Physician Conspired with Bonavilla to Effect Health Insurance Fraud

Post 5212

Read the full article at https://www.linkedin.com/pulse/conviction-health-insurance-fraud-upheld-barry-zalma-esq-cfe-2hnsc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on government-assisted insurance (Medi-Cal/Medicaid), convincing them to switch to group insurance policies obtained by Free Choice. Patients were falsely represented as employees of sham companies (Drexel Group, Kingmakers) to qualify for these policies.

In The People v. Dennis Davin Bonavilla, 081765, California Court of Appeals, Fourth District, Second Division (October 9, 2025) people identified as patients of Bonavilla and Free Choice Healthcare’s patients signed documents (often without ...

The Modern Claims Adjuster

Post 5211

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail

Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-2-barry-zalma-esq-cfe-ndt5c, see the video at and at 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.
Adjusters After the Turn of the Century

I don’t see adjusters operating today like I, and my colleagues. were back in the late 1960’s early 1970’s. The basics of claims handling I was taught seemed to be ignored until the states, like California, found it necessary to reiterate the custom and practice I applied when I was an adjuster, with the California Fair Claims ...

See the full video at and at and at https://zalma.com/blog plus more than 5200 posts.

Private Limitation In Accordance With Statute Defeats a Claim

Post 5204

There is No Good Reason to Delay Filing Suit

In Christian Care Center v. American Alternative Insurance Corporation, Civil Action No. 4:25-CV-00321-O, United States District Court, N.D. Texas, Fort Worth Division (October 6, 2025) a private limitation of action provision effective barred the suit.

KEY FACTS:

Plaintiff and Defendant:

The case involves an insured, the Christian Care Center (Plaintiff) and its insurer American Alternative Insurance (Defendant) in a coverage dispute.

Loss Event:

Plaintiff’s property sustained damage due to a storm on April 27, 2020.
Insurance Claim:

Plaintiff submitted a claim to Defendant on February 2, 2022, which was denied on July 29, 2022.

Lawsuit:

Plaintiff sued alleging breach of contract and violations of Chapters 541 ...

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 ...

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 ...

Sometimes the Best Court Decision is to Do Nothing

Post 5209

Read the full article at https://www.linkedin.com/pulse/abstention-protects-against-risk-potentially-fact-zalma-esq-cfe-chkzc, and at https://zalma.com/blog plus more than 5200 posts.

In Starr Indemnity & Liability Company v. Scottsdale Insurance Company, No. 24-CV-3309 (PKC) (TAM), United States District Court, E.D. New York (September 30, 2025) the parties C.C.C. and HCC filed actions against Scottsdale in New York state court regarding Scottsdale’s insurance coverage obligations.

FACTS

Underlying Labor Litigation:

Hector David Campoverde sustained injuries from a scaffold fall at a construction site in Brooklyn, New York, on September 14, 2015. Campoverde, an employee of Vazquez Bro Restoration Inc., was working for C.C.C. Renovation Inc., a subcontractor of L&M Builders Group LLC.

LEGAL ISSUES

Declaratory Judgment:

Starr sought a declaratory judgment regarding Scottsdale’s obligations under the 2014-2015 and 2015-2016 policies.
Abstention ...