• Lose if You Fail to Respond to Motion for Summary Disposition

    INSURERS FIND FRAUDSTERS ARE OFTEN INCOMPETENT

    Post 4943

    Read the full article at https://www.linkedin.com/pulse/lose-you-fail-respond-motion-summary-disposition-zalma-esq-cfe-rhstc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts.

    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) the Court of Appeals resolved the dispute.

    In a consolidated first-party and third-party no-fault action, plaintiff appealed from two orders granting summary disposition in favor of defendants, including the fraud of the plaintiff.

    FACTUAL BACKGROUND

    After a motor vehicle accident involving plaintiff and Pugh. Plaintiff alleged 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 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.

    Shortly after Pugh filed her motion, Citizens filed its own motion arguing that plaintiff made material misrepresentations to Citizens regarding the extent of his injuries, which rendered him ineligible for benefits under the statute.

    The trial court concluded that plaintiff failed to establish that he sustained a serious impairment of body function and therefore summary disposition in favor of Pugh was appropriate.

    With regard to Citizens’ motion, the trial court found “that absolutely no genuine issue of material fact exists as to whether Plaintiff knowingly made numerous materially false statements in his claims for PIP benefits relative to his alleged injuries and physical restrictions” arising out of the car accident.

    THRESHOLD INJURY

    Plaintiff argued that the trial court erred by finding that there was no genuine issue of material fact regarding whether plaintiff met the serious-impairment threshold. However, plaintiff’s failure to respond to the motion for summary disposition made it impossible for him to support his argument.

    The Plaintiff tried to use the defendants evidence as support against the motions. The attempt failed. The objectively manifested requirement means that plaintiffs must introduce evidence that generally requires medical testimony. Pugh presented objective medical records indicating that there was no physical basis for plaintiff’s subjective complaints of pain. Plaintiff’s deposition testimony only set forth mere subjective complaints of pain.

    Because plaintiff cannot show a factual dispute as to whether he suffered an objectively manifested impairment, he failed to satisfy the threshold serious-impairment requirement.

    FRAUDULENT INSURANCE ACT

    A person who presents or causes to be presented an oral or written statement, including computer-generated information, as part of or in support of a claim for payment or another benefit knowing that the statement contains false information concerning a fact or thing material to the claim commits a fraudulent insurance act that is subject to the penalties imposed by statute.

    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 to the insurer or the state, 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.

    As to both motions for summary disposition, plaintiff failed to show that any genuine issue of material facts exists. Accordingly, the trial court did not err by granting summary disposition in favor of defendants.

    ZALMA OPINION

    As I get older the competence of those who attempt to defraud insurers gets less and less competent. Kallco is an example of the lack of competence. He claimed all kinds of injuries and inability to work or play with his children and, when faced with a competent defense, he ignored the motions, failed to respond, and when he lost he appealed claiming the motions against him gave enough evidence to raise a issue of fact. What a waste of the court’s time and I must ask why, with such convincing evidence, no criminal charges were brought.

    (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

    Sorry about the delay in posting. I’m recovering from pneumonia and spending most of the last week in bed with pills, Kleenex, coughing and sleep which I couldn’t get in the hospital. Should be act in shape next week but doctors make no promises.
    Lose if You Fail to Respond to Motion for Summary Disposition INSURERS FIND FRAUDSTERS ARE OFTEN INCOMPETENT Post 4943 Read the full article at https://www.linkedin.com/pulse/lose-you-fail-respond-motion-summary-disposition-zalma-esq-cfe-rhstc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. 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) the Court of Appeals resolved the dispute. In a consolidated first-party and third-party no-fault action, plaintiff appealed from two orders granting summary disposition in favor of defendants, including the fraud of the plaintiff. FACTUAL BACKGROUND After a motor vehicle accident involving plaintiff and Pugh. Plaintiff alleged 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 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. Shortly after Pugh filed her motion, Citizens filed its own motion arguing that plaintiff made material misrepresentations to Citizens regarding the extent of his injuries, which rendered him ineligible for benefits under the statute. The trial court concluded that plaintiff failed to establish that he sustained a serious impairment of body function and therefore summary disposition in favor of Pugh was appropriate. With regard to Citizens’ motion, the trial court found “that absolutely no genuine issue of material fact exists as to whether Plaintiff knowingly made numerous materially false statements in his claims for PIP benefits relative to his alleged injuries and physical restrictions” arising out of the car accident. THRESHOLD INJURY Plaintiff argued that the trial court erred by finding that there was no genuine issue of material fact regarding whether plaintiff met the serious-impairment threshold. However, plaintiff’s failure to respond to the motion for summary disposition made it impossible for him to support his argument. The Plaintiff tried to use the defendants evidence as support against the motions. The attempt failed. The objectively manifested requirement means that plaintiffs must introduce evidence that generally requires medical testimony. Pugh presented objective medical records indicating that there was no physical basis for plaintiff’s subjective complaints of pain. Plaintiff’s deposition testimony only set forth mere subjective complaints of pain. Because plaintiff cannot show a factual dispute as to whether he suffered an objectively manifested impairment, he failed to satisfy the threshold serious-impairment requirement. FRAUDULENT INSURANCE ACT A person who presents or causes to be presented an oral or written statement, including computer-generated information, as part of or in support of a claim for payment or another benefit knowing that the statement contains false information concerning a fact or thing material to the claim commits a fraudulent insurance act that is subject to the penalties imposed by statute. 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 to the insurer or the state, 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. As to both motions for summary disposition, plaintiff failed to show that any genuine issue of material facts exists. Accordingly, the trial court did not err by granting summary disposition in favor of defendants. ZALMA OPINION As I get older the competence of those who attempt to defraud insurers gets less and less competent. Kallco is an example of the lack of competence. He claimed all kinds of injuries and inability to work or play with his children and, when faced with a competent defense, he ignored the motions, failed to respond, and when he lost he appealed claiming the motions against him gave enough evidence to raise a issue of fact. What a waste of the court’s time and I must ask why, with such convincing evidence, no criminal charges were brought. (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 Sorry about the delay in posting. I’m recovering from pneumonia and spending most of the last week in bed with pills, Kleenex, coughing and sleep which I couldn’t get in the hospital. Should be act in shape next week but doctors make no promises.
    WWW.LINKEDIN.COM
    Discover thousands of collaborative articles on 2500+ skills
    Discover 100 collaborative articles on domains such as Marketing, Public Administration, and Healthcare. Our expertly curated collection combines AI-generated content with insights and advice from industry experts, providing you with unique perspectives and up-to-date information on many skills and their applications.
    0 Reacties 0 aandelen 905 Views
  • GENERAL FLYNN

    #KariLakeWon and some of those involved w/ AZ elections are going to find themselves in very hot water.
    Quote
    Mila Joy
    @MilaLovesJoe
    ·
    4h
    Maricopa County, AZ said these signatures match.

    Arizona must not think Trump will prosecute election fraudsters.

    They are wrong.

    Arizona election officials will face Trump's wrath.

    They will end up in prison.
    Show more

    https://x.com/GenFlynn/status/1855785280290320883
    GENERAL FLYNN #KariLakeWon and some of those involved w/ AZ elections are going to find themselves in very hot water. Quote Mila Joy @MilaLovesJoe · 4h Maricopa County, AZ said these signatures match. Arizona must not think Trump will prosecute election fraudsters. They are wrong. Arizona election officials will face Trump's wrath. They will end up in prison. Show more https://x.com/GenFlynn/status/1855785280290320883
    Like
    1
    0 Reacties 0 aandelen 991 Views

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

    ZIFL – Volume 28 Number 21

    Posted on November 1, 2024 by Barry Zalma

    Post 4924

    See the full video at and at

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

    The Source for the Insurance Fraud Professional

    Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ This issue contains the following articles about insurance fraud:

    Pill Mill Doctor’s Conviction Affirmed

    HEALTH CARE FRAUD CONVICTION AFFIRMED

    ACTING AS A DR. FEEL GOOD IS A FEDERAL CRIME

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

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

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

    More McClenny Moseley & Associates Issues

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

    10/24/2024

    MMA BANKRUPTCY HEARING TO DECIDE WHETHER TRUSTEE WILL BE APPOINTED

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

    Injured While Drunk on the Job Gets Workers’ Compensation Benefits

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

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

    Man Bites Dog Story:

    Fraudsters Arbitration Attempts Stopped

    Arbitration Stayed for Suspected Chiropractors’ Fraudulent No Fault Medical Claims

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

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

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

    Health Insurance Fraud Convictions

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

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

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

    Officer Caught Aiding Criminals for Cash

    Police Officer who took Bribes from Insurance Fraudster Convicted

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

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

    Convictions of Other Than Health Insurance Fraud

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

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

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

    The Need to Understand the Mutability of Memory

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

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

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

    Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf
    Zalma’s Insurance Fraud Letter – November 1, 2024 ZIFL – Volume 28 Number 21 Posted on November 1, 2024 by Barry Zalma Post 4924 See the full video at and at Subscribe to ZIFL at https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D The Source for the Insurance Fraud Professional Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ This issue contains the following articles about insurance fraud: Pill Mill Doctor’s Conviction Affirmed HEALTH CARE FRAUD CONVICTION AFFIRMED ACTING AS A DR. FEEL GOOD IS A FEDERAL CRIME According to the Sixth Circuit Dr. David Jankowski’s medical clinics relied on several unusual billing and prescription practices, many of which were illegal and Jankowski fraudulently billed Medicare for services he did not provide and prescribed controlled substances to patients whose conditions did not call for such treatment, with some patients unlawfully trafficking their prescribed drugs. In United States Of America v. David Jankowski, M.D., No. 23-1404, United States Court of Appeals, Sixth Circuit (October 23, 2024) the Sixth Circuit disposed of the fraudsters claims on appeal. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf More McClenny Moseley & Associates Issues This is ZIFL’s thirty sixth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana and what appears to be an effort to profit from what some Magistrate and District judges indicate may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana. 10/24/2024 MMA BANKRUPTCY HEARING TO DECIDE WHETHER TRUSTEE WILL BE APPOINTED Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Injured While Drunk on the Job Gets Workers’ Compensation Benefits An appellate court in New York has upheld a decision of the Workers’ Compensation Board in favor of an injured employee of an electrical contractor company because intoxication was not the sole cause of the accident. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Man Bites Dog Story: Fraudsters Arbitration Attempts Stopped Arbitration Stayed for Suspected Chiropractors’ Fraudulent No Fault Medical Claims Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf In Government Employees Insurance Company, (“GEICO”) v. Didier Demesmin, M.D., et al, No. 23-CV-6191 (ARR) (MMH), United States District Court, E.D. New York (October 23, 2024) GEICO sought to enjoin defendants Manuel A. Mendoza, D.C. and Mendoza Chiropractic Office PC (collectively the “Mendoza Defendants”) from pursuing certain “no-fault” insurance collection arbitrations or initiating new collections proceedings during the pendency of this lawsuit. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Health Insurance Fraud Convictions Louisiana Nursing Home Owner to Pay $8.2M for Misusing Assets During Ida Bob Dean Jr a Louisiana nursing home owner and several companies he operated have agreed to an $8.2 million consent judgment to resolve allegations that they misappropriated and misused the assets and income of four nursing homes in Louisiana before and after Hurricane Ida’s landfall in August 2021. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Officer Caught Aiding Criminals for Cash Police Officer who took Bribes from Insurance Fraudster Convicted Demarkco Johnson (“Johnson”), appealed his convictions for taking bribes about insurance fraud. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Convictions of Other Than Health Insurance Fraud Former Lake Forest Agent Convicted On 90 Counts Of Insurance Fraud After Stealing Nearly $200,000 In Premium Payments Karen Marie Dondanville, 56, of Mission Viejo, California, a former Lake Forest insurance agent was convicted on 90 counts of insurance fraud after stealing nearly $200,000 in premium payments. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf The Need to Understand the Mutability of Memory Investigators and lawyers believe what they are told by eye witnesses who describe what he or she says with conviction. However, every professional investigator or litigator must know that memory is not necessarily accurate because very few people have a perfect eidetic (photographic) memory. Memory is a fluid and often unreliable human function. Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Go to the podcast Zalma On Insurance at https://podcasters.spotify.com/pod/show/barry-zalma/support; Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog. Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/; Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ and GTTR at https://gettr.com/@zalma Read the full article and all 18 pages of ZIFL at https://zalma.com/blog/wp-content/uploads/2024/10/ZIFL-11-01-2024.pdf
    0 Reacties 0 aandelen 3K Views

  • Man Bites Dog Story: Fraudsters Arbitration Attempts Stopped

    Arbitration Stayed for Suspected Chiropractors’ Fraudulent No Fault Medical Claims

    Post 4921

    Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-fraudsters-arbitration-attempts-zalma-esq-cfe-5yw6c, see the full video at and at and at https://zalma.com/blog.

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

    BACKGROUND

    GEICO provides personal injury protection benefits on a “no-fault” basis, which means that, after an accident, insured drivers and their passengers are entitled to certain benefits for medically necessary healthcare services regardless of who was at fault.

    GEICO sued a group of healthcare providers who allegedly carried out an insurance scheme to obtain fraudulent no-fault benefit payments from GEICO. The USDC granted the motion based on its conclusion that (1) GEICO would experience irreparable harm absent a stay, (2) GEICO raised a serious question going to the merits, and (3) the balance of hardships tipped in GEICO’s favor.

    Subsequently, GEICO requested leave to file a second amended complaint to add allegations concerning the Mendoza defendants which was granted.

    In total, GEICO seeks recovery of more than $5.9 million in wrongfully obtained benefits payments from the three groups of defendants, as well as a declaration that it is not obligated to reimburse defendants for outstanding no-fault claims.

    After filing the second amended complaint, GEICO filed the present motion seeking an order staying all pending no-fault benefits arbitrations between GEICO and the Mendoza defendants and enjoining the Mendoza defendants from commencing new collections proceedings during the pendency of this action.

    DISCUSSION

    GEICO Will Experience Irreparable Harm Absent A Stay.

    Irreparable harm is certain and imminent harm for which a monetary award does not adequately compensate. the risk of inconsistent judgments in no-fault insurance disputes can constitute irreparable harm separate and apart from the expenditure of time and money spent on parallel proceedings. As with the parallel proceedings brought by the Demesmin and Khanan defendants, the risk of inconsistent outcomes is great enough to establish irreparable harm.

    GEICO established irreparable harm because permitting arbitrations to proceed will subject it to a risk of judgments that may be inconsistent with future judicial rulings.

    GEICO Has Shown At Least Some Serious Questions Going To The Merits, And The Balance Of Hardships Tips In Its Favor.

    GEICO’s amended complaint details a complex scheme of fraudulent billing and referrals among a network of chiropractic providers. GEICO’s allegations concerning the Mendoza defendants’ role are well developed through numerous examples of charges billed without proper documentation or under suspicious circumstances and a table of more than 45,000 suspect claims.

    The balance of hardships also tips in GEICO’s favor because the Mendoza defendants have not established any hardship, beyond a delay in reimbursement. Because the defendants will presumably be entitled to collect interest on their pending claims if they prevail, the delay does not outweigh the risk of inconsistent outcomes faced by GEICO.

    A Stay Does Not Violate The Anti-Injunction Act.

    The Anti-Injunction Act (“AIA”) prohibits federal courts from enjoining proceedings in state court “except as expressly authorized by Act of Congress, or where necessary in aid of its jurisdiction, or to protect or effectuate its judgments.” 28 U.S.C. § 2283. The AIA does not, however, limit the court’s authority to enjoin ongoing private arbitration proceedings or the court’s authority to enjoin defendants from initiating future state court proceedings.

    GEICO’s motion was granted and a preliminary injunction was issued: staying all pending no-fault insurance collection arbitrations that have been Commenced against GEICO by or on behalf of the Mendoza defendants, pending the disposition of GEICO’s claims in this action, and enjoining the Mendoza defendants and anyone acting on their behalf from commencing new no-fault arbitrations and litigations against GEICO pending the disposition of GEICO’s claims in this action.

    ZALMA OPINION

    The USDC, and other courts dealing with No-Fault auto insurance claims, has acted to help insurers defeat attempted insurance fraud – a crime in each state like New Jersey – which became necessary because state prosecutors seemed to ignore the crimes reported to them by insurers like GEICO. It is essential that insurers be proactive against fraud to shame the insurance fraud investigators in each state to do their job and prosecute the fraud perpetrators. Every insurer, faced with such fraud, should emulate GEICO.

    (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
    Man Bites Dog Story: Fraudsters Arbitration Attempts Stopped Arbitration Stayed for Suspected Chiropractors’ Fraudulent No Fault Medical Claims Post 4921 Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-fraudsters-arbitration-attempts-zalma-esq-cfe-5yw6c, see the full video at and at and at https://zalma.com/blog. In Government Employees Insurance Company, (“GEICO”) v. Didier Demesmin, M.D., et al, No. 23-CV-6191 (ARR) (MMH), United States District Court, E.D. New York (October 23, 2024) GEICO sought to enjoin defendants Manuel A. Mendoza, D.C. and Mendoza Chiropractic Office PC (collectively the “Mendoza Defendants”) from pursuing certain “no-fault” insurance collection arbitrations or initiating new collections proceedings during the pendency of this lawsuit. BACKGROUND GEICO provides personal injury protection benefits on a “no-fault” basis, which means that, after an accident, insured drivers and their passengers are entitled to certain benefits for medically necessary healthcare services regardless of who was at fault. GEICO sued a group of healthcare providers who allegedly carried out an insurance scheme to obtain fraudulent no-fault benefit payments from GEICO. The USDC granted the motion based on its conclusion that (1) GEICO would experience irreparable harm absent a stay, (2) GEICO raised a serious question going to the merits, and (3) the balance of hardships tipped in GEICO’s favor. Subsequently, GEICO requested leave to file a second amended complaint to add allegations concerning the Mendoza defendants which was granted. In total, GEICO seeks recovery of more than $5.9 million in wrongfully obtained benefits payments from the three groups of defendants, as well as a declaration that it is not obligated to reimburse defendants for outstanding no-fault claims. After filing the second amended complaint, GEICO filed the present motion seeking an order staying all pending no-fault benefits arbitrations between GEICO and the Mendoza defendants and enjoining the Mendoza defendants from commencing new collections proceedings during the pendency of this action. DISCUSSION GEICO Will Experience Irreparable Harm Absent A Stay. Irreparable harm is certain and imminent harm for which a monetary award does not adequately compensate. the risk of inconsistent judgments in no-fault insurance disputes can constitute irreparable harm separate and apart from the expenditure of time and money spent on parallel proceedings. As with the parallel proceedings brought by the Demesmin and Khanan defendants, the risk of inconsistent outcomes is great enough to establish irreparable harm. GEICO established irreparable harm because permitting arbitrations to proceed will subject it to a risk of judgments that may be inconsistent with future judicial rulings. GEICO Has Shown At Least Some Serious Questions Going To The Merits, And The Balance Of Hardships Tips In Its Favor. GEICO’s amended complaint details a complex scheme of fraudulent billing and referrals among a network of chiropractic providers. GEICO’s allegations concerning the Mendoza defendants’ role are well developed through numerous examples of charges billed without proper documentation or under suspicious circumstances and a table of more than 45,000 suspect claims. The balance of hardships also tips in GEICO’s favor because the Mendoza defendants have not established any hardship, beyond a delay in reimbursement. Because the defendants will presumably be entitled to collect interest on their pending claims if they prevail, the delay does not outweigh the risk of inconsistent outcomes faced by GEICO. A Stay Does Not Violate The Anti-Injunction Act. The Anti-Injunction Act (“AIA”) prohibits federal courts from enjoining proceedings in state court “except as expressly authorized by Act of Congress, or where necessary in aid of its jurisdiction, or to protect or effectuate its judgments.” 28 U.S.C. § 2283. The AIA does not, however, limit the court’s authority to enjoin ongoing private arbitration proceedings or the court’s authority to enjoin defendants from initiating future state court proceedings. GEICO’s motion was granted and a preliminary injunction was issued: staying all pending no-fault insurance collection arbitrations that have been Commenced against GEICO by or on behalf of the Mendoza defendants, pending the disposition of GEICO’s claims in this action, and enjoining the Mendoza defendants and anyone acting on their behalf from commencing new no-fault arbitrations and litigations against GEICO pending the disposition of GEICO’s claims in this action. ZALMA OPINION The USDC, and other courts dealing with No-Fault auto insurance claims, has acted to help insurers defeat attempted insurance fraud – a crime in each state like New Jersey – which became necessary because state prosecutors seemed to ignore the crimes reported to them by insurers like GEICO. It is essential that insurers be proactive against fraud to shame the insurance fraud investigators in each state to do their job and prosecute the fraud perpetrators. Every insurer, faced with such fraud, should emulate GEICO. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk
    0 Reacties 0 aandelen 2K Views 0
  • Trump Warns Democrats: “Election Fraudsters Will Be Sent To Prison For Long Periods Of Time” https://www.infowars.com/posts/trump-warns-democrats-election-fraudsters-will-be-sent-to-prison-for-long-periods-of-time/
    Trump Warns Democrats: “Election Fraudsters Will Be Sent To Prison For Long Periods Of Time” https://www.infowars.com/posts/trump-warns-democrats-election-fraudsters-will-be-sent-to-prison-for-long-periods-of-time/
    Wow
    1
    0 Reacties 0 aandelen 517 Views
  • I clipped this from a post....
    EVERYONE should read it!

    If we want to change the WORLD, we must start by changing OURSELVES!
    Being "tolerant" of #Evil is NOT the position a Christian takes!

    I'll be "tolerant" of Freemasons, just like Jesus was "tolerant" of the money-changers!
    Speaking of which... We should not be tolerant of them either!

    #Bankers are modern money changers folks!
    And they are stealing the earth, which was given to YOU, using worthless paper!

    The Advent Truth
    Admin

    Freemasonry: the all-embracing Heresy
    Freemasonry is a pagan cult that pretends to embrace all religions, but only in order to negate them all. Our lust for more power, money, and sex is unleashed inside this all-embracing heresy called Roman Catholic Freemasonry. The lower instincts become the higher. Accordingly, culture has been degraded and we have no real collective identity or ideals, just animal appetites. Lead by this satanic "G"ay m.a.f.i.a, all the humanity is becoming a bizarre sex cult.

    Inside the Freemasonry, only their inner circles are aware that the "Craft" is in fact devoted to Satanism, serving pagan gods behind a veil of false Judaism (Synagogue of Satan). These masonic Satanists disguise their agenda in warm and fuzzy buzzwords like "economic justice" and "international peace".

    They also have drafted a new world constitution called the "Earth Charter". In 2002, the Earth Charter was presented to the United Nations (UN) in a pantheistic 21st Century replica of the Ark of the Covenant called "the Ark of Hope". For many centuries, the world has been subject to a gradual and subtle process of Masonic occultist indoctrination.

    Religion is portrayed as irrelevant and the human "liberation" is defined as being able to have sex with anything and anyone, talking about bodily functions and exposing the body (the Temple of the Most High) in public. Also as humanity is continually made sicker by this heretic cult that is trying to rule over us, the man has become more and more beast-like.

    The untold fact is that we cannot understand the modern world unless we appreciate that it is the result of a gigantic Masonic conspiracy, planned by the Vatican and the Jesuits (IHS). Without belonging to the freemasonry and participating in their pacts and filthy oaths, there is no chance of a fast career, regardless of how talented one is.

    Essentially, a dominant segment of Western society has joined the Zionist financial elite in embracing Freemasonry, a satanic philosophy that represents a death wish for civilization. They imagine somehow they will profit from the oppression, lies and suffering caused by their Vatican's "New World Order".


    Incredible and bizarre as it sounds, 300 mainly Zionist banking families have used Freemasonry as an instrument to subvert, control and degrade the Western world. Masons are responsible for communism, Zionism, socialism, liberalism, feminism, anarchism and all the other "isms" in our society - "divide and conquer" they say.

    These "world revolutionary", "progressive" movements ensnare millions of gullible idealists by promising a utopia based on materialism and "reason" and dedicated to "liberty, equality and fraternity," "public ownership" or some other idealistic sounding claptrap. The common goal of these Masonic inspired movements is to undermine race, religion, nation and family ("all collective forces except our own") by promoting social division, self indulgence and "tolerance", miscegenation, atheism, nihilism, globalism, sexual "liberation" and homosexuality thereby reducing humanity to a uniform dysfunctional and malleable mush.

    Ultimately, Freemasons not only control politics but also virtually every sector of Western society, including the so called "science and culture".

    In last instance, Freemasonry is a cancer on earth - a club of fraudsters - nothing but the Vatican's m.a.f.i.a. Wherever the name of the Catholic church can't appear involved, there you will find the Roman Catholic Freemasonry infiltrated - as in the schemes of the m.a.f.i.a itself.
    I clipped this from a post.... EVERYONE should read it! If we want to change the WORLD, we must start by changing OURSELVES! Being "tolerant" of #Evil is NOT the position a Christian takes! I'll be "tolerant" of Freemasons, just like Jesus was "tolerant" of the money-changers! Speaking of which... We should not be tolerant of them either! #Bankers are modern money changers folks! And they are stealing the earth, which was given to YOU, using worthless paper! The Advent Truth Admin Freemasonry: the all-embracing Heresy Freemasonry is a pagan cult that pretends to embrace all religions, but only in order to negate them all. Our lust for more power, money, and sex is unleashed inside this all-embracing heresy called Roman Catholic Freemasonry. The lower instincts become the higher. Accordingly, culture has been degraded and we have no real collective identity or ideals, just animal appetites. Lead by this satanic "G"ay m.a.f.i.a, all the humanity is becoming a bizarre sex cult. Inside the Freemasonry, only their inner circles are aware that the "Craft" is in fact devoted to Satanism, serving pagan gods behind a veil of false Judaism (Synagogue of Satan). These masonic Satanists disguise their agenda in warm and fuzzy buzzwords like "economic justice" and "international peace". They also have drafted a new world constitution called the "Earth Charter". In 2002, the Earth Charter was presented to the United Nations (UN) in a pantheistic 21st Century replica of the Ark of the Covenant called "the Ark of Hope". For many centuries, the world has been subject to a gradual and subtle process of Masonic occultist indoctrination. Religion is portrayed as irrelevant and the human "liberation" is defined as being able to have sex with anything and anyone, talking about bodily functions and exposing the body (the Temple of the Most High) in public. Also as humanity is continually made sicker by this heretic cult that is trying to rule over us, the man has become more and more beast-like. The untold fact is that we cannot understand the modern world unless we appreciate that it is the result of a gigantic Masonic conspiracy, planned by the Vatican and the Jesuits (IHS). Without belonging to the freemasonry and participating in their pacts and filthy oaths, there is no chance of a fast career, regardless of how talented one is. Essentially, a dominant segment of Western society has joined the Zionist financial elite in embracing Freemasonry, a satanic philosophy that represents a death wish for civilization. They imagine somehow they will profit from the oppression, lies and suffering caused by their Vatican's "New World Order". Incredible and bizarre as it sounds, 300 mainly Zionist banking families have used Freemasonry as an instrument to subvert, control and degrade the Western world. Masons are responsible for communism, Zionism, socialism, liberalism, feminism, anarchism and all the other "isms" in our society - "divide and conquer" they say. These "world revolutionary", "progressive" movements ensnare millions of gullible idealists by promising a utopia based on materialism and "reason" and dedicated to "liberty, equality and fraternity," "public ownership" or some other idealistic sounding claptrap. The common goal of these Masonic inspired movements is to undermine race, religion, nation and family ("all collective forces except our own") by promoting social division, self indulgence and "tolerance", miscegenation, atheism, nihilism, globalism, sexual "liberation" and homosexuality thereby reducing humanity to a uniform dysfunctional and malleable mush. Ultimately, Freemasons not only control politics but also virtually every sector of Western society, including the so called "science and culture". In last instance, Freemasonry is a cancer on earth - a club of fraudsters - nothing but the Vatican's m.a.f.i.a. Wherever the name of the Catholic church can't appear involved, there you will find the Roman Catholic Freemasonry infiltrated - as in the schemes of the m.a.f.i.a itself.
    0 Reacties 0 aandelen 6K Views
  • Trump on a landslide victory that is “Too Big To Rig”. (24 seconds) This is what the deep state criminals, democrats, uniparty and election fraudsters fear the most. This election cycle is going to be Biblical.
    https://t.me/davidavocadowolfe/121880
    Trump on a landslide victory that is “Too Big To Rig”. (24 seconds) This is what the deep state criminals, democrats, uniparty and election fraudsters fear the most. This election cycle is going to be Biblical. https://t.me/davidavocadowolfe/121880
    0 Reacties 0 aandelen 1K Views 0
  • PLEASE BE AWARE - WE ARE AT WAR
    WE ARE AT WAR IN ANY KIND OF OUR LIFE..

    THE INTERNET IS A MAIN BATTLEFIELD SO PLEASE BE AWARE
    >> WHAT ARE YOU ARE SHARING
    >> WHAT KIND OF SOURCES
    >>>>>
    IN OUR CHANNEL WE MOST OFTEN DO NOT SHARE POSTS WHICH HAVE @ CONNECTIONS... (if unkonown)
    WHY?
    BOTS INFILTRATING @ (CHANNELS) CHATS! AND STARTING TO SPAM..
    Please do your research on this topic
    Always do your research
    BOTS AND FRAUDSTERS ARE A VERY BIG PROBLEM, NOT ONLY IN TELEGRAM BUT EVERYWHERE

    THIS IS ONE MAIN POINT..

    WE ARE AT WAR...

    https://rumble.com/v28ov4k--fifth-generation-warfare-and-sovereignty-dr-robert-malone.html
    PLEASE BE AWARE - WE ARE AT WAR WE ARE AT WAR IN ANY KIND OF OUR LIFE.. THE INTERNET IS A MAIN BATTLEFIELD SO PLEASE BE AWARE >> WHAT ARE YOU ARE SHARING >> WHAT KIND OF SOURCES >>>>> IN OUR CHANNEL WE MOST OFTEN DO NOT SHARE POSTS WHICH HAVE @ CONNECTIONS... (if unkonown) WHY? BOTS INFILTRATING @ (CHANNELS) CHATS! AND STARTING TO SPAM.. Please do your research on this topic Always do your research BOTS AND FRAUDSTERS ARE A VERY BIG PROBLEM, NOT ONLY IN TELEGRAM BUT EVERYWHERE THIS IS ONE MAIN POINT.. WE ARE AT WAR... https://rumble.com/v28ov4k--fifth-generation-warfare-and-sovereignty-dr-robert-malone.html
    0 Reacties 0 aandelen 2K Views
  • I JUST GOT SWATTED
    1. https://www.bitchute.com/video/isST4R0HHftF/
    2. https://ugetube.com/watch/GN117K8IgFH8jba
    3. https://newtube.app/user/RenaudBe/VDx08ga
    4. https://rumble.com/v1hclib
    5. https://www.bitchute.com/video/mSXTrt9B46N9/ (Backup)
    Hey, if it works for Donald Trump and other political fraudsters, than maybe it would work for me as well. These days, every body wants to play the victim for news cameras, from AOC's hands in the back, fake handcuff arrest, to Trump staging anything he can get away with, to make us forget about his mismanagement of the scamdemic, and to increase his popularity; And the gullible mindless sheep, seem to swallow it all in full too. After the fake news, enjoy the fake police circus.

    PS: Still waiting for Trump to release to the public his surveillance video footage of his Mar-a-Lago raid, with the FBI going into Melania's sexy underwear drawers for nuclear codes, but I won't hold my breath for it, as it probably doesn't exist, or they would be crisis actors; It's all just drama queen theater for the media. The funny thing was when Republicans were all Blue Lives Matter, very much pro police, and especially during the Covid Tyranny, with people getting thousand dollar fines for not wearing masks, or not being 6 feet apart; But when it's the FBI Federal police force investigating some of them, their tune suddenly changed to what the Democrats were whistling not too long ago, about de-funding police in cities. They're all a bunch of hypocrites, if you ask me, playing their childish political games, for extra points, like 5-year-olds.

    #Swat #Police #TrumpRaid #Swatted #PoliceSwat #FBI #Trump #Raid #PoliceRaid #MarALagoRaid
    I JUST GOT SWATTED 1. https://www.bitchute.com/video/isST4R0HHftF/ 2. https://ugetube.com/watch/GN117K8IgFH8jba 3. https://newtube.app/user/RenaudBe/VDx08ga 4. https://rumble.com/v1hclib 5. https://www.bitchute.com/video/mSXTrt9B46N9/ (Backup) Hey, if it works for Donald Trump and other political fraudsters, than maybe it would work for me as well. These days, every body wants to play the victim for news cameras, from AOC's hands in the back, fake handcuff arrest, to Trump staging anything he can get away with, to make us forget about his mismanagement of the scamdemic, and to increase his popularity; And the gullible mindless sheep, seem to swallow it all in full too. After the fake news, enjoy the fake police circus. PS: Still waiting for Trump to release to the public his surveillance video footage of his Mar-a-Lago raid, with the FBI going into Melania's sexy underwear drawers for nuclear codes, but I won't hold my breath for it, as it probably doesn't exist, or they would be crisis actors; It's all just drama queen theater for the media. The funny thing was when Republicans were all Blue Lives Matter, very much pro police, and especially during the Covid Tyranny, with people getting thousand dollar fines for not wearing masks, or not being 6 feet apart; But when it's the FBI Federal police force investigating some of them, their tune suddenly changed to what the Democrats were whistling not too long ago, about de-funding police in cities. They're all a bunch of hypocrites, if you ask me, playing their childish political games, for extra points, like 5-year-olds. #Swat #Police #TrumpRaid #Swatted #PoliceSwat #FBI #Trump #Raid #PoliceRaid #MarALagoRaid
    0 Reacties 0 aandelen 4K Views
  • W2 SCAMS AND HOW TO AVOID THEM

    The IRS and FBI have been warning business owners about W2 scams for years. Most of these scams come in the form of suspicious emails or phone calls. Learn about the most common W2 phishing and W2 fraud scams and how to avoid them in the following article. Don’t let fraudsters get the best of your business.

    https://www.paystubsnow.com/w2-scams-and-how-to-avoid-them/

    #Business #w2scams #w2 #phonecalls
    W2 SCAMS AND HOW TO AVOID THEM The IRS and FBI have been warning business owners about W2 scams for years. Most of these scams come in the form of suspicious emails or phone calls. Learn about the most common W2 phishing and W2 fraud scams and how to avoid them in the following article. Don’t let fraudsters get the best of your business. https://www.paystubsnow.com/w2-scams-and-how-to-avoid-them/ #Business #w2scams #w2 #phonecalls
    WWW.PAYSTUBSNOW.COM
    W2 Scams and How to Avoid Them - Pay Stubs Now
    What is a W2 scam? How do you avoid becoming a victim of these scams. Learn about W2 phone scams and phishing in this article.
    0 Reacties 0 aandelen 3K Views
Zoekresultaten
Sponsor

We are 100% funded for October.

Thanks to everyone who helped out. 🥰

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

Xephula Funding Meter

Please Donate Here