Zalma’s Insurance Fraud Letter – November 15, 2023

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ZIFL – Volume 27 Issue 22

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The Resource for the Insurance Claims and Insurance Fraud Professionals

This, the 22nd issue of the 27th Year of ZIFL includes articles and reports relating to insurance fraud, including:

Insurance Fraud is a Violent Crime

Plea of Guilty of Murder for Insurance Cannot Be Withdrawn

In State of Ohio v. Darin Brusiter, No. 112410, 2023-Ohio-3794, Court of Appeals of Ohio, Eighth District, Cuyahoga (October 19, 2023) Darin Burster (“Brusiter”) appealed for the third time from the trial court’s denial of his post-sentence motion to withdraw his guilty plea.

FACTS

In April 2011, Brusiter was charged with two counts of aggravated murder, with murder-for-hire and firearm specifications, kidnapping, insurance fraud, and tampering with evidence in relation to the killing of Asia Harris (“Harris”). Harris’s husband Samuel Wilson was also charged in the same indictment.

Brusiter filed a motion to suppress the statements he made to the police as being in violation of Miranda v. Arizona, 384 U.S. 436, 86 S.Ct. 1602, 16 L.Ed.2d 694 (1966). On May 2, 2012, the court denied Brusiter’s motion and that same day he pled guilty to one count each of aggravated murder, kidnapping, insurance fraud, and tampering with evidence. The court sentenced Brusiter to an agreed term of “33 years to life” in prison.

Read the full article and the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/11/ZIFL-11-15-2023.pdf

More McClenny Moseley & Associates Issues

This is ZIFL’s eighteenth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana and what appears to be an effort to profit from what some Magistrate and District judges indicate may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana.

February 14, 2023

Looking back in time, attorney William P. Gibbens, representing MMA advised USDC Judge Michael B. North, that McClenny, Moseley & Associates admits to instances where MMA told Carriers they represented the insured when they in fact represented Apex Roofing & Restoration.

The letter sent by MMA’s Counsel William P. Gibbens reported to Judge North that, in Exhibit D, there are 856 cases in which MMA admits to telling insurers that they represent the homeowner, when they actually represent Apex Roofing. They also admit to receiving funds from carriers after making these false statements.

November 7, 2023

Louisiana State Police Investigators Told WWL-TV They Are Starting Their Investigation with Five St. Tammany Parish Cases and Expanding From There.

Read the full article and the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/11/ZIFL-11-15-2023.pdf

How an Agent Defrauded the Insurer She Represented

In Destiney Kashia Xiong v. Security National Life Insurance Company, No. 2019AP2320, Court of Appeals of Wisconsin, District III (February 22, 2022) the Court of Appeal resolved the issues raised and allowed the case to go to trial with the insurer asserting a fraud defense. Destiney sued for breach of contract and various torts. Security attempted to plead a fraud defense based on circumstances it claims to have learned of after Wang’s death-including that Wang was not Destiney’s father and that he was unaware the policies were even issued.

Read the full article and the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/11/ZIFL-11-15-2023.pdf

Health Insurance Fraud Convictions

Addiction Treatment Center Supervisor Admits to Participating in a Scheme to Defraud Federal, State, and Private Health Care Insurers

Recovery Connections Centers of America Social Worker Admits to Leadership Role In Scheme To Bill Insurers For More Full Client Sessions Than Could Be Provided In A 24-Hour Day

Mi Ok Song Bruining, 63, of Warwick, RI, a clinical social worker on November 9, 2023, admitted to a federal judge that she helped devise and execute a scheme that shortchanged Rhode Island and Massachusetts substance abuse disorder patients out of counseling and treatment services while, at the same time, defrauding Medicare, Medicaid, and other health insurers out of more than $3.5 million dollars.

Read the full article and reports of dozens of convictions and the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/11/ZIFL-11-15-2023.pdf

Insurance Fraudster Was a Very Bad Man

Insurance Fraudsters Convicted of Other Crimes

In my experience those who commit property or casualty insurance fraud are seldom arrested, even more rarely are they tried and convicted. Roberto Torner was an insurance criminal who avoided arrest for his insurance fraud activities but, because he was a serious criminal and dangerous, was arrested, tried and convicted of violent crimes. He filed a motion to vacate his conviction and sentence in United States of America v. Roberto Torner, CRIMINAL No. 3:17-343, United States District Court, M.D. Pennsylvania (November 1, 2023) and the USDC kept Torner in Prison.

Read the full article and the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/11/ZIFL-11-15-2023.pdf

Other Insurance Fraud Convictions

N.Y. No-Fault Fraudster Pleads Guilty, Agrees to Pay $40M in Restitution

Laurelle Monet Manley-Williams, 34, A Maryland claims adjuster pleaded guilty to one count of theft after she was caught manipulating auto insurance claims so she could steal from her employers.

Manley-Williams was hired as a claims adjuster for Agency Insurance Co. in July 2018. Only two months later, she started altering auto accident claims that were assigned to her by adding fraudulent passengers and issuing benefit checks to them, which she deposited into her own bank account.

To avoid detection, Manley-Williams later deleted the fictitious passengers from AIC’s records. She was able to steal $11,440.27 from the insurer before resigning in October 2018.

Read the full article and the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/11/ZIFL-11-15-2023.pdf

Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and [email protected]

Over the last 55 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals.

See the full issue at http://zalma.com/blog/wp-content/uploads/2023/11/ZIFL-11-15-2023.pdf

Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He is available at http://www.zalma.com and [email protected]

Over the last 55 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud.

See the full issue at https://lnkd.in/d8XPgzB6