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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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April 02, 2025
Challenge to Guilty Plea Fails

Post Conviction Review Results in Affirmation of Sentence
Post 5036

See the full video at https://rumble.com/v6rjqp3-challenge-to-guilty-plea-fails.html and at https://youtu.be/1atskrw8-og and at https://zalma.com/blog plus more than 5000 posts.

Lewis R. Brown, appealed from the December 20, 2023 order entered in the Delaware County, Pennsylvania Court of Common Pleas denying his petition filed pursuant to the Post Conviction Relief Act (“PCRA”), 42 Pa.C.S. §§ 9541-46, as meritless.

In Commonwealth Of Pennsylvania v. Lewis R. Brown, No. 197 EDA 2024, No. J-S02022-25, Superior Court of Pennsylvania (March 24, 2025) reviewed his appeal after his request for post sentence motion to reconsider his sentence was denied.

FACTS

On June 21, 2022, Appellant entered an open guilty plea to Insurance Fraud, Theft by Deception, Criminal Use of a Communication Facility, and Conspiracy to Commit Insurance Fraud. In pleading guilty, Appellant admitted that he called his insurance company regarding a fraudulent claim from Delaware County and received payment for the fraudulent claim at his residence in Delaware County.

On August 15, 2022, the trial court sentenced Appellant to a term of 18 to 48 months of incarceration, a concurrent term of 6 years of probation, and restitution.

Plea counsel filed a post-sentence motion for reconsideration of sentence, which the trial court granted. The court resentenced Appellant to a term of 15 to 36 months of incarceration, a concurrent term of 6 years of probation, and restitution.

On October 11, 2022, Brown obtained new counsel who filed a motion for reconsideration of sentence, which the trial court denied. Then, Appellant pro se filed the instant PCRA petition. The PCRA court appointed counsel who, on March 14, 2023, filed an amended petition.

In the amended petition, Appellant came up with an amazing assertion that Philadelphia County was the proper jurisdiction for this matter because the conduct underlying the charges against him “occurred via telephone communication in the City of Philadelphia” and no criminal behavior occurred in Delaware County so his plea of guilty should be rescinded.

THE PCRA COURT

On September 19, 2023, the PCRA court held a hearing on the petition, permitting Brown to speak. Brown stated that he believed Delaware County lacked jurisdiction because all criminal conduct occurred in Philadelphia County.

ISSUES

Appellant’s counsel raised the following issues:

1 Did the [PCRA] court abuse its discretion by denying [] Appellant’s [PCRA] petition after a hearing where he presented evidence that jurisdiction and/or venue was improper in Delaware County, Pennsylvania, where all the criminal conduct occurred in Philadelphia County?
2 Was plea counsel ineffective for failing to challenge venue and/or jurisdiction where all criminal conduct occurred in Philadelphia County?

To support the motion Counsel is required to submit a “no merit” brief (1) detailing the nature and extent of her review; (2) listing each issue the petitioner wishes to have raised on review; and (3) explaining why the petitioner’s issues are meritless. The Court then conducts its own independent review of the record to determine if the petition is meritless.

ANALYSIS

An appellate court must give great deference to the findings of the PCRA court if the record contains any support for those findings. The PCRA court’s credibility determinations are binding on the appellate court.

A petitioner must establish that the issues raised in the PCRA petition have not been previously litigated or waived, and that the failure to litigate the issue prior to or during trial, during unitary review or on direct appeal could not have been the result of any rational, strategic or tactical decision by counsel.

Notwithstanding Appellant’s claim at the PCRA hearing that his criminal conduct took place only in Philadelphia County, the record reflects that Appellant received payment on the fraudulent insurance claim underlying this matter at his residence in Delaware County. Thus, venue was proper in Delaware County.

In fact, given that Delaware County had jurisdiction over this matter and venue was proper there, the trial court would likely have denied any motion to transfer venue and, thus, the outcome of this case would have likely been the same.

The PCRA court’s decision is supported by the evidence of record and free from legal error. Accordingly, Appellant’s claims merit no relief.

The order of the PCRA Court was affirmed.

ZALMA OPINION

The Commonwealth of Pennsylvania has created a Post Conviction Review Court to allow convicted criminals to review the sentences handed down by the trial court that convicted him. In this case, after pleading guilty to the crime of insurance fraud, was upset by the sentence he received. He was able to get it modified once and tried to say he was tried in the wrong jurisdiction to remove the sentence. His arguments were specious and the appellate court did not fall for his scheme and he will stay in prison as ordered.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:29
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5 hours ago
Gap in Coverage not Bad Faith

USDC Dismisses Multiple Counts Against Insurer

Post 5038

See the full video at https://rumble.com/v6rjvsl-gap-in-coverage-not-bad-faith.html and at https://youtu.be/P9hzlsS8O4g, and at https://zalma.com/blog plus more than 5000 posts.

Vincent Cusumano and Vincent Cusumano Architect P.C. (VCA), alleged that the defendants, Berkshire Hathaway issued a professional liability policy with a three-month gap in coverage, which precluded coverage for claims arising from prior work. The plaintiffs asserted thirteen causes of action, including breach of contract, promissory estoppel, and common law fraud.

In Vincent Cusumano Architect P.C. and Vincent Cusumano v. Berkshire Hathaway Direct Insurance Company d/b/a Three By Berkshire Hathaway, Todd Sharpee, John Does 1-10 names being fictitious and unknown, and ABC Corps. 1-10 names being fictitious and unknown, Civil Action No. 23-cv-22970 (JXN)(JSA), United States District Court, D. New Jersey (March 29, 2025) dismissed multiple causes of action.

COUNTS DISMISSED

The court ...

00:05:38
April 01, 2025
Zalma’s Insurance Fraud Letter – April 1, 2025

ZIFL Volume 29, Issue 7

The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gQM9yR3n and at https://lnkd.in/gZDkH7RU, and at https://zalma.com/blog plus more than 5000 posts.

April 1, 2025

Post 5035

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 April 1, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf.

This issue contains the following articles about insurance fraud:
Lawyers Sanctioned for Tricking a Witness With a False Document

The United States District Court Eastern District Of Texas Marshall Division, Civil Action No. 2:23-CV-00160-JRG in a case entitled Cognipower, LLC v. Samsung Electronics Co., Ltd et al, a report was filed by David Folsom, Special ...

00:09:21
March 31, 2025
The Rare Abuse of the Appraisal Process

An Important Alternative Dispute Resolution Procedure
Post 5034

Sanctions & The Appraisal Process

Read the full article at https://lnkd.in/gTDubMra, see the full video at https://lnkd.in/gRG_iPVc and at https://lnkd.in/gJ2D7w_2 and at https://zalma.com/blog plus more than 5000 posts.

Appraisal is a form of alternative dispute resolution that sets a disputed loss amount. When an insurance policy has an appraisal provision, the right to appraisal is not permissive but is instead mandatory, so once a demand for appraisal is made, neither party has the right to deny that demand. [McGowan v. First Acceptance Ins. Co., Inc., 411 F.Supp.3d 1293, 1296 (M.D. Fla. 2019).]

Sometimes the appraisal process is abused by people attempting to abuse an insurer and bring about a future bad faith suit rather than resolve the claim. In an example of such abuse attorney Eric Dick demanded appraisal on behalf of his client only to do everything necessary to make it impossible to reach a fair award.

The Court made the following findings in ...

00:11:51
March 13, 2025

Read the full article at https://www.linkedin.com/pulse/duties-liabilities-insurance-brokers-barry-zalma-esq-cfe-mmpbc, if you Subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.

Duties and Liabilities of Insurance Brokers

Posted on March 12, 2025 by Barry Zalma

Excellence in Claims Handling

This blog post is just a taste of the full article that is only available to subscribers to Excellence in Claims Handling. Anyone can subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.

Cases in which insurance brokers’ liability is in question depend in part on whether brokers are seen to be serving a fiduciary role or simply acting as a conduit between the insured and the insurer.

A person or an entity is a fiduciary with respect to a plan to the extent:

he exercises any discretionary authority or discretionary control respecting management of such plan ...

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March 12, 2025

Read the full article at https://www.linkedin.com/pulse/duties-liabilities-insurance-brokers-barry-zalma-esq-cfe-mmpbc, if you Subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.

Duties and Liabilities of Insurance Brokers

Posted on March 12, 2025 by Barry Zalma

Excellence in Claims Handling

This blog post is just a taste of the full article that is only available to subscribers to Excellence in Claims Handling. Anyone can subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.

Cases in which insurance brokers’ liability is in question depend in part on whether brokers are seen to be serving a fiduciary role or simply acting as a conduit between the insured and the insurer.

A person or an entity is a fiduciary with respect to a plan to the extent:

he exercises any discretionary authority or discretionary control respecting management of such plan ...

post photo preview
February 25, 2025
Adjusting Liability Claims

The Basics Needed by a Liability Adjuster

Post 5003
Posted on February 25, 2025 by Barry Zalma

See the full video at and at

Adjusting liability insurance claims requires skill, patience, knowledge of insurance, basic knowledge of tort and contract law, and knowledge and experience as an investigator. The liability claims adjuster is faced with the following basic obligations:

  • To understand the law of torts as applied in the state where the adjuster works.
  • To understand the law of contracts as applied in the state where the adjuster works.
  • To understand sufficient medical terminology to be able to evaluate claims of injury.
  • To understand the costs to repair or replace damaged real or personal property.
  • To understand how to read and apply the terms and conditions of a liability insurance policy.
  • To understand how to thoroughly investigate all claims assigned.
  • To conduct an investigation of every claim ...
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