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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conspiracy conviction did not necessarily imply intent to kill at the time of the murder, suggesting that he could have withdrawn from the conspiracy.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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Post number 5301

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March 11, 2026
Public Adjusters Attempt to Represent an Insured Subject to APA Clause

Anti-Public Adjuster Clause Is Effective in New York

Post number 5301

Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster

In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.

FACTS

NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...

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March 10, 2026
Acting as Your Own Lawyer is Foolish

Proof of Highly Contaminated Water is Required for Extra Payments

Post number 5300

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Acting as Your Own Lawyer is Foolish

Evidence of Breach of Contract Survives Dismissal of All Other Charges

In Lee Lifeng Hsu and Jane Yuchen Hsu v. State Farm Fire And Casualty Company, C. A. No. N24C-09-020 CLS, Superior Court of Delaware (February 27, 2026) a claim to State Farm who paid approximately $61,000 after assessments but denied coverage for additional items including ceramic tiles, the kitchen floor ceiling, underlayment plywood, and numerous personal property items resulted in suit by the Hsu’s acting in pro per.
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March 20, 2026
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Post number 5307

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In May 2019, a fire damaged business personal property belonging to the plaintiffs, which was stored in portable storage containers at their Manhattan premises. At the time of the fire, the plaintiffs were insured under a businessowners insurance policy (BOP) issued by the defendant Hanover Insurance Company which provided general coverage for business personal property, and which included a specific extension for “Business Personal Property Temporarily in Portable Storage Units” (the portable storage ...

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March 20, 2026
Failure to Provide Well-Pled Facts Defeats Most of Action

ERISA Saves Fraudulent Claims Suit

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Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity

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FACTUAL BACKGROUND

United and Oxford, who administer both ERISA and ...

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March 19, 2026
Failure to Provide Well-Pled Facts Defeats Most of Action

ERISA Saves Fraudulent Claims Suit

Post number 5306

Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.

Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity

In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.

FACTUAL BACKGROUND

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