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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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July 24, 2025
Prosecutors Use Omnibus Motion in Limine to Limit Trial

The Need For and Application of a Motion in Limine

Post 5153

Lawyers Present & Argue Motions in Limine to Control Trial Excess

See the full video at https://lnkd.in/gBv_pukH and at https://lnkd.in/gnX4tyXK, and at https://zalma.com/blog plus 5100 posts.

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 Hearsay Statements

The Government sought to preclude the defendant from introducing her own self-serving statements as inadmissible hearsay.
The Court deferred ruling on this request, requiring specific statements to be identified for admissibility assessment.

Use of Interview Reports to Impeach Government Witnesses

The Government requested to preclude the defendant from using interview reports to impeach witnesses unless the statements were verbatim or adopted by the witnesses.
The Court deferred ruling, requiring a factual determination on the nature of the statements.

Unopposed Motions in Limine

The Court granted several unopposed motions, including:

Exclusion of arguments suggesting selective prosecution.
Preclusion of comments on the Government’s failure to call a particular witness.
Exclusion of plea negotiations and related statements.
Exclusion of evidence blaming Medicare as the victim.
Exclusion of evidence related to harm or prejudice caused by the indictment.
Preclusion of arguments for acquittal based on reasons other than evidence and law.

DISCUSSION

Evidence And Argument Related To Specific Instances Of “Good Deeds” And “Law Abidingness”

The government argued that evidence and argument related to specific instances of “good deeds” and “law-abidingness,” including evidence of defendant’s legitimate billing or legitimate services, as circumstantial proof that she is not guilty, should be excluded. Defendant argued that honesty is a pertinent character trait to 18 U.S.C. § 1347, and defendant should not be precluded from introducing any character evidence.

Federal Rules of Evidence 404 states: “Evidence of a person’s character is not admissible to prove that on a particular occasion the person acted in accordance with the character or trait.”

Defendant was charged with six counts of health care fraud. Defendant’s character is not an essential element of the charges against her. Accordingly, the Court granted the government’s motion to exclude evidence and argument related to specific instances of “good deeds” and “law abidingness.”

Testimony About Defendant’s Own Hearsay Statements To Witnesses Or Other Third Parties

The government asked to preclude defendant from attempting to elicit or admit her own self-serving statements made to law enforcement agents, government investigators, or other witnesses as inadmissible hearsay. Defendant argued that granting the government’s motion would deny defendant the right to respond to inaccuracies, embellishments, and mischaracterizations introduced by the government through the defendant’s inculpatory statements.

Without viewing the statements that defendant seeks to admit, the Court could not rule on a blanket request to prohibit the introduction of defendant’s own statements.

Use Of Interview Reports Prepared By Law Enforcement Agents To Impeach Government Witnesses

The government sought to preclude defendant from introducing an interview report to impeach a witness as a prior inconsistent statement of anyone other than the report’s author. The Court could not issue a blanket ruling without first deciding whether the statements were verbatim, or whether the witnesses had subscribed to or otherwised adopted the statements as their own.

Evidence And Argument That The Defendant Should Be Acquitted For Reasons Other Than The Evidence And The Law

Jury nullification is not a right belonging to the defendant. Jury nullification is not desirable and that trial judges should exercise their power to prevent it when possible. The USDC categorically rejected the idea that, in a society, committed to the rule of law, jury nullification is desirable or that courts may permit it to occur when it is within their authority to prevent. Accordingly, the Court granted the government’s motion to preclude defendant from introducing evidence and argument that she should be acquitted for reasons other than the evidence and the law.

ZALMA OPINION

The government, faced with a well represented counsel seeking to avoid conviction for health insurance fraud, with evidence that is inappropriate. To protect the government’s case and to reduce irrelevant and useless testimony, the blanket motion in limine was partially successful and the trial judge will rule on other evidentiary attempts during trial when the evidence can be reviewed. The jury in the case will appreciate the limitations on presentation of inappropriate evidence by the defense.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:09:08
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23 hours ago
$500 a Day Penalty if no Workers’ Compensation Insurance

Refusal to Provide Workers’ Compensation is Expensive
Post 5240

Read the full article at https://lnkd.in/guC9dnqA, see the video at https://lnkd.in/gVxz-qmk and at https://lnkd.in/gUTAnCZw, and at https://zalma.com/blog plus more than 5200 posts.

In Illinois Department of Insurance, Insurance Compliance Department v.USA Water And Fire Restoration, Inc., And Nicholas Pacella, Individually And As Officer, Nos. 23WC021808, 18INC00228, No. 25IWCC0467, the Illinois Department of Insurance (Petitioner) initiated an investigation after the Injured Workers’ Benefit Fund (IWBF) was added to a pending workers’ compensation claim. The claim alleged a work-related injury during employment with the Respondents who failed to maintain workers’ compensation Insurance.

Company Overview:

USA Water & Fire Restoration, Inc. was incorporated on January 17, 2014, and dissolved on June 14, 2019, for failure to file annual reports and pay franchise taxes. It then operated under assumed names including USA Board Up & Glass Co. and USA Plumbing and Sewer. The business ...

00:09:22
December 09, 2025
Go Directly to Jail, Do not Pass Go

Arsonist Incompetently Moves Pro Se to Avoid Prison

Post 5239

Read the full article at https://lnkd.in/gRX8TfKn, see the video at https://lnkd.in/gY3Jvnqp and at https://lnkd.in/gRCaaf-3, and at https://zalma.com/blog plus more than 5200 posts.

In Christopher A. Barosh v. Morris Houser, et al., Civ. No. 22-0769, United States District Court, E.D. Pennsylvania (November 25, 2025) a convicted arsonist and insurance fraudster moved the USDC acting in Pro se filed Objections to Magistrate Judge Reid’s Recommendation that the US District Judge dismiss his § 2254 Petition to avoid jail.

BACKGROUND

In October 2005, Barosh set fire to his girlfriend’s Philadelphia home — some 25 hours before the cancellation of the property’s insurance policy. Several witnesses saw Barosh leaving the property shortly before the fire erupted. After the fire, Barosh made “two separate admissions of guilt.”

He attempted to pay an acquaintance to provide him with an alibi for the time of the arson. The eyewitnesses, brother, and ...

00:07:00
December 08, 2025
Settlement & Release Finalizes Dispute Against Payor

Conditional Release Allows Supplemental Claims
Post 5238

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A Release Should Totally Resolve Dispute

In Harvey et al. v. Hall, No. A25A1774, Court of Appeals of Georgia, Fourth Division (December 3, 2025) Paul Harvey, an employee of Arthur J. Dovers (d/b/a 3D Mobile Home Services), drove a truck towing a trailer loaded with machinery and equipment. Harvey fell asleep, veered off the road, and crashed into a culvert, causing Lamar Hall serious injuries.

FACTS OF SETTLEMENT

On August 18, 2020, Hall signed a limited liability release under OCGA § 33-24-41.1, releasing Harvey, Dovers, and their insurer (Georgia Farm Bureau Insurance Company) from liability for the accident in exchange for $50,000, “except to the extent other insurance coverage is available which covers the claim.”

Dovers’s general liability insurer (Republic-Vanguard ...

00:07:01
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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