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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October 01, 2024
Zalma’s Insurance Fraud Letter – October 1, 2024

October 1, 1979 – 2024, Another Anniversary
Post 4901
Read the full article at https://lnkd.in/gCWa-Du7, see the full video at https://lnkd.in/gYBfBXp4 and at https://lnkd.in/gmwrV8qE and at https://zalma.com/blog; and https://lnkd.in/gWpS8p8H.

October 1, 2024
ZIFL – 10/1/2024 -Volume 28, Issue 19

Forty five years ago today I left the world of the employed and became an entrepreneur by opening my own law firm. The law practice was incorporated shortly thereafter as Barry Zalma, Inc. When I opened for business on October 1, 1979, I had no clients and no certainty that I would have any in the future. I had borrowed money from the bank to carry me through the first six months and was concerned about my ability to pay the loan with my third child about to be born. At 8:10 a.m. on October 1, 1979, Alan Warboys, called from London and provided me with my first case as an independent lawyer to represent Certain Underwriters at Lloyd’s, London. He, and the Lloyd’s Underwriters he represented, showed faith in me as a lawyer and insurance expert. Alan is now, and will forever be, my first client and a good friend.

https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

Lie on an Application About Primary Residence is Ground for Rescission

Plaintiff Homesite Insurance Company’s (Homesite) moved for Summary Judgment seeking a judicial declaration that it is entitled to rescission of Defendant Zhen Jiang’s homeowners’ insurance policy and enter summary judgment in its favor on Mr. Jiang’s bad faith counterclaims. In Homesite Insurance Company v. Zhen Jiang, No. CV-21-00554-TUC-JGZ, United States District Court, D. Arizona (September 16, 2024) the USDC explained an insurer’s right to rescission.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

More McClenny Moseley & Associates Issues

This is ZIFL’s thirty sixth installment of the saga of McClenny, Moseley & Associates 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.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

World Wide Insurance Fraud

In an article by Kenneth Araullo on Sep 16, 2024 in ReinsuranceBusiness Mr. Araullo reports on the fact that fraud remains a top concern for insurers worldwide, according to the findings from the Reinsurance Group of America (RGA) 2024 Global Claims Fraud Survey. He notes: “The report highlights the ongoing challenges insurers face in managing fraud, with 74% of survey respondents indicating that the number of fraud cases is either holding steady or increasing compared to previous years.” He also notes that Reinsurance Group of America (RGA) 2024 Global Claims Fraud Survey. “35% of respondents said claims fraud had increased, while 39% reported no change. In underwriting fraud, 85% of respondents noted either no change or an increase in fraudulent activities, with 17% seeing an uptick.” You can read the full article here.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf
Intentional Arson Even for Mental Health Assistance Requires Jail

Hunter Hipp pleaded guilty to first-degree arson after intentionally setting fires in the kitchen and living room of his apartment. He notified the district court in writing of his intent to move “for a dispositional and/or durational departure from the presumptive sentence,” and at sentencing he argued exclusively that he was particularly amenable to probation.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

Insurance Fraud is a Serious Crime

Why Insurance Fraud is Not Taken Seriously by Police & Prosecutors

State insurance departments near the turn of the century recognized that insurance fraud is a serious crime taking multiple billions of dollars from the insurance industry. Local police and prosecutors were not concerned, even after insurance fraud was made a felony, because no one suffered physical injury or death. Insurance fraud just cost a lot of money to insurers who were perceived as extremely wealthy and more victimizers than victim.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

Health Insurance Fraud Convictions

Behavioral Healthcare Company Executive Pleads Guilty to Healthcare Fraud

Miguel Saravia, 42, of Hanson, pleaded guilty to six counts of health care fraud. U.S. District Court Judge Allison D. Burroughs scheduled sentencing for Jan. 2, 2025.

Saravia, the Chief Executive Officer of Dana Group Associates, who is also the former Chief Operating Officer of Prime Behavioral Health, pleaded guilty to a scheme to defraud health care benefit programs by directing false billing for patient visits. From approximately 2017 to 2022, Saravia directed a group of individuals with no billing or medical training to enter Current Procedural Terminology codes (CPT) for therapy services that were not provided and to upcode CPT codes used for psychotherapy visits. Saravia submitted, or directed the submission of, false claims for treatment that was not provided or for more complex and expensive treatment than was provided.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

The Public Adjuster & Fraud

In Chubb & Son Inc. v. Consoli, 283 A.D. 2d 297, 726 N.Y.S. 2d 398 (N.Y. App. Div. 05/22/2001), a public adjuster was involved in a scheme with one of Chubb’s adjusters to intentionally inflate a claim and then pay Chubb’s adjuster to approve the claim. The insureds’ public adjuster was later convicted on charges of mail and tax fraud and Chubb’s representative was found guilty of defrauding Chubb.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

Ghost Broker Sentenced

Mohamed Choudhary, 33, who sold invalid insurance policies and tried to take out car insurance for himself by covering up his driving offences and using a fake no-claims discount certificate was sentenced to two years in prison, suspended for two years at Inner London Crown Court on 13 September 2024. He is subject to a six-month curfew, which runs daily from 9pm to 6am and is monitored by an electronic tag. He must also complete 150 hours of unpaid work and pay £1,630 in costs.

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

Barry Zalma

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 also serves as an arbitrator or mediator for insurance related disputes. He practiced law in 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].

Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/09/ZIFL-10-01-2024.pdf

00:10:36
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May 26, 2026
He Who Acts as His Own Lawyer Has an Idiot for a Client

Arsonist Tried To Represent Himself, Failed, and Sought Habeas Relief

Post number 5357

Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.

Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed

In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.

FACTS

Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...

00:08:55
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May 11, 2026
Severe Punishment for Failure to Obey Court Orders

Foolish to Repeatedly Disobey Court Orders

All That Remains For Trial Is Plaintiff’s Damages On Each Of These Claims And Establishing Proximate Causation Of Those Damages.

Post number 5348

See the full video at and at and at https://zalma.com/blog plus 5300 posts.

In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).

FACTUAL BACKGROUND

This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...

00:08:27
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May 08, 2026
Ambiguous Contract to Repair not an Assignment

The Right to Negotiate with Insurer is Not an Assignment of Claims

Post number 5347

Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.

Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer

In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.

FACTUAL BACKGROUND

In ...

00:08:02
12 hours ago
Insurer Contended it was not Defrauded

Qui Tam Case Without Evidence to Prove Fraud Fails

Post number 5369

Read the full article at https://www.linkedin.com/pulse/qui-tam-insurer-contended-defrauded-barry-zalma-esq-cfe-pgfgc and at https://zalma.com/blog plus more than 5550 posts.

In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended parties in an automobile collision case involving a McLaren and a tour van. After that case settled for $25,000, the firm filed a qui tam action under California’s Insurance Frauds Prevention Act (IFPA) against Silver Bird Auto Leasing, LLC, X-Law Group, PC, and Filippo Marchino. The firm alleged three fraudulent acts in the underlying litigation:

1. the complaint falsely stated the McLaren was making a “legal turn,”
2. respondents produced a fraudulent repair bill/estimate, and
3. respondents failed to disclose Marchino’s GEICO insurance and its payment for repairs....

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12 hours ago
Default Judgment Must be Respected by Federal Court

Full Faith and Credit Act Controlled

Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.

Posted on June 9, 2026 by Barry Zalma

Post number 5368

Posted on June 9, 2026 by Barry Zalma

In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.

After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...

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June 09, 2026
Default Judgment Must be Respected by Federal Court

Full Faith and Credit Act Controlled

Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.

Posted on June 9, 2026 by Barry Zalma

Post number 5368

Posted on June 9, 2026 by Barry Zalma

In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.

After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...

post photo preview
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