages Must Be Added to Gross Income for Tax Purposes

See the full article at https://www.linkedin.com/pulse/punitive-damages-must-added-gross-income-tax-purposes-barry-n08yc and at https://zalma.com/blog plus subscribe at https://barryzalma.substack.com/subscribe.

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.

A TASTE OF EXCELLENCE IN CLAIMS HANDLING

The stated purpose of punitive damages is to punish a wrongdoer civilly to deter the wrongdoer and others from acting wrongfully. Insurance Bad Faith litigants dream of large punitive damage awards as a bonus and revenge upon the insurer that did not treat them fairly.

Punitive damages may be awarded where there is substantial harm and where there is none. [Restatement (First) of Torts § 908 cmt. c (Am. L. Inst. 1939); see also ...

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March 13, 2025

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 ...

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