More Prosecution is Needed to Deter Insurance Fraud
Post 4826
Read the full article at https://lnkd.in/gVw4MFZZ, see the full video at https://lnkd.in/gghQy4N9 and at https://lnkd.in/ggpJh3vy and at https://zalma.com/blog plus more than 4800 posts.
Thomas Orville McLaughlin II was convicted of committing a fraudulent insurance act, making a false information, and interfering with law enforcement. He appealed claiming several of the State’s exhibits were improperly admitted and that a defense witness was improperly excluded.
In State of Kansas v. Thomas Orville McLaughlin II, No. 124,221, Court of Appeals of Kansas (June 21, 2024) McLaughlin sought relief from his conviction for insurance fraud.
MCLAUGHLIN REPORTS A HOME BURGLARY AND IS LATER CONVICTED
On August 2, 2016, Thomas McLaughlin reported a burglary. He contacted law enforcement and later spoke to Officer Travis Debarge about the burglary. McLaughlin advised the officer that his storage container had been robbed and three ATVs were missing. The following day, McLaughlin also spoke to Detective Mark Montague about the burglary at his residence. During their conversation, McLaughlin presented the detective with a list of stolen items, including tools, TVs, guns, and jewelry.
At trial, the State presented photographs that showed McLaughlin moving a TV and other items out of his house the night before the alleged burglary.
In making his insurance claim, McLaughlin was required to provide documentation of the ATVs’ purchase. At trial, Melissa Webber from Progressive testified about McLaughlin’s inconsistent statements, noting how, at first, McLaughlin said that he did not have one of the ATV titles. He had claimed that the titles and bills of sale for the ATVS were not available because they were kept in a safe that was later reported stolen. Yet in the same interview, McLaughlin told Webber that the title was destroyed in a house fire a year prior. Webber had recorded her conversations with McLaughlin. The recording was played at the trial.
At trial, McLaughlin’s ex-wife Skye Gaskell, testified about McLaughlin’s and her actions toward defrauding the insurance company. Her trial testimony also included admitting that she had lied to the insurance investigators both in their initial investigation and during her sworn statements taken in her deposition. The jury also heard evidence that Gaskell still possessed some of the reportedly stolen tools from the alleged burglary.
Two of the State’s witnesses-Hundley and Montague-both testified that it was McLaughlin who submitted the false documents. And it was McLaughlin who purchased the insurance for the ATVs. For each of the three ATVs, the State showed how the ATVs were not owned by McLaughlin during the period that he had claimed and presented evidence of McLauglin’s actions towards his claimed ownership.
The jury convicted McLaughlin of committing a fraudulent insurance act, making false information and interference with law enforcement. He was sentenced to 12 months in jail, suspended for 24 months of probation.
ZALMA OPINION
Considering the light sentence for a serious, planned, premeditated insurance fraud, McLaughlin had the unmitigated gall to appeal the conviction ignoring the detailed evidence of his fraud and the testimony of his co-conspirator-wife who only married him for his money. More prosecutions of insurance fraud perpetrators are needed and when convicted the sentence needs to be severe to deter others from attempting insurance fraud who might be more competent at fraud than McLaughlin.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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ZIFL – Volume 29, Issue 21
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post 5220
Read the full article at https://lnkd.in/gRMJpi4s, see the video at https://lnkd.in/gwGSd6ZA & at https://lnkd.in/gbDiuFJy, and at https://zalma.com/blog plus more than 5200 posts.
See the video at & at https://rumble.com/v711hr0-zalmas-insurance-fraud-letter-november-1-2025.html
See the full 18 page issue of ZIFL at ZIFL-11-01-2025
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th 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/
Conviction for Health Insurance Fraud Upheld
Physician Conspired with Bonavilla to Effect Health Insurance Fraud
Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on ...
The Professional Claims Handler
Post 5218
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-8-barry-zalma-esq-cfe-zdwsc, see the full video at https://rumble.com/v70zl4s-the-zalma-philosophy-of-claims-handling-part-8.html and at https://youtu.be/MIYcF71ffRQ, and at https://zalma.com/blog plus more than 5200 posts.
Claims Commandment X – Thou Shall Not Pretend to be a Lawyer
Some experienced and professional claims people know the law in their area of expertise better than most lawyers.
Adjusters should be adjusters and leave lawyering to lawyers. Similarly, lawyers should be lawyers and never try to be adjusters.
Claims Commandment XI – Thou Shall Empathize With the Claimant
Everyone presenting a claim is unhappy, disturbed, shocked, injured and needs help.
Empathy is identification with and understanding of another’s situation, feelings, and motives. It is the ability to understand another person’s circumstances, point of view, thoughts, and feelings....
HOW TO CREATE AN EXCELLENCE IN CLAIMS HANDLING PROGRAM
See the full video at https://rumble.com/v70wb2i-the-zalma-philosophy-of-claims-handling-part-6.html and at https://youtu.be/tL5nDKPEs40 and at https://zalma.com/blog plus more than 5200 posts.
Post 5217
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.
An Excellence in Claims Handling program begins with a statement in the insurer’s claims manual or statement of professionalism that it is dedicated to providing excellence in claims handling to every insured who presents a claim.
The excellence in claims handling program should include, at a minimum:
A series of lectures supported by text materials explaining:
A definition of insurance.
How to read and understand an insurance policy.
How to interview an insured, witness, or claimant.
How to assist an insured in the insured’s obligation to ...
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 ...
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 ...
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 ...
