• I am Thankful

    Thanksgiving Wishes from the Zalma Family

    Post 4938

    Posted on November 27, 2024 by Barry Zalma

    See the full video at and at hope, on this Thanksgiving weekend, that you can join my family and me remembering that it is more important to think about our blessings and those things that we have to be thankful for than to get in line for “Black Friday” to buy an inexpensive flat screen t.v. or tablet. Enjoy the holiday and your family as I will.

    My family and I have much to be thankful for this year. My first born daughter, Stephanie Zalma, continues to care for my wife 24 hours a day 7 days a week with love and patience as Thea continues as Nana to our two grandchildren and the loving mother of our three children.

    After receiving a new Aortic Heart Valve I am personally in good health, walking about 25 miles a week. Exercising my, apparently unusual, mode of retirement, I work only six to eight hours a day doing what I love the most, writing about insurance, insurance claims, insurance law and acting as an insurance claims consultant and expert witness.

    To me, I am thankful for you, my friends, clients and readers of “Zalma’s Insurance Fraud Letter,” my blog “Zalma on Insurance,” and my books and other writing including the third Edition of the ten volumes of my treatise, “Zalma on Insurance Claims” and the Fourteenth Edition of “Property Investigation Checklists.”

    As a first generation American I am honored to join with all Americans the ability to celebrate Thanksgiving that started when the United States was a dream and just a colony of Great Britain, to give thanks for the good things in life at least once a year. It took Abraham Lincoln, our greatest President to make it an official holiday. The Thanksgiving holiday gives me and my family the opportunity to consider the blessings we have received and to thank all who have made it possible.

    Please allow me this opportunity to explain to you all the things I, and my family, can continue to give thanks for:

    1. I have loved my wife of almost 57 years since we first met when she was nine and I was twelve.
    2. I am thankful that she still loves me and lets me make clear every day that I love her more now than I did when she ignored me when I was 12.
    3. My three adult children who are successes in their own right.
    4. That my three children who put up with my wife and I, and are healthy, successful, and mostly happy in what they do.
    5. My almost eight-year-old granddaughter and my 22 year-old grandson live nearby, my grandson is now a successful college graduate from Puget Sound University in Washington state and working full time in I.T.
    6. My clients who, for the more than 57 years have allowed me to earn a living doing what I love. I practiced law until I let my license go inactive, acting as a consultant, testifying as an expert witness and writing materials to help others provide excellence in claims services as members of the insurance profession.
    7. My publishers the American Bar Association, Full Court Press, Fastcase.com, Thomson Reuters and Amazon.com.
    8. My dearly departed parents and grandparents for having the good sense to leave the Ottoman Empire at the beginning of the 20th Century so we could avoid the Holocaust and I could be born American.
    9. My country for giving me a place to live and work in peace and complain about it without fear.
    10. The state of California, where I was born, and have lived for 82 years, for allowing me to have my home and grow my family, and the ability to pay California’s high taxes for the privilege.
    11. Those of you who read what I write and gain something from it.
    12. Eighty two years of mostly good health, but for a small heart attack,clogged arteries, a failed Aortic heart valve, ant the surgeons that gave me the ability to continue to work – albeit at a reduced rate.
    13. Allowing me the health and ambition to avoid my cardiologist by walking every day and working on my garden and bonsai with one of my Chinese Elms in a pot for more than 49 years.
    14. The hundreds of friends I have never met but with whom the Internet has allowed me to communicate in parts of the world I have never visited.
    15. The wonder of the Internet that allows me to publish E-books, ZIFL and my blog instantly on line.
    16. That my family can get together to express our thanks for each other and our happiness this year again without a need for anything but enjoying each other’s company and some good food.
    17. That most of you who I know only by my publications can also gather with your families to express your thanks.

    When I enlisted in the U.S. Army in 1964, I volunteered ostensibly to avoid the draft and volunteered to serve anywhere in the world. Fortunately, the Army made assignments in alphabetical order and I was sent by the U.S. Army Intelligence Corps to Peoria, Illinois where I became a Special Agent in Charge of an office investigating people who sought security clearances. I was trained to be an investigator and enjoyed every minute of the job.

    Until the Army I had never seen a river without a concrete bottom only to see the mighty Mississippi as my first real river. I had never seen snow other than in the distance on mountains only to find myself shoveling the snow off the driveway in the small half-of-a-house I rented from an old couple who could not do it themselves.

    My investigative assignments required me to travel throughout Central Illinois from the Iowa to the Indiana borders. I stopped at court houses along the way, all of which had signs that Abraham Lincoln practiced law there. Those experiences with the courts, law enforcement officers, and court personnel probably gave me the incentive to become a lawyer.

    When I finished my three year enlistment I returned home, proposed marriage to the love of my life, who fortunately for me, accepted. I began the study of law at night and found my first real job where I could use the skills I learned in the Army. I was hired as a claims trainee at the Fireman’s Fund American Insurance Company who spent the time to train me to be a claims adjuster. The training was, unlike modern insurers, thorough. I was required to read a treatise on insurance and insurance claims handling. I was sent out with experienced adjusters in all types of insurance Fireman’s Fund wrote to learn as they adjusted claims, and eventually allowed to deal with the public under close supervision.

    Contrary to the requirements of the insurance industry at the time, Fireman’s Fund allowed me to study law at night while I worked as a full-time insurance adjuster. I was fortunate enough to work for a claims manager – Coleman T. Mobley – who did not require me to go out of state to adjust major storm claims if it interfered with my law school studies. Since I was in law school 50 weeks a year the only catastrophe storm duty I was required to work was a fire storm that burned from the San Fernando Valley to the ocean at Malibu. Because of Mr. Mobley and the Fireman’s Fund I was able to complete my studies and pass the California Bar in 1971 and be admitted to the California Bar on January 2, 1972.

    I took a cut in pay to get my first job as an Associate Attorney with a law firm that was willing to teach me to be a lawyer handling every kind of problem a new lawyer could face from wills, tort claims, divorce, drunk driving, trials, depositions, and dozens of orders to show cause in multiple courts around the Inland Empire of California. By doing so, when I started practicing law in 1972, I became a lawyer who could deal with any issue brought to me. I was fortunate enough to be able to move to an insurance law firm in Century City where I was assigned to a coverage lawyer who was trying to deal with over 500 active matters and, who, when I arrived, assigned 250 of the matters to me and pointed me to the firm’s library to learn what to do.

    At the time new technology was an IBM Selectric typewriter that could erase errors from the keyboard without the need to use white-out paint. I did legal research in the firm’s large library which, when it was inadequate for the task, I drove to the County Law Library in downtown Los Angeles to adequately research legal questions .

    Research in a large library took days to find support for an issue. I needed three professional legal secretaries to keep up with my dictation. Now, using modern technology, I can do the same legal research in 30 minutes on Fastcase.com, need no secretary, and can operate my consulting, writing, training and publishing businesses with no employees.

    In 1979 I decided it was time to be my own boss. I started a law firm called Barry Zalma, Inc. with a secretary who came from my last firm and brought an IBM Selectric typewriter with her into a small windowless office. I had obtained a line of credit from a bank that I hoped would carry us until the practice started since the only case I was sure of when I moved into my new office, was my sister’s rear-ender from which I could not, and did not, take a fee.

    The office was furnished with a file cabinet from my father-in-law’s dental practice and a dining room table from my wife’s grandmother who had passed away. I received my first call at 8:10 a.m. on the first day, October 1, 1979, from Alan Worboys, a claims person speaking for Certain Underwriters at Lloyd’s, London and my practice began. Alan became, and still is, a long time friend. I had nothing to do on October 3, 1979 so I wrote an article for publication. After that, I had no peace and the firm quickly grew to 9 lawyers and a staff to serve them all defending people who were insured and acting as coverage counsel for insurers who needed advice and counsel concerning interpretation of insurance contracts and how to deal with attempted fraud. I, and the lawyers who joined the firm also provided defense to insureds of our clients and defense of suits against the insurers for tort, including the tort of bad faith.

    I was more successful than I ever expected. I, whose experience was limited to Los Angeles County and Central Illinois, found a need to travel to Taipei, Taiwan and London, England on behalf of my clients. I worked, as I had learned from my father who survived the Depression, 16 hours a day, six or seven days a week. When I became 75 years old my firm had been reduced back to a sole practice and I decided it was time to stop practicing law and become a consultant and fulfill my childhood dream to be an author.

    I am a very lucky and happy man. I do work that I love. I fulfilled my childhood dreams. I Live in a home I have owned for more than 49 years that my wife and I adapted and increased as children were born to meet our needs. I have the love of my life with me and look forward to celebrating our 57th wedding anniversary next month. I am honored that my eldest daughter has come back to live with us and care for my wife and I who are not able to do everything we used to do.

    I have three wonderful children, two grandchildren and all live close. My son, and his business shares my office building and has time to visit with me as allowed by his busy schedule.

    (c) 2024 Barry Zalma & ClaimSchool, Inc.

    Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

    Subscribe to my substack at https://barryzalma.substack.com/subscribe

    Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg

    Go to the Insurance Claims Library – https://lnkd.in/gwEYk

    This is a long article so go to https://www.linkedin.com/pulse/i-am-thankful-barry-zalma-esq-cfe-bzysc, to read the full article.
    I am Thankful Thanksgiving Wishes from the Zalma Family Post 4938 Posted on November 27, 2024 by Barry Zalma See the full video at and at hope, on this Thanksgiving weekend, that you can join my family and me remembering that it is more important to think about our blessings and those things that we have to be thankful for than to get in line for “Black Friday” to buy an inexpensive flat screen t.v. or tablet. Enjoy the holiday and your family as I will. My family and I have much to be thankful for this year. My first born daughter, Stephanie Zalma, continues to care for my wife 24 hours a day 7 days a week with love and patience as Thea continues as Nana to our two grandchildren and the loving mother of our three children. After receiving a new Aortic Heart Valve I am personally in good health, walking about 25 miles a week. Exercising my, apparently unusual, mode of retirement, I work only six to eight hours a day doing what I love the most, writing about insurance, insurance claims, insurance law and acting as an insurance claims consultant and expert witness. To me, I am thankful for you, my friends, clients and readers of “Zalma’s Insurance Fraud Letter,” my blog “Zalma on Insurance,” and my books and other writing including the third Edition of the ten volumes of my treatise, “Zalma on Insurance Claims” and the Fourteenth Edition of “Property Investigation Checklists.” As a first generation American I am honored to join with all Americans the ability to celebrate Thanksgiving that started when the United States was a dream and just a colony of Great Britain, to give thanks for the good things in life at least once a year. It took Abraham Lincoln, our greatest President to make it an official holiday. The Thanksgiving holiday gives me and my family the opportunity to consider the blessings we have received and to thank all who have made it possible. Please allow me this opportunity to explain to you all the things I, and my family, can continue to give thanks for: 1. I have loved my wife of almost 57 years since we first met when she was nine and I was twelve. 2. I am thankful that she still loves me and lets me make clear every day that I love her more now than I did when she ignored me when I was 12. 3. My three adult children who are successes in their own right. 4. That my three children who put up with my wife and I, and are healthy, successful, and mostly happy in what they do. 5. My almost eight-year-old granddaughter and my 22 year-old grandson live nearby, my grandson is now a successful college graduate from Puget Sound University in Washington state and working full time in I.T. 6. My clients who, for the more than 57 years have allowed me to earn a living doing what I love. I practiced law until I let my license go inactive, acting as a consultant, testifying as an expert witness and writing materials to help others provide excellence in claims services as members of the insurance profession. 7. My publishers the American Bar Association, Full Court Press, Fastcase.com, Thomson Reuters and Amazon.com. 8. My dearly departed parents and grandparents for having the good sense to leave the Ottoman Empire at the beginning of the 20th Century so we could avoid the Holocaust and I could be born American. 9. My country for giving me a place to live and work in peace and complain about it without fear. 10. The state of California, where I was born, and have lived for 82 years, for allowing me to have my home and grow my family, and the ability to pay California’s high taxes for the privilege. 11. Those of you who read what I write and gain something from it. 12. Eighty two years of mostly good health, but for a small heart attack,clogged arteries, a failed Aortic heart valve, ant the surgeons that gave me the ability to continue to work – albeit at a reduced rate. 13. Allowing me the health and ambition to avoid my cardiologist by walking every day and working on my garden and bonsai with one of my Chinese Elms in a pot for more than 49 years. 14. The hundreds of friends I have never met but with whom the Internet has allowed me to communicate in parts of the world I have never visited. 15. The wonder of the Internet that allows me to publish E-books, ZIFL and my blog instantly on line. 16. That my family can get together to express our thanks for each other and our happiness this year again without a need for anything but enjoying each other’s company and some good food. 17. That most of you who I know only by my publications can also gather with your families to express your thanks. When I enlisted in the U.S. Army in 1964, I volunteered ostensibly to avoid the draft and volunteered to serve anywhere in the world. Fortunately, the Army made assignments in alphabetical order and I was sent by the U.S. Army Intelligence Corps to Peoria, Illinois where I became a Special Agent in Charge of an office investigating people who sought security clearances. I was trained to be an investigator and enjoyed every minute of the job. Until the Army I had never seen a river without a concrete bottom only to see the mighty Mississippi as my first real river. I had never seen snow other than in the distance on mountains only to find myself shoveling the snow off the driveway in the small half-of-a-house I rented from an old couple who could not do it themselves. My investigative assignments required me to travel throughout Central Illinois from the Iowa to the Indiana borders. I stopped at court houses along the way, all of which had signs that Abraham Lincoln practiced law there. Those experiences with the courts, law enforcement officers, and court personnel probably gave me the incentive to become a lawyer. When I finished my three year enlistment I returned home, proposed marriage to the love of my life, who fortunately for me, accepted. I began the study of law at night and found my first real job where I could use the skills I learned in the Army. I was hired as a claims trainee at the Fireman’s Fund American Insurance Company who spent the time to train me to be a claims adjuster. The training was, unlike modern insurers, thorough. I was required to read a treatise on insurance and insurance claims handling. I was sent out with experienced adjusters in all types of insurance Fireman’s Fund wrote to learn as they adjusted claims, and eventually allowed to deal with the public under close supervision. Contrary to the requirements of the insurance industry at the time, Fireman’s Fund allowed me to study law at night while I worked as a full-time insurance adjuster. I was fortunate enough to work for a claims manager – Coleman T. Mobley – who did not require me to go out of state to adjust major storm claims if it interfered with my law school studies. Since I was in law school 50 weeks a year the only catastrophe storm duty I was required to work was a fire storm that burned from the San Fernando Valley to the ocean at Malibu. Because of Mr. Mobley and the Fireman’s Fund I was able to complete my studies and pass the California Bar in 1971 and be admitted to the California Bar on January 2, 1972. I took a cut in pay to get my first job as an Associate Attorney with a law firm that was willing to teach me to be a lawyer handling every kind of problem a new lawyer could face from wills, tort claims, divorce, drunk driving, trials, depositions, and dozens of orders to show cause in multiple courts around the Inland Empire of California. By doing so, when I started practicing law in 1972, I became a lawyer who could deal with any issue brought to me. I was fortunate enough to be able to move to an insurance law firm in Century City where I was assigned to a coverage lawyer who was trying to deal with over 500 active matters and, who, when I arrived, assigned 250 of the matters to me and pointed me to the firm’s library to learn what to do. At the time new technology was an IBM Selectric typewriter that could erase errors from the keyboard without the need to use white-out paint. I did legal research in the firm’s large library which, when it was inadequate for the task, I drove to the County Law Library in downtown Los Angeles to adequately research legal questions . Research in a large library took days to find support for an issue. I needed three professional legal secretaries to keep up with my dictation. Now, using modern technology, I can do the same legal research in 30 minutes on Fastcase.com, need no secretary, and can operate my consulting, writing, training and publishing businesses with no employees. In 1979 I decided it was time to be my own boss. I started a law firm called Barry Zalma, Inc. with a secretary who came from my last firm and brought an IBM Selectric typewriter with her into a small windowless office. I had obtained a line of credit from a bank that I hoped would carry us until the practice started since the only case I was sure of when I moved into my new office, was my sister’s rear-ender from which I could not, and did not, take a fee. The office was furnished with a file cabinet from my father-in-law’s dental practice and a dining room table from my wife’s grandmother who had passed away. I received my first call at 8:10 a.m. on the first day, October 1, 1979, from Alan Worboys, a claims person speaking for Certain Underwriters at Lloyd’s, London and my practice began. Alan became, and still is, a long time friend. I had nothing to do on October 3, 1979 so I wrote an article for publication. After that, I had no peace and the firm quickly grew to 9 lawyers and a staff to serve them all defending people who were insured and acting as coverage counsel for insurers who needed advice and counsel concerning interpretation of insurance contracts and how to deal with attempted fraud. I, and the lawyers who joined the firm also provided defense to insureds of our clients and defense of suits against the insurers for tort, including the tort of bad faith. I was more successful than I ever expected. I, whose experience was limited to Los Angeles County and Central Illinois, found a need to travel to Taipei, Taiwan and London, England on behalf of my clients. I worked, as I had learned from my father who survived the Depression, 16 hours a day, six or seven days a week. When I became 75 years old my firm had been reduced back to a sole practice and I decided it was time to stop practicing law and become a consultant and fulfill my childhood dream to be an author. I am a very lucky and happy man. I do work that I love. I fulfilled my childhood dreams. I Live in a home I have owned for more than 49 years that my wife and I adapted and increased as children were born to meet our needs. I have the love of my life with me and look forward to celebrating our 57th wedding anniversary next month. I am honored that my eldest daughter has come back to live with us and care for my wife and I who are not able to do everything we used to do. I have three wonderful children, two grandchildren and all live close. My son, and his business shares my office building and has time to visit with me as allowed by his busy schedule. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk This is a long article so go to https://www.linkedin.com/pulse/i-am-thankful-barry-zalma-esq-cfe-bzysc, to read the full article.
    BARRYZALMA.SUBSTACK.COM
    Subscribe to Excellence in Claims Handling
    A series of writings and/or videos to help understand insurance, insurance claims, and becoming an insurance claims professional and who need to provide or receive competent and Excellence in Claims Handling. Click to read Excellence in Claims Handling, by Barry Zalma, a Substack publication with thousands of subscribers.
    0 Commentaires 0 Parts 659 Vue
  • Andrew Tate 'Hollywood SELL YOUR SOUL Project' - "Lawyers offered me 50,000,000 dollars for a contract and I said no because they didn’t want me to mention Gaza, LGBT and other stuff"
    Andrew Tate 'Hollywood SELL YOUR SOUL Project' - "Lawyers offered me 50,000,000 dollars for a contract and I said no because they didn’t want me to mention Gaza, LGBT and other stuff"
    0 Commentaires 0 Parts 495 Vue 8
  • Hiding Behind the BAR
    Why Attorneys are not Lawyers

    Feudal Tenancy

    If you think you are a landowner in America, take a close look at the warranty deed or fee title to your land. You will almost always find the words "tenant" or "tenancy." The title or deed document establishing your right as a tenant, not that of a landowner, has been prepared for transfer by a licensed BAR Attorney, just as it was carried out within the original English feudal system we presumed we had escaped from in 1776.

    A human being is the tenant to a feudal superior. A feudal tenant is a legal person who pays rent or services of some sort for the use and occupation of another's land. The land has been conveyed to the tenant's use, but the actual ownership remains with the superior. If a common person does not own what he thought was his land (he's legally defined as a "feudal tenant," not the superior owner), then a superior person owns the land and the feudal tenant - person pays him to occupy the land.

    This is the hidden Feudal Law in America. When a person (a.k.a. human being, corporation, natural person, partnership, association, organization, etc.) pays taxes to the tax assessor of the civil county or city government (also a person), it is a payment to the superior land owner for the right to be a tenant and to occupy the land belonging to the superior. If this were not so, then how could a local government sell the house and land of a person for not rendering his services (taxes)?

    We used to think that there was no possible way feudal law could be exercised in America, but the facts have proven otherwise. It's no wonder they hid the definition of a human being behind the definition of a man. The next time you enter into an agreement or contract with another person (legal entity), look for the keywords person, individual, and natural person describing who you are.

    Are you the entity the other person claims you are? When you "appear" before their jurisdiction and courts, you have agreed that you are a legal person unless you show them otherwise. You will have to deny that you are the person and state who you really are. Is the flesh and blood standing there in that courtroom a person by their legal definition?

    https://educate-yourself.org/cn/attorneysarenotlawyers13mar05.shtml
    Hiding Behind the BAR Why Attorneys are not Lawyers Feudal Tenancy If you think you are a landowner in America, take a close look at the warranty deed or fee title to your land. You will almost always find the words "tenant" or "tenancy." The title or deed document establishing your right as a tenant, not that of a landowner, has been prepared for transfer by a licensed BAR Attorney, just as it was carried out within the original English feudal system we presumed we had escaped from in 1776. A human being is the tenant to a feudal superior. A feudal tenant is a legal person who pays rent or services of some sort for the use and occupation of another's land. The land has been conveyed to the tenant's use, but the actual ownership remains with the superior. If a common person does not own what he thought was his land (he's legally defined as a "feudal tenant," not the superior owner), then a superior person owns the land and the feudal tenant - person pays him to occupy the land. This is the hidden Feudal Law in America. When a person (a.k.a. human being, corporation, natural person, partnership, association, organization, etc.) pays taxes to the tax assessor of the civil county or city government (also a person), it is a payment to the superior land owner for the right to be a tenant and to occupy the land belonging to the superior. If this were not so, then how could a local government sell the house and land of a person for not rendering his services (taxes)? We used to think that there was no possible way feudal law could be exercised in America, but the facts have proven otherwise. It's no wonder they hid the definition of a human being behind the definition of a man. The next time you enter into an agreement or contract with another person (legal entity), look for the keywords person, individual, and natural person describing who you are. Are you the entity the other person claims you are? When you "appear" before their jurisdiction and courts, you have agreed that you are a legal person unless you show them otherwise. You will have to deny that you are the person and state who you really are. Is the flesh and blood standing there in that courtroom a person by their legal definition? https://educate-yourself.org/cn/attorneysarenotlawyers13mar05.shtml
    Hiding Behind the BAR: Why Attorneys are not Lawyers
    March 13, 2005. In the U.S., they're collectively called everything from "attorney" to "lawyer" to "counselor." Are these terms truly equivalent, or has the identity of one been mistaken for another? What exactly is a "Licensed BAR Attorney?" This credential accompanies every legal paper produced by attorneys - along with a State Bar License number. As we are about to show you, an ‘attorney’ is not a ‘lawyer,’ yet the average American improperly interchanges these words as if they represent the same occupation, and the average American attorney unduly accepts the honor to be called "lawyer" when he is not.
    0 Commentaires 0 Parts 1KB Vue

  • Bad Faith Set Up Fails

    Read the full article at https://www.linkedin.com/pulse/bad-faith-set-up-fails-barry-zalma-esq-cfe-jllxc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts.
    Inadequate Information Made Refusal to Pay Policy Limits Not Bad Faith

    INADEQUATE MEDICAL AUTHORIZATION USED TO CAUSE INSURER TO REFUSE SETTLEMENT DEMAND

    Post 4930

    Kara Flick appealed from the judgment after a jury rejected her claims for breach of contract and breach of the implied covenant of good faith and fair dealing. Flick contends the judgment should be reversed due to juror misconduct.

    In KARA FLICK v. UNITED SERVICES AUTOMOBILE ASSOCIATION, B330507, California Court of Appeals, Second District, Sixth Division (November 5, 2024) the Court of Appeals resolved the dispute.

    FACTUAL HISTORY

    After sustaining injuries in an automobile accident caused by Francisco Reyes, Jr., Flick had her attorney send Reyes's insurer, the United Services Automobile Association (USAA), a letter explaining the severity of her injuries and an authorization for the release of her medical records. Flick's attorney followed up with a settlement demand two months later, requesting that USAA pay Flick the entirety of Reyes's $100,000 policy limit in exchange for a release of liability. Attached to the demand was a single medical record from Flick's neurologist.

    USAA investigated Flick's claim and determined it did not have sufficient information to accept or reject her demand. Flick then filed a personal injury lawsuit against Reyes. The jury found in her favor and awarded nearly $1.7 million in damages.

    Flick, with an assignment from the Reyes, sued USAA for breach of contract and breach of the implied covenant of good faith and fair dealing.

    TRIAL

    At trial, a USAA claims adjustor admitted that Reyes was fully at fault for the accident with Flick. Reyes could therefore be exposed to liability in excess of his policy limits-if Flick provided sufficient documentation to support her claim.

    USAA's expert on insurance claims handling and another of its claims service managers both agreed with the supervisor that Flick's authorization was invalid and inadequate to allow USAA to obtain Flick's medical records.

    USAA needed additional records before it could determine the value of Flick's claim. Those records could have included the medical bills Flick provided to her own insurance company, the multiple doctor's notes she had excusing her from work, or the thumb drive recording her purported speech problems, all of which were entered into evidence at her personal injury trial. Because they were not provided to USAA, it was "very difficult to place a value on" Flick's claim.

    Flick's expert testified that USAA's handling of the settlement demand "was clearly unreasonable."

    Flick also did not respond to USAA's requests for additional information.

    By a vote of nine to three, the jury found that Flick did not make a reasonable settlement demand of USAA and rejected her claims for breach of contract and breach of the implied covenant of good faith and fair dealing. The trial court polled the jury, and each juror confirmed their vote.

    DISCUSSION

    The Court of Appeals concluded the trial court did not abuse its discretion in denying Flick's new trial motion. USAA successfully rebutted the presumption of prejudice by showing there is no reasonable probability that the juror, D.C.'s misconduct by not explaining he did not hear all of the adjuster's testimony, actually harmed Flick.

    Much of the adjustor's testimony consisted of facts regarding his communications with Flick's attorney - facts that were undisputed.

    What was disputed-whether Flick's settlement demand was reasonable-was the subject of other witness testimony, including USAA's expert on insurance claims handling, its supervising claims service manager, Flick's personal injury attorney, and her expert witness on insurance claims handling.

    What the admitted evidence showed was that D.C. confirmed multiple times that he voted that Flick did not make a reasonable settlement demand:

    Based on this record there was no reasonable probability that D.C.'s alleged juror misconduct actually harmed Flick.

    ZALMA OPINION

    The tort of bad faith arose from abuse by insurers on those they insured. Since its adoption in California about three quarters of a century ago, the abuse has been turned on to insurers. Ms. Flick's counsel placed a demand for settlement on USAA that it could not reasonably and in good faith to its insured, Reyes, because it was incomplete and inadequately supported and forced Flick and Reyes go through a trial where she received an uncollectible judgment against Reyes in hopes of a gigantic bad faith judgment. After much litigation and USAA spending a great deal to defend itself she received the $100,000 policy limit. USAA was punished but neither Flick nor her lawyers profited from the scheme or the appeal.

    (c) 2024 Barry Zalma & ClaimSchool, Inc.

    Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

    Subscribe to my substack at https://barryzalma.substack.com/subscribe

    Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg

    Go to the Insurance Claims Library – https://lnkd.in/gwEYk
    Bad Faith Set Up Fails Read the full article at https://www.linkedin.com/pulse/bad-faith-set-up-fails-barry-zalma-esq-cfe-jllxc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. Inadequate Information Made Refusal to Pay Policy Limits Not Bad Faith INADEQUATE MEDICAL AUTHORIZATION USED TO CAUSE INSURER TO REFUSE SETTLEMENT DEMAND Post 4930 Kara Flick appealed from the judgment after a jury rejected her claims for breach of contract and breach of the implied covenant of good faith and fair dealing. Flick contends the judgment should be reversed due to juror misconduct. In KARA FLICK v. UNITED SERVICES AUTOMOBILE ASSOCIATION, B330507, California Court of Appeals, Second District, Sixth Division (November 5, 2024) the Court of Appeals resolved the dispute. FACTUAL HISTORY After sustaining injuries in an automobile accident caused by Francisco Reyes, Jr., Flick had her attorney send Reyes's insurer, the United Services Automobile Association (USAA), a letter explaining the severity of her injuries and an authorization for the release of her medical records. Flick's attorney followed up with a settlement demand two months later, requesting that USAA pay Flick the entirety of Reyes's $100,000 policy limit in exchange for a release of liability. Attached to the demand was a single medical record from Flick's neurologist. USAA investigated Flick's claim and determined it did not have sufficient information to accept or reject her demand. Flick then filed a personal injury lawsuit against Reyes. The jury found in her favor and awarded nearly $1.7 million in damages. Flick, with an assignment from the Reyes, sued USAA for breach of contract and breach of the implied covenant of good faith and fair dealing. TRIAL At trial, a USAA claims adjustor admitted that Reyes was fully at fault for the accident with Flick. Reyes could therefore be exposed to liability in excess of his policy limits-if Flick provided sufficient documentation to support her claim. USAA's expert on insurance claims handling and another of its claims service managers both agreed with the supervisor that Flick's authorization was invalid and inadequate to allow USAA to obtain Flick's medical records. USAA needed additional records before it could determine the value of Flick's claim. Those records could have included the medical bills Flick provided to her own insurance company, the multiple doctor's notes she had excusing her from work, or the thumb drive recording her purported speech problems, all of which were entered into evidence at her personal injury trial. Because they were not provided to USAA, it was "very difficult to place a value on" Flick's claim. Flick's expert testified that USAA's handling of the settlement demand "was clearly unreasonable." Flick also did not respond to USAA's requests for additional information. By a vote of nine to three, the jury found that Flick did not make a reasonable settlement demand of USAA and rejected her claims for breach of contract and breach of the implied covenant of good faith and fair dealing. The trial court polled the jury, and each juror confirmed their vote. DISCUSSION The Court of Appeals concluded the trial court did not abuse its discretion in denying Flick's new trial motion. USAA successfully rebutted the presumption of prejudice by showing there is no reasonable probability that the juror, D.C.'s misconduct by not explaining he did not hear all of the adjuster's testimony, actually harmed Flick. Much of the adjustor's testimony consisted of facts regarding his communications with Flick's attorney - facts that were undisputed. What was disputed-whether Flick's settlement demand was reasonable-was the subject of other witness testimony, including USAA's expert on insurance claims handling, its supervising claims service manager, Flick's personal injury attorney, and her expert witness on insurance claims handling. What the admitted evidence showed was that D.C. confirmed multiple times that he voted that Flick did not make a reasonable settlement demand: Based on this record there was no reasonable probability that D.C.'s alleged juror misconduct actually harmed Flick. ZALMA OPINION The tort of bad faith arose from abuse by insurers on those they insured. Since its adoption in California about three quarters of a century ago, the abuse has been turned on to insurers. Ms. Flick's counsel placed a demand for settlement on USAA that it could not reasonably and in good faith to its insured, Reyes, because it was incomplete and inadequately supported and forced Flick and Reyes go through a trial where she received an uncollectible judgment against Reyes in hopes of a gigantic bad faith judgment. After much litigation and USAA spending a great deal to defend itself she received the $100,000 policy limit. USAA was punished but neither Flick nor her lawyers profited from the scheme or the appeal. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk
    WWW.LINKEDIN.COM
    Discover thousands of collaborative articles on 2500+ skills
    Discover 100 collaborative articles on domains such as Marketing, Public Administration, and Healthcare. Our expertly curated collection combines AI-generated content with insights and advice from industry experts, providing you with unique perspectives and up-to-date information on many skills and their applications.
    0 Commentaires 0 Parts 2KB Vue

  • Chiropractor Disciplined for Improper Billing

    Chiropractor Lies to Board and Loses Right to Practice

    Post 4930

    Read the full article at https://www.linkedin.com/pulse/chiropractor-disciplined-improper-billing-barry-zalma-esq-cfe-4qjdc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts.

    This appeal arises from an attempt by the state of Illinois to impose discipline upon plaintiff Christopher D. Leone, D.C., due to certain improper activities performed as a licensed chiropractor in the state of Illinois.

    In Christopher D. Leone, D.C. v. The Department Of Financial And Professional Regulation, Division Of Professional Regulation; and Cecilia Abundis, in Her Official Capacity as Acting Director of the Department of Financial and Professional Regulation, No. 4-22-0753, 2024 IL App (4th) 220753-U, Court of Appeals of Illinois, Fourth District (November 6, 2024) the Court of Appeal resolved the multiple claims of the chiropractor.

    BACKGROUND

    Leone has practiced as a chiropractor since 1999 and initially practiced in the state of Washington. The matter was resolved pursuant to an informal disposition via stipulation.

    Leone began practicing in Illinois in 2004, and in 2010 and a consent order was issued pursuant to which Leone admitted to the allegations and was reprimanded with a $5000 fine and a requirement that he undertake 20 hours of continuing education; 10 of those hours were to focus on Medicare billing and insurance coding and another 10 on record keeping.

    In 2013, the United States alleged that Leone “knowingly and fraudulently” submitted Medicare claims of less than $1000 for one-on-one physical therapy services that were not provided. Following negotiation, the parties entered into a plea agreement, pursuant to which Leone pleaded guilty to the one-count information and stipulated to a factual basis for his plea.

    Shortly after the Medicare fraud charge was filed against Leone, the State filed a five-count complaint alleging multiple violations of the Medical Practices Act of 1987 (Act). During the litigation, Leone applied to renew his chiropractic license. One of the questions on the application asked whether he had been convicted of any criminal offense, state or federal, since July 2011; Leone answered, “No,” failing to document the Medicare fraud conviction.

    Attempting to explain his federal guilty plea, Leone said that he was unable to modify the language in the plea agreement, as “the time for negotiations had run out” and the plea was a “take-it-or-leave-it” proposition. Leone read the plea agreement line by line and, although he claimed it contained false information, he signed it.

    ALJ Report and Recommendation

    The Administrative Law Judge (ALJ) issued his report and recommendation, finding that, pursuant to the guilty plea in the federal case, Leone had admitted that his patients performed physical therapy on their own without supervision. Also, Leone admitted in his plea that entries in patient records indicating that they received hands-on or one-on-one physical therapy were false. Further, the guilty plea established that Leone knowingly submitted claims to Medicare for services that he did not provide. Leone had also billed private insurers numerous times under the same code as Medicare.

    The conviction also established that he engaged in false billing and false entries in patient records. The ALJ recommended an indefinite suspension of Leone’s license for a minimum of two years.

    An expert testified that chiropractors who engaged in Medicare fraud violated several tenets of chiropractic ethics.

    There was a pattern of overcharging for services that were not provided, false notations in patient records to support the false charges, and the submission of false claims to insurance that went on for at least five years. Leone obtained fees by fraud, deceit, or misrepresentation, and those actions fell below the professional and ethical standards required of chiropractors in Illinois. Leone’s conduct, along with his past disciplinary history, “demonstrate[d] a pattern of behavior that [was] not acceptable.”

    ANALYSIS

    It was undisputed that Leone submitted charges under billing code 97110. Leone pled guilty to submitting a false demand for payment upon the United States. In his plea, Leone admitted to billing for services that were not actually provided to his patients as claimed, “and the instruments containing the demands for payment of public money, therefore were false when they were submitted” and “were submitted to Medicare with the knowledge that he did not perform the service charged.”

    The guilty plea supports the conclusion that Leone knowingly and intentionally submitted claims for reimbursement for services provided under code 97110 where the services did not meet the requirements to be paid under that code. This pattern went on for approximately five years, resulting in 1324 false claims in the amount of $93,900.

    The Department established a violation of the Act where Leone failed to note the federal conviction on his renewal application.
    Discipline

    A review of the initial circuit court order in this matter reveals that it merely recommended that the Department consider probation as a punishment; it did not make a ruling to that effect.

    There was no abuse of discretion in the discipline imposed. For the reasons stated, the Court reversed the circuit court’s judgment and affirm the Director’s decision.

    ZALMA OPINION

    Leone successfully committed fraud on the United States, the state of Illinois, and the insurance industry by falsely billing services he did not provide. He pleaded guilty to one count of Federal Health Insurance fraud and then lied to the state of Illinois when he applied to renew his license. With lawyers and retained experts he delayed the sanction for years. The Court of Appeals finally resolved the multiple disputes and applied an appropriate sanction and suspension of his license. He should consider himself lucky that he was not prosecuted criminally by the state and the US Government accepted his plea.

    (c) 2024 Barry Zalma & ClaimSchool, Inc.

    Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

    Subscribe to my substack at https://barryzalma.substack.com/subscribe

    Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg

    Go to the Insurance Claims Library – https://lnkd.in/gwEYk
    Chiropractor Disciplined for Improper Billing Chiropractor Lies to Board and Loses Right to Practice Post 4930 Read the full article at https://www.linkedin.com/pulse/chiropractor-disciplined-improper-billing-barry-zalma-esq-cfe-4qjdc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. This appeal arises from an attempt by the state of Illinois to impose discipline upon plaintiff Christopher D. Leone, D.C., due to certain improper activities performed as a licensed chiropractor in the state of Illinois. In Christopher D. Leone, D.C. v. The Department Of Financial And Professional Regulation, Division Of Professional Regulation; and Cecilia Abundis, in Her Official Capacity as Acting Director of the Department of Financial and Professional Regulation, No. 4-22-0753, 2024 IL App (4th) 220753-U, Court of Appeals of Illinois, Fourth District (November 6, 2024) the Court of Appeal resolved the multiple claims of the chiropractor. BACKGROUND Leone has practiced as a chiropractor since 1999 and initially practiced in the state of Washington. The matter was resolved pursuant to an informal disposition via stipulation. Leone began practicing in Illinois in 2004, and in 2010 and a consent order was issued pursuant to which Leone admitted to the allegations and was reprimanded with a $5000 fine and a requirement that he undertake 20 hours of continuing education; 10 of those hours were to focus on Medicare billing and insurance coding and another 10 on record keeping. In 2013, the United States alleged that Leone “knowingly and fraudulently” submitted Medicare claims of less than $1000 for one-on-one physical therapy services that were not provided. Following negotiation, the parties entered into a plea agreement, pursuant to which Leone pleaded guilty to the one-count information and stipulated to a factual basis for his plea. Shortly after the Medicare fraud charge was filed against Leone, the State filed a five-count complaint alleging multiple violations of the Medical Practices Act of 1987 (Act). During the litigation, Leone applied to renew his chiropractic license. One of the questions on the application asked whether he had been convicted of any criminal offense, state or federal, since July 2011; Leone answered, “No,” failing to document the Medicare fraud conviction. Attempting to explain his federal guilty plea, Leone said that he was unable to modify the language in the plea agreement, as “the time for negotiations had run out” and the plea was a “take-it-or-leave-it” proposition. Leone read the plea agreement line by line and, although he claimed it contained false information, he signed it. ALJ Report and Recommendation The Administrative Law Judge (ALJ) issued his report and recommendation, finding that, pursuant to the guilty plea in the federal case, Leone had admitted that his patients performed physical therapy on their own without supervision. Also, Leone admitted in his plea that entries in patient records indicating that they received hands-on or one-on-one physical therapy were false. Further, the guilty plea established that Leone knowingly submitted claims to Medicare for services that he did not provide. Leone had also billed private insurers numerous times under the same code as Medicare. The conviction also established that he engaged in false billing and false entries in patient records. The ALJ recommended an indefinite suspension of Leone’s license for a minimum of two years. An expert testified that chiropractors who engaged in Medicare fraud violated several tenets of chiropractic ethics. There was a pattern of overcharging for services that were not provided, false notations in patient records to support the false charges, and the submission of false claims to insurance that went on for at least five years. Leone obtained fees by fraud, deceit, or misrepresentation, and those actions fell below the professional and ethical standards required of chiropractors in Illinois. Leone’s conduct, along with his past disciplinary history, “demonstrate[d] a pattern of behavior that [was] not acceptable.” ANALYSIS It was undisputed that Leone submitted charges under billing code 97110. Leone pled guilty to submitting a false demand for payment upon the United States. In his plea, Leone admitted to billing for services that were not actually provided to his patients as claimed, “and the instruments containing the demands for payment of public money, therefore were false when they were submitted” and “were submitted to Medicare with the knowledge that he did not perform the service charged.” The guilty plea supports the conclusion that Leone knowingly and intentionally submitted claims for reimbursement for services provided under code 97110 where the services did not meet the requirements to be paid under that code. This pattern went on for approximately five years, resulting in 1324 false claims in the amount of $93,900. The Department established a violation of the Act where Leone failed to note the federal conviction on his renewal application. Discipline A review of the initial circuit court order in this matter reveals that it merely recommended that the Department consider probation as a punishment; it did not make a ruling to that effect. There was no abuse of discretion in the discipline imposed. For the reasons stated, the Court reversed the circuit court’s judgment and affirm the Director’s decision. ZALMA OPINION Leone successfully committed fraud on the United States, the state of Illinois, and the insurance industry by falsely billing services he did not provide. He pleaded guilty to one count of Federal Health Insurance fraud and then lied to the state of Illinois when he applied to renew his license. With lawyers and retained experts he delayed the sanction for years. The Court of Appeals finally resolved the multiple disputes and applied an appropriate sanction and suspension of his license. He should consider himself lucky that he was not prosecuted criminally by the state and the US Government accepted his plea. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk
    WWW.LINKEDIN.COM
    Discover thousands of collaborative articles on 2500+ skills
    Discover 100 collaborative articles on domains such as Marketing, Public Administration, and Healthcare. Our expertly curated collection combines AI-generated content with insights and advice from industry experts, providing you with unique perspectives and up-to-date information on many skills and their applications.
    0 Commentaires 0 Parts 2KB Vue

  • Canada flagged around 2,400 money laundering cases involving lawyers
    #NoMoreLiberalsAndNDP
    #SayingTheQuietPartOutLoud
    #resigntrudeau
    #JustSayNoMore
    https://tnc.news/2024/11/10/money-laundering-lawyers-fintrac/
    via @truenorthcentre
    Canada flagged around 2,400 money laundering cases involving lawyers 🇨🇦 #NoMoreLiberalsAndNDP 🇨🇦 🇨🇦 #SayingTheQuietPartOutLoud 🇨🇦 🇨🇦 #resigntrudeau 🇨🇦 🇨🇦 #JustSayNoMore 🇨🇦 https://tnc.news/2024/11/10/money-laundering-lawyers-fintrac/ via @truenorthcentre
    TNC.NEWS
    Canada flagged around 2,400 money laundering cases involving lawyers
    Canada’s financial crimes watchdog has flagged thousands of suspected cases of criminal money laundering operations involving legal professionals.
    0 Commentaires 0 Parts 337 Vue

  • Zalma’s Insurance Fraud Letter – November 1, 2024

    ZIFL – Volume 28 Number 21

    Posted on November 1, 2024 by Barry Zalma

    Post 4924

    See the full video at and at

    Subscribe to ZIFL at https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

    The Source for the Insurance Fraud Professional

    Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th 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/ This issue contains the following articles about insurance fraud:

    Pill Mill Doctor’s Conviction Affirmed

    HEALTH CARE FRAUD CONVICTION AFFIRMED

    ACTING AS A DR. FEEL GOOD IS A FEDERAL CRIME

    According to the Sixth Circuit Dr. David Jankowski’s medical clinics relied on several unusual billing and prescription practices, many of which were illegal and Jankowski fraudulently billed Medicare for services he did not provide and prescribed controlled substances to patients whose conditions did not call for such treatment, with some patients unlawfully trafficking their prescribed drugs.

    In United States Of America v. David Jankowski, M.D., No. 23-1404, United States Court of Appeals, Sixth Circuit (October 23, 2024) the Sixth Circuit disposed of the fraudsters claims on appeal.

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    More McClenny Moseley & Associates Issues

    This is ZIFL’s thirty sixth 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.

    10/24/2024

    MMA BANKRUPTCY HEARING TO DECIDE WHETHER TRUSTEE WILL BE APPOINTED

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    Injured While Drunk on the Job Gets Workers’ Compensation Benefits

    An appellate court in New York has upheld a decision of the Workers’ Compensation Board in favor of an injured employee of an electrical contractor company because intoxication was not the sole cause of the accident.

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    Man Bites Dog Story:

    Fraudsters Arbitration Attempts Stopped

    Arbitration Stayed for Suspected Chiropractors’ Fraudulent No Fault Medical Claims

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    In Government Employees Insurance Company, (“GEICO”) v. Didier Demesmin, M.D., et al, No. 23-CV-6191 (ARR) (MMH), United States District Court, E.D. New York (October 23, 2024) GEICO sought to enjoin defendants Manuel A. Mendoza, D.C. and Mendoza Chiropractic Office PC (collectively the “Mendoza Defendants”) from pursuing certain “no-fault” insurance collection arbitrations or initiating new collections proceedings during the pendency of this lawsuit.

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    Health Insurance Fraud Convictions

    Louisiana Nursing Home Owner to Pay $8.2M for Misusing Assets During Ida

    Bob Dean Jr a Louisiana nursing home owner and several companies he operated have agreed to an $8.2 million consent judgment to resolve allegations that they misappropriated and misused the assets and income of four nursing homes in Louisiana before and after Hurricane Ida’s landfall in August 2021.

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    Officer Caught Aiding Criminals for Cash

    Police Officer who took Bribes from Insurance Fraudster Convicted

    Demarkco Johnson (“Johnson”), appealed his convictions for taking bribes about insurance fraud.

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    Convictions of Other Than Health Insurance Fraud

    Former Lake Forest Agent Convicted On 90 Counts Of Insurance Fraud After Stealing Nearly $200,000 In Premium Payments

    Karen Marie Dondanville, 56, of Mission Viejo, California, a former Lake Forest insurance agent was convicted on 90 counts of insurance fraud after stealing nearly $200,000 in premium payments.

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    The Need to Understand the Mutability of Memory

    Investigators and lawyers believe what they are told by eye witnesses who describe what he or she says with conviction. However, every professional investigator or litigator must know that memory is not necessarily accurate because very few people have a perfect eidetic (photographic) memory. Memory is a fluid and often unreliable human function.

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf

    Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Go to the podcast Zalma On Insurance at https://podcasters.spotify.com/pod/show/barry-zalma/support; Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog. Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/; Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ and GTTR at https://gettr.com/@zalma

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf
    Zalma’s Insurance Fraud Letter – November 1, 2024 ZIFL – Volume 28 Number 21 Posted on November 1, 2024 by Barry Zalma Post 4924 See the full video at and at Subscribe to ZIFL at https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D The Source for the Insurance Fraud Professional Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th 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/ This issue contains the following articles about insurance fraud: Pill Mill Doctor’s Conviction Affirmed HEALTH CARE FRAUD CONVICTION AFFIRMED ACTING AS A DR. FEEL GOOD IS A FEDERAL CRIME According to the Sixth Circuit Dr. David Jankowski’s medical clinics relied on several unusual billing and prescription practices, many of which were illegal and Jankowski fraudulently billed Medicare for services he did not provide and prescribed controlled substances to patients whose conditions did not call for such treatment, with some patients unlawfully trafficking their prescribed drugs. In United States Of America v. David Jankowski, M.D., No. 23-1404, United States Court of Appeals, Sixth Circuit (October 23, 2024) the Sixth Circuit disposed of the fraudsters claims on appeal. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf More McClenny Moseley & Associates Issues This is ZIFL’s thirty sixth 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. 10/24/2024 MMA BANKRUPTCY HEARING TO DECIDE WHETHER TRUSTEE WILL BE APPOINTED Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Injured While Drunk on the Job Gets Workers’ Compensation Benefits An appellate court in New York has upheld a decision of the Workers’ Compensation Board in favor of an injured employee of an electrical contractor company because intoxication was not the sole cause of the accident. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Man Bites Dog Story: Fraudsters Arbitration Attempts Stopped Arbitration Stayed for Suspected Chiropractors’ Fraudulent No Fault Medical Claims Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf In Government Employees Insurance Company, (“GEICO”) v. Didier Demesmin, M.D., et al, No. 23-CV-6191 (ARR) (MMH), United States District Court, E.D. New York (October 23, 2024) GEICO sought to enjoin defendants Manuel A. Mendoza, D.C. and Mendoza Chiropractic Office PC (collectively the “Mendoza Defendants”) from pursuing certain “no-fault” insurance collection arbitrations or initiating new collections proceedings during the pendency of this lawsuit. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Health Insurance Fraud Convictions Louisiana Nursing Home Owner to Pay $8.2M for Misusing Assets During Ida Bob Dean Jr a Louisiana nursing home owner and several companies he operated have agreed to an $8.2 million consent judgment to resolve allegations that they misappropriated and misused the assets and income of four nursing homes in Louisiana before and after Hurricane Ida’s landfall in August 2021. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Officer Caught Aiding Criminals for Cash Police Officer who took Bribes from Insurance Fraudster Convicted Demarkco Johnson (“Johnson”), appealed his convictions for taking bribes about insurance fraud. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Convictions of Other Than Health Insurance Fraud Former Lake Forest Agent Convicted On 90 Counts Of Insurance Fraud After Stealing Nearly $200,000 In Premium Payments Karen Marie Dondanville, 56, of Mission Viejo, California, a former Lake Forest insurance agent was convicted on 90 counts of insurance fraud after stealing nearly $200,000 in premium payments. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf The Need to Understand the Mutability of Memory Investigators and lawyers believe what they are told by eye witnesses who describe what he or she says with conviction. However, every professional investigator or litigator must know that memory is not necessarily accurate because very few people have a perfect eidetic (photographic) memory. Memory is a fluid and often unreliable human function. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Go to the podcast Zalma On Insurance at https://podcasters.spotify.com/pod/show/barry-zalma/support; Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog. Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/; Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ and GTTR at https://gettr.com/@zalma Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf
    0 Commentaires 0 Parts 2KB Vue
  • Alberta gov’t condemns censorship of Jordan Peterson by regulatory board! Alberta Premier Danielle Smith condemned professional colleges and other bodies for regulating the personal beliefs and political opinions of doctors, lawyers, psychologists, and other professionals.
    #NoMoreLiberalsAndNDP
    #SayingTheQuietPartOutLoud
    #resigntrudeau
    #JustSayNoMore
    https://www.rebelnews.com/alberta_govt_condemns_censorship_of_jordan_peterson_by_regulatory_board
    Alberta gov’t condemns censorship of Jordan Peterson by regulatory board! Alberta Premier Danielle Smith condemned professional colleges and other bodies for regulating the personal beliefs and political opinions of doctors, lawyers, psychologists, and other professionals. 🇨🇦 #NoMoreLiberalsAndNDP 🇨🇦 🇨🇦 #SayingTheQuietPartOutLoud 🇨🇦 🇨🇦 #resigntrudeau 🇨🇦 🇨🇦 #JustSayNoMore 🇨🇦 https://www.rebelnews.com/alberta_govt_condemns_censorship_of_jordan_peterson_by_regulatory_board
    WWW.REBELNEWS.COM
    Alberta gov’t condemns censorship of Jordan Peterson by regulatory board
    Alberta Premier Danielle Smith condemned professional colleges and other bodies for regulating the personal beliefs and political opinions of doctors, lawyers, psychologists, and other professionals.
    Like
    1
    0 Commentaires 0 Parts 522 Vue
  • Jesse Watters: “Politico reports Kamala Harris has hundreds of lawyers on call in all 50 states. Her massive legal team is already waging electoral war in the courts.
    Jesse Watters: “Politico reports Kamala Harris has hundreds of lawyers on call in all 50 states. Her massive legal team is already waging electoral war in the courts.
    0 Commentaires 0 Parts 308 Vue 0
  • The New York Appellate Court crushed the junk lawfare case against Trump where they claimed he committed fraud by over-valuating his property for a loan. The bank said they loaned him the money because he paid his loans back and the value of the property was irrelevant. There was no victim and Trump didn't do anything wrong. The Judges had the Democrat lawyers begging not to be sanctioned in their closing arguments. He will get all of his money back and the Democrats will look dumber than they already are. You wouldn't think they could look any dumber, but they found a way to do so.
    The New York Appellate Court crushed the junk lawfare case against Trump where they claimed he committed fraud by over-valuating his property for a loan. The bank said they loaned him the money because he paid his loans back and the value of the property was irrelevant. There was no victim and Trump didn't do anything wrong. The Judges had the Democrat lawyers begging not to be sanctioned in their closing arguments. He will get all of his money back and the Democrats will look dumber than they already are. You wouldn't think they could look any dumber, but they found a way to do so.
    0 Commentaires 0 Parts 745 Vue
Plus de résultats
Commandité

We are 100% funded for October.

Thanks to everyone who helped out. 🥰

Xephula monthly operating expenses for 2024 - Server: $143/month - Backup Software: $6/month - Object Storage: $6/month - SMTP Service: $10/month - Stripe Processing Fees: ~$10/month - Total: $175/month

Xephula Funding Meter

Please Donate Here