Inadequate Litigant’s Cases Dismissed Plaintiff, by her Litigation Appears to Establish the Report for a Mental Health Evaluation Was Appropriate Read the full article at https://lnkd.in/gECRyZ-f, see the full video at https://lnkd.in/gs_4Bby9 and at https://lnkd.in/g67dDK8q, and https://zalma.com/blog plus more than 4950 posts. Post 4950 In Samreen Riaz v. State Of California, et al., F087504, California Court of Appeals, Fifth District (December 2, 2024) the California Court of Appeals found itself asked to resolve suits against an individual and the state of California from an inadequate but excessively litigious plaintiff. FACTS Samreen Riaz was a licensed dentist – she lost her license to practice because of the facts underlying this case. According to her, there is an elaborate conspiracy to harass, stalk, threaten, and ultimately prevent her from testifying in a separate “whistleblower” case involving “OSHA and HIPPA Violations” at a medical facility. Riaz sued raising numerous claims against numerous individuals and government entities. The opposing parties challenged the complaint’s viability through demurrer and anti-SLAPP proceedings. The trial court sustained the demurrers and granted the anti-SLAPP motion, leaving Riaz with no viable claim. Riaz appealed. BACKGROUND The facts underlying this case involve four discrete events. First: Riaz sued a medical facility and suffered an alleged eye injury while attempting to testify in that case. Second: She sought treatment for that eye injury but was refused service and then sued that doctor in small claims court. Third: That doctor reported Riaz to the Dental Board of California which, in turn, initiated mental health competence proceedings against Riaz. Fourth: Riaz’s license to practice dentistry was revoked, and she filed the complaint at issue in this case. Initial Lawsuit Against Medical Facility Acting as a “whistleblower,” Riaz “disclosed … OSHA, Hippa, recruited patient, potential insurance fraud and anti-competent activities in the market” at a medical facility. After filing a lawsuit on that basis, Riaz claimed she suffered “organized harassment,” culminating in “permanent eye damage” after a sheriff-department employee pointed a finger in her face while attempting to enter the courthouse in her “whistleblower” case. Visiting Doctor for Eye Injury Riaz visited Dr. Cantrell to treat an eye injury. She claimed Cantrell became combative, refused to answer Riaz’s questions, and declined to treat Riaz. The next day, Riaz filed a complaint with the Medical Board of California. Several days later, she filed a small claims case against Cantrell, essentially alleging discrimination, negligence, and retaliation. A small claims judgment was eventually entered in Cantrell’s favor. Report to Dental Board Cantrell reported Riaz to the Dental Board. The Dental Board issued an order to Riaz to comply with a mental health examination “to evaluate her fitness to practice safely ….” (See Bus. &Prof. Code, § 820.) Riaz failed to comply with the order. Since Riaz continued to disobey the order, her license to practice dentistry was ultimately revoked. Instant Complaint and Judgment Riaz sued Cantrell, various government entities, and several individuals working for those entities (collectively, the State). The complaint alleged an elaborate conspiracy among all the defendants to injure Riaz, to intimidate her to prevent her from testifying, and to retaliate against her for the “whistleblower” case. The trial court sustained the demurrers and granted the anti-SLAPP motion resulting in total dismissal. DISCUSSION Did the trial court err in granting the anti-SLAPP motion? Did it err in sustaining the demurrers? The California Court of Appeals concluded the trial court did not err. Anti-SLAPP Motion In the anti-SLAPP motion, Cantrell argued his furnishing information to the Dental Board was protected activity and defeated claims “for discrimination, fraud, defamation, retaliation[,] and intentional infliction of emotional distress[.]” In opposition to the anti-SLAPP motion, Riaz claimed again Cantrell “made inaccurate, knowingly misleading statements to the [D]ental [B]oard to defame and harm [Riaz] based on disclosing patient information.” The trial court concluded furnishing those documents to the board constituted protected activity. ANALYSIS Litigation of an anti-SLAPP motion involves a two-step process. First, the moving defendant bears the burden of establishing that the challenged allegations or claims that arise from protected activity in which the defendant has engaged. Second, for each claim that does arise from protected activity, the plaintiff must show the claim has at least minimal merit. If the plaintiff cannot make this showing, the court will, and did, strike the claim. If there is no merit, the claim is stricken. The Court of Appeals noted that Riaz failed to adduce any evidence-including exhibits, declarations, judicial notice, and testimony-to substantiate her allegation Cantrell reported her to the Dental Board for retribution. She failed to adduce admissible evidence on the point. DEMURRERS Both Cantrell and the State filed demurrers to Riaz’s complaint.. Additional Background A small claims plaintiff is collaterally estopped from relitigating the same issue in superior court where the record is sufficiently clear to determine that the issue was litigated and decided against plaintiff in the small claims action. Governmental immunity is an affirmative defense properly raised by demurrer. Government Code section 821.6 immunizes public employees from liability for ‘instituting or prosecuting any judicial or administrative proceeding’ within the scope of their employment, even if the employees act ‘maliciously and without probable cause. Riaz alleged her claims arose in July 2022. Her written government claim was submitted in April 2023, more than six months later. Accordingly, the claims were barred, at least insofar as they stemmed from the section 820 order. CONCLUSION AND SUMMARY Riaz failed to allege colorable claims against either Cantrell or the State. The potential claims against Cantrell were either tried and resolved against her in small claims court or dismissed pursuant to the anti-SLAPP statute. The potential claims against the State were either barred for failure to timely present them under the Government Claims Act, or the State was immune under Government Code sections 821.6, 818.4, and 821.2. ZALMA OPINION It is axiomatic that a person who represents himself has a fool for a client. The litigation history, the multiple actions, and the lack of consistency and evidence, establish that Dr. Cantrell was correct when he advised the Dental Board that a mental health examination to evaluate her fitness to practice safely…” was correct. She refused to fulfill her obligation to the Dental Board to be evaluated because she was concerned she would not pass. This case is an abuse of Doctor Cantrell and the state and should have resulted in serious sanctions. (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

Everything Needed by the Insurance Claims Professional from Barry Zalma The Insurance Claims Library Barry Zalma Dec 17, 2024 https://zalma.com/blog/insurance-claims-library/ Over the last 57 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the Insurance Claims Library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals. All of the books are available at the insurance claims library with links to Amazon or the publishers.

Falsely Claiming to Be an Insurer Can be Criminal To Sue for Business Disparagement Evidence is Required Post 4951, Posted on December 17, 2024 by Barry Zalma Read the full article at https://www.linkedin.com/pulse/falsely-claiming-insurer-can-criminal-barry-zalma-esq-cfe-3bwrc, see the full video at and at and at https://zalma.com/blog plus more than 4950 posts. See the full video at and at Plaintiff Route App, Inc.’s (“Route”) moved the USDC to Dismiss two counterclaims asserted by OrderProtection.com, Inc. (“OrderProtection”). In Route App, Inc. v. Orderprotection.Com, Inc.; Julian Wilson, et al, No. 2:23cv606 DAK, United States District Court, D. Utah (December 9, 2024) found no evidence supporting a claim of business disparagement or business defamation. BACKGROUND This case involves a dispute between Route, a post-purchase shipping insurance provider, and a competitor, OrderProtection. In its Complaint, Route alleges that OrderProtection and several of Route’s former employees misappropriated trade secrets to create a competing business. In response to Route’s Complaint, OrderProtection filed an Answer and Counterclaims, asserting four causes of action: (1) Unfair Competition in Violation of the Lanham Act; (2) Defamation Per Se/Defamation/Business Disparagement; (3) Tortious Interference with Existing and Prospective Economic Relations; and (4) Negligent Misrepresentation. The facts pertaining to OrderProtection’s claim for “Defamation/Defamation Per Se/Business Disparagement” are essentially that Route employees have allegedly told OrderProtection customers and potential customers that they should work with Route instead of OrderProtection because Route is a “legal insurance provider” and OrderProtection is not. OrderProtection argued that Route is not a licensed insurance company and that, at best, Route affiliates with an insurance producer to procure its own insurance coverage (which does not benefit customers or merchants). More importantly both Route and OrderProtection in essence both self-fund the warranty protection they provide, and thus a customer is no better off with Route’s protection package than with OrderProtection’s competitive offering. DISCUSSION Specifically, while OrderProtection’s Opposition Memorandum does not explicitly state that it conceded its defamation and defamation per se claims, OrderProtection never addresses Route’s argument that it could not properly maintain these causes of action in the context of this case. Even if OrderProtection had not conceded these claims, it failed to establish that these claims are viable in the context of this case. Further, OrderProtection made no argument that Utah law recognizes a “hybrid” cause of action for “Defamation Per Se/Defamation/Business Disparagement,” wherein a business disparagement claim may be analyzed using defamation or defamation per se case law rather than case law pertaining to a business disparagement claim. Business Disparagement The parties agree that to state a claim for business disparagement (sometimes called injurious falsehood), OrderProtection must allege (1) falsity of the statement made; (2) malice by the party making the statement; and (3) special damages. According to Route, while OrderProtection has made allegations of lost customers, it has not named specific individuals, nor has it alleged with particularity any financial losses, which is required under Rule 9(b) of the Federal Rules of Civil Procedure. The court declined to recognize a “business disparagement per se” cause of action in which special damages need not be alleged, and it declined to recognize a business disparagement claim that relies on a statement that is “false by implication,” which is a concept that has been recognized in defamation cases. Route’s Motion to Dismiss was granted and OrderProtection’s claims for defamation and defamation per se were dismissed with prejudice. Its claim for business disparagement was dismissed without prejudice, and OrderProtection may file a Motion for Leave to Amend by January 10, 2025, if it is able to allege a proper business disparagement claim, as discussed above. ZALMA OPINION Two businesses claiming to be issuers of insurance who were not licensed insurers claimed to be victims of disparagement by the other. Customers, because of the various claims shifted from one party to the other who, contrary to their claims, were self funding what they alleged was insurance of shipments of goods. The court in a Solomon-like decision ignored the fact that both claimed to be insurers when they were not and used the false claims to take over clients. Both lost and the court gave OrderProtection the attempt to state a business disparagement claim implying that the court did not believe OrderProtection would be able to plead a viable cause of action. The State of Utah Department of Insurance should consider this case. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk

Intent to Move is not a Residence Residence Premises Requires the Insured to Live in Residence Post 4944 Read the full article at https://www.linkedin.com/pulse/intent-move-residence-barry-zalma-esq-cfe-qmlxc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. In Paul Villalobos v. Clear Blue Insurance Company, No. 24-20125, United States Court of Appeals, Fifth Circuit (December 10, 2024) the the Fifth Circuit affirmed the district court’s dismissa of Plaintiff-Appellant Paul Villalobos’s breach of contract claim following a coverage dispute between himself and his insurer, Clear Blue Insurance Company, because he admitted he did not live in the insured premises. FACTS Villalobos is named on a Clear Blue homeowners’ policy, which provides coverage for property located at 7503 Muirwood Lane in Houston, Texas (the “Property”). The policy’s “Property Coverages” section states in pertinent part: “We cover . . . [t]he dwelling on the ‘residence premises’ shown in the Declarations.” The policy defines “residence premises,” also in pertinent part, as “[t]he one-family dwelling where you reside . . . on the inception date of the policy period shown in the Declarations.” The Declarations page lists Villalobos as the insured, his mailing address as the Property, and the inception date as September 21, 2021. In mid-November 2021, Villalobos reported to Clear Blue that wind and hail had damaged the Property’s roof earlier that month. Clear Blue denied coverage after Villalobos admitted he lived in Colorado and had never resided at the Property. Villalobos sued Clear Blue, alleging breach of contract, breach of the duty of good faith and fair dealing, violations of the Texas Deceptive Trade Practices Act and the Texas Insurance Code, fraud, and ongoing conspiracy to commit illegal acts. ANALYSIS During his deposition, Villalobos testified that he lived in Colorado for over nine years and did not reside at the Property when the Clear Blue policy went into effect. Clear Blue moved for summary judgment on Villalobos’s claims, arguing there was no insurance coverage for Villalobos’s property damage as a matter of law. Applying Louisiana law, the Fifth Circuit has previously determined that an identical residence requirement in a homeowners’ insurance policy required “more than purchasing a home or intending to move into it.” GeoVera Specialty Ins. Co. v. Joachin, 964 F.3d 390, 393 (5th Cir. 2020). Applying Joachin the Fifth Circuit agreed with the district court that the Property did not satisfy the policy’s residence requirement and was not a covered “residence premises” because: it is undisputed that Villalobos did not reside on the Property on the inception date of the Clear Blue policy; and Villalobos’s only material argument on appeal is that he intended to move onto the Property. Joachin held that “intending to move” is not enough. The Fifth Circuit concluded that there is no coverage under the policy. Accordingly, Villalobos’s breach of contract claim failed and the USDC’s judgment was affirmed. ZALMA OPINION That something as obvious as a home in Texas cannot be the residence premises of a person who lives full time in Colorado. Insurers issue property insurance policies providing coverage similar to a homeowners policy to the owner of a rental property while a homeowners policy limits coverage to the person who actually resides at the property. That this case went to the Fifth Circuit was the waste of Plaintiff’s time and money, the waste of the time of the trial court, and the waste of the time of the Fifth Circuit who rendered a concise and clear opinion. A less kind judge or appellate court would have imposed sanctions on the party plaintiff and his counsel. (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

Trial Must Proceed Under Plaintiff’s True Name Fraud Defense Insufficient to Allow Plaintiff to Sue Under Pseudonym Post 4944 Read the full article at https://www.linkedin.com/pulse/trial-must-proceed-under-plaintiffs-true-name-barry-zalma-esq-cfe-zc7ic/, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. LITIGANTS MUST NOT HIDE THEIR IDENTITY Plaintiff sued State Farm under a pseudonym. The Court subsequently issued an order requiring Plaintiff to proceed using his actual name. Plaintiff appealed that order, and he now seeks to stay the Court’s order while his appeal is pending in James Doe v. State Farm General Insurance Company, No. 23-cv-04734-JSC, United States District Court, N.D. California (November 26, 2024). BACKGROUND Plaintiff alleged State Farm improperly and in bad faith denied coverage for his claim involving a lost wristwatch that retails at approximately $30,300. He filed his complaint under the pseudonym “James Doe,” insisting a pseudonym was necessary “to protect his privacy, his family, his reputation, and his livelihood, because he has been struggling with mental illnesses.” The Court rescinded its order permitting Plaintiff to proceed anonymously. At a ZOOM hearing the Court informed Plaintiff his actual name appeared on the Zoom screen. Although Plaintiff had yet to file a motion to stay the Court’s order requiring him to proceed under his actual name. The Court denied State Farm’s motion as to the breach of contract and wrongful policy cancellation claims. Jury trial is scheduled to commence in May 2025. DISCUSSION Parties may use pseudonyms in the unusual case when nondisclosure of the party’s identity is necessary to protect a person from harassment, injury, ridicule or personal embarrassment. Plaintiff based his claim for anonymity on two grounds: 1. Plaintiff argues anonymity is necessary because he has revealed highly sensitive and personal matters about himself, his mental illnesses and physical injuries in the course of the case. Yet, Plaintiff did not identify where in the record those highly sensitive matters are discussed. Plaintiff has not sought to redact any portions of his filings, assuming anything in them may be concealed from the public. So, Plaintiff is unlikely to prevail on this theory. 2. Plaintiff argues anonymity is necessary because the accusation of insurance fraud will ruin his reputation for honesty before a jury has passed judgment on his credibility and honesty at trial. Plaintiff states the case involves grave social stigmatization to Plaintiff because he has been accused of committing or seeking to commit insurance fraud. The USDC noted that Plaintiff showed no reasonable probability that an insurer’s material misrepresentation defense transforms a breach of contract claim into a matter of sensitive and highly personal nature, Here, Plaintiff is seeking coverage for a lost wristwatch. If an accusation of insurance fraud were sufficiently stigmatizing to warrant anonymity, then plaintiffs could proceed anonymously virtually anytime they challenge an insurer’s denial of coverage on the basis of a material misrepresentation. The Ninth Circuit’s mandate requires that parties only use pseudonyms in the unusual case. IRREPARABLE INJURY Plaintiff failed to demonstrate he will be irreparably injured absent a stay. The injury Plaintiff fears has already occurred to some extent by Plaintiff’s own doing. He appeared at a public hearing using his actual name. Further, in its recent summary judgment order, the Court concluded there was a dispute of fact as to whether Plaintiff intentionally concealed or misrepresented a material fact or circumstance relating to his insurance. At this point in this proceeding, there has been no finding of insurance fraud. HOIST ON HIS OWN PETARD Given that Plaintiff himself proceeded at a public hearing without taking steps to prevent the very disclosure he claims is so injurious, Plaintiff has not met his burden on the irreparable injury factor. As summary judgment was denied on the breach of contract claim, the case is proceeding to trial. The public interest lies in transparent and public court proceedings, especially trials. The Court denied Plaintiff’s motion to stay the order requiring Plaintiff to proceed under his actual name. ZALMA OPINION Pursuing litigation under a pseudonym because the defendant insurer claimed the Plaintiff attempted insurance fraud because his mental health and reputation would be harmed by the claims is insufficient. First, Plaintiff chose to sue State Farm. He could protect his mental health and reputation by not suing. Second, he was willing to attend a Zoom hearing with his true name showing, thereby effectively waiving the claim of anonymity. It could easily be concluded that he has sued under a pseudonym because he was embarrassed he was caught. (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

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.

CHUTZPAH: GET AWAY WITH MURDER AND COMPLAIN ABOUT SENTENCE Burn Husband to Death for Insurance Money & Plea to Avoid Jail Post 4942 Posted on December 10, 2024 by Barry Zalma See the full video at and at FACTS Mendy Powell Neal, who was charged with the first degree premeditated and felony murder of her husband and the aggravated arson of their home, entered a North Carolina v. Alford, 400 U.S. 25, 37 (1970), best interest plea to voluntary manslaughter, a Class C felony, in exchange for the dismissal of the felony murder and aggravated arson counts of the presentment and an agreed range of three to four years, with the trial court to determine the length and manner of service of the sentence. At the conclusion of the sentencing hearing, the trial court denied the Defendant’s request for judicial diversion, determined that she was not a suitable candidate for probation or other alternative sentencing, and sentenced her as a Range I, standard offender to four years at 30% in the Tennessee Department of Correction. In State Of Tennessee v. Mendy Powell Neal, No. M2023-01176-CCA-R3-CD, Court of Criminal Appeals of Tennessee, Nashville (November 26, 2024) the Court of Criminal Appeals affirmed the trial court. The Defendant’s husband, Matthew Neal, died in a house fire that totally consumed the couple’s Charlotte log home. The Defendant was charged with the first degree premediated murder of the victim, the first degree felony murder of the victim during the perpetration of an aggravated arson, and the aggravated arson of the home. The Defendant proceeded to a jury trial where the State presented evidence for three days establishing the crimes. The neighbor, Mr. Swan and a responding deputy, who could hear the victim moaning on the other side of the closed front door, attempted to enter the home but were unable due to the intensity of the fire. The next day, the victim’s burned body was found within ten feet of the front door. The victim was burned over 95% of his body and died of carbon monoxide toxicity and thermal injury. Autopsy showed he was drugged and couldn’t escape. Regardless of the evidence of premeditated murder the trial court found that the Defendant’s lack of a criminal history was an applicable mitigating factor and enhancement factors that the victim was particularly vulnerable because of age or physical or mental disability, that the Defendant treated or allowed the victim to be treated with exceptional cruelty during the commission of the offense, that the Defendant had no hesitation about committing the crime when the risk to human life was high, and that the Defendant abused a position of private trust that significantly facilitated the commission of the offense. The trial court found that sentencing the Defendant to the maximum length in the Tennessee Department of Correction “was the just and proper sentence due to the Defendant’s misrepresentation and dishonesty as well as the overwhelming circumstantial proof of Defendant’s conniving and forethought regarding the crime.” ANALYSIS The Court of Criminal Appeals found that there was nothing that warranted waiver of the timely notice of appeal requirement with respect to the trial court’s original sentencing determinations and the trial court acted well within its discretion in declining to reduce or modify the Defendant’s sentence. The Defendant did not show any circumstances, warranting the alteration of her sentence in the interest of justice. ZALMA OPINION It takes a massive amount of chutzpah (Yiddish for unmitigated gall) to drug your husband so he could not escape being burned to death after setting fire to the house to kill him and collect on a life insurance policy, and then, when damning evidence was presented offer a Alford plea to manslaughter. To then complain that court imposed the maximum sentence even though her agreement with the court changed the aggravated, premeditated murder that could have resulted in life in prison to manslaughter and only 4 years. (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.

Zalma's Insurance Fraud Letter - December 1, 2024 ZIFL Volume 28 No. 22 Post 4939 Read the full article at Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdfand at https://zalma.com/blog. Subscribe to ZIFL at https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D The Source for the Insurance Fraud Professional https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ This issue contains the following articles about insurance fraud: The EUO is a Material Condition Precedent A Key Tool in the Effort to Reduce Fraud Claim Properly Denied for Refusal to Testify at EUO I spoke recently at the Conference of the Southern California Fraud Investigators Association on the Examination Under Oath as a tool to help insureds prove their losses and what happens when an insured fails or refuses to testify. This case emphasizes the purpose of my talk. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Thanksgiving Wishes from the Zalma Family My family and I have much to be thankful for this year. My first born daughter, Stephanie Zalma, continues to care for my wife 24 hours a day 7 days a week with love and patience as Thea continues as Nana to our two grandchildren and the loving mother of our three children. After receiving a new Aortic Heart Valve I am personally in good health, walking about 25 miles a week. Exercising my, apparently unusual mode of retirement, I work only six to eight hours a day doing what I love the most, writing about insurance, insurance claims, insurance law and acting as an insurance claims consultant and expert witness. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf More McClenny Moseley & Associates Issues This is ZIFL’s thirty eighth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana and what appears to be an effort to profit from what some Magistrate and District judges may be criminal to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Ethical Behavior & Insurance Insurance, from the time of its first agreement to the present day has always been a business requiring ethical behavior between the insurer and the insured and between the insured and the insurer. The concept of ethical behavior refers to well-founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues, all of which are essential to the lawyer. Ethics refers to those standards that impose the reasonable obligations to refrain from murder, rape, theft, assault, slander, and fraud. Ethical standards also include those that imply virtues of honesty, compassion, and loyalty. There are rights presumed to exist such as those described in the Declaration of Independence submitted to King George of England in 1776 that held: We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of happiness. The unalienable rights also include the right to life, the right to freedom from injury, and the right to liberty. Such standards are adequate standards of ethics because they are supported by consistent and well-founded reasons. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Health Insurance Fraud Convictions Michigan Woman Convicted of $1.4M Health Care Kickback Scheme Mary Smettler-Bolton, 71, of Oakland County, Michigan was convicted November 22, 2024 for her role in a conspiracy to defraud the United States and receive illegal health care kickbacks. According to court documents and evidence presented at trial, Mary referred Medicare beneficiaries to several Metro Detroit home health companies in exchange for hundreds of thousands of dollars in kickbacks paid by the owners and operators of the home health companies. Over the course of four years, she and her co-conspirators caused over $1.4 million of loss to Medicare. Smettler-Bolton was convicted of one count of conspiracy to defraud the United States and receive illegal health care kickbacks and one count of violating the federal Anti-Kickback Statute. She is scheduled to be sentenced on March 3, 2025, and faces a maximum penalty of five years in prison on the conspiracy count and a maximum penalty of 10 years in prison on the kickback count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors. Read the full article about dozens more convictions at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Convictions of Other Than Health Insurance Fraud Creative Fraudster Guilty of $229K Insurance Fraud Schemes Justin Mack, a native of Buffalo, New York, and a resident of Cleveland, Ohio, was sentenced on November 25, 2024 in the Cuyahoga County Court of Common Pleas. Mack, an Ohio man was sentenced to five years in prison and ordered to pay restitution for filing 24 fraudulent claims with multiple insurance companies, totaling more than $229,000. An extensive investigation uncovered Mack’s pattern of submitting altered documentation, falsified claims, and using other people’s identities to fraudulently secure payouts from multiple insurance companies. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf The Examination Under Oath Is Not Part of a Judicial Process Although the EUO is a formal proceeding it is not part of a judicial process nor is it subject to the rules set out by codes of civil procedure. There is no right to object to questions and never a judge present to rule on the objections. The testimony at the EUO is required to be presented in accordance with the obligation imposed on an insured to deal fairly and in good faith with the insurer. Read the full article at https://zalma.com/blog/wp-content/uploads/2024/12/ZIFL-12-01-2024.pdf Barry Zalma Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Write to Mr. Zalma at [email protected]; https://www.zalma.com; https://zalma.com/blog. He publishes daily articles at https://zalma.substack.com, Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ to consider more than 50 volumes written by Barry Zalma on insurance and insurance claims handling. Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/; Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ and GTTR at https://gettr.com/@zalma

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

When Rejected in Writing no UM/UIM Coverage Read the full article at https://lnkd.in/gwt49KRg, see the full video at https://lnkd.in/ggwkMJ_U and at https://lnkd.in/gbFpkHtK and https://zalma.com/blog plus more than 4900 posts. When Rejected in Writing no UM/UIM Coverage Post 4939 Karina Monasterio appealed the district court’s judgment in favor of Progressive Express Insurance Company on Progressive’s complaint for declaratory judgment and Monasterio’s counterclaim against Progressive, and in favor of Rasier-DC, LLC and Uber Technologies, Inc. on her crossclaim against those defendants. In Progressive Express Insurance Company v. Karina Monasterio, Uber Technologies, Inc., Rasier – DC, LLC, No. 24-11256, United States Court of Appeals, Eleventh Circuit (November 18, 2024) the Eleventh Circuit affirmed the USDC. FACTS Progressive sued for declaratory judgment. Monasterio counterclaimed seeking a declaration that Florida’s TNC Act required Progressive, Rasier-DC, and Uber to provide uninsured motorist coverage for her accident. Florida’s TNC Act required insurance coverage may be maintained by the TNC, the TNC driver, or the TNC vehicle owner, or it may be provided by a combination of their policies. FLORIDA UM/UIM COVERAGE REQUIREMENTS Florida Statutes provide that no motor vehicle liability insurance policy which provides bodily injury liability coverage shall be delivered or issued for delivery in this state with respect to any “specifically insured or identified motor vehicle” registered or principally garaged in this state unless uninsured motor vehicle coverage is provided therein or supplemental thereto. Neither Rasier-DC nor any other named insured paid the premium for uninsured motorist coverage. THE APPEAL The Eleventh Circuit concluded that the statutory text is clear. The policy was not issued for any “specifically insured or identified motor vehicle” registered or garaged in Florida. So, the requirements of the statute did not apply. Because statute did not require uninsured motorist coverage for the auto insurance policy the TNC Act did not. ZALMA OPINION It is always important for a court to read the language of the applicable statute and the policy to determine coverage on an automobile insurance policy. Here the TNC, Raiser-DC rejected UM/UIM coverage and coverage was clearly not required by the statute. The only question I have is why the parties thought it was worth their time and effort to appeal to the Eleventh Circuit. (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://lnkd.in/gmmzUVBy Go to X @bzalma; Go to the Insurance Claims Library – https://lnkd.in/gwEYk