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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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December 20, 2024
Covid Delay of Trial Appropriate

No Right to Trial if Defendant Waives Right to Speedy Trial by Defendant

Post 4953

Read the full article at https://www.linkedin.com/pulse/covid-delay-trial-appropriate-barry-zalma-esq-cfe-64ndc, see the full video at and at and https://zalma.com/blog plus more than 4950 posts.

On February 12, 2020, the State charged Franklin Lee Boger with one count of Level 2 felony arson resulting in serious bodily injury, four counts of Level 4 felony arson, one count of Level 6 felony arson, and one count of Level 5 felony insurance fraud. Boger’s trial was set for a date certain, continued with the agreement of Boger several times and without his agreement several times. He appealed in Franklin Lee Boger v. State of Indiana, No. 24A-CR-1003, Court of Appeals of Indiana (December 5, 2024) seeking dismissal of the charges because of the delays.

FACTS

The State filed charges against Boger on February 12, 2020. On March 11, ...

00:07:21
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December 19, 2024
USAA Punished for it Claims Handling

Punitive Damages Should be Awarded With Caution and Within Narrow Limits

Read the full article at https://www.linkedin.com/pulse/usaa-punished-claims-handling-barry-zalma-esq-cfe-nbp2c, see the full video at and at and at https://zalma.com/blog plus more than 4950 posts.

Posted on December 19, 2024 by Barry Zalma

DISPUTE OVER HURRICANE DAMAGES RESULTS IN MAJOR PUNITIVE DAMAGES FOR BAD FAITH

Although he Mississippi Supreme Court recognized the need to only award punitive damages with caution and within narrow limits, it did not limit its award in accordance with that maxim. After almost 19 years of litigation the last appeal resolved the various disputes.
FACTS

Hurricane Katrina destroyed Paul and Sylvia Minor’s home on August 29, 2005. The Minors had a homeowner’s insurance policy with United Services Automobile Association (USAA). The USAA policy covered damage caused by wind but excluded damage ...

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December 18, 2024
Inadequate Litigant’s Cases Dismissed

Plaintiff, by her Litigation Appears to Establish the Report for a Mental Health Evaluation Was Appropriate

Read the full article at https://lnkd.in/gECRyZ-f, see the full video at https://lnkd.in/gs_4Bby9 and at https://lnkd.in/g67dDK8q, and https://zalma.com/blog plus more than 4950 posts.

Post 4950

In Samreen Riaz v. State Of California, et al., F087504, California Court of Appeals, Fifth District (December 2, 2024) the California Court of Appeals found itself asked to resolve suits against an individual and the state of California from an inadequate but excessively litigious plaintiff.

FACTS

Samreen Riaz was a licensed dentist – she lost her license to practice because of the facts underlying this case. According to her, there is an elaborate conspiracy to harass, stalk, threaten, and ultimately prevent her from testifying in a separate “whistleblower” case involving “OSHA and HIPPA Violations” at a medical facility.

Riaz sued raising numerous claims against numerous individuals and government entities. The opposing parties challenged the ...

00:10:40
December 12, 2024

What is the Meaning of “Void”

An article For Subscribers to Excellence in Claims Handling You can Subscribe for only $5 a month to Excellence in Claims Handling at https://barryzalma.substack.com/subscribe

“Void” can mean either void or voidable. Void is defined as “of no legal force or effect and so incapable of confirmation or ratification.”

Voidable is defined as “capable of being adjudged void, invalid and of no force (a voidable contract may be set aside usually at the option of one party).”[1] The Restatement 2d of Contracts defines a “voidable contract” as a valid transaction with legal consequences until the power of avoidance is exercised.

Although jurisdictions are split as to the meaning of void in this context the distinction is largely semantic since the actions required of insurers wishing to dispose of a void or voidable insurance contract are ultimately the same.

The full article is available only to subscribers to Excellence in Claims ...

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December 12, 2024

What is the Meaning of “Void”

An article For Subscribers to Excellence in Claims Handling You can Subscribe for only $5 a month to Excellence in Claims Handling at https://barryzalma.substack.com/subscribe

“Void” can mean either void or voidable. Void is defined as “of no legal force or effect and so incapable of confirmation or ratification.”

Voidable is defined as “capable of being adjudged void, invalid and of no force (a voidable contract may be set aside usually at the option of one party).”[1] The Restatement 2d of Contracts defines a “voidable contract” as a valid transaction with legal consequences until the power of avoidance is exercised.

Although jurisdictions are split as to the meaning of void in this context the distinction is largely semantic since the actions required of insurers wishing to dispose of a void or voidable insurance contract are ultimately the same.

The full article is available only to subscribers to Excellence in Claims ...

December 02, 2024
Zalma's Insurance Fraud Letter - December 1, 2024

ZIFL Volume 28 No. 22

Post 4939

Read the full article at Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdfand at https://zalma.com/blog.

Subscribe to ZIFL at https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

The Source for the Insurance Fraud Professional https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th 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/  This issue contains the following articles about insurance fraud:

The EUO is a Material Condition Precedent
A Key Tool in the Effort to ...

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