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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May 21, 2025
Murder & Insurance Fraud

Insurance Fraud is a Violent Crime
Post 5079

Read the full article at https://lnkd.in/g4fAqCZ9, see the full video at https://lnkd.in/gJ-wNkW4 and at https://lnkd.in/gjH7AwNq, and at https://zalma.com/blog plus more than 5050 posts.

No Resentence: Murderer for Hire & Insurance Fraud Stays in Prison

James Theron Elliott was convicted by a jury for multiple crimes, including first-degree murder, stemming from a conspiracy to kill jewelry dealer Ben Rudman. Elliott had hired Charles Thomas to carry out the murder in exchange for valuable consideration, which the jury confirmed through the special circumstance finding of “murder for hire.”

In The People v. James Theron Elliott, H051762, California Court of Appeals, Sixth District (May 14, 2025) James Theron Elliott was convicted for conspiracy to commit murder, robbery, grand theft, and insurance fraud, as well as first-degree murder.

TRIAL DETAILS

Elliott was charged with three counts, including conspiracy to commit murder, and the jury was instructed on various theories of murder liability, including conspiracy and felony murder. The jury ultimately found Elliott guilty on all counts, and his conviction was based on the direct aiding and abetting theory, which remained valid under the law even after recent legislative changes.

RESENTENCING PETITION

In 2023, after many years in prison, Elliott filed a petition for resentencing under section 1172.6, claiming that he met the statutory conditions for relief. He argued that his conspiracy conviction did not necessarily imply intent to kill at the time of the murder, suggesting that he could have withdrawn from the conspiracy. The prosecution opposed the petition.

COURT’S RULING

The trial court denied Elliott’s petition, stating that conspiracy to commit murder is not eligible for resentencing under section 1172.6. The court noted that the jury’s true finding of the murder for hire special circumstance further confirmed Elliott’s intent to murder.

LEGAL PRINCIPLES

Senate Bill No. 1437 amended the felony murder rule and clarified the requirements for murder liability. The changes did not affect the direct aiding and abetting theory of murder, which requires the defendant to possess malice aforethought.

Elliott’s conviction was not impacted by the legislative changes, and he remained ineligible for resentencing.

CONCLUSION

The California Court of Appeals affirmed the trial court’s decision to deny Elliott’s resentencing petition, concluding that he was not entitled to relief under the amended Penal Code due to the nature of his convictions.

Defendant was required to show, among other things, that he was “convicted of felony murder or murder under the natural and probable consequences doctrine” and that he could no longer be convicted “because of” the 2019 statutory changes. Defendant could not satisfy those requirements because he was convicted of first degree murder under a theory of direct aiding and abetting express malice murder that is unaffected by the 2019 changes.

By convicting defendant of conspiracy to commit murder, the jury necessarily found he harbored the intent to kill when he conspired to commit murder.

CONSPIRACY TO COMMIT MURDER IS NOT ELIGIBLE FOR RESENTENCING UNDER SECTION 1172.6

Because conspiracy to commit murder is based on the conspirator’s own mental state, it requires that a defendant either act with malice or intend to kill. And because section 1172.6 does not offer relief for a person convicted of conspiracy to commit murder, any purported instructional error regarding that conviction which could have been asserted on direct appeal is irrelevant. The Legislature when it enacted Senate Bill No. 1437 did nothing to change the applicable law so as to resurrect an argument he had already abandoned.

ZALMA OPINION

Many prosecutors and judges refuse to accept the fact that insurance fraud is a violent crime. Mr. Elliot, as part of his insurance fraud attempt hired a person to murder a jeweler and was convicted of conspiracy to commit murder which required the jury to find that he directly aided and abetted the murder with express malice to murder he was not entitled to resentencing. It is good to see the California Court of Appeals accepting the fact that insurance fraud is a violent crime coupled with an intent to commit murder for hire.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:15
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9 hours ago
USDC Holds Fraud in Abeyance

Court Restrains Health Care Providers Attempts at Fraud
Post 5080

See the full video at https://lnkd.in/g9_M6Zx9 and at https://lnkd.in/g_gv5gaY, and at https://zalma.com/blog plus more than 5050 posts.

USDC Holds Fraud in Abeyance

Illegal Financial Arrangements Between Health Care Professionals Stopped

In Government Employees Insurance Company, GEICO Indemnity Company, GEICO General Insurance Company and GEICO Casualty Company v. Akiva Imaging Inc., Rashbi Diagnostics Imaging Inc., et. al, No. 1:24-CV-6549 (FB) (JAM), United States District Court, E.D. New York (May 19, 2025)

Plaintiffs:

GEICO companies collectively referred to as “Plaintiffs” or “GEICO” .

Defendants:

Akiva Imaging Inc., Rashbi Diagnostics Imaging Inc., and other health care providers “Defendants.”

Massiveness Of Fraudulent Scheme:

Defendants contend that the scheme here does not reach the size and complexity required by the Circuit in Tri-Borough to find serious questions going to the merits and to apply the exceptions...

00:07:37
May 20, 2025
Failure to Reserve Rights Limits Argument of Insurer

When There are Two Damage Causing Events The Aggregate Limit Applies
Post 5078

Read the full article at https://lnkd.in/gkp6gpb7, see the full video at https://lnkd.in/g5CmHxYg and at https://lnkd.in/gBStm3-x, and at https://zalma.com/blog plus more than 5050 posts.

In February 2024, in the matter of Ciara Kilburn, et al. v. Bill Simmon, et al., 20-CV-461, a jury returned a plaintiffs’ verdict against Defendant The Media Factory f/k/a Vermont Community Access Media, Inc. (“VCAM”) and one of its employees.

VCAM’s liability insurer, plaintiff Hanover Insurance Company (“Hanover”) sued VCAM and the plaintiffs in the underlying suit, seeking a declaration as to the scope of its coverage obligations with respect to that verdict.

In The Hanover Insurance Company v. The Media Factory f/k/a Vermont Community Access Media, Inc. et al, 2025 Vt Super 051401, No. 24-CV-03700, Superior Court of Vermont, Civil Division, Chittenden Unit (May 14, 2025) decided how many occurrences impinged on the Hanover policy.

...

00:06:59
May 19, 2025
Police Officers Immune From Suit

Statutory Immunity Defeats Suit for Wrongful Death Suit Against Police Officers
Post 5077

See the full video at https://lnkd.in/gHWaCM5A and at https://lnkd.in/gEBvEyA2, and at https://zalma.com/blog plus more than 5050 posts.

Posted on May 19, 2025 by Barry Zalma

Claim of Wrongful Death by Taser Fails

When a wrongful-death claim brought by Clayton Franklin, the administrator of his son Cody’s estate, against the City of Ozark and two police officers following Cody’s death in custody resulted in a grant of summary judgment in favor of the defendants, Franklin appealed, arguing that the statute of limitations did not apply and that the defendants were not immune from the claim.

In Clayton Franklin As Adminstrator For The Estate Of Cody J. Franklin v. City Of Ozark, Arkansas; Nathan Griffith; And Joseph Griffith, No. CV-24-331, Court of Appeals of Arkansas, Division IV, 2025 Ark.App. 308 (May 14, 2025) the trial court’s decision was affirmed.

FACTUAL BACKGROUND

1 Wrongful Death Claim: Clayton...

00:06:16
May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

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 ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

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 ...

April 30, 2025
The Devil’s in The Details

A Heads I Win, Tails You Lose Story
Post 5062

Posted on April 30, 2025 by Barry Zalma

"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ­­­Perpetrators than any Other Crime."

Immigrant Criminals Attempt to Profit From Insurance Fraud

People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.

The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...

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