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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January 30, 2025
Failure to Profit From the Crime of Insurance Fraud Does not Excuse the Crime

CONVICTION FOR INSURANCE FRAUD AFFIRMED

Post 4984

UNSUCCESSFUL FAKE ACCIDENT STILL GOES TO JAIL

Read the full article at https://lnkd.in/gBvuyK3F, see the full video at https://lnkd.in/gWJAwz_h and at https://lnkd.in/gf9_pqzn and at https://zalma.com/blog plus more than 4950 posts.

THE PEOPLE v. STEPHEN R. JACKSON, H052419, California Court of Appeals, Sixth District (January 23, 2025) Jackson tried to have his felony conviction reduced to a misdemeanor because of Proposition 47.

FACTUAL BACKGROUND

In 1992, Jackson was charged by information with conspiracy to commit insurance fraud, causing or participating in a vehicular collision or any other vehicular accident for the purpose of presenting a false or fraudulent claim; presenting or causing to be presented a false or fraudulent insurance claim; presenting a false or fraudulent claim for loss or theft, destruction, damage, or conversion of the contents of a motor vehicle; and, preparing a false police report and authorization of medical records/employment records with intent to present it in support of a false or fraudulent claim. Jackson was convicted by plea of count 2, violation of Insurance Code section 1871.1, subdivision (a)(3), a felony, and placed on felony probation.

In 2024, Jackson filed an application to have his felony conviction designated as a misdemeanor

Proposition 47, approved in November 2014, makes certain drug-and theft-related offenses misdemeanors. Nothing in the relevant statute bases the punishment for the crime of participating in a vehicular collision for the purpose of presenting a false claim on the value of the property or claim at issue.

In addition to alleging that the value of the claim at issue in his conviction should make him eligible for relief under section 1170.18, subdivision (f), Jackson argued that he “was never given a check,” “never saw the check”, and that he “didn’t destroy any property or damage any property.”

ANALYSIS

Stephen R. Jackson’s appeal was based on his conviction for causing or participating in a vehicular collision to present a false or fraudulent claim. He argued that under Proposition 47, which reduces certain property theft crimes to misdemeanors when the value is $950 or less, his offense should also be reclassified since the value of the checks was under $950.

Key Points

1. Both before and after Proposition 47, Jackson’s offense was classified as a felony under Insurance Code section 1871.1 and current Penal Code section 550.
2. The legislature intended to treat causing or participating in a vehicular collision for the purpose of presenting a false claim as a felony, regardless of the value of the claim.
3. The punishment for Jackson’s crime does not depend on the claim’s value, unlike other offenses under Insurance Code section 1871.1 and section 550, which are misdemeanors if the claim is below certain amounts.

Conclusion

The trial court properly denied Jackson’s section 1170.18, subdivision (f) petition to redesignate his felony conviction for causing or participating in a vehicular collision or any other vehicular accident for the purpose of presenting a false or fraudulent claim as a misdemeanor.

ZALMA OPINION

The people of California did away with most of Proposition 47 but it was in effect when Jackson was convicted. However, since his crime, auto insurance fraud, is always a felony even if he was so incompetent he made nothing from his crime, he was properly convicted and the court refused to change his felony to a misdemeanor. There is no excuse for committing insurance fraud and even if the fraud failed to make any money for Jackson he committed the crime. Jackson was probably caught, tried and convicted because he was an incompetent criminal and must now continue to live with the shame of a felony conviction.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:21
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October 31, 2025
The Zalma Philosophy of Claims Handling – Part 8

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....

00:11:08
October 28, 2025
The Zalma Philosophy of Claims Handling – Part 6

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 ...

00:08:40
October 27, 2025
The Zalma Philosophy of Claims Handling – Part 5

The Professional Claims Handler

Post 5216

Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-5-barry-zalma-esq-cfe-jde8c, see the full video at https://rumble.com/v70q4x8-the-zalma-philosophy-of-claims-handling-part-5.html and at https://youtu.be/6b9tZQsEkB4, and at https://zalma.com/blog plus more than 5200 posts.

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.
Standards to be a Professional Claims Adjuster

The Insurance claims professional should be a person who:

1. Can read and understand the insurance policies issued by the insurer.
2. Understands the promises made by the policy.
3. Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
4. Are competent investigators.
5. Have empathy and recognize the difference between empathy and sympathy.
6. ...

00:08:18
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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