• Weapons distribution: Hunter Biden involved in war guns vendor connection; it may warrant further investigation or clarification, business dealings.
    Weapons distribution: Hunter Biden involved in war guns vendor connection; it may warrant further investigation or clarification, business dealings.
    0 Comments 0 Shares 115 Views
  • https://www.christianpost.com/news/biden-declares-icc-arrest-warrant-against-netanyahu-outrageous.html
    https://www.christianpost.com/news/biden-declares-icc-arrest-warrant-against-netanyahu-outrageous.html
    WWW.CHRISTIANPOST.COM
    Biden declares ICC arrest warrant against Netanyahu 'outrageous,' vows to 'stand with Israel'
    President Joe Biden decried the International Criminal Court s decision to issue an arrest warrant against Israeli Prime Minister Benjamin Netanyahu and Minister of Defense Yoav Gallant, calling the
    0 Comments 0 Shares 271 Views
  • Here's the podcast of last nights LIVE broadcast where Craig & Diane discussed Matt Gaetz out Pam Bondi in as Trump's AG pick; Trump's Day One EOs; justice served (sort of) for Lakin Riley; & the ICC issues arrest warrants for Netanyahu, Galant, & Hamas leader ... listen to it & past shows at https://rspradio1.podbean.com ... on our RSP website....go to Podcasts.
    Here's the podcast of last nights LIVE broadcast where Craig & Diane discussed Matt Gaetz out Pam Bondi in as Trump's AG pick; Trump's Day One EOs; justice served (sort of) for Lakin Riley; & the ICC issues arrest warrants for Netanyahu, Galant, & Hamas leader ... listen to it & past shows at https://rspradio1.podbean.com ... on our RSP website....go to Podcasts.
    0 Comments 0 Shares 724 Views
  • RIGHT SIDE PATRIOTS...LIVE! ... Today, Friday, November 22nd from 7pm to 8:00pm EST, Craig and Diane discuss Matt Gaetz out Pam Bondi in as Trump's AG pick; Trump's Day One EOs; justice served (sort of) for Lakin Riley; and the ICC issues warrants for Netanyahu, Galant, and Hamas leader's arrest. On https://rspradio1.com Click 'LISTEN LIVE.'
    RIGHT SIDE PATRIOTS...LIVE! ... Today, Friday, November 22nd from 7pm to 8:00pm EST, Craig and Diane discuss Matt Gaetz out Pam Bondi in as Trump's AG pick; Trump's Day One EOs; justice served (sort of) for Lakin Riley; and the ICC issues warrants for Netanyahu, Galant, and Hamas leader's arrest. On https://rspradio1.com Click 'LISTEN LIVE.'
    0 Comments 0 Shares 736 Views
  • COL. Douglas Macgregor : Netanyahu Arrest Warrant !!! - PLUS - Russia fires ICBM into #Ukraine
    !!!

    https://www.youtube.com/watch?v=KPJmh_bAxlA
    COL. Douglas Macgregor : Netanyahu Arrest Warrant !!! - PLUS - Russia fires ICBM into #Ukraine !!! https://www.youtube.com/watch?v=KPJmh_bAxlA
    0 Comments 0 Shares 365 Views

  • Appear for a Scheduled EUO or Lose

    Failure to Honor Conditions Precedent Voids Coverage in New York

    Post 4937

    Read the full article at https://www.linkedin.com/pulse/appear-scheduled-euo-lose-barry-zalma-esq-cfe-gvkec/, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts.

    State Farm contended that it is entitled to summary judgment because of the failure to appear for examination under oath (EUO) by multiple defendants. State Farm contended that timely notices were properly mailed to the Claimants who failed to appear.

    In State Farm Mutual Automobile Insurance Company v. Alford A. Smith, M.D., et al, 2024 NY Slip Op 33802(U), Index No. 155607/2020, Motion Seq. No. 003, Supreme Court, New York County, Appellate Division (October 24, 2024) court ruled in favor of State Farm.

    The Supreme Court of New York County ORDERED that the plaintiff, State Farm Mutual Automobile Insurance Company’s (“State Farm/Plaintiff’), motion for summary judgment was GRANTED against defendants, Alford A. Smith, M.D., P.C., and the multiple other defendants who are doctors, chiropractors and other health services, (hereinafter collectively (“The Defendants”).

    FACTS

    The Supreme Court found that the EUO scheduling letters were timely requested and claimants failed to appear at that EUO. The documentary evidence showed that plaintiff sent the EUO scheduling letters to the claimants within 15 business days of receiving the prescribed verification forms as required by New York statute.

    FRAUD, FAILURE TO APPEAR FOR EUO & FAILURE TO SIGN TRANSCRIPT ARE BREACHES OF MATERIAL CONDITION PRECEDENT

    The Appellate Division upheld the Supreme Court’s ruling that the failure to appear for an EUO that was requested in a timely fashion by the insurer is a breach of a condition precedent to coverage and voids the policy ab initio. In addition, although claimant Griselda Torres unlike the other defendants, appeared for her EUO, Torres failed to return a subscribed copy of her EUO transcript.

    State Farm properly and effectively argued that appearing for and testifying at EUO and returning the transcripts of the EUO are conditions precedent to coverage and failure to sign and return the transcript warranted a denial of the claims.

    State Farm demonstrated in its motion and supporting evidence that multiple claimants breached a condition precedent to coverage by failing to appear for properly noticed EUOs on two separate occasions. Furthermore, claimant Griselda Torres’ failure to subscribe and return the transcript of her EUOsviolated a condition precedent to coverage and warranted denial of the claims.

    Moreover, there was nothing on the Court’s record to suggest that the scheduled EUOs were not justified, nor held at a place and time that was not reasonably convenient to the defendants.

    CONCLUSION

    State Farm’s motion seeking summary judgment in its favor was GRANTED as to THE multiple defendants and it was further ORDERED that any requested relief sought not expressly addressed herein has nonetheless been considered; and it was further ORDERED that the case shall continue against the remaining defendants; and it was further ORDERED that within 30 days of entry, plaintiff shall serve a copy of this decision/order upon the defendants with notice of entry.

    ZALMA OPINION

    The defendants in this case were doctors, physicians, chiropractors and other health care providers who billed State Farm for services provided to people who were injured in automobile accidents and assigned their rights to the providers who tried to collect their billings without complying with the EUO condition. They all lost their claims because they refused to appear except one defendant who appeared but failed to sign the transcript of the EUO and return it to State Farm. They all lost their claims and State Farm will continue its actions against many more defendants not subject to the motion.

    (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
    Appear for a Scheduled EUO or Lose Failure to Honor Conditions Precedent Voids Coverage in New York Post 4937 Read the full article at https://www.linkedin.com/pulse/appear-scheduled-euo-lose-barry-zalma-esq-cfe-gvkec/, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. State Farm contended that it is entitled to summary judgment because of the failure to appear for examination under oath (EUO) by multiple defendants. State Farm contended that timely notices were properly mailed to the Claimants who failed to appear. In State Farm Mutual Automobile Insurance Company v. Alford A. Smith, M.D., et al, 2024 NY Slip Op 33802(U), Index No. 155607/2020, Motion Seq. No. 003, Supreme Court, New York County, Appellate Division (October 24, 2024) court ruled in favor of State Farm. The Supreme Court of New York County ORDERED that the plaintiff, State Farm Mutual Automobile Insurance Company’s (“State Farm/Plaintiff’), motion for summary judgment was GRANTED against defendants, Alford A. Smith, M.D., P.C., and the multiple other defendants who are doctors, chiropractors and other health services, (hereinafter collectively (“The Defendants”). FACTS The Supreme Court found that the EUO scheduling letters were timely requested and claimants failed to appear at that EUO. The documentary evidence showed that plaintiff sent the EUO scheduling letters to the claimants within 15 business days of receiving the prescribed verification forms as required by New York statute. FRAUD, FAILURE TO APPEAR FOR EUO & FAILURE TO SIGN TRANSCRIPT ARE BREACHES OF MATERIAL CONDITION PRECEDENT The Appellate Division upheld the Supreme Court’s ruling that the failure to appear for an EUO that was requested in a timely fashion by the insurer is a breach of a condition precedent to coverage and voids the policy ab initio. In addition, although claimant Griselda Torres unlike the other defendants, appeared for her EUO, Torres failed to return a subscribed copy of her EUO transcript. State Farm properly and effectively argued that appearing for and testifying at EUO and returning the transcripts of the EUO are conditions precedent to coverage and failure to sign and return the transcript warranted a denial of the claims. State Farm demonstrated in its motion and supporting evidence that multiple claimants breached a condition precedent to coverage by failing to appear for properly noticed EUOs on two separate occasions. Furthermore, claimant Griselda Torres’ failure to subscribe and return the transcript of her EUOsviolated a condition precedent to coverage and warranted denial of the claims. Moreover, there was nothing on the Court’s record to suggest that the scheduled EUOs were not justified, nor held at a place and time that was not reasonably convenient to the defendants. CONCLUSION State Farm’s motion seeking summary judgment in its favor was GRANTED as to THE multiple defendants and it was further ORDERED that any requested relief sought not expressly addressed herein has nonetheless been considered; and it was further ORDERED that the case shall continue against the remaining defendants; and it was further ORDERED that within 30 days of entry, plaintiff shall serve a copy of this decision/order upon the defendants with notice of entry. ZALMA OPINION The defendants in this case were doctors, physicians, chiropractors and other health care providers who billed State Farm for services provided to people who were injured in automobile accidents and assigned their rights to the providers who tried to collect their billings without complying with the EUO condition. They all lost their claims because they refused to appear except one defendant who appeared but failed to sign the transcript of the EUO and return it to State Farm. They all lost their claims and State Farm will continue its actions against many more defendants not subject to the motion. (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
    0 Comments 0 Shares 1K Views
  • 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 Comments 0 Shares 1K Views
  • “Dismantling of America” by Cabal - MG Paul Vallely, Quo Warranto’s & JAG Letters w/Norman Traversy
    WestPoint Grad 1961, U.S. Army Ranger and VietNam Combat Veteran, Major General Paul E Vallely (ret.) is the co-founder and Chairman of Stand Up America Foundation. He is the author or co-author of multiple books, including “America’s End Game for the 21st Century: A Blueprint for Saving our Country” and his newest release the “Dismantling of America”
    https://rumble.com/v5bmo6i-dismantling-of-america-by-cabal-mg-paul-vallely-quo-warrantos-and-jag-lette.html
    “Dismantling of America” by Cabal - MG Paul Vallely, Quo Warranto’s & JAG Letters w/Norman Traversy WestPoint Grad 1961, U.S. Army Ranger and VietNam Combat Veteran, Major General Paul E Vallely (ret.) is the co-founder and Chairman of Stand Up America Foundation. He is the author or co-author of multiple books, including “America’s End Game for the 21st Century: A Blueprint for Saving our Country” and his newest release the “Dismantling of America” https://rumble.com/v5bmo6i-dismantling-of-america-by-cabal-mg-paul-vallely-quo-warrantos-and-jag-lette.html
    0 Comments 0 Shares 681 Views

  • Zalma’s Insurance Fraud Letter September 15, 2024

    Zalma’s Insurance Fraud Letter

    A ClaimSchool™ Publication © 2024 Barry Zalma & ClaimSchool, Inc.

    Read the full issue at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-november-15-2024-barry-zalma-esq-cfe-cxkycVolume 28, Issue 21 – November 15, 2024

    “Honor, justice, and humanity, forbid us tamely to surrender that freedom which we received from our gallant ancestors, and which our innocent posterity have a right to receive from us. We cannot endure the infamy and guilt of resigning succeeding generations to that wretchedness which inevitably awaits them if we basely entail hereditary bondage on them.”

    Thomas Jefferson

    Insurance Fraud Requires Doctor to Lose his License

    Sexual Misconduct, Fraud, Bribery & Unnecessary Surgery Revokes License

    Louis Quartararo appealed from an August 22, 2022 final agency decision of the State Board of Medical Examiners (Board), revoking his license to practice medicine and surgery in New Jersey. The Superior Court of New Jersey, in In The Matter Of The Suspension Or Revocation Of The License Of Louis Quartararo, M.D. License No. 25MA07137700 To Practice Medicine And Surgery In The State Of New Jersey, No. A-0425-22, Superior Court of New Jersey, Appellate Division (October 31, 2024) affirmed the revocation.

    The Board charged Dr. Quartararo with engaging in sexual contact with patients; negligent acts by performing surgeries with co-surgeons who lacked the requisite privileges; and acts of fraud, deception and misrepresentation by miscoding procedures on patient operative reports and listing procedures in the reports he had not performed for the purpose of ensuring insurance coverage.

    FACTS

    Quartararo was a physician and Board-certified orthopedic surgeon licensed to practice medicine in New Jersey.

    Approximately one week before K.D. was scheduled to meet with Board investigators, Quartararo gave K.D. $20,916, which K.D. told an investigator was “for school.” Later, Quartararo’s attorney offered her more money to retract the statement she had made to the Board about her relationship with Quartararo.

    THE OAL HEARING

    At a formal hearing, the Board’s expert, Dr. Ashraf addressed Quartararo’s treatment of patient Y.O. revealed that the surgical procedures Quartararo performed were not medically necessary. In reviewing the description of Quartararo’s procedure on Y.O.’s spine, Dr. Ashraf concluded that Quartararo’s surgery on Y.O.’s completely normal spine “is gross negligence.”

    Regarding the fraud claims alleging that Quartararo had failed to properly code surgical procedures that he performed on E.S., D.C., Y.O., L.V., D.E., and V.C., Dr. Ashraf testified that the “whole function” of the “operations” section on the first page of the operative report was to list the procedures that were performed during the operation and he testified that, despite “laminotomy” appearing on the first page of V.C.’s and D.C.’s reports, their post-surgery MRIs revealed that laminotomies had not been performed.

    THE ALJ’S DECISION

    The Administrative Law Judge (ALJ) issued a comprehensive seventy-nine-page decision and concluded that Quartararo had “engaged in gross malpractice, professional misconduct, failure to comply with regulations administered by the Board, and failure to be of good moral character.”

    On August 22, 2022, the Board filed its final decision, revoking Quartararo’s license for a minimum of seven years from the date of voluntary surrender, April 5, 2019. The Board concluded that Quartararo’s “misconduct warrants a serious penalty in excess of that recommended by [the ALJ]” and that he “flagrantly ignored, and in fact shattered professional norms when he engaged in sexual misconduct with patients Y.R. and K.D.” The Board found Quartararo’s conduct was “so egregious that the only appropriate discipline is a license revocation.”

    The Board also imposed an aggregate monetary sanction of $343,909.75, comprised of a civil penalty of $90,000, $61,684.75 in costs, and $192,225 in attorney’s fees.

    Quartararo Argued

    The Board determined that revocation was warranted because he preyed on two vulnerable patients employed intimidation and coercion tactics to dissuade at least one of his victims-K.D.- from testifying about the true nature of their relation and resorted to making threats resulting in the issuance of a temporary restraining order against him.

    Quartararo admitted he had not performed laminotomies and that he had used the laminotomy code to ensure that he would be paid by insurance carriers. He did so rather than correctly coding the procedures he actually performed because of the risk he would otherwise not be paid.

    ZIFL OPINION

    Quartararo admitted before the ALJ that he committed fraud by billing insurers for laminotomies that he did not perform. As such he admitted to committing a federal as well as a New Jersey felony that should be presented to the US Attorney and the local District Attorney for prosecution. He lost his license because he took advantage sexually of vulnerable patients, committed gross acts of malpractice and profited from knowing insurance fraud. The people of New Jersey are now safe from his criminal and unprofessional conduct for a few more years, and in my opinion he should be prosecuted and sentenced to prison for the fraud.

    Read the full issue at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-november-15-2024-barry-zalma-esq-cfe-cxkyc

    IT PAYS INSURER DEFENDANTS TO INVESTIGATE INJURY CLAIMS

    In Chris Kallco v. Melissa Lynn Pugh, Chris Kallco, and Precise Mri Of Michigan, LLC v. Citizens Insurance Company Of The Midwest and Melissa Lynn Pugh, No. 368156, Court of Appeals of Michigan (October 30, 2024) affirmed the trial court’s decision.

    Plaintiff appealed from two orders granting summary disposition in favor of defendants even though he failed to respond to either motion.

    FACTUAL BACKGROUND

    This case arises out of a motor vehicle accident that occurred on March 9, 2020 involving plaintiff and Pugh. Plaintiff alleges that he sustained injuries from the accident. A year after the accident, plaintiff brought a negligence claim against Pugh, alleging that, because of Pugh’s negligence, plaintiff sustained “severe permanent and progressive personal injuries and serious impairment of a body function, including but not necessarily limited to: Head, Neck, Back, Shoulders ….” Plaintiff also brought a claim against Citizens for PIP benefits, including medical expenses, work loss, and replacement services.

    Pugh and Citizens moved for summary disposition arguing that plaintiff could not meet his burden of showing that he sustained a threshold injury under the no-fault act and, therefore, he could not maintain his negligence claim against her. Pugh submitted the deposition testimony of the plaintiff and the report of an independent medical examination (IME) conducted by Dr. James Bragman on December 27, 2021. Dr. Bragman further observed that plaintiff had “near full range of motion” in his neck and that he was “eminently capable” of standing and touching his toes despite his refusal to do so. Dr. Bragman noted that plaintiff had “very little” medical treatment documented in his records and that he had been undergoing physical therapy for six months with no medical basis for doing so. An investigator’s report includes pictures of plaintiff walking, riding a child’s bicycle, squatting, bending over, lifting a bicycle out of a minivan unassisted, playing with a dog, driving a car, and twisting his neck.

    Citizens’ motion argued that plaintiff made material misrepresentations to Citizens regarding the extent of his injuries, which rendered him ineligible for benefits.

    The trial court found that, based upon the evidence presented, plaintiff failed to establish that he sustained a serious impairment of body function and therefore summary disposition in favor of Pugh was appropriate.

    THRESHOLD INJURY

    Plaintiff argued that the trial court erred by granting summary disposition in favor of Pugh.

    Under the no fault statute, the threshold question of whether the person has suffered a serious impairment of body function should be determined by the court as a matter of law as long as there is no factual dispute regarding the nature and extent of the person’s injuries that is material to determining whether the threshold standards are met.

    Plaintiff was obligated to respond to Pugh’s motion in order to meet his burden of demonstrating that a fact question existed as to whether he suffered a serious impairment of body function.

    The parts of plaintiff’s deposition identified by Pugh do not establish a genuine issue of material fact as to whether he suffered a serious impairment of body function. The relevant portions of plaintiff’s deposition testimony fail to rebut the evidence and instead set forth, at best, mere subjective complaints of pain.

    FRAUDULENT INSURANCE ACT

    The fraud statute finds that a person who presents or causes or to be presented an oral or written statement knowing that the statement contains false information concerning a fact or thing material to the claim commits a fraudulent insurance act under that is subject to the penalties imposed under the statute. A claim that contains or is supported by a fraudulent insurance act as described in this subsection is ineligible for payment of PIP benefits.

    An individual commits a “fraudulent insurance act” when: (1) the person presents or causes to be presented an oral or written statement, (2) the statement is part of or in support of a claim for no-fault benefits, and (3) the claim for benefits was submitted to the MAIPF. Further, (4) the person must have known that the statement contained false information, and (5) the statement concerned a fact or thing material to the claim.

    ZIFL OPINION

    The evidence presented by the defendants were damning since they established the injuries claimed were false. Plaintiff failed to respond to the motions to his detriment and sought reconsideration without any admissible evidence that he was truly injured. The defendants established that the Plaintiff committed fraud and he is lucky that this was a civil finding not a criminal proceeding that, in my opinion, should be presented by the prosecutor.

    More McClenny Moseley & Associates Issues

    This is ZIFL’s thirty seventh 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 may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana.

    Health Insurance Fraud Convictions
    Pharmacist and Brother Convicted of $15M Medicare, Medicaid, and Private Insurer Fraud Scheme

    Raad Kouza, a pharmacist in Wayne County, Michigan, and his brother, Ramis Kouza, of Oakland County, Michigan, billed Medicare, Medicaid, and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated in Michigan. A federal jury convicted the pharmacy owner and his brother November 8, 2024 for conspiracy to commit health care fraud and wire fraud.

    Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024-1.pdf

    Indicators of Bad Faith Set Up

    Some of the more common red flags of a bad faith set-up include the following:

    The claimant makes a policy limits settlement demand quickly after an accident, thereby depriving the insurer of the ability to conduct a full investigation.
    Quick demands that are combined with a limited amount of time to accept, again, in the hopes that records cannot be obtained and the investigation cannot be completed within that limited time period, and the settlement will be refused.
    The claimant makes a settlement offer with one or more unusual acceptance conditions.
    The involvement of the claimant’s counsel pre-dates certain medical or psychiatric care (e.g., testing and treatment for alleged mild traumatic brain injury)

    Read the full article and the full issue of ZIFL at http://https//zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024.pdf

    Convictions of Other Than Health Insurance Fraud
    Star in Reality TV Series Pleads Guilty Crop Insurance Fraud

    Steve A. McBee, 52, waived his right to a grand jury and pleaded guilty to a federal information that charges him with one count of federal crop insurance fraud. McBee, a Missouri farmer who appears in a reality TV show about his family’s farming operation pleaded guilty this week to a multi-million dollar fraud scheme involving federal crop insurance benefits.

    Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024-1.pdf

    Chutzpah – STOLI Fraudster Claims Hardship
    Felon Seeks Release from Home Confinement in Luxury Apartment in New York City

    Insurance Fraud is a serious crime, especially when it takes advantage of the elderly to defraud insurers in a Stranger Originated Life Insurance (STOLI) scheme. In United States Of America v. Michael Binday, No. 12 CR 152 (CM), United States District Court, S.D. New York (November 4, 2024) the defendant continued to use the wealth he gained from his fraud to impose on the courts of the United States with frivolous and unfounded motions.

    Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024-1.pdf

    Barry Zalma, Esq., CFE

    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.
    Zalma’s Insurance Fraud Letter September 15, 2024 Zalma’s Insurance Fraud Letter A ClaimSchool™ Publication © 2024 Barry Zalma & ClaimSchool, Inc. Read the full issue at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-november-15-2024-barry-zalma-esq-cfe-cxkycVolume 28, Issue 21 – November 15, 2024 “Honor, justice, and humanity, forbid us tamely to surrender that freedom which we received from our gallant ancestors, and which our innocent posterity have a right to receive from us. We cannot endure the infamy and guilt of resigning succeeding generations to that wretchedness which inevitably awaits them if we basely entail hereditary bondage on them.” Thomas Jefferson Insurance Fraud Requires Doctor to Lose his License Sexual Misconduct, Fraud, Bribery & Unnecessary Surgery Revokes License Louis Quartararo appealed from an August 22, 2022 final agency decision of the State Board of Medical Examiners (Board), revoking his license to practice medicine and surgery in New Jersey. The Superior Court of New Jersey, in In The Matter Of The Suspension Or Revocation Of The License Of Louis Quartararo, M.D. License No. 25MA07137700 To Practice Medicine And Surgery In The State Of New Jersey, No. A-0425-22, Superior Court of New Jersey, Appellate Division (October 31, 2024) affirmed the revocation. The Board charged Dr. Quartararo with engaging in sexual contact with patients; negligent acts by performing surgeries with co-surgeons who lacked the requisite privileges; and acts of fraud, deception and misrepresentation by miscoding procedures on patient operative reports and listing procedures in the reports he had not performed for the purpose of ensuring insurance coverage. FACTS Quartararo was a physician and Board-certified orthopedic surgeon licensed to practice medicine in New Jersey. Approximately one week before K.D. was scheduled to meet with Board investigators, Quartararo gave K.D. $20,916, which K.D. told an investigator was “for school.” Later, Quartararo’s attorney offered her more money to retract the statement she had made to the Board about her relationship with Quartararo. THE OAL HEARING At a formal hearing, the Board’s expert, Dr. Ashraf addressed Quartararo’s treatment of patient Y.O. revealed that the surgical procedures Quartararo performed were not medically necessary. In reviewing the description of Quartararo’s procedure on Y.O.’s spine, Dr. Ashraf concluded that Quartararo’s surgery on Y.O.’s completely normal spine “is gross negligence.” Regarding the fraud claims alleging that Quartararo had failed to properly code surgical procedures that he performed on E.S., D.C., Y.O., L.V., D.E., and V.C., Dr. Ashraf testified that the “whole function” of the “operations” section on the first page of the operative report was to list the procedures that were performed during the operation and he testified that, despite “laminotomy” appearing on the first page of V.C.’s and D.C.’s reports, their post-surgery MRIs revealed that laminotomies had not been performed. THE ALJ’S DECISION The Administrative Law Judge (ALJ) issued a comprehensive seventy-nine-page decision and concluded that Quartararo had “engaged in gross malpractice, professional misconduct, failure to comply with regulations administered by the Board, and failure to be of good moral character.” On August 22, 2022, the Board filed its final decision, revoking Quartararo’s license for a minimum of seven years from the date of voluntary surrender, April 5, 2019. The Board concluded that Quartararo’s “misconduct warrants a serious penalty in excess of that recommended by [the ALJ]” and that he “flagrantly ignored, and in fact shattered professional norms when he engaged in sexual misconduct with patients Y.R. and K.D.” The Board found Quartararo’s conduct was “so egregious that the only appropriate discipline is a license revocation.” The Board also imposed an aggregate monetary sanction of $343,909.75, comprised of a civil penalty of $90,000, $61,684.75 in costs, and $192,225 in attorney’s fees. Quartararo Argued The Board determined that revocation was warranted because he preyed on two vulnerable patients employed intimidation and coercion tactics to dissuade at least one of his victims-K.D.- from testifying about the true nature of their relation and resorted to making threats resulting in the issuance of a temporary restraining order against him. Quartararo admitted he had not performed laminotomies and that he had used the laminotomy code to ensure that he would be paid by insurance carriers. He did so rather than correctly coding the procedures he actually performed because of the risk he would otherwise not be paid. ZIFL OPINION Quartararo admitted before the ALJ that he committed fraud by billing insurers for laminotomies that he did not perform. As such he admitted to committing a federal as well as a New Jersey felony that should be presented to the US Attorney and the local District Attorney for prosecution. He lost his license because he took advantage sexually of vulnerable patients, committed gross acts of malpractice and profited from knowing insurance fraud. The people of New Jersey are now safe from his criminal and unprofessional conduct for a few more years, and in my opinion he should be prosecuted and sentenced to prison for the fraud. Read the full issue at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-november-15-2024-barry-zalma-esq-cfe-cxkyc IT PAYS INSURER DEFENDANTS TO INVESTIGATE INJURY CLAIMS In Chris Kallco v. Melissa Lynn Pugh, Chris Kallco, and Precise Mri Of Michigan, LLC v. Citizens Insurance Company Of The Midwest and Melissa Lynn Pugh, No. 368156, Court of Appeals of Michigan (October 30, 2024) affirmed the trial court’s decision. Plaintiff appealed from two orders granting summary disposition in favor of defendants even though he failed to respond to either motion. FACTUAL BACKGROUND This case arises out of a motor vehicle accident that occurred on March 9, 2020 involving plaintiff and Pugh. Plaintiff alleges that he sustained injuries from the accident. A year after the accident, plaintiff brought a negligence claim against Pugh, alleging that, because of Pugh’s negligence, plaintiff sustained “severe permanent and progressive personal injuries and serious impairment of a body function, including but not necessarily limited to: Head, Neck, Back, Shoulders ….” Plaintiff also brought a claim against Citizens for PIP benefits, including medical expenses, work loss, and replacement services. Pugh and Citizens moved for summary disposition arguing that plaintiff could not meet his burden of showing that he sustained a threshold injury under the no-fault act and, therefore, he could not maintain his negligence claim against her. Pugh submitted the deposition testimony of the plaintiff and the report of an independent medical examination (IME) conducted by Dr. James Bragman on December 27, 2021. Dr. Bragman further observed that plaintiff had “near full range of motion” in his neck and that he was “eminently capable” of standing and touching his toes despite his refusal to do so. Dr. Bragman noted that plaintiff had “very little” medical treatment documented in his records and that he had been undergoing physical therapy for six months with no medical basis for doing so. An investigator’s report includes pictures of plaintiff walking, riding a child’s bicycle, squatting, bending over, lifting a bicycle out of a minivan unassisted, playing with a dog, driving a car, and twisting his neck. Citizens’ motion argued that plaintiff made material misrepresentations to Citizens regarding the extent of his injuries, which rendered him ineligible for benefits. The trial court found that, based upon the evidence presented, plaintiff failed to establish that he sustained a serious impairment of body function and therefore summary disposition in favor of Pugh was appropriate. THRESHOLD INJURY Plaintiff argued that the trial court erred by granting summary disposition in favor of Pugh. Under the no fault statute, the threshold question of whether the person has suffered a serious impairment of body function should be determined by the court as a matter of law as long as there is no factual dispute regarding the nature and extent of the person’s injuries that is material to determining whether the threshold standards are met. Plaintiff was obligated to respond to Pugh’s motion in order to meet his burden of demonstrating that a fact question existed as to whether he suffered a serious impairment of body function. The parts of plaintiff’s deposition identified by Pugh do not establish a genuine issue of material fact as to whether he suffered a serious impairment of body function. The relevant portions of plaintiff’s deposition testimony fail to rebut the evidence and instead set forth, at best, mere subjective complaints of pain. FRAUDULENT INSURANCE ACT The fraud statute finds that a person who presents or causes or to be presented an oral or written statement knowing that the statement contains false information concerning a fact or thing material to the claim commits a fraudulent insurance act under that is subject to the penalties imposed under the statute. A claim that contains or is supported by a fraudulent insurance act as described in this subsection is ineligible for payment of PIP benefits. An individual commits a “fraudulent insurance act” when: (1) the person presents or causes to be presented an oral or written statement, (2) the statement is part of or in support of a claim for no-fault benefits, and (3) the claim for benefits was submitted to the MAIPF. Further, (4) the person must have known that the statement contained false information, and (5) the statement concerned a fact or thing material to the claim. ZIFL OPINION The evidence presented by the defendants were damning since they established the injuries claimed were false. Plaintiff failed to respond to the motions to his detriment and sought reconsideration without any admissible evidence that he was truly injured. The defendants established that the Plaintiff committed fraud and he is lucky that this was a civil finding not a criminal proceeding that, in my opinion, should be presented by the prosecutor. More McClenny Moseley & Associates Issues This is ZIFL’s thirty seventh 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 may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana. Health Insurance Fraud Convictions Pharmacist and Brother Convicted of $15M Medicare, Medicaid, and Private Insurer Fraud Scheme Raad Kouza, a pharmacist in Wayne County, Michigan, and his brother, Ramis Kouza, of Oakland County, Michigan, billed Medicare, Medicaid, and Blue Cross Blue Shield of Michigan for prescription medications that they did not dispense at pharmacies they owned or operated in Michigan. A federal jury convicted the pharmacy owner and his brother November 8, 2024 for conspiracy to commit health care fraud and wire fraud. Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024-1.pdf Indicators of Bad Faith Set Up Some of the more common red flags of a bad faith set-up include the following: The claimant makes a policy limits settlement demand quickly after an accident, thereby depriving the insurer of the ability to conduct a full investigation. Quick demands that are combined with a limited amount of time to accept, again, in the hopes that records cannot be obtained and the investigation cannot be completed within that limited time period, and the settlement will be refused. The claimant makes a settlement offer with one or more unusual acceptance conditions. The involvement of the claimant’s counsel pre-dates certain medical or psychiatric care (e.g., testing and treatment for alleged mild traumatic brain injury) Read the full article and the full issue of ZIFL at http://https//zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024.pdf Convictions of Other Than Health Insurance Fraud Star in Reality TV Series Pleads Guilty Crop Insurance Fraud Steve A. McBee, 52, waived his right to a grand jury and pleaded guilty to a federal information that charges him with one count of federal crop insurance fraud. McBee, a Missouri farmer who appears in a reality TV show about his family’s farming operation pleaded guilty this week to a multi-million dollar fraud scheme involving federal crop insurance benefits. Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024-1.pdf Chutzpah – STOLI Fraudster Claims Hardship Felon Seeks Release from Home Confinement in Luxury Apartment in New York City Insurance Fraud is a serious crime, especially when it takes advantage of the elderly to defraud insurers in a Stranger Originated Life Insurance (STOLI) scheme. In United States Of America v. Michael Binday, No. 12 CR 152 (CM), United States District Court, S.D. New York (November 4, 2024) the defendant continued to use the wealth he gained from his fraud to impose on the courts of the United States with frivolous and unfounded motions. Read the full article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/11/ZIFL-11-15-2024-1.pdf Barry Zalma, Esq., CFE 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.
    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 Comments 0 Shares 3K Views
  • PRESIDENT TRUMP video!

    THE END OF THE DEEP STATE:

    President Trump’s Plan to Dismantle the Deep State and Return Power to the American People. Here's my plan to dismantle the deep state and reclaim our democracy from Washington corruption once and for all, and corruption it is.

    First, I will immediately re-issue my 2020 Executive Order restoring the President's authority to remove rogue bureaucrats. And I will wield that power very aggressively.

    Second, we will clean out all of the corrupt actors in our National Security and Intelligence apparatus, and there are plenty of them. The departments and agencies that have been weaponized will be completely overhauled so that faceless bureaucrats will never again be able to target and persecute conservatives, Christians, or the left's political enemies, which they're doing now at a level that nobody can believe even possible.

    Third, we will totally reform FISA courts which are so corrupt that the judges seemingly do not care when they are lied to in warrant applications. So many judges have seen so many applications that they know were wrong, or at least they must have known. They do nothing about it, they're lied to.

    Fourth, to expose the hoaxes and abuses of power that have been tearing our country apart, we will establish a Truth and Reconciliation Commission to declassify and publish all documents on Deep State spying, censorship, and corruption, and there are plenty of them.

    Fifth, we will launch a major crackdown on government leakers who collude with the fake news to deliberately weave false narratives and to subvert our government and our democracy. When possible, we will press criminal charges.

    Sixth, we will make every Inspector General's Office independent and physically separated from the departments they oversee so they do not become the protectors of the Deep State.

    Seventh, I will ask Congress to establish an independent auditing system to continually monitor our intelligence agencies to ensure they are not spying on our citizens or running disinformation campaigns against the American people, or that they are not spying on someone's campaign like they spied on my campaign.

    Eighth, we will continue the effort launched by the Trump administration to move parts of the sprawling federal bureaucracy to new locations outside the Washington Swamp. Just as I moved the Bureau of Land Management to Colorado, as many as 100,000 government positions can be moved out. And I mean immediately out of Washington to places filled with patriots who love America, and they really do love America.

    Ninth, I will work to ban federal bureaucrats from taking jobs at the companies they deal with and that they regulate. So they deal with these companies and they regulate these companies and then they want to take jobs from these companies. Doesn't work that way—such a public display cannot go on and it's taking place all the time, like with Big Pharma.

    Finally, I will push a constitutional amendment to impose term limits on members of Congress.

    This is how I will shatter the deep state and restore government that is controlled by the people and for the people.

    Thank you very much.

    https://substack.com/@randpaulreview/note/c-76114041
    PRESIDENT TRUMP video! THE END OF THE DEEP STATE: President Trump’s Plan to Dismantle the Deep State and Return Power to the American People. Here's my plan to dismantle the deep state and reclaim our democracy from Washington corruption once and for all, and corruption it is. First, I will immediately re-issue my 2020 Executive Order restoring the President's authority to remove rogue bureaucrats. And I will wield that power very aggressively. Second, we will clean out all of the corrupt actors in our National Security and Intelligence apparatus, and there are plenty of them. The departments and agencies that have been weaponized will be completely overhauled so that faceless bureaucrats will never again be able to target and persecute conservatives, Christians, or the left's political enemies, which they're doing now at a level that nobody can believe even possible. Third, we will totally reform FISA courts which are so corrupt that the judges seemingly do not care when they are lied to in warrant applications. So many judges have seen so many applications that they know were wrong, or at least they must have known. They do nothing about it, they're lied to. Fourth, to expose the hoaxes and abuses of power that have been tearing our country apart, we will establish a Truth and Reconciliation Commission to declassify and publish all documents on Deep State spying, censorship, and corruption, and there are plenty of them. Fifth, we will launch a major crackdown on government leakers who collude with the fake news to deliberately weave false narratives and to subvert our government and our democracy. When possible, we will press criminal charges. Sixth, we will make every Inspector General's Office independent and physically separated from the departments they oversee so they do not become the protectors of the Deep State. Seventh, I will ask Congress to establish an independent auditing system to continually monitor our intelligence agencies to ensure they are not spying on our citizens or running disinformation campaigns against the American people, or that they are not spying on someone's campaign like they spied on my campaign. Eighth, we will continue the effort launched by the Trump administration to move parts of the sprawling federal bureaucracy to new locations outside the Washington Swamp. Just as I moved the Bureau of Land Management to Colorado, as many as 100,000 government positions can be moved out. And I mean immediately out of Washington to places filled with patriots who love America, and they really do love America. Ninth, I will work to ban federal bureaucrats from taking jobs at the companies they deal with and that they regulate. So they deal with these companies and they regulate these companies and then they want to take jobs from these companies. Doesn't work that way—such a public display cannot go on and it's taking place all the time, like with Big Pharma. Finally, I will push a constitutional amendment to impose term limits on members of Congress. This is how I will shatter the deep state and restore government that is controlled by the people and for the people. Thank you very much. https://substack.com/@randpaulreview/note/c-76114041
    SUBSTACK.COM
    Rand Paul Review on Substack
    THE END OF THE DEEP STATE: President Trump’s Plan to Dismantle the Deep State and Return Power to the American People. Here's my plan to dismantle the deep state and reclaim our democracy from Washington corruption once and for all, and corruption it is. First, I will immediately re-issue my 2020 Executive Order restoring the President's authority to remove rogue bureaucrats. And I will wield that power very aggressively. Second, we will clean out all of the corrupt actors in our National Security and Intelligence apparatus, and there are plenty of them. The departments and agencies that have been weaponized will be completely overhauled so that faceless bureaucrats will never again be able to target and persecute conservatives, Christians, or the left's political enemies, which they're doing now at a level that nobody can believe even possible. Third, we will totally reform FISA courts which are so corrupt that the judges seemingly do not care when they are lied to in warrant applications. So many judges have seen so many applications that they know were wrong, or at least they must have known. They do nothing about it, they're lied to. Fourth, to expose the hoaxes and abuses of power that have been tearing our country apart, we will establish a Truth and Reconciliation Commission to declassify and publish all documents on Deep State spying, censorship, and corruption, and there are plenty of them. Fifth, we will launch a major crackdown on government leakers who collude with the fake news to deliberately weave false narratives and to subvert our government and our democracy. When possible, we will press criminal charges. Sixth, we will make every Inspector General's Office independent and physically separated from the departments they oversee so they do not become the protectors of the Deep State. Seventh, I will ask Congress to establish an independent auditing system to continually monitor our intelligence agencies to ensure they are not spying on our citizens or running disinformation campaigns against the American people, or that they are not spying on someone's campaign like they spied on my campaign. Eighth, we will continue the effort launched by the Trump administration to move parts of the sprawling federal bureaucracy to new locations outside the Washington Swamp. Just as I moved the Bureau of Land Management to Colorado, as many as 100,000 government positions can be moved out. And I mean immediately out of Washington to places filled with patriots who love America, and they really do love America. Ninth, I will work to ban federal bureaucrats from taking jobs at the companies they deal with and that they regulate. So they deal with these companies and they regulate these companies and then they want to take jobs from these companies. Doesn't work that way—such a public display cannot go on and it's taking place all the time, like with Big Pharma. Finally, I will push a constitutional amendment to impose term limits on members of Congress. This is how I will shatter the deep state and restore government that is controlled by the people and for the people. Thank you very much.
    0 Comments 2 Shares 2K Views
More Results
Sponsored

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