• Fraudulent Claims of Injury Defeated

    Respond to Motions for Summary Adjudication or Always Lose
    Posted on November 8, 2024 by Barry Zalma

    Post 4928

    Read the full article at https://www.linkedin.com/pulse/fraudulent-claims-injury-defeated-barry-zalma-esq-cfe-kitgc, See the full video at and at and at https://zalma.com/blog

    IT PAYS DEFENDANTS TO INVESTIGATE INJURY CLAIMS

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

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

    FACTUAL BACKGROUND

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

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

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

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

    THRESHOLD INJURY

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

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

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

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

    FRAUDULENT INSURANCE ACT

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

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

    ZALMA OPINION

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

    (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
    Fraudulent Claims of Injury Defeated Respond to Motions for Summary Adjudication or Always Lose Posted on November 8, 2024 by Barry Zalma Post 4928 Read the full article at https://www.linkedin.com/pulse/fraudulent-claims-injury-defeated-barry-zalma-esq-cfe-kitgc, See the full video at and at and at https://zalma.com/blog IT PAYS DEFENDANTS TO INVESTIGATE INJURY CLAIMS Plaintiff appealed from two orders granting summary disposition in favor of defendants even though he failed to respond to either motion. In Chris Kallco v. Melissa Lynn Pugh, Chris Kallco, and Precise Mri Of Michigan, LLC v. Citizens Insurance Company Of The Midwest and Melissa Lynn Pugh, No. 368156, Court of Appeals of Michigan (October 30, 2024) affirmed the trial court’s decision. FACTUAL BACKGROUND This case arises out of a motor vehicle accident that occurred on March 9, 2020 involving plaintiff and Pugh. Plaintiff alleges that he sustained injuries from the accident. A year after the accident, plaintiff brought a negligence claim against Pugh, alleging that, because of Pugh’s negligence, plaintiff sustained “severe permanent and progressive personal injuries and serious impairment of a body function, including but not necessarily limited to: Head, Neck, Back, Shoulders ….” Plaintiff also brought a claim against Citizens for PIP benefits, including medical expenses, work loss, and replacement services. Pugh and Citizens moved for summary disposition arguing that plaintiff could not meet his burden of showing that he sustained a threshold injury under the no-fault act and, therefore, he could not maintain his negligence claim against her. Pugh submitted the deposition testimony of the plaintiff and the report of an independent medical examination (IME) conducted by Dr. James Bragman on December 27, 2021. Dr. Bragman further observed that plaintiff had “near full range of motion” in his neck and that he was “eminently capable” of standing and touching his toes despite his refusal to do so. Dr. Bragman noted that plaintiff had “very little” medical treatment documented in his records and that he had been undergoing physical therapy for six months with no medical basis for doing so. An investigator’s report includes pictures of plaintiff walking, riding a child’s bicycle, squatting, bending over, lifting a bicycle out of a minivan unassisted, playing with a dog, driving a car, and twisting his neck. Citizens’ motion argued that plaintiff made material misrepresentations to Citizens regarding the extent of his injuries, which rendered him ineligible for benefits. The trial court found that, based upon the evidence presented, plaintiff failed to establish that he sustained a serious impairment of body function and therefore summary disposition in favor of Pugh was appropriate. THRESHOLD INJURY Plaintiff argued that the trial court erred by granting summary disposition in favor of Pugh. Under the no fault statute the threshold question of whether the person has suffered a serious impairment of body function should be determined by the court as a matter of law as long as there is no factual dispute regarding the nature and extent of the person’s injuries that is material to determining whether the threshold standards are met. Plaintiff was obligated to respond to Pugh’s motion in order to meet his burden of demonstrating that a fact question existed as to whether he suffered a serious impairment of body function. The parts of plaintiff’s deposition identified by Pugh do not establish a genuine issue of material fact as to whether he suffered a serious impairment of body function. The relevant portions of plaintiff’s deposition testimony fail to rebut the evidence and instead set forth, at best, mere subjective complaints of pain. FRAUDULENT INSURANCE ACT The fraud statute finds that a person who presents or causes to be presented an oral or written statement knowing that the statement contains false information concerning a fact or thing material to the claim commits a fraudulent insurance act under that is subject to the penalties imposed under the statute. A claim that contains or is supported by a fraudulent insurance act as described in this subsection is ineligible for payment of PIP benefits. An individual commits a “fraudulent insurance act” when: (1) the person presents or causes to be presented an oral or written statement, (2) the statement is part of or in support of a claim for no-fault benefits, and (3) the claim for benefits was submitted to the MAIPF. Further, (4) the person must have known that the statement contained false information, and (5) the statement concerned a fact or thing material to the claim. ZALMA OPINION The evidence presented by the defendants were damning since they established the injuries claimed were false. Plaintiff failed to respond to the motions to his detriment and sought reconsideration without any admissible evidence that he was truly injured. The defendants established that the Plaintiff committed fraud and he is lucky that this was a civil finding not a criminal proceeding that, in my opinion, should be presented by the prosecutor. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk
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  • Truth!
    Someone recently asked me why I like Trump. My answer was that I don't really like a lot of things about Trump.
    But this election is not about choosing the most likeable person.
    We are voting between two vastly different ideologies. We are voting for the country we want to leave our children and grandchildren.
    Trump represents that future and has proven that he can deliver. He is a patriot to the core and even served his country for 4 years without pay.
    That moment when someone says,
    "I can't believe you're voting for Trump". I simply reply, “I'm NOT voting for Trump.”
    I'm voting for the First Amendment and freedom of speech. I'm voting for the right to speak my opinion and not be censored.
    I’m voting for secure borders and LEGAL immigration. I am voting for election integrity to include mandatory voter ID. (Why would anyone vote against this?)
    I'm voting for the Second Amendment and my right to defend my life and my family.
    I'm voting for the police to be respected once again.
    I am voting for law & order and an end to allowing protesters to trespass and burn our cities, destroying innocent small business. (Tim Walz)
    I am voting for personal responsibility and the end of the revolving door where criminals are being put back on the street. (Kamala Harris)
    I'm voting for the next Supreme Court Justice(s) to protect the Constitution and the Bill of Rights.
    I’m voting for a return of our troops from foreign countries and the end to America’s involvement in foreign conflicts.
    I'm voting for the Electoral College and for the Republic in which we live.
    I’m voting for the continued appointment of Federal Judges who respect the Constitution and the Bill of Rights.
    I’m voting for keeping our jobs to remain in America and not be outsourced all over the world - to China, Mexico and other foreign countries.
    I am voting for doing away with all of the freebies given to all of the illegals and not looking after the needs of the American citizens and homeless veterans.
    I'm voting for the military & the veterans who fought for this country
    I'm voting to keep men out of women's sports.
    I’m voting for peace progress in the Middle East.
    I’m voting to fight against human/child trafficking.
    I'm voting for Freedom of Religion.
    I am voting for the return of teaching math, history, and science instead of the indoctrination of our children.
    I'm not just voting for one person.
    I'm voting for the future of my Country.
    I'm voting for my children and my grandchildren to ensure their freedoms
    America is the greatest country in the world, hense why everyone wants to immigrate here. So why do you want to change it?
    Why do politicians want to enact policies that have failed in other countries throughout history?
    I'm not voting for Trump.
    I'm voting for America.
    Copied and pasted, keep it going
    Truth! Someone recently asked me why I like Trump. My answer was that I don't really like a lot of things about Trump. But this election is not about choosing the most likeable person. We are voting between two vastly different ideologies. We are voting for the country we want to leave our children and grandchildren. Trump represents that future and has proven that he can deliver. He is a patriot to the core and even served his country for 4 years without pay. That moment when someone says, "I can't believe you're voting for Trump". I simply reply, “I'm NOT voting for Trump.” I'm voting for the First Amendment and freedom of speech. I'm voting for the right to speak my opinion and not be censored. I’m voting for secure borders and LEGAL immigration. I am voting for election integrity to include mandatory voter ID. (Why would anyone vote against this?) I'm voting for the Second Amendment and my right to defend my life and my family. I'm voting for the police to be respected once again. I am voting for law & order and an end to allowing protesters to trespass and burn our cities, destroying innocent small business. (Tim Walz) I am voting for personal responsibility and the end of the revolving door where criminals are being put back on the street. (Kamala Harris) I'm voting for the next Supreme Court Justice(s) to protect the Constitution and the Bill of Rights. I’m voting for a return of our troops from foreign countries and the end to America’s involvement in foreign conflicts. I'm voting for the Electoral College and for the Republic in which we live. I’m voting for the continued appointment of Federal Judges who respect the Constitution and the Bill of Rights. I’m voting for keeping our jobs to remain in America and not be outsourced all over the world - to China, Mexico and other foreign countries. I am voting for doing away with all of the freebies given to all of the illegals and not looking after the needs of the American citizens and homeless veterans. I'm voting for the military & the veterans who fought for this country I'm voting to keep men out of women's sports. I’m voting for peace progress in the Middle East. I’m voting to fight against human/child trafficking. I'm voting for Freedom of Religion. I am voting for the return of teaching math, history, and science instead of the indoctrination of our children. I'm not just voting for one person. I'm voting for the future of my Country. I'm voting for my children and my grandchildren to ensure their freedoms America is the greatest country in the world, hense why everyone wants to immigrate here. So why do you want to change it? Why do politicians want to enact policies that have failed in other countries throughout history? I'm not voting for Trump. I'm voting for America. Copied and pasted, keep it going
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