Zalma’s Insurance Fraud Letter – September 1, 2024
Post 4864
See the full video at https://rumble.com/v5d8ave-zalmas-insurance-fraud-letter-september-1-2024.html and at https://youtu.be/oFPrxW3aEM0
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:
Some Claim “Insurance Fraud Cost Statistics Are a Fraud” Or Are They Just an Estimate?
In an article entitled Insurance Fraud Cost Statistics Are a Fraud by attorney Chip Merlin, published August 15, 2024, claims that Insurance companies claim that when claims numbers are simply made up, that act constitutes fraud. If that is so, then insurance company fraud statistics are a fraud. The often wrongfully cited estimate of $308.6 billion is an admittedly “make believe” estimate.
The post Insurance Fraud Cost Statistics Are a Fraud appeared first on Property Insurance Coverage Law Blog.
As readers of ZIFL are aware, insurance fraud exists, and I publish twice a month large lists of reported convictions of people and entities for the crime of insurance fraud. Since, in the last 57 years I have been involved in insurance fraud topics it is rare that people are actually arrested, indicted, tried and convicted for the crime of insurance fraud, the convictions are the only reliable evidence of the extent of fraud. It is clear from previous issues that the convictions show multiple millions of dollars in fraud that were established in a court of law.
See the full article and the full 18 page edition of ZIFL here
Insurance Fraudster Who Represents Herself is Foolish
Convicted Felon Incompetently Seeks Shortened Sentence in Pro Se Pleading
Rameeza S. Chowdhury (“Chowdhury”) appealed as her own attorney from the order dismissing her petition pursuant to the Post Conviction Relief Act (“PCRA”) and lost so she must serve the full sentence.
In Commonwealth Of Pennsylvania v. Rameeza S. Chowdhury, No. 1491 MDA 2023, No. J-S19027-24, Superior Court of Pennsylvania (August 8, 2024) Chowdhury’s attempt to get out of jail was found to have been made without an appropriate basis and incompetently.
See the full article and the full 18 page edition of ZIFL here
More McClenny Moseley & Associates Issues
This is ZIFL’s thirty fourth 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.
June 17, 2024
ORDER: UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF LOUISIANA
See the full article and the full 18 page edition of ZIFL here
Seven Years in Prison for No Fault Fraud
Defendant Must Pay $46 Million Restitution in Installments
On November 1,2023, Defendant Roman Israilov pled guilty to conspiracy to commit healthcare fraud and aggravated identity theft in connection with a long-running no-fault insurance fraud scheme. On May 23, 2024, the USDC sentenced Israilov to seven years’ imprisonment and three years’ supervised release.
See the full article and the full 18 page edition of ZIFL here
Health Insurance Fraud Convictions
Connecticut Dentists Pay $1.7 million to Settle False Claims Allegations
STANISLAV GINTAUTAS, DDS and TATIANA AGABABAEVA, DDS, and their businesses, FAMILY DENTISTRY OF BRIDGEPORT PC, FAMILY DENTISTRY OF HARTFORD PLLC, and FAMILY DENTISTRY OF STAMFORD, PC, have entered into a civil settlement agreement with the federal and state governments and have paid $1.7 million to resolve allegations that they violated the federal and state False Claims Acts.
See the full article, dozense of convictions and the full 18 page edition of ZIFL here
Convicted of a Variety of Fraud Schemes Including Insurance Fraud
Defendant Moved for Acquittal and New Trial
Defendant Chiagoziem Kizito Okeke (“Okeke”) was charged with two counts: conspiracy to commit wire fraud and conspiracy to commit money laundering. He was convicted by a jury and moved the court for acquittal or a new trial in United States v. Chiagoziem Kizito Okeke, No. 4:21-CR-253(29), the United States District Court, E.D. Texas (August 21, 2024) ruled on the motion.
See the full article and the full 18 page edition of ZIFL here
Convictions of Other Than Health Insurance Fraud
Kansas Man Sentenced for Securities Fraud
Jesse Wayne Harris, age 36, was sentenced in Sedgwick County, Kansas District Court on August 20, 2024 to 30 months in prison for three level four felonies of securities fraud. He was taken into custody last week to begin his prison sentence.
Starting in 2016, Harris sold securities to raise investment funds for two schemes. Instead of using investor funds for the purposes Harris promised investors, Harris misappropriated the vast majority of funds, using them for his personal use and to pay other investors. Such activity is the hallmark of a “Ponzi scheme”- a fraudulent scheme where money taken from later investors is paid to earlier investors to create the false appearance that the scheme is generating returns.
See the full article and the full 18 page edition of ZIFL here
State Passes New Bill to Pay Fraud Division Detectives Equal to Other State Detectives
Governor Newsom has until September 30, 2024, to act on the bill.
Until On August 30, 2024 Insurance Commissioner Ricardo Lara and Assemblymember Lisa Calderon, Chair of the Assembly Insurance Committee, announced that the California Senate and Assembly have passed Assembly Bill 2872, which would support the work of sworn officers at the California Department of Insurance who are the state’s leaders in preventing and stopping insurance fraud. This bill would help close the pay gap between the Department’s sworn fraud detectives and sworn officers in other state agencies, helping strengthen staff retention and enforcement efforts that protect public safety. AB 2872 is now headed to Governor Newsom’s desk for his consideration.
See the full article and the full 18 page edition of ZIFL here
Dealing With the Nervous Person During An EUO
When investigating fraud, the professional knows how to exploit the subject’s fear of being caught in an illegal act of deception and of suffering punishment. How much fear a person feels at the time of the EUO depends, obviously, on the person’s personal background and psychological makeup. But the time that has elapsed between the actual committing of a fraud and any investigative EUO can be of equal importance. The subject, knowing that the professional has been actively compiling background information, will often enter the EUO with an acutely heightened sense of fear. Many find it impossible to hide the obvious signs of this accumulated fear. These are the “nervous persons,” as distinct from the “cool customers” discussed in the last chapter.
The nervous person tries hard to control the outward signs of nervousness by concentrating on restraining emotion. Sometimes, to mask or reduce stress, this type of subject will resort to taking drugs.
The interviewer should, therefore, always question the person interviewed about possible drug use, whether that involves prescription medicines or illegal drugs.
See the full article and the full 18 page edition of ZIFL here
Go to my Interview on the Art of Adjusting Podcast & https://youtu.be/SSRT6wnJih4?list=PLlT0OplvuGo04nAni7oOuPDEn3ebKaDTC
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders.
See the full article and the full 18 page edition of ZIFL here
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