Zalma’s Insurance Fraud Letter – June 1, 2024
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Read the full 26 page issue here in Adobe pdf format.
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:
The Scope of Loss
When dealing with a potential fraudulent first party-property loss it is essential that the investigation into the claim is through and prompt. To do a thorough investigation of a property loss it is essential that the insured and the company’s adjuster agree to a complete scope of loss so that the investigation into the amount of the loss is prepared and agreed to in immediately.
In a loss to structures or contents the scope of loss is generated at the first meeting between the adjuster and the insured. The scope of loss is where both parties agree on the categories of property damaged.
Read the full 26 page issue here in Adobe pdf format.
More McClenny Moseley & Associates Issues
This is ZIFL’s twenty ninth 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.
April 26, 2024 – MMA Generated Lawsuits Dismissed
Read the article and the full 26 page issue here in Adobe pdf format.
Insureds are Made More Equal Than Insurers
California Court of Appeals Extends Meaning of Statute to Make Insured More Powerful than Insurers at EUO
As George Orwell explained in his novel “Animal Farm” we are all equal, but some are more equal than others. In Vladimir Myasnyankin v. Nationwide Mutual Insurance Company, A166946, A167445, California Court of Appeals, First District, Fifth Division (January 30, 2024) the Court of Appeals decided, over the dissent of the Presiding Judge that the insured in a disputed claim is more equal than the insurer.
Read the article and the full 26 page issue here in Adobe pdf format.
New Book
The Compact Book of Adjusting Property Claims – Fourth Edition
In Kindle, paperback and hardback formats, The Compact Book of Adjusting Property Claims, Fourth Edition is now available for purchase here and here. The Fourth Edition contains updates and clarifications from the first three editions plus additional material for the working adjuster and the insurance coverage lawyer.
Read the article and the full 26 page issue here in Adobe pdf format.
Health Insurance Fraud Convictions
The federal prosecutors and courts have been busy prosecuting health insurance fraud.
Doctor, One of Top Prescribers of Opioids in Massachusetts, Is Sentenced
Dr. Olarewaju James Oladipo, of Canton, a Massachusetts, an orthopedic surgeon who prosecutors say was one of the top prescribers of opioid drugs in the state was sentenced in federal court in Boston for his role in a health care fraud scheme.
Oladipo was sentenced by U.S. District Court Judge Allison D. Burroughs to 16 months in prison, followed by one year of supervised release. In December 2023, Oladipo was convicted by a federal jury of 10 counts of health care fraud.
Read the article and dozens of convictions and the full 26 page issue here in Adobe pdf format.
New Book Now Available from Barry Zalma
Property Investigation Checklists: Uncovering Insurance Fraud, 14th Edition
Read the article and the full 26 page issue here in Adobe pdf format.
Other Insurance Fraud Convictions
Tennessee Man Sentenced to Over 3 Years in Federal Prison for Crop Insurance Fraud
David Garrett Manion, 61, of Lafayette, Tennessee, was sentenced to 3 years and 6 months in federal prison, followed by 3 years of supervised release, and was ordered to pay $3.5 million in restitution for defrauding the federal crop insurance program.
According to court documents, Manion was convicted for defrauding the federal crop insurance program between 2016 and 2022. Manion also has a prior 2016 conviction for defrauding the federal crop insurance program. As part of that 2016 case, Manion agreed to a five-year debarment from the federal crop insurance program administered by the United States Department of Agriculture Risk Management Agency.
While that case was being resolved, however, Manion devised a scheme under which other family members applied for and received crop insurance for tobacco that was farmed by and belonged to Manion. In addition to $3.5 million in criminal restitution, Manion agreed to pay the Risk Management Agency nearly $5.5 million to resolve other outstanding issues.
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
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About Barry Zalma
An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.
