• Falsely Claiming to Be an Insurer Can be Criminal

    To Sue for Business Disparagement Evidence is Required

    Post 4951, Posted on December 17, 2024 by Barry Zalma

    Read the full article at https://www.linkedin.com/pulse/falsely-claiming-insurer-can-criminal-barry-zalma-esq-cfe-3bwrc, see the full video at and at and at https://zalma.com/blog plus more than 4950 posts.

    See the full video at and at

    Plaintiff Route App, Inc.’s (“Route”) moved the USDC to Dismiss two counterclaims asserted by OrderProtection.com, Inc. (“OrderProtection”). In Route App, Inc. v. Orderprotection.Com, Inc.; Julian Wilson, et al, No. 2:23cv606 DAK, United States District Court, D. Utah (December 9, 2024) found no evidence supporting a claim of business disparagement or business defamation.

    BACKGROUND

    This case involves a dispute between Route, a post-purchase shipping insurance provider, and a competitor, OrderProtection. In its Complaint, Route alleges that OrderProtection and several of Route’s former employees misappropriated trade secrets to create a competing business. In response to Route’s Complaint, OrderProtection filed an Answer and Counterclaims, asserting four causes of action: (1) Unfair Competition in Violation of the Lanham Act; (2) Defamation Per Se/Defamation/Business Disparagement; (3) Tortious Interference with Existing and Prospective Economic Relations; and (4) Negligent Misrepresentation.

    The facts pertaining to OrderProtection’s claim for “Defamation/Defamation Per Se/Business Disparagement” are essentially that Route employees have allegedly told OrderProtection customers and potential customers that they should work with Route instead of OrderProtection because Route is a “legal insurance provider” and OrderProtection is not.

    OrderProtection argued that Route is not a licensed insurance company and that, at best, Route affiliates with an insurance producer to procure its own insurance coverage (which does not benefit customers or merchants). More importantly both Route and OrderProtection in essence both self-fund the warranty protection they provide, and thus a customer is no better off with Route’s protection package than with OrderProtection’s competitive offering.
    DISCUSSION

    Specifically, while OrderProtection’s Opposition Memorandum does not explicitly state that it conceded its defamation and defamation per se claims, OrderProtection never addresses Route’s argument that it could not properly maintain these causes of action in the context of this case.

    Even if OrderProtection had not conceded these claims, it failed to establish that these claims are viable in the context of this case. Further, OrderProtection made no argument that Utah law recognizes a “hybrid” cause of action for “Defamation Per Se/Defamation/Business Disparagement,” wherein a business disparagement claim may be analyzed using defamation or defamation per se case law rather than case law pertaining to a business disparagement claim.

    Business Disparagement

    The parties agree that to state a claim for business disparagement (sometimes called injurious falsehood), OrderProtection must allege (1) falsity of the statement made; (2) malice by the party making the statement; and (3) special damages. According to Route, while OrderProtection has made allegations of lost customers, it has not named specific individuals, nor has it alleged with particularity any financial losses, which is required under Rule 9(b) of the Federal Rules of Civil Procedure.

    The court declined to recognize a “business disparagement per se” cause of action in which special damages need not be alleged, and it declined to recognize a business disparagement claim that relies on a statement that is “false by implication,” which is a concept that has been recognized in defamation cases.

    Route’s Motion to Dismiss was granted and OrderProtection’s claims for defamation and defamation per se were dismissed with prejudice. Its claim for business disparagement was dismissed without prejudice, and OrderProtection may file a Motion for Leave to Amend by January 10, 2025, if it is able to allege a proper business disparagement claim, as discussed above.

    ZALMA OPINION

    Two businesses claiming to be issuers of insurance who were not licensed insurers claimed to be victims of disparagement by the other. Customers, because of the various claims shifted from one party to the other who, contrary to their claims, were self funding what they alleged was insurance of shipments of goods. The court in a Solomon-like decision ignored the fact that both claimed to be insurers when they were not and used the false claims to take over clients. Both lost and the court gave OrderProtection the attempt to state a business disparagement claim implying that the court did not believe OrderProtection would be able to plead a viable cause of action.

    The State of Utah Department of Insurance should consider this case.

    (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
    Falsely Claiming to Be an Insurer Can be Criminal To Sue for Business Disparagement Evidence is Required Post 4951, Posted on December 17, 2024 by Barry Zalma Read the full article at https://www.linkedin.com/pulse/falsely-claiming-insurer-can-criminal-barry-zalma-esq-cfe-3bwrc, see the full video at and at and at https://zalma.com/blog plus more than 4950 posts. See the full video at and at Plaintiff Route App, Inc.’s (“Route”) moved the USDC to Dismiss two counterclaims asserted by OrderProtection.com, Inc. (“OrderProtection”). In Route App, Inc. v. Orderprotection.Com, Inc.; Julian Wilson, et al, No. 2:23cv606 DAK, United States District Court, D. Utah (December 9, 2024) found no evidence supporting a claim of business disparagement or business defamation. BACKGROUND This case involves a dispute between Route, a post-purchase shipping insurance provider, and a competitor, OrderProtection. In its Complaint, Route alleges that OrderProtection and several of Route’s former employees misappropriated trade secrets to create a competing business. In response to Route’s Complaint, OrderProtection filed an Answer and Counterclaims, asserting four causes of action: (1) Unfair Competition in Violation of the Lanham Act; (2) Defamation Per Se/Defamation/Business Disparagement; (3) Tortious Interference with Existing and Prospective Economic Relations; and (4) Negligent Misrepresentation. The facts pertaining to OrderProtection’s claim for “Defamation/Defamation Per Se/Business Disparagement” are essentially that Route employees have allegedly told OrderProtection customers and potential customers that they should work with Route instead of OrderProtection because Route is a “legal insurance provider” and OrderProtection is not. OrderProtection argued that Route is not a licensed insurance company and that, at best, Route affiliates with an insurance producer to procure its own insurance coverage (which does not benefit customers or merchants). More importantly both Route and OrderProtection in essence both self-fund the warranty protection they provide, and thus a customer is no better off with Route’s protection package than with OrderProtection’s competitive offering. DISCUSSION Specifically, while OrderProtection’s Opposition Memorandum does not explicitly state that it conceded its defamation and defamation per se claims, OrderProtection never addresses Route’s argument that it could not properly maintain these causes of action in the context of this case. Even if OrderProtection had not conceded these claims, it failed to establish that these claims are viable in the context of this case. Further, OrderProtection made no argument that Utah law recognizes a “hybrid” cause of action for “Defamation Per Se/Defamation/Business Disparagement,” wherein a business disparagement claim may be analyzed using defamation or defamation per se case law rather than case law pertaining to a business disparagement claim. Business Disparagement The parties agree that to state a claim for business disparagement (sometimes called injurious falsehood), OrderProtection must allege (1) falsity of the statement made; (2) malice by the party making the statement; and (3) special damages. According to Route, while OrderProtection has made allegations of lost customers, it has not named specific individuals, nor has it alleged with particularity any financial losses, which is required under Rule 9(b) of the Federal Rules of Civil Procedure. The court declined to recognize a “business disparagement per se” cause of action in which special damages need not be alleged, and it declined to recognize a business disparagement claim that relies on a statement that is “false by implication,” which is a concept that has been recognized in defamation cases. Route’s Motion to Dismiss was granted and OrderProtection’s claims for defamation and defamation per se were dismissed with prejudice. Its claim for business disparagement was dismissed without prejudice, and OrderProtection may file a Motion for Leave to Amend by January 10, 2025, if it is able to allege a proper business disparagement claim, as discussed above. ZALMA OPINION Two businesses claiming to be issuers of insurance who were not licensed insurers claimed to be victims of disparagement by the other. Customers, because of the various claims shifted from one party to the other who, contrary to their claims, were self funding what they alleged was insurance of shipments of goods. The court in a Solomon-like decision ignored the fact that both claimed to be insurers when they were not and used the false claims to take over clients. Both lost and the court gave OrderProtection the attempt to state a business disparagement claim implying that the court did not believe OrderProtection would be able to plead a viable cause of action. The State of Utah Department of Insurance should consider this case. (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
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  • Monday, December 9, 2024

    Bishop Robert Barron

    Cycle C

    Solemnity

    Immaculate Conception

    Advent

    2nd wk of Advent

    Topics

    AnnunciationBlessed Virgin Mary.Immaculate ConceptionPope Pius IX

    Bible References

    Luke 1:26-38

    Friends, today we celebrate the Solemnity of the Immaculate Conception of the Blessed Virgin Mary. 

    In 1854, Pope Pius IX declared the dogma of the Immaculate Conception—the truth that Mary, through a special grace, was preserved free from original sin from the first moment of her conception. 

    Were this not the case, the angel would not have referred to her at the Annunciation as Kecharitomene (full of grace). Why would God do such a thing? And wouldn’t this imply that Mary does not need to be redeemed? 

    The traditional answer is that God wanted to prepare a worthy vessel for the reception of his Word. Just as the Holy of Holies in the temple was kept pure and inviolate, so the definitive Temple, the true Ark of the Covenant, which is Mary herself, should all the more be untrammeled. 

    Bl. John Duns Scotus explained that Mary is indeed redeemed by the grace of her Son, but since that grace exists outside of time, it can be applied in a way that transcends the ordinary rhythms of time. Therefore, Mary, by a kind of preemptive strike, was delivered by Christ’s grace from original sin.

    Gospel Reflections

    Meditate on Daily Gospel Reflections from Bishop Robert Barron
    Monday, December 9, 2024 Bishop Robert Barron Cycle C Solemnity Immaculate Conception Advent 2nd wk of Advent Topics AnnunciationBlessed Virgin Mary.Immaculate ConceptionPope Pius IX Bible References Luke 1:26-38 Friends, today we celebrate the Solemnity of the Immaculate Conception of the Blessed Virgin Mary.  In 1854, Pope Pius IX declared the dogma of the Immaculate Conception—the truth that Mary, through a special grace, was preserved free from original sin from the first moment of her conception.  Were this not the case, the angel would not have referred to her at the Annunciation as Kecharitomene (full of grace). Why would God do such a thing? And wouldn’t this imply that Mary does not need to be redeemed?  The traditional answer is that God wanted to prepare a worthy vessel for the reception of his Word. Just as the Holy of Holies in the temple was kept pure and inviolate, so the definitive Temple, the true Ark of the Covenant, which is Mary herself, should all the more be untrammeled.  Bl. John Duns Scotus explained that Mary is indeed redeemed by the grace of her Son, but since that grace exists outside of time, it can be applied in a way that transcends the ordinary rhythms of time. Therefore, Mary, by a kind of preemptive strike, was delivered by Christ’s grace from original sin. Gospel Reflections Meditate on Daily Gospel Reflections from Bishop Robert Barron
    0 Commentaires 0 Parts 500 Vue

  • In the blink of an eye, the procedure changed into the following: mine ores make smelt of ore to forge bronze daggers chicken execution, then sell the rest to the greedy clerk at the shop, and use the cash to buy tools. And on and so forth it goes on. As of now I've consumed all the energy drinks available I have available. I've never had to fight this intensely in my entire life to get rid of chickens. I took another bottle of red bull, knowing it could be quite a, hard night.

    As a kid I didn't experience that tight loop Jagex has created with their world. Everything worked. I did not realize that the shopkeeper took away of your hard-earned chicken breasts, because before were I an ordinary account I would have traded them to another user at a price ten times greater than. Being an ironman, you must master the mechanics of each skill to build.

    I had my second revelation after I became bored of the chickens and set out to develop my archery ability: "Ranged." I focused on the job to be completed, using the money I received from my shopkeeper, I purchased a bronze hatchet at the Lumbridge Axe store. I then cut down a nearby tree. wood is checked. After that, I returned at the store's general department. I believe that the storekeeper was expecting me. The shopkeeper's robe smelled of chicken from his lunch, and he smiled his evil, corrupted grin. Unwillingly, I spent the rest portion of my coins to purchase an instrument: required to flytch to my bow. Fletching and checking.

    There was the bow's husk that began to form the next item to my wish list were flax from the nearby fields, and the spinning wheel so that I could construct the bowstring. Within a short time I had my own bow, and I sat on my couch for an while with a smile in my eyes. I was starting to realize the game's concept all about. There is a lot of satisfaction when you earn your living from this game. If I had played an account that was normal, the procedure could have been streamlined to purchasing the bow from the Grand Exchange and carrying on my way.

    I did not realize until later that the making of a bow required use of a variety of abilities: woodcutting to make an ax, farming to harvest the flax, then fletching to make the bow, and connect the bowstring. Then came the next goal of my archery instruction and ammunition. Then my practice changed into mines for minerals, making smiths for the making of arrowheads and then fletching to make the design of archers. Even my blood feud with the chickens paid off when they produced feathers to make my archers.

    Within the first couple of hours, my perspective of the game shifted into more expansive. The game's mechanics in the Ironman mode appear to be targeted towards experienced players who have a long time ago finished their end-game content and are looking for new challenges. This is not to say that the game aren't played and loved by everyone both old and new. I must take my bow to Jagex for this The mechanic operates in ways I didn't comprehend until I experienced it.

    As a senile old man who is enjoying watching the scenery, I could not avoid noticing the accomplishments of the company. The ability to create your own way across Gielinor is a far enjoyable experience when you realize that the only way to achieve it is due to your own determination and perseverance. It's a refreshing change from an old game that's been in existence for a long time. The mechanic has also made me think on other MMO's. Is an ironman-inspired system applied to other games of the genre?

    The answer is complex. The mechanic is able to work across a variety of games so long as they meet the right elements in their game to support the player base, for instance, the game could require a variety of skills that players to put their time into and crafting systems. I think this method is particularly effective for Runescape due to its tightly knit game world as well as its loopable mechanism.
    Rsorder.com: The most professional site to Buy OSRS Gold/RS3 Gold, items, accounts, power leveling, and questing services.
    In the blink of an eye, the procedure changed into the following: mine ores make smelt of ore to forge bronze daggers chicken execution, then sell the rest to the greedy clerk at the shop, and use the cash to buy tools. And on and so forth it goes on. As of now I've consumed all the energy drinks available I have available. I've never had to fight this intensely in my entire life to get rid of chickens. I took another bottle of red bull, knowing it could be quite a, hard night. As a kid I didn't experience that tight loop Jagex has created with their world. Everything worked. I did not realize that the shopkeeper took away of your hard-earned chicken breasts, because before were I an ordinary account I would have traded them to another user at a price ten times greater than. Being an ironman, you must master the mechanics of each skill to build. I had my second revelation after I became bored of the chickens and set out to develop my archery ability: "Ranged." I focused on the job to be completed, using the money I received from my shopkeeper, I purchased a bronze hatchet at the Lumbridge Axe store. I then cut down a nearby tree. wood is checked. After that, I returned at the store's general department. I believe that the storekeeper was expecting me. The shopkeeper's robe smelled of chicken from his lunch, and he smiled his evil, corrupted grin. Unwillingly, I spent the rest portion of my coins to purchase an instrument: required to flytch to my bow. Fletching and checking. There was the bow's husk that began to form the next item to my wish list were flax from the nearby fields, and the spinning wheel so that I could construct the bowstring. Within a short time I had my own bow, and I sat on my couch for an while with a smile in my eyes. I was starting to realize the game's concept all about. There is a lot of satisfaction when you earn your living from this game. If I had played an account that was normal, the procedure could have been streamlined to purchasing the bow from the Grand Exchange and carrying on my way. I did not realize until later that the making of a bow required use of a variety of abilities: woodcutting to make an ax, farming to harvest the flax, then fletching to make the bow, and connect the bowstring. Then came the next goal of my archery instruction and ammunition. Then my practice changed into mines for minerals, making smiths for the making of arrowheads and then fletching to make the design of archers. Even my blood feud with the chickens paid off when they produced feathers to make my archers. Within the first couple of hours, my perspective of the game shifted into more expansive. The game's mechanics in the Ironman mode appear to be targeted towards experienced players who have a long time ago finished their end-game content and are looking for new challenges. This is not to say that the game aren't played and loved by everyone both old and new. I must take my bow to Jagex for this The mechanic operates in ways I didn't comprehend until I experienced it. As a senile old man who is enjoying watching the scenery, I could not avoid noticing the accomplishments of the company. The ability to create your own way across Gielinor is a far enjoyable experience when you realize that the only way to achieve it is due to your own determination and perseverance. It's a refreshing change from an old game that's been in existence for a long time. The mechanic has also made me think on other MMO's. Is an ironman-inspired system applied to other games of the genre? The answer is complex. The mechanic is able to work across a variety of games so long as they meet the right elements in their game to support the player base, for instance, the game could require a variety of skills that players to put their time into and crafting systems. I think this method is particularly effective for Runescape due to its tightly knit game world as well as its loopable mechanism. Rsorder.com: The most professional site to Buy OSRS Gold/RS3 Gold, items, accounts, power leveling, and questing services.
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  • Zalma's Insurance Fraud Letter - December 1, 2024

    ZIFL Volume 28 No. 22

    Post 4939

    Read the full article at Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdfand at https://zalma.com/blog.

    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 https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    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:

    The EUO is a Material Condition Precedent
    A Key Tool in the Effort to Reduce Fraud
    Claim Properly Denied for Refusal to Testify at EUO

    I spoke recently at the Conference of the Southern California Fraud Investigators Association on the Examination Under Oath as a tool to help insureds prove their losses and what happens when an insured fails or refuses to testify. This case emphasizes the purpose of my talk.

    Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    Thanksgiving Wishes from the Zalma Family

    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.

    Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    More McClenny Moseley & Associates Issues

    This is ZIFL’s thirty eighth 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 to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana.

    Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    Ethical Behavior & Insurance

    Insurance, from the time of its first agreement to the present day has always been a business requiring ethical behavior between the insurer and the insured and between the insured and the insurer.

    The concept of ethical behavior refers to well-founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues, all of which are essential to the lawyer.

    Ethics refers to those standards that impose the reasonable obligations to refrain from murder, rape, theft, assault, slander, and fraud. Ethical standards also include those that imply virtues of honesty, compassion, and loyalty.

    There are rights presumed to exist such as those described in the Declaration of Independence submitted to King George of England in 1776 that held:

    We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of happiness.

    The unalienable rights also include the right to life, the right to freedom from injury, and the right to liberty. Such standards are adequate standards of ethics because they are supported by consistent and well-founded reasons.

    Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    Health Insurance Fraud Convictions

    Michigan Woman Convicted of $1.4M Health Care Kickback Scheme

    Mary Smettler-Bolton, 71, of Oakland County, Michigan was convicted November 22, 2024 for her role in a conspiracy to defraud the United States and receive illegal health care kickbacks.

    According to court documents and evidence presented at trial, Mary referred Medicare beneficiaries to several Metro Detroit home health companies in exchange for hundreds of thousands of dollars in kickbacks paid by the owners and operators of the home health companies. Over the course of four years, she and her co-conspirators caused over $1.4 million of loss to Medicare.

    Smettler-Bolton was convicted of one count of conspiracy to defraud the United States and receive illegal health care kickbacks and one count of violating the federal Anti-Kickback Statute. She is scheduled to be sentenced on March 3, 2025, and faces a maximum penalty of five years in prison on the conspiracy count and a maximum penalty of 10 years in prison on the kickback count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

    Read the full article about dozens more convictions at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    Convictions of Other Than Health Insurance Fraud

    Creative Fraudster Guilty of $229K Insurance Fraud Schemes

    Justin Mack, a native of Buffalo, New York, and a resident of Cleveland, Ohio, was sentenced on November 25, 2024 in the Cuyahoga County Court of Common Pleas. Mack, an Ohio man was sentenced to five years in prison and ordered to pay restitution for filing 24 fraudulent claims with multiple insurance companies, totaling more than $229,000.

    An extensive investigation uncovered Mack’s pattern of submitting altered documentation, falsified claims, and using other people’s identities to fraudulently secure payouts from multiple insurance companies.

    Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    The Examination Under Oath Is Not Part of a Judicial Process

    Although the EUO is a formal proceeding it is not part of a judicial process nor is it subject to the rules set out by codes of civil procedure. There is no right to object to questions and never a judge present to rule on the objections. The testimony at the EUO is required to be presented in accordance with the obligation imposed on an insured to deal fairly and in good faith with the insurer.

    Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf

    Barry Zalma

    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. Write to Mr. Zalma at [email protected]; https://www.zalma.com; https://zalma.com/blog. He publishes daily articles at https://zalma.substack.com, Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ to consider more than 50 volumes written by Barry Zalma on insurance and insurance claims handling.

    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
    Zalma's Insurance Fraud Letter - December 1, 2024 ZIFL Volume 28 No. 22 Post 4939 Read the full article at Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdfand at https://zalma.com/blog. 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 https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf 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: The EUO is a Material Condition Precedent A Key Tool in the Effort to Reduce Fraud Claim Properly Denied for Refusal to Testify at EUO I spoke recently at the Conference of the Southern California Fraud Investigators Association on the Examination Under Oath as a tool to help insureds prove their losses and what happens when an insured fails or refuses to testify. This case emphasizes the purpose of my talk. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Thanksgiving Wishes from the Zalma Family 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. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf More McClenny Moseley & Associates Issues This is ZIFL’s thirty eighth 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 to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Ethical Behavior & Insurance Insurance, from the time of its first agreement to the present day has always been a business requiring ethical behavior between the insurer and the insured and between the insured and the insurer. The concept of ethical behavior refers to well-founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues, all of which are essential to the lawyer. Ethics refers to those standards that impose the reasonable obligations to refrain from murder, rape, theft, assault, slander, and fraud. Ethical standards also include those that imply virtues of honesty, compassion, and loyalty. There are rights presumed to exist such as those described in the Declaration of Independence submitted to King George of England in 1776 that held: We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of happiness. The unalienable rights also include the right to life, the right to freedom from injury, and the right to liberty. Such standards are adequate standards of ethics because they are supported by consistent and well-founded reasons. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Health Insurance Fraud Convictions Michigan Woman Convicted of $1.4M Health Care Kickback Scheme Mary Smettler-Bolton, 71, of Oakland County, Michigan was convicted November 22, 2024 for her role in a conspiracy to defraud the United States and receive illegal health care kickbacks. According to court documents and evidence presented at trial, Mary referred Medicare beneficiaries to several Metro Detroit home health companies in exchange for hundreds of thousands of dollars in kickbacks paid by the owners and operators of the home health companies. Over the course of four years, she and her co-conspirators caused over $1.4 million of loss to Medicare. Smettler-Bolton was convicted of one count of conspiracy to defraud the United States and receive illegal health care kickbacks and one count of violating the federal Anti-Kickback Statute. She is scheduled to be sentenced on March 3, 2025, and faces a maximum penalty of five years in prison on the conspiracy count and a maximum penalty of 10 years in prison on the kickback count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors. Read the full article about dozens more convictions at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Convictions of Other Than Health Insurance Fraud Creative Fraudster Guilty of $229K Insurance Fraud Schemes Justin Mack, a native of Buffalo, New York, and a resident of Cleveland, Ohio, was sentenced on November 25, 2024 in the Cuyahoga County Court of Common Pleas. Mack, an Ohio man was sentenced to five years in prison and ordered to pay restitution for filing 24 fraudulent claims with multiple insurance companies, totaling more than $229,000. An extensive investigation uncovered Mack’s pattern of submitting altered documentation, falsified claims, and using other people’s identities to fraudulently secure payouts from multiple insurance companies. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf The Examination Under Oath Is Not Part of a Judicial Process Although the EUO is a formal proceeding it is not part of a judicial process nor is it subject to the rules set out by codes of civil procedure. There is no right to object to questions and never a judge present to rule on the objections. The testimony at the EUO is required to be presented in accordance with the obligation imposed on an insured to deal fairly and in good faith with the insurer. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Barry Zalma 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. Write to Mr. Zalma at [email protected]; https://www.zalma.com; https://zalma.com/blog. He publishes daily articles at https://zalma.substack.com, Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ to consider more than 50 volumes written by Barry Zalma on insurance and insurance claims handling. 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
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  • EVERYTHING that takes place in this world REQUIRES your consent

    Sometimes, the most powerful thing you can do is to refuse to consent. To stand your ground and say "NO, I do not consent"

    And that goes both for life and #Law!
    The #Media manufactures the "consent" of people ignorant of this concept
    EVERYTHING that takes place in this world REQUIRES your consent Sometimes, the most powerful thing you can do is to refuse to consent. To stand your ground and say "NO, I do not consent" And that goes both for life and #Law! The #Media manufactures the "consent" of people ignorant of this concept
    0 Commentaires 0 Parts 196 Vue 0
  • https://www.oann.com/video/oan-contribution/immaculate-conception-the-governments-secret-ufo-program/
    https://www.oann.com/video/oan-contribution/immaculate-conception-the-governments-secret-ufo-program/
    WWW.OANN.COM
    Immaculate Constellation: The Government’s Secret UFO Program
    A joint hearing in Congress tries to pull the veil off the Pentagon's secret UAP/UFO recovery and reverse-engineering program.
    Angry
    1
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  • Teaching "Islamic Religious Concepts" Brings Social Conflict To Canada
    #NoMoreLiberalsAndNDP
    #SayingTheQuietPartOutLoud
    #resigntrudeau
    #JustSayNoMore
    https://open.substack.com/pub/bradsalzberg/p/teaching-islamic-religious-concepts
    Teaching "Islamic Religious Concepts" Brings Social Conflict To Canada 🇨🇦 #NoMoreLiberalsAndNDP 🇨🇦 🇨🇦 #SayingTheQuietPartOutLoud 🇨🇦 🇨🇦 #resigntrudeau 🇨🇦 🇨🇦 #JustSayNoMore 🇨🇦 https://open.substack.com/pub/bradsalzberg/p/teaching-islamic-religious-concepts
    OPEN.SUBSTACK.COM
    Teaching "Islamic Religious Concepts" Brings Social Conflict To Canada
    “There is something very disturbing in this case. It is this attempt by a group of teachers to introduce Islamist religious concepts into a public school,” stated Quebec Premier Francois Legault.
    Like
    Vomit
    2
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  • https://settingbrushfires.com/5g-emfs-crucial-misconceptions-to-avoid-understand-a-solution-video/
    https://settingbrushfires.com/5g-emfs-crucial-misconceptions-to-avoid-understand-a-solution-video/
    SETTINGBRUSHFIRES.COM
    5G & EMFs: Crucial Misconceptions To Avoid & Understand - & A Solution (Video) - Setting Brushfires
    In this episode, our friend Cory Hillis from FixEMFs.com joins me to talk about the misconceptions about 5G and EMFs, what they actually do and how they are harmful to the body. He then offers a simple, organic solution to the problem. Visit Cory’s Site – Get a free home ...
    0 Commentaires 0 Parts 468 Vue
  • https://thewashingtonstandard.com/5g-emfs-crucial-misconceptions-to-avoid-understand-a-solution-video/
    https://thewashingtonstandard.com/5g-emfs-crucial-misconceptions-to-avoid-understand-a-solution-video/
    THEWASHINGTONSTANDARD.COM
    5G & EMFs: Crucial Misconceptions To Avoid & Understand - & A Solution (Video) - The Washington Standard
    In this episode, our friend Cory Hillis from FixEMFs.com joins me to talk about the misconceptions about 5G and EMFs, what they actually do and how they are harmful to the body. He then offers a simple, organic solution to the problem. Visit Cory’s Site – Get a free home ...
    0 Commentaires 0 Parts 442 Vue
  • Historic Catholic Church in France destroyed in arson attack
    The historic Church of the Immaculate Conception in Saint-Omer, France, was destroyed in an arson attack on Sept. 2. The fire destroyed the belfry, framework and roof of the church, which is located near Calais in the north of France.
    Historic Catholic Church in France destroyed in arson attack The historic Church of the Immaculate Conception in Saint-Omer, France, was destroyed in an arson attack on Sept. 2. The fire destroyed the belfry, framework and roof of the church, which is located near Calais in the north of France.
    WWW.NATURALNEWS.COM
    Historic Catholic Church in France destroyed in arson attack – NaturalNews.com
    The historic Church of the Immaculate Conception in Saint-Omer, France, was destroyed in an arson attack on Sept. 2. The fire destroyed the belfry, framework and roof of the church, which is located near Calais in the north of France. Evidence suggest that the conflagration was due to arson after officials found traces of breaking through a […]
    0 Commentaires 0 Parts 372 Vue
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