Zalma's Insurance Fraud Letter - December 15, 2023

ZIFL - Volume 27 - Issue 24

Merry Christmas,  Happy Hanukah, and May the Winter Solstice be Peaceful & Mild

The Resource for the Insurance Claims and Insurance Fraud Professionals

This, the 24th issue of the 27th Year of ZIFL includes articles and reports relating to insurance fraud, including:

 Former Root Marketing Exec Pleads Guilty to Taking Over $10 Million From the Insurer

Brinson Caleb “BC” Silver, former chief marketing officer for insurtech Root, has pleaded guilty to stealing more than $10 million from his former employer and violating court orders.

According to the U.S. Attorney’s Office for the Southern District of Ohio, Silver, 43, of Culver City, California, pleaded guilty to one count each of wire fraud and contempt of court and has agreed to pay more than $10.2 million in restitution. A prison sentence of 24-51 months has been recommended.

Read the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf

More McClenny Moseley & Associates Issues
This is ZIFL’s twenteeth 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.
December 8, 2023 – History of MMA Issues

Read the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf

The Insurance Examination Under Oath
A Tool Available to Insurers to Thoroughly Investigate Claims

The insurance Examination Under Oath (“EUO”) is a formal type of interview authorized by an insurance contract. It is taken under the authority provided by a condition of the insurance contract that compels the insured to appear and give sworn testimony on the demand of the insurer or find his, her or its claim rejected for breach of a condition. A notary and a certified shorthand reporter are always present to give the oath to the person interviewed and record the entire conversation.

Read the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf

Health Insurance Fraud Convictions
Doctor and Wife Admit Genetic Testing Kickback and Bribery Scheme

Yitzchok “Barry” Kurtzer, 63, and his wife, Robin Kurtzer, 62, both of Monsey, New York, a Pennsylvania doctor, and his wife admitted to their roles in schemes to solicit and receive kickbacks and bribes in exchange for ordering genetic tests.

Read the full issue of ZIFL and about dozens of fraud convictions at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf

What is Needed to Deter Insurance Fraud?

To do so the insurers must train their staff to recognize the elements of both the crime of insurance fraud and the elements of the civil tort of insurance fraud. If well trained, insurance personnel collecting information about a potential insurance fraud, will know the type and quality of information that either a prosecutor or a civil defense lawyer will need to prove fraud was attempted.

Some estimates indicate that more money goes out fighting fraud than is saved. Others show that every dollar spent by insurers to defeat fraud save the insurer as much as seven dollars in fraudulent claims. Although insurance fraud is a crime in almost every jurisdiction in the United States it is seldom prosecuted.

Read the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf

Other Insurance Fraud Convictions
North Carolina Insurance Agent Can’t Appeal Sentence in $700,000 Fraud

Glenda Taylor-Sanders, of Charlotte, North Carolina, a former insurance agent who pleaded guilty to defrauding trucking company clients and a premium finance company of hundreds of thousands of dollars cannot challenge her sentence and restitution order, a federal appeals court decided.

Read the full issue and dozens of convictions at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf

Fraud After Catastrophes

Over the past few decades fraud has become an ever escalating problem. It is part of the CODB equation and quickly becomes just one more cost to be passed on to the insurance buying public. When a catastrophe hits everyone suffers. The victims of the catastrophe suffer. The insurers whose staff is not adequately trained to investigate and adjust claims and recognize fraud compounds the suffering of the victims and costs the insurer.

Read the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf

Barry Zalma

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. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and zalma@zalma.com

Over the last 55 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals.

Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455; Subscribe to Zalma on Insurance at locals.com https://zalmaoninsurance.local.com/subscribe. 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 zalma@zalma.com; http://www.zalma.com; http://zalma.com/blog; I publish daily articles at https://zalma.substack.com, Follow Mr. Zalma on Twitter at https://twitter.com/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/ 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/  Follow Mr. Zalma on Twitter at https://twitter.com/bzalma, Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921, Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg, Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ and GTTR at https://gettr.com/@zalma

Read the full issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2023/12/ZIFL-12-15-2023.pdf