• My name is Jake Lang & I have been a January 6 Hostage - incarcerated & tortured without a trial for 3 years, 10 months and 5 days by the Deepstate!

    I will not accept a pardon unless ALL Jan 6 Prisoners are pardoned.

    The 1561+ January 6 Political Prisoners are unanimously calling upon President Trump to SAVE OUR LIVES & follow his heart: Pardon All J6ers on Day One

    NO MAN LEFT BEHIND TO ROT IN THE GULAG!

    We have drafted the J6 Day One Freedom Petition ( J6Pardons.com ) that has been signed by tens of thousands of red blooded Americans, including Conservative Luminaries:

    Jim Hoft, Laura Loomer, Darren Beattie, Diamond & Silk, Grant Stinchfield, Brandon Straka, Cara Castronuova, Wayne Allyn Root, Ann Vandersteel, Doug Billings, Jeff Crouere, Behizy, Matt Wallce, Couy Griffin, Treniss Evans, David Sumrall & Suzzane Monk

    The weaponization of the DOJ has gone too far, and destroyed thousands of lives with an overzealous political persecution of Trump supporters.

    Trump knows how it feels to be railroaded, denied due process & an impartial jury. To be convicted by the corrupt media before you ever step foot in court.

    Every Jan 6er was entrapped by our own Federal Government at the Capitol, a clear set up to paint Trump & his supporters as domestic terrorists!!

    The hundreds of patriotic men who have assault charges (590 out of 1561 defendants) such as myself - were forced to defend our own lives & the lives of the unarmed women and elderly around us.

    The Capitol Police murdered a young defenseless woman Roseanne Boyland, a 38 year old angel from Georgia in my arms. After this many men including myself took up a serious defensive position.

    The numerous award winning documentaries on J6 prove that we were NOT the aggressors, but responded as brave American men do to oppression & violence: we stood our ground & defended those around us.

    Nearly 4 years I have traded tears and prayers with my brothers in the Gulag, getting to know each and every man & see his Godly character -

    I can unequivocally say this crop of patriots & Christians are the BEST AMERICANS WE HAVE: they are bold and brave, kind and concerned fathers & husbands, leaders and lovers of God and Country.

    Unbreakable, indomitable, unrelenting 1776 patriots who would die to defend our Constitution without moments hesitation.

    Humble hard workers, military veterans & school teachers. Bus drivers, doctors, Olympic athletes, NFL players, Broadway stars and missionary servants of the Lord.

    Carpenters, plumbers, roofers, electricians, fathers, husbands: Man amongst men.

    This outrageous stain on American history, similar to the Japanese internment camps in World War II, has gone on long enough. Its time to set free the captives, and break the shackles of two tiered justice.

    Its time to release, pardon & fully expunge / erase the records of every single January 6 Hostage. Point blank period.

    History calls us to this moment of National Reconciliation, the American people have all but lost their faith in the judicial system watching Trump & the J6 witch hunt continue for 4 long years. We need to restore belief & trust in American jurisprudence.

    The immediate release of the Jan 6ers is where we start this battle to revive our degenerated institutions that used to be sacred.

    We are trusting the new MAGA Attorney General will also put an end to the Weaponized DOJ and immediately HALT all new J6 investigations & arrests, and DISMISS all current pending cases.

    How many J6 grandmothers need to be ripped out of their homes at gunpoint by a tyrannical FBI GESTAPO squadron and railroaded into federal prisons before we STOP THIS MADNESS!?!

    My conscious is clear before the Savior of man: that just as blanket pardons were issued after the Civil War to restore national unity, we too should be looking at this national healing moment with reverence & earnest expectations!

    President Trump will not let us down, we stand behind you Mr. President!

    NOT A SINGLE J6ER WAS GIVEN A FAIR TRIAL!!!

    J6Pardons.com to sign the official J6 Day One Freedom Petition

    #MAGA #FULLPARDONS #BREAKEVERYCHAIN #FREEATLAST #JANUARY20TH #INAUGURATION #LIBERATIONDAY
    https://x.com/JakeLangJ6/status/1859657832951632228?t=Ba2gzLPyrEytXhVvOHtSLw&s=09
    My name is Jake Lang & I have been a January 6 Hostage - incarcerated & tortured without a trial for 3 years, 10 months and 5 days by the Deepstate! I will not accept a pardon unless ALL Jan 6 Prisoners are pardoned. The 1561+ January 6 Political Prisoners are unanimously calling upon President Trump to SAVE OUR LIVES & follow his heart: Pardon All J6ers on Day One NO MAN LEFT BEHIND TO ROT IN THE GULAG! We have drafted the J6 Day One Freedom Petition ( J6Pardons.com ) that has been signed by tens of thousands of red blooded Americans, including Conservative Luminaries: Jim Hoft, Laura Loomer, Darren Beattie, Diamond & Silk, Grant Stinchfield, Brandon Straka, Cara Castronuova, Wayne Allyn Root, Ann Vandersteel, Doug Billings, Jeff Crouere, Behizy, Matt Wallce, Couy Griffin, Treniss Evans, David Sumrall & Suzzane Monk The weaponization of the DOJ has gone too far, and destroyed thousands of lives with an overzealous political persecution of Trump supporters. Trump knows how it feels to be railroaded, denied due process & an impartial jury. To be convicted by the corrupt media before you ever step foot in court. Every Jan 6er was entrapped by our own Federal Government at the Capitol, a clear set up to paint Trump & his supporters as domestic terrorists!! The hundreds of patriotic men who have assault charges (590 out of 1561 defendants) such as myself - were forced to defend our own lives & the lives of the unarmed women and elderly around us. The Capitol Police murdered a young defenseless woman Roseanne Boyland, a 38 year old angel from Georgia in my arms. After this many men including myself took up a serious defensive position. The numerous award winning documentaries on J6 prove that we were NOT the aggressors, but responded as brave American men do to oppression & violence: we stood our ground & defended those around us. Nearly 4 years I have traded tears and prayers with my brothers in the Gulag, getting to know each and every man & see his Godly character - I can unequivocally say this crop of patriots & Christians are the BEST AMERICANS WE HAVE: they are bold and brave, kind and concerned fathers & husbands, leaders and lovers of God and Country. Unbreakable, indomitable, unrelenting 1776 patriots who would die to defend our Constitution without moments hesitation. Humble hard workers, military veterans & school teachers. Bus drivers, doctors, Olympic athletes, NFL players, Broadway stars and missionary servants of the Lord. Carpenters, plumbers, roofers, electricians, fathers, husbands: Man amongst men. This outrageous stain on American history, similar to the Japanese internment camps in World War II, has gone on long enough. Its time to set free the captives, and break the shackles of two tiered justice. Its time to release, pardon & fully expunge / erase the records of every single January 6 Hostage. Point blank period. History calls us to this moment of National Reconciliation, the American people have all but lost their faith in the judicial system watching Trump & the J6 witch hunt continue for 4 long years. We need to restore belief & trust in American jurisprudence. The immediate release of the Jan 6ers is where we start this battle to revive our degenerated institutions that used to be sacred. We are trusting the new MAGA Attorney General will also put an end to the Weaponized DOJ and immediately HALT all new J6 investigations & arrests, and DISMISS all current pending cases. How many J6 grandmothers need to be ripped out of their homes at gunpoint by a tyrannical FBI GESTAPO squadron and railroaded into federal prisons before we STOP THIS MADNESS!?! My conscious is clear before the Savior of man: that just as blanket pardons were issued after the Civil War to restore national unity, we too should be looking at this national healing moment with reverence & earnest expectations! President Trump will not let us down, we stand behind you Mr. President! NOT A SINGLE J6ER WAS GIVEN A FAIR TRIAL!!! J6Pardons.com to sign the official J6 Day One Freedom Petition #MAGA #FULLPARDONS #BREAKEVERYCHAIN #FREEATLAST #JANUARY20TH #INAUGURATION #LIBERATIONDAY https://x.com/JakeLangJ6/status/1859657832951632228?t=Ba2gzLPyrEytXhVvOHtSLw&s=09
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  • EUO is a Material Condition Precedent

    Claim Properly Denied for Refusal to Testify at EUO

    Post 4936

    Read the full article at https://www.linkedin.com/pulse/euo-material-condition-precedent-barry-zalma-esq-cfe-exccc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts.

    See the full video at and at

    Erin Hughes appealed from the grant of summary judgment in favor of defendant and respondent Farmers Insurance Exchange (Farmers) on her causes of action for breach of contract and bad faith arising after Farmers’ denial of Hughes’s property insurance claim because she refused to testify at a second examination under oath (EUO).

    In Erin Hughes v. Farmers Insurance Exchange, B331168, California Court of Appeals (November 8, 2024) the condition precedent was enforced.

    FACTUAL BACKGROUND

    Hughes is the owner of real property in Malibu (the property). In December 2020, Hughes obtained an insurance policy to cover the property for fire loss through the California FAIR Plan Association (FAIR Plan). Also in December 2020, Hughes obtained a homeowner’s insurance policy from Farmers to cover perils other than fire, including losses due to theft (the policy).

    One month later, in January 2021, the property sustained significant fire damage. Hughes contacted Farmers, which advised her that fire loss was not covered by her Farmers policy, and she would have to pursue any such claim through her FAIR Plan policy. Unhappy, on January 21, 2021, Hughes tendered a theft claim under the Farmers policy, asserting in excess of $2 million worth of personal property was stolen from the property.

    Farmers ultimately denied the claim on January 5, 2022, on the ground that Hughes failed to cooperate with Farmers’ investigation, including by failing to participate in a second examination under oath as required by the policy.
    Hughes’s Complaint Against Farmers

    One week after the denial of her claim, Hughes sued Farmers and alleged Farmers demanded “duplicative, onerous and/or unnecessary” documentation of stolen items. Further, she alleged Farmers subjected her to “two confrontational, accusatory and grueling examinations under oath.” Hughes alleged her second examination under oath had been “suspended due to [her] medical condition,” but Farmers disregarded her condition and demanded a third examination.

    Farmers’ Motion for Summary Judgment

    Farmers moved for summary judgment contending it properly denied Hughes’s theft claim based on her failure to cooperate with Farmers’ investigation of her claim as well as her material misrepresentations in obtaining the Farmers policy.

    In May 2021, as part of Farmers’ theft claim investigation, Hughes participated in an examination under oath. During the examination, Hughes’s counsel informed the Farmers attorney he had just sent more than 40 additional receipts that the attorney would be receiving shortly. Recognizing they would not have time to go through the new items that day and the examination would need to continue on a future date, the Farmers attorney proposed “continu[ing] to work with one another to identify what’s missing.” In response, Hughes and her counsel agreed, with Hughes stating she would be happy to get “every single thing that you need and I’ll send it to my attorney right away.”

    In October 2021, a second session of the examination under oath was held regarding documentation Hughes had produced during and after the first session. Hughes appeared remotely with counsel and before any questions were asked of her, she objected to a further examination.

    Hughes accused the Farmers attorney of interrogating her “like a fucking criminal” and stated, “if you want to take my deposition . . . you are going to take a second deposition in court, and that’s going to be a formal deposition.” Hughes’s remote connection then cut out, and her counsel indicated she would not proceed with the examination.

    Farmers informed Hughes that it was denying coverage based on her failure to cooperate with Farmers’ investigation and particularly her refusal to proceed with the second examination under oath.
    Trial Court’s Grant of Summary Judgment and Denial of Hughes’s Continuance Request and Motion for New Trial

    The trial court granted summary judgment in favor of Farmers. Noting an insurer has “an absolute right” to require the insured to submit to an examination under oath “as long as the insurer exercises the right reasonably,” the court determined Hughes had not shown Farmers acted unreasonably. The court concluded summary judgment was appropriate “based solely on failure to cooperate.”

    DISCUSSION

    The trial court properly concluded there was no genuine dispute that Hughes’s failure to participate in an examination under oath constituted a material breach of the policy; accordingly, Farmers was excused from having to pay on Hughes’s claim. The right to require the insured to submit to an examination under oath concerning all proper subjects of inquiry is reasonable as a matter of law.

    An insured’s compliance with a policy requirement to submit to an examination under oath is a prerequisite to the right to receive benefits under the policy.
    Because Hughes refused to cooperate with Farmers’ investigation by participating in and completing her examination under oath, she cannot establish her own performance under the policy.
    Breach of Implied Covenant Claim

    The implied covenant of good faith and fair dealing is based on general contract law and the long-standing rule that neither party will do anything which will injure the right of the other to receive the benefits of the agreement. Hughes’s claim for bad faith fails as a matter of law.

    ZALMA OPINION

    Wildfires tend to destroy everything. That is why insurers are unwilling to write fire insurance in Malibu and other areas prone to wildfires and obtain fire insurance from the Fair Plan, an organization designed to cover uninsurable risks. Because of the destruction done by a wildfire or a dwelling fire a $2 million dollar theft loss after a fire is questionable and a good reason to take a thorough EUO. Farmers tried to do so and Hughes refused without reason after admitting she left open much investigation elements at the agreed conclusion of the first session and an agreement to a second only to refuse.

    (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
    EUO is a Material Condition Precedent Claim Properly Denied for Refusal to Testify at EUO Post 4936 Read the full article at https://www.linkedin.com/pulse/euo-material-condition-precedent-barry-zalma-esq-cfe-exccc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. See the full video at and at Erin Hughes appealed from the grant of summary judgment in favor of defendant and respondent Farmers Insurance Exchange (Farmers) on her causes of action for breach of contract and bad faith arising after Farmers’ denial of Hughes’s property insurance claim because she refused to testify at a second examination under oath (EUO). In Erin Hughes v. Farmers Insurance Exchange, B331168, California Court of Appeals (November 8, 2024) the condition precedent was enforced. FACTUAL BACKGROUND Hughes is the owner of real property in Malibu (the property). In December 2020, Hughes obtained an insurance policy to cover the property for fire loss through the California FAIR Plan Association (FAIR Plan). Also in December 2020, Hughes obtained a homeowner’s insurance policy from Farmers to cover perils other than fire, including losses due to theft (the policy). One month later, in January 2021, the property sustained significant fire damage. Hughes contacted Farmers, which advised her that fire loss was not covered by her Farmers policy, and she would have to pursue any such claim through her FAIR Plan policy. Unhappy, on January 21, 2021, Hughes tendered a theft claim under the Farmers policy, asserting in excess of $2 million worth of personal property was stolen from the property. Farmers ultimately denied the claim on January 5, 2022, on the ground that Hughes failed to cooperate with Farmers’ investigation, including by failing to participate in a second examination under oath as required by the policy. Hughes’s Complaint Against Farmers One week after the denial of her claim, Hughes sued Farmers and alleged Farmers demanded “duplicative, onerous and/or unnecessary” documentation of stolen items. Further, she alleged Farmers subjected her to “two confrontational, accusatory and grueling examinations under oath.” Hughes alleged her second examination under oath had been “suspended due to [her] medical condition,” but Farmers disregarded her condition and demanded a third examination. Farmers’ Motion for Summary Judgment Farmers moved for summary judgment contending it properly denied Hughes’s theft claim based on her failure to cooperate with Farmers’ investigation of her claim as well as her material misrepresentations in obtaining the Farmers policy. In May 2021, as part of Farmers’ theft claim investigation, Hughes participated in an examination under oath. During the examination, Hughes’s counsel informed the Farmers attorney he had just sent more than 40 additional receipts that the attorney would be receiving shortly. Recognizing they would not have time to go through the new items that day and the examination would need to continue on a future date, the Farmers attorney proposed “continu[ing] to work with one another to identify what’s missing.” In response, Hughes and her counsel agreed, with Hughes stating she would be happy to get “every single thing that you need and I’ll send it to my attorney right away.” In October 2021, a second session of the examination under oath was held regarding documentation Hughes had produced during and after the first session. Hughes appeared remotely with counsel and before any questions were asked of her, she objected to a further examination. Hughes accused the Farmers attorney of interrogating her “like a fucking criminal” and stated, “if you want to take my deposition . . . you are going to take a second deposition in court, and that’s going to be a formal deposition.” Hughes’s remote connection then cut out, and her counsel indicated she would not proceed with the examination. Farmers informed Hughes that it was denying coverage based on her failure to cooperate with Farmers’ investigation and particularly her refusal to proceed with the second examination under oath. Trial Court’s Grant of Summary Judgment and Denial of Hughes’s Continuance Request and Motion for New Trial The trial court granted summary judgment in favor of Farmers. Noting an insurer has “an absolute right” to require the insured to submit to an examination under oath “as long as the insurer exercises the right reasonably,” the court determined Hughes had not shown Farmers acted unreasonably. The court concluded summary judgment was appropriate “based solely on failure to cooperate.” DISCUSSION The trial court properly concluded there was no genuine dispute that Hughes’s failure to participate in an examination under oath constituted a material breach of the policy; accordingly, Farmers was excused from having to pay on Hughes’s claim. The right to require the insured to submit to an examination under oath concerning all proper subjects of inquiry is reasonable as a matter of law. An insured’s compliance with a policy requirement to submit to an examination under oath is a prerequisite to the right to receive benefits under the policy. Because Hughes refused to cooperate with Farmers’ investigation by participating in and completing her examination under oath, she cannot establish her own performance under the policy. Breach of Implied Covenant Claim The implied covenant of good faith and fair dealing is based on general contract law and the long-standing rule that neither party will do anything which will injure the right of the other to receive the benefits of the agreement. Hughes’s claim for bad faith fails as a matter of law. ZALMA OPINION Wildfires tend to destroy everything. That is why insurers are unwilling to write fire insurance in Malibu and other areas prone to wildfires and obtain fire insurance from the Fair Plan, an organization designed to cover uninsurable risks. Because of the destruction done by a wildfire or a dwelling fire a $2 million dollar theft loss after a fire is questionable and a good reason to take a thorough EUO. Farmers tried to do so and Hughes refused without reason after admitting she left open much investigation elements at the agreed conclusion of the first session and an agreement to a second only to refuse. (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
    WWW.LINKEDIN.COM
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  • The Remarkable Life of Dietrich Bonhoeffer: A Story of Courage and Faith
    Dietrich Bonhoeffer, a German theologian, is a Christian hero for many. Executed by the Nazis just days before the end of WWII for his participation in a plot to assassinate Hitler, Bonhoeffer is hailed as a 20th-century martyr. But Bonhoeffer struggled with a moral dilemma – his religious views were in stark contrast to the evil he saw all around him. He chose to face possible imprisonment and execution and to remain faithful to the principles of his belief in God. Across the political and theological spectrum, Bonhoeffer is celebrated as an icon of true Christianity and his theological writings are classics throughout the Christian world.
    https://rumble.com/v3l3a37-the-remarkable-life-of-dietrich-bonhoeffer-a-story-of-courage-and-faith.html
    The Remarkable Life of Dietrich Bonhoeffer: A Story of Courage and Faith Dietrich Bonhoeffer, a German theologian, is a Christian hero for many. Executed by the Nazis just days before the end of WWII for his participation in a plot to assassinate Hitler, Bonhoeffer is hailed as a 20th-century martyr. But Bonhoeffer struggled with a moral dilemma – his religious views were in stark contrast to the evil he saw all around him. He chose to face possible imprisonment and execution and to remain faithful to the principles of his belief in God. Across the political and theological spectrum, Bonhoeffer is celebrated as an icon of true Christianity and his theological writings are classics throughout the Christian world. https://rumble.com/v3l3a37-the-remarkable-life-of-dietrich-bonhoeffer-a-story-of-courage-and-faith.html
    0 Σχόλια 0 Μοιράστηκε 629 Views
  • GOD WANTS YOU To Win…the only real question, is Do YOU Want to win?
    #LiveFEARLESSLY
    https://thewayinternational.com/building-faithfulness-financial-stewardship/
    THIS LINK Is only good through next Saturday:
    https://www.theway.org/sunday-teaching-services/current/
    GOD WANTS YOU To Win…the only real question, is Do YOU Want to win? #LiveFEARLESSLY https://thewayinternational.com/building-faithfulness-financial-stewardship/ THIS LINK Is only good through next Saturday: https://www.theway.org/sunday-teaching-services/current/
    0 Σχόλια 0 Μοιράστηκε 371 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.
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  • Oklahoma State Official Moves to Create “Office of Religious Liberty and Patriotism”
    https://thechristiantribune.com/oklahoma-state-official-moves-to-create-office-of-religious-liberty-and-patriotism/

    FIRST PARAGRAPH: The Oklahoma Education Department, led by the pro-faith State Superintended Ryan Walters, is moving to create the “Office of Religious Liberty and Patriotism.” The initiative is the latest effort from Walters, who has made headlines for his faith-based efforts at the state level, such as putting the Christian Bible back in classrooms across Oklahoma.
    Oklahoma State Official Moves to Create “Office of Religious Liberty and Patriotism” https://thechristiantribune.com/oklahoma-state-official-moves-to-create-office-of-religious-liberty-and-patriotism/ FIRST PARAGRAPH: The Oklahoma Education Department, led by the pro-faith State Superintended Ryan Walters, is moving to create the “Office of Religious Liberty and Patriotism.” The initiative is the latest effort from Walters, who has made headlines for his faith-based efforts at the state level, such as putting the Christian Bible back in classrooms across Oklahoma.
    THECHRISTIANTRIBUNE.COM
    Oklahoma State Official Moves to Create “Office of Religious Liberty and Patriotism”
    The Oklahoma Education Department, led by the pro-faith State Superintended Ryan Walters, is moving to create the "Office of Religious Liberty and
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  • Revelation
    Chapter 3

    1 And unto the angel of the church in Sardis write; These things saith he that hath the seven Spirits of God, and the seven stars; I know thy works, that thou hast a name that thou livest, and art dead.

    2 Be watchful, and strengthen the things which remain, that are ready to die: for I have not found thy works perfect before God.

    3 Remember therefore how thou hast received and heard, and hold fast, and repent. If therefore thou shalt not watch, I will come on thee as a thief, and thou shalt not know what hour I will come upon thee.

    4 Thou hast a few names even in Sardis which have not defiled their garments; and they shall walk with me in white: for they are worthy.

    5 He that overcometh, the same shall be clothed in white raiment; and I will not blot out his name out of the book of life, but I will confess his name before my Father, and before his angels.

    6 He that hath an ear, let him hear what the Spirit saith unto the churches.

    7 And to the angel of the church in Philadelphia write; These things saith he that is holy, he that is true, he that hath the key of David, he that openeth, and no man shutteth; and shutteth, and no man openeth;

    8 I know thy works: behold, I have set before thee an open door, and no man can shut it: for thou hast a little strength, and hast kept my word, and hast not denied my name.

    9 Behold, I will make them of the synagogue of Satan, which say they are Jews, and are not, but do lie; behold, I will make them to come and worship before thy feet, and to know that I have loved thee.

    10 Because thou hast kept the word of my patience, I also will keep thee from the hour of temptation, which shall come upon all the world, to try them that dwell upon the earth.

    11 Behold, I come quickly: hold that fast which thou hast, that no man take thy crown.

    12 Him that overcometh will I make a pillar in the temple of my God, and he shall go no more out: and I will write upon him the name of my God, and the name of the city of my God, which is new Jerusalem, which cometh down out of heaven from my God: and I will write upon him my new name.

    13 He that hath an ear, let him hear what the Spirit saith unto the churches.

    14 And unto the angel of the church of the Laodiceans write; These things saith the Amen, the faithful and true witness, the beginning of the creation of God;

    15 I know thy works, that thou art neither cold nor hot: I would thou wert cold or hot.

    16 So then because thou art lukewarm, and neither cold nor hot, I will spue thee out of my mouth.

    17 Because thou sayest, I am rich, and increased with goods, and have need of nothing; and knowest not that thou art wretched, and miserable, and poor, and blind, and naked:

    18 I counsel thee to buy of me gold tried in the fire, that thou mayest be rich; and white raiment, that thou mayest be clothed, and that the shame of thy nakedness do not appear; and anoint thine eyes with eyesalve, that thou mayest see.

    19 As many as I love, I rebuke and chasten: be zealous therefore, and repent.

    20 Behold, I stand at the door, and knock: if any man hear my voice, and open the door, I will come in to him, and will sup with him, and he with me.

    21 To him that overcometh will I grant to sit with me in my throne, even as I also overcame, and am set down with my Father in his throne.

    22 He that hath an ear, let him hear what the Spirit saith unto the churches.
    Revelation Chapter 3 1 And unto the angel of the church in Sardis write; These things saith he that hath the seven Spirits of God, and the seven stars; I know thy works, that thou hast a name that thou livest, and art dead. 2 Be watchful, and strengthen the things which remain, that are ready to die: for I have not found thy works perfect before God. 3 Remember therefore how thou hast received and heard, and hold fast, and repent. If therefore thou shalt not watch, I will come on thee as a thief, and thou shalt not know what hour I will come upon thee. 4 Thou hast a few names even in Sardis which have not defiled their garments; and they shall walk with me in white: for they are worthy. 5 He that overcometh, the same shall be clothed in white raiment; and I will not blot out his name out of the book of life, but I will confess his name before my Father, and before his angels. 6 He that hath an ear, let him hear what the Spirit saith unto the churches. 7 And to the angel of the church in Philadelphia write; These things saith he that is holy, he that is true, he that hath the key of David, he that openeth, and no man shutteth; and shutteth, and no man openeth; 8 I know thy works: behold, I have set before thee an open door, and no man can shut it: for thou hast a little strength, and hast kept my word, and hast not denied my name. 9 Behold, I will make them of the synagogue of Satan, which say they are Jews, and are not, but do lie; behold, I will make them to come and worship before thy feet, and to know that I have loved thee. 10 Because thou hast kept the word of my patience, I also will keep thee from the hour of temptation, which shall come upon all the world, to try them that dwell upon the earth. 11 Behold, I come quickly: hold that fast which thou hast, that no man take thy crown. 12 Him that overcometh will I make a pillar in the temple of my God, and he shall go no more out: and I will write upon him the name of my God, and the name of the city of my God, which is new Jerusalem, which cometh down out of heaven from my God: and I will write upon him my new name. 13 He that hath an ear, let him hear what the Spirit saith unto the churches. 14 And unto the angel of the church of the Laodiceans write; These things saith the Amen, the faithful and true witness, the beginning of the creation of God; 15 I know thy works, that thou art neither cold nor hot: I would thou wert cold or hot. 16 So then because thou art lukewarm, and neither cold nor hot, I will spue thee out of my mouth. 17 Because thou sayest, I am rich, and increased with goods, and have need of nothing; and knowest not that thou art wretched, and miserable, and poor, and blind, and naked: 18 I counsel thee to buy of me gold tried in the fire, that thou mayest be rich; and white raiment, that thou mayest be clothed, and that the shame of thy nakedness do not appear; and anoint thine eyes with eyesalve, that thou mayest see. 19 As many as I love, I rebuke and chasten: be zealous therefore, and repent. 20 Behold, I stand at the door, and knock: if any man hear my voice, and open the door, I will come in to him, and will sup with him, and he with me. 21 To him that overcometh will I grant to sit with me in my throne, even as I also overcame, and am set down with my Father in his throne. 22 He that hath an ear, let him hear what the Spirit saith unto the churches.
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  • Bad Faith Set Up Fails

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

    INADEQUATE MEDICAL AUTHORIZATION USED TO CAUSE INSURER TO REFUSE SETTLEMENT DEMAND

    Post 4930

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

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

    FACTUAL HISTORY

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

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

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

    TRIAL

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

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

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

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

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

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

    DISCUSSION

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

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

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

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

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

    ZALMA OPINION

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

    (c) 2024 Barry Zalma & ClaimSchool, Inc.

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

    1 Unto the angel of the church of Ephesus write; These things saith he that holdeth the seven stars in his right hand, who walketh in the midst of the seven golden candlesticks;

    2 I know thy works, and thy labour, and thy patience, and how thou canst not bear them which are evil: and thou hast tried them which say they are apostles, and are not, and hast found them liars:

    3 And hast borne, and hast patience, and for my name's sake hast laboured, and hast not fainted.

    4 Nevertheless I have somewhat against thee, because thou hast left thy first love.

    5 Remember therefore from whence thou art fallen, and repent, and do the first works; or else I will come unto thee quickly, and will remove thy candlestick out of his place, except thou repent.

    6 But this thou hast, that thou hatest the deeds of the Nicolaitans, which I also hate.

    7 He that hath an ear, let him hear what the Spirit saith unto the churches; To him that overcometh will I give to eat of the tree of life, which is in the midst of the paradise of God.

    8 And unto the angel of the church in Smyrna write; These things saith the first and the last, which was dead, and is alive;

    9 I know thy works, and tribulation, and poverty, (but thou art rich) and I know the blasphemy of them which say they are Jews, and are not, but are the synagogue of Satan.

    10 Fear none of those things which thou shalt suffer: behold, the devil shall cast some of you into prison, that ye may be tried; and ye shall have tribulation ten days: be thou faithful unto death, and I will give thee a crown of life.

    11 He that hath an ear, let him hear what the Spirit saith unto the churches; He that overcometh shall not be hurt of the second death.

    12 And to the angel of the church in Pergamos write; These things saith he which hath the sharp sword with two edges;

    13 I know thy works, and where thou dwellest, even where Satan's seat is: and thou holdest fast my name, and hast not denied my faith, even in those days wherein Antipas was my faithful martyr, who was slain among you, where Satan dwelleth.

    14 But I have a few things against thee, because thou hast there them that hold the doctrine of Balaam, who taught Balac to cast a stumblingblock before the children of Israel, to eat things sacrificed unto idols, and to commit fornication.

    15 So hast thou also them that hold the doctrine of the Nicolaitans, which thing I hate.

    16 Repent; or else I will come unto thee quickly, and will fight against them with the sword of my mouth.

    17 He that hath an ear, let him hear what the Spirit saith unto the churches; To him that overcometh will I give to eat of the hidden manna, and will give him a white stone, and in the stone a new name written, which no man knoweth saving he that receiveth it.

    18 And unto the angel of the church in Thyatira write; These things saith the Son of God, who hath his eyes like unto a flame of fire, and his feet are like fine brass;

    19 I know thy works, and charity, and service, and faith, and thy patience, and thy works; and the last to be more than the first.

    20 Notwithstanding I have a few things against thee, because thou sufferest that woman Jezebel, which calleth herself a prophetess, to teach and to seduce my servants to commit fornication, and to eat things sacrificed unto idols.

    21 And I gave her space to repent of her fornication; and she repented not.

    22 Behold, I will cast her into a bed, and them that commit adultery with her into great tribulation, except they repent of their deeds.

    23 And I will kill her children with death; and all the churches shall know that I am he which searcheth the reins and hearts: and I will give unto every one of you according to your works.

    24 But unto you I say, and unto the rest in Thyatira, as many as have not this doctrine, and which have not known the depths of Satan, as they speak; I will put upon you none other burden.

    25 But that which ye have already hold fast till I come.

    26 And he that overcometh, and keepeth my works unto the end, to him will I give power over the nations:

    27 And he shall rule them with a rod of iron; as the vessels of a potter shall they be broken to shivers: even as I received of my Father.

    28 And I will give him the morning star.

    29 He that hath an ear, let him hear what the Spirit saith unto the churches.
    Revelation Chapter 2 1 Unto the angel of the church of Ephesus write; These things saith he that holdeth the seven stars in his right hand, who walketh in the midst of the seven golden candlesticks; 2 I know thy works, and thy labour, and thy patience, and how thou canst not bear them which are evil: and thou hast tried them which say they are apostles, and are not, and hast found them liars: 3 And hast borne, and hast patience, and for my name's sake hast laboured, and hast not fainted. 4 Nevertheless I have somewhat against thee, because thou hast left thy first love. 5 Remember therefore from whence thou art fallen, and repent, and do the first works; or else I will come unto thee quickly, and will remove thy candlestick out of his place, except thou repent. 6 But this thou hast, that thou hatest the deeds of the Nicolaitans, which I also hate. 7 He that hath an ear, let him hear what the Spirit saith unto the churches; To him that overcometh will I give to eat of the tree of life, which is in the midst of the paradise of God. 8 And unto the angel of the church in Smyrna write; These things saith the first and the last, which was dead, and is alive; 9 I know thy works, and tribulation, and poverty, (but thou art rich) and I know the blasphemy of them which say they are Jews, and are not, but are the synagogue of Satan. 10 Fear none of those things which thou shalt suffer: behold, the devil shall cast some of you into prison, that ye may be tried; and ye shall have tribulation ten days: be thou faithful unto death, and I will give thee a crown of life. 11 He that hath an ear, let him hear what the Spirit saith unto the churches; He that overcometh shall not be hurt of the second death. 12 And to the angel of the church in Pergamos write; These things saith he which hath the sharp sword with two edges; 13 I know thy works, and where thou dwellest, even where Satan's seat is: and thou holdest fast my name, and hast not denied my faith, even in those days wherein Antipas was my faithful martyr, who was slain among you, where Satan dwelleth. 14 But I have a few things against thee, because thou hast there them that hold the doctrine of Balaam, who taught Balac to cast a stumblingblock before the children of Israel, to eat things sacrificed unto idols, and to commit fornication. 15 So hast thou also them that hold the doctrine of the Nicolaitans, which thing I hate. 16 Repent; or else I will come unto thee quickly, and will fight against them with the sword of my mouth. 17 He that hath an ear, let him hear what the Spirit saith unto the churches; To him that overcometh will I give to eat of the hidden manna, and will give him a white stone, and in the stone a new name written, which no man knoweth saving he that receiveth it. 18 And unto the angel of the church in Thyatira write; These things saith the Son of God, who hath his eyes like unto a flame of fire, and his feet are like fine brass; 19 I know thy works, and charity, and service, and faith, and thy patience, and thy works; and the last to be more than the first. 20 Notwithstanding I have a few things against thee, because thou sufferest that woman Jezebel, which calleth herself a prophetess, to teach and to seduce my servants to commit fornication, and to eat things sacrificed unto idols. 21 And I gave her space to repent of her fornication; and she repented not. 22 Behold, I will cast her into a bed, and them that commit adultery with her into great tribulation, except they repent of their deeds. 23 And I will kill her children with death; and all the churches shall know that I am he which searcheth the reins and hearts: and I will give unto every one of you according to your works. 24 But unto you I say, and unto the rest in Thyatira, as many as have not this doctrine, and which have not known the depths of Satan, as they speak; I will put upon you none other burden. 25 But that which ye have already hold fast till I come. 26 And he that overcometh, and keepeth my works unto the end, to him will I give power over the nations: 27 And he shall rule them with a rod of iron; as the vessels of a potter shall they be broken to shivers: even as I received of my Father. 28 And I will give him the morning star. 29 He that hath an ear, let him hear what the Spirit saith unto the churches.
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  • Democratic Faith!
    https://rumble.com/v10o9g5-incredible-must-watch-video-of-capitol-police-allowing-protesters-to-enter-.html
    Democratic Faith! https://rumble.com/v10o9g5-incredible-must-watch-video-of-capitol-police-allowing-protesters-to-enter-.html
    0 Σχόλια 0 Μοιράστηκε 331 Views
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