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May 08, 2024
Incompetent Insurance Fraud Claim Results in Conviction

Fraudster Pawns Jewelry & Then Claims it Stolen

Red the full article at https://lnkd.in/gRBUuUzB, see the full video at https://lnkd.in/gDAD4wpv and at https://lnkd.in/gBDuW7Ui and at https://zalma.com/blog plus more than 4750 posts.

Post 4796

The defendant, Vincent Chaney, appealed two orders from Superior Court denying his motions to suppress and for a new trial. In State of New Hampshire v. Vincent Chaney, No. 2022-0718, Supreme Court of New Hampshire (May 3, 2024) resolved the dispute over Chaney’s conviction.

FACTS

In 2018, the defendant traveled to Florida and purchased three pieces of jewelry: (1) a necklace worth $63,138 (hereinafter, the large necklace); (2) a necklace worth $4,500 (hereinafter, the small necklace); and (3) a bracelet worth $16,050. Following the purchases, the defendant took out an insurance policy with Phoenix Insurance Company, also known as Travelers Insurance, on all three pieces of jewelry.

Chaney filed an insurance claim with Travelers Insurance for the small necklace and bracelet. Travelers Insurance paid the claim in March. In May, the defendant filed a second claim with Travelers Insurance alleging that the large necklace had been stolen during an armed robbery in Boston.

Travelers ultimately denied the second claim due to the defendant’s non-cooperation and referred the case to the New Hampshire Insurance Department (Department), indicating that it believed the insurance claim to be suspicious. During the state’s investigation, the investigator learned that Castro had twice pawned a bracelet identical to the one reported missing in the first insurance claim. At the time of the investigation, the bracelet remained at the pawn shop.

In December 2019, the investigator interviewed Ms. Castro who lived with Chaney after he obtained approval for a one-party intercept in order to record the interview. Castro described the three pieces of jewelry and alleged that they were all either missing or stolen. She stated that she had an older bracelet at her house similar to the one that went missing but that she had never insured the older bracelet due to its age. She also stated that she had never pawned the older bracelet.

Castro changed her story and stated that the bracelet at the pawn shop was the older bracelet that she previously claimed was at her house. The interview ended soon thereafter.

After obtaining a warrant the state’s search discovered drugs, drug paraphernalia, multiple firearms, and one of the missing necklaces. The defendant was subsequently charged with possession of a controlled substance with intent to sell and numerous counts of being a felon in possession of a deadly weapon. The defendant was separately charged with three counts of insurance fraud in connection with the claims he made to Travelers Insurance.

ANALYSIS

To suppress evidence seized under a search warrant, the defendant must show that the misrepresentations in the supporting affidavit were material and were made intentionally or recklessly. Materiality is determined by whether, if the omitted statements were included, there would still be probable cause.

In its order on the defendant’s motion to suppress, the trial court concluded that the affidavit supporting the search warrant did not contain any material misrepresentations or omissions that rendered the warrant invalid. Regarding the investigator’s failure to mention the friend’s corroboration, the court ruled any such omission was immaterial to a finding of probable cause.

Finally, the court found that, although the defendant’s assertion that the investigator, rather than Castro, initiated the termination of the interview was “mostly accurate,” The Supreme Court agreed with the trial court’s well-reasoned and thorough order that the affidavit supporting the search warrant did not contain any material omissions or misrepresentations that rendered the warrant invalid.

The task of the issuing court is to make a practical, common-sense decision whether given all the circumstances set forth in the affidavit before it, including “veracity” and basis of knowledge of persons supplying hearsay information, there is a fair probability that contraband or evidence of a crime will be found in a particular place.

The reviewing court may consider only the information that the police brought to the issuing court’s attention. Neither the issuing court nor the reviewing court could have considered the 2005 receipt when determining probable cause, and any alleged error in not attempting to introduce it at the suppression hearing did not prejudice the defendant’s case. The order was affirmed and Mr. Chaney’s conviction stood affirmed.

ZALMA OPINION

Mr. Chaney was involved in an amateurish attempt at insurance fraud by reporting the theft of jewelry that he had pawned, a fact easy for a police agency to establish but difficult for an insurer to determine. Chaney was caught when the pawned jewelry was found, a search warrant was obtained and the police not only found in his residence one of the “stolen” items, plus drugs sufficient to arrest him as a drug dealer as well as a perpetrator of insurance fraud. He tried to claim the warrants were improper and the Supreme Court refused his claims.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:08:15
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May 17, 2024
Officer Immune from Suit

Insurance for State of Delaware Waives Sovereign Immunity

Read the full article at https://lnkd.in/gUZqz9kE, see the full video at https://lnkd.in/gN_MYPbK and at https://lnkd.in/g-3Pn_-T, and at https://zalma.com/blog plus more than 4800 post.

Post 4803

On February 15, 2023, Kimberly Letke (“Plaintiff”) filed a pro se Complaint against Defendant Matthew Sprinkle (“Sprenkle”) for defamation and malicious prosecution. On October 3, 2023, Plaintiff filed another Complaint added Defendants Cpl. Tyler Beulter of the DNREC police (“Beulter”) and the Attorney General of Delaware, Kathleen Jennings (“Jennings”), in which she added three additional claims: false arrest and violations of public trust, unlawful detention, and violations of her rights under the Fourth Amendment to the United States Constitution.

In Kimberly Letke v. Matthew Sprenkle, CPL. Tyler Beulter, and Attorney General Kathleen Jennings, C.A. Nos. S23C-10-019 CAK, S23C-10-002 CAK, Superior Court of Delaware (May 6, 2024) the court was faced...

00:07:02
May 16, 2024
Overcharge of Force Placed Insurance Defense to Foreclosure

Force Placed Insurance Charges Allow Special Defense to Foreclosure

Read the full article at https://lnkd.in/dZSesj2Q, see the full video at https://lnkd.in/dCYDuKxw and at https://lnkd.in/dUbx5bf8 and at https://zalma.com/blog plus more than 4800 posts.

Post 4802

In an action to foreclose a mortgage the trial court granted in part the plaintiff’s motion to strike the defendant’s special defenses and counterclaim; subsequently, the court, Cirello, J., granted the plaintiff’s motion for summary judgment as to liability only; thereafter, the court, Spader, J., rendered judgment of foreclosure by sale, and the defendant appealed.

In M&T Bank v. Robert R. Lewis, No. SC 20817, Supreme Court of Connecticut (April 30, 2024) the appeal of a foreclosure judgment presented one question important to insurance professionals: Whether allegations of impropriety in a mortgagee’s force placement of property insurance arise from the making, validity or enforcement of the mortgage for purposes of a special defense to a foreclosure ...

00:08:20
May 15, 2024
Zalma’s Insurance Fraud Letter – May 15, 2024

Read the full article at https://lnkd.in/dAKdNkM8, see the full video at https://lnkd.in/dbNmmGji and at https://lnkd.in/ddU7NHaH, and https://zalma.com/blog plus more than 4800 posts.

Post 4801

The Source for the Insurance Fraud Professional

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:

Incompetent Insurance Fraud Claim Results in Conviction

Fraudster Pawns Jewelry & Then Claims it Stolen

The defendant, Vincent Chaney, appealed two orders from Superior Court denying his motions to suppress and for a new trial. In State of New Hampshire v. Vincent Chaney, No. 2022-0718, Supreme Court of New Hampshire (May 3, 2024) resolved the dispute over Chaney’s conviction.

Read the full 23 page issue here in Adobe pdf format ...

00:10:03
April 29, 2024
Telling the Truth Can't Be Defamatory

After Health Provider Entity's Management is Arrested for Fraud Reporting Suspicion to Beneficiaries is not Defamation

Read the full article at https://lnkd.in/gvC28cS4, see the full video at https://lnkd.in/giQW_bJK and at https://lnkd.in/gYSqE46x, and https://zalma.com/blog plus more than 4750 posts.

BrainBuilders, LLC appealed from an order granting summary judgment in favor of defendants Optum, Inc., et al (collectively, defendants) in Brainbuilders, LLC v. Optum, Inc., Optum Services, Inc., et al, No. A-0621-22, Superior Court of New Jersey, Appellate Division (April 19, 2024) resolved claims of defamation.

FACTS

Letters dated July 25, 2017 and August 2017 sent by the Optum entities to BrainBuilders' patients following an investigation into purported fraud by individuals associated with BrainBuilders.

BrainBuilders provides healthcare services to children on the autism spectrum. As an out-of-network or non-participating healthcare provider, BrainBuilders receives reimbursement for claims only if a patient's health ...

April 01, 2024
Zalma's Insurance Fraud Letter - April 1, 2024

Read the full article at https://lnkd.in/gvKdq6Qc and at https://zalma.com/blog and the full article in pdf at https://lnkd.in/gBj_3yVw plus more than 4750 posts.

ZIFL-04-01-2024 Volume 28, Number 7

Post 4766

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.

This month's issue contains multiple articles for the insurance fraud professional and the insurance claims professional. The current issue can be read in full at https://lnkd.in/gBj_3yVw and includes the following articles:

Prison Employee Commits a Crime She Was Employed to Prevent

GUILTY OF WORKERS’ COMPENSATION FRAUD

On January 10, 2022, defendant Tiffinie Marvell Jones was convicted by a jury of one count of insurance fraud. Jones filed a motion for a new trial, which was denied. On appeal, Jones argued that there was insufficient evidence to support the verdict, that her trial counsel provided ...

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March 27, 2024
Red Flags of Insurance Fraud

Indicators of Insurance Fraud are Investigative Tools

Barry Zalma
Mar 27, 2024

Read the full article at https://lnkd.in/gvtv9gCz where you can see more red flags, see the full video at https://lnkd.in/gMirVfZc and at https://lnkd.in/g2ndng5r and at https://zalma.com/blog plus more than 4750 posts.

Post 4763

Suspicious claims have common attributes. Insurers and their anti-fraud organizations have collated the common attributes into lists of indicators or red flags of fraud. The lists were created as training aids and to be used to determine whether further investigation is required to determine if a claim is legitimate or false and fraudulent. Continually growing, these lists are known as the “red flags” or “indicators” of fraud lists. There are many different categories, ranging from those associated with the claim itself or with insureds to indicators of specific types of fraud, such as bodily injury fraud or arson for profit.

If, when assessing a claim, three or more red flags are found the need for further investigation should be considered and evaluated by the claims person, a supervisor and the insurer’s special investigative unit. The...

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