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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 30, 2024
Appeal Dismissed Even With Fraud Allegation

Appeal Lost Due to Failure to Provide an Adequate Record

Post 4810

Read the full article at https://lnkd.in/gtmux5eq, see the full video at https://lnkd.in/gtfP7szv and at https://lnkd.in/gE4K9Bgy and at https://zalma.com/blog plus more than 4800 posts.

In an action to recover damages for personal injuries, the defendant Myrtle 6, LLC, appealed from an order of the Supreme Court, Kings County (Lawrence S. Knipel, J.). The order, insofar as appealed from, denied those branches of the motion of the defendant Myrtle 6, LLC to stay the trial ,to vacate the note of issue, and to compel discovery.

The Appellate Court, in Jay Bing v. Myrtle 6, LLC, 2024 NY Slip Op 02516, No. 2022-03586, Index No. 519239/16, Supreme Court of New York, Second Department (May 8, 2024) resolved the appeal after finding the record on appeal to be inadequate.

FACTS

The plaintiff commenced this action against the defendant Myrtle 6, LLC and another defendant to recover damages for personal injuries. The defendant moved to stay the action, vacate the note of issue, and compel discovery. The Supreme Court issued a stay of trial and granted leave for the defendant to amend its answer and allege various fraud defenses.

The defendant alleged that there was a related criminal case pending against the plaintiff’s previous attorney in connection to an insurance fraud scheme. Although the defendant’s affirmation in support of its motion stated that the details of the fraud scheme were outlined in prior motions with exhibits, none of the prior motions or exhibits were included in the record on appeal.

In an order after oral arguments the Supreme Court inter alia, denied those branches of the defendant’s motion which were to stay the trial, to vacate the note of issue, and to compel discovery.

ANALYSIS

It is the obligation of the person seeking to appeal a judgment, the appellant, to assemble a proper record on appeal. Generally speaking, a

n appellant’s record on appeal must contain all of the relevant papers before the Supreme Court. In New York and every other state, appeals that are not based upon complete and proper records must be dismissed.

The appellate court observed that the record provided to it by the appellant was inadequate for meaningful appellate review. The appellant failed to include all relevant documents that were before the Supreme Court (the trial court). The record failed to include the exhibits allegedly demonstrating that the plaintiff’s former counsel was involved in a fraud scheme. Since these omissions have rendered meaningful appellate review of the court’s order virtually impossible, the appeal must be dismissed.

ZALMA OPINION

When a plaintiff’s lawyer is under arrest for insurance fraud the right of an injured party to establish a claim against the defendant becomes problematic. The appeal of the order could have been effective but failed because the record on appeal was inadequate. The Appellant is not without a remedy, the defendants can sue their lawyers for malpractice.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:05:29
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22 hours ago
Man Bites Dog Story – Hertz Sues Alleged Fraudsters

Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers

Post 5222

Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

Proactive Victim of Fraud Defeats Health Care Providers

In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.

FACTUAL BACKGROUND

Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.

Plaintiff also ...

00:06:28
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23 hours ago
Man Bites Dog Story – Hertz Sues Alleged Fraudsters

Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers

Post 5222

Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

Proactive Victim of Fraud Defeats Health Care Providers

In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.

FACTUAL BACKGROUND

Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.

Plaintiff also moved...

00:06:28
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November 05, 2025
Not Nice to Shop the Federal Court to Avoid State Court

Who’s on First? State or Federal Court

Post 5222

Read the full article at https://lnkd.in/gWj97cFs, see the video at https://lnkd.in/gtS6CpUX and at https://lnkd.in/gQEAeyHc,

Conflict Between State & Federal Court Requires Abstention

See the video at https://lnkd.in/gtS6CpUX and at https://lnkd.in/gQEAeyHc,

Conflict Between State & Federal Court Requires Abstention

Hector David Campoverde was injured at a Brooklyn construction site in 2015. Campoverde was an employee of Vazquez Bro Restoration Inc., a subcontractor for C.C.C. Renovation Inc., which was itself a subcontractor for general contractor L&M Builders Group LLC. In Starr Indemnity & Liability Company v. Scottsdale Insurance Company, No. 24-CV-3309 (PKC) (TAM), United States District Court, E.D. New York (September 30, 2025) was asked to determine whether one or more of the involved insurers is obligated to indemnify Campoverde, and in what order Camporverde can receive indemnity, from one or more insurer.

Underlying Incident:

Campoverde sued the ...

00:07:43
October 31, 2025
The Zalma Philosophy of Claims Handling – Part 9

The Professional Claims Handler
Post 5219

Posted on October 31, 2025 by Barry Zalma

An Insurance claims professionals should be a person who:

Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.

How to Create Claims Professionals

To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...

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October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail

Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.

My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
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