ZIFL Volume 28 Issue 24
Merry Christmas & Happy Hannukah
Read the full article at https://lnkd.in/gkPK-7um, see the full video at https://lnkd.in/gBdYtnB5 and at https://lnkd.in/g4ja8wk4; and at https://zalma.com/blog plus more than 4900 posts.
Zalma’s Insurance Fraud Letter
Posted on December 16, 2024 by Barry Zalma
See the full video at and at https://youtu.be/xeMbQbPnq3I
A Christmas Fable of Fraud
This, the last issue of Zalma’s Insurance Fraud Letter for its 28th year, 2024, contains articles on the following subjects:
ZIFL publishes this story at Christmas time every year. I hope you like it again.
[The story that follows is fiction based, in part, on a true case worked on by me. Any similarity to real people is unintentional. It is meant only to educate fraud professionals about how some unscrupulous people use the crime of insurance fraud for fun and profit during the Christmas season.]
Raymond Alexander had no religion. He cared only for himself and the money he could ...
The Need For and Application of a Motion in Limine
Post 5153
Lawyers Present & Argue Motions in Limine to Control Trial Excess
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In United States Of America v. Scharmaine Lawson Baker, Criminal Action No. 24-99, USDC, E.D. Louisiana (July 7, 2025) Scharmaine Lawson Baker was charged with six counts of health care fraud. She pled not guilty, and her trial was scheduled.
BACKGROUND
Government’s Omnibus Motion in Limine
The Government filed an omnibus motion in limine which included several requests to exclude certain types of evidence and arguments.
Exclusion of Evidence and Argument Related to Specific Instances of “Good Deeds” and “Law-Abidingness”
The Government argued that such evidence is irrelevant and improper character evidence.
The Court granted the motion, stating that the defendant’s character is not an essential element of the charges.
Testimony About Defendant’s Own ...
Act as Your Own Lawyer and Failure is Almost Certain
No Suit Can be Maintained if Claims are Facially Implausible
Post 5152
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In Gabaryaahla Israel and Akiva Israel, Beneficiaries v. Caliber Home Loans, Inc., et al., No. CIV-24-1255-D, United States District Court, W.D. Oklahoma (July 11, 2025) Wells Fargo Bank, N.A.’s Moved to Dismiss Plaintiffs’ Complaint for Fraud, Quiet Title, Injunctive Relief, Breach of Contract, Declaratory Judgment, Damages, Racketeer Influenced Corrupt Organizations Act (RICO) Violations, and Trover and Midfirst Bank’s Rule 12(b)(6) Motion to Dismiss.
Plaintiffs, who are self-represented, failed to respond to the motions to dismiss within 21 days as required by LCvR7.1(g) (establishing a 21-day deadline, and noting that any motion that is not opposed within 21 days may, in the discretion of the court, be deemed confessed.
BACKGROUND:
The plaintiffs brought this action against the ...
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Workers’ Compensation Insurer Sues to Collect Premiums Avoided by Fraud
It’s Fraud to Lie on Application for Insurance
Post 5121
In The Commissioners Of The State Insurance Fund v. Capcon Construction Industries Corp., Capcon Construction Supply Corp., Jab Masonry Corp., Agra Masonry Inc., Agra Industries Usa Corp, A&A Masonry Corp., Alexander Shvartsberg, Darren Caputo, Maryann Furman, 2025 NY Slip Op 32359(U), Index No. 452680/2024, Motion Seq. No. 002, Supreme Court, New York County (July 2, 2025) the court dealt with a fraudulent application for workers’ compensation insurance.
BACKGROUND
On March 3, 2015, A&A Masonry Corp. applied for workers’ compensation insurance coverage from the New York State Insurance Fund (SIF).
On January 15, 2016, Agra Masonry Inc. was incorporated with Maryann Furman as the sole shareholder and President.
On January 4, 2018, SIF canceled ...
Rulings on Motions Reduced the Issues to be Presented at Trial
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CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
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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/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
