Monthly Archives: December 2010

>Zalma’s Insurance Fraud Letter — January 1, 2011

>Major Fraud Conviction Affirmed Zalma’s Insurance Fraud Letter (ZIFL) begins its fifthteenth year of publication with an article explaining that insurance fraud is often difficult to prove. Prosecutors hate to bring to trial insurance fraud cases because many jurors are … Continue reading

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>Happy New Year

>This has been a most interesting year — much like the old Chinese curse “may you live in interesting times.” Hopefully 2011 will be a less interesting year where we can all enjoy a life filled with joy, useful and … Continue reading

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>Why it is Often Best to Use a Summary Judgment to Encourage Settlement

>     The Danger of Winning at Summary Judgment    © 2010    Barry Zalma The only truly concluded lawsuits are a suit that is settled by the parties or one that has been tried and the Supreme Court refuses hearing or … Continue reading

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>Fifth Amendment Requires Pause in Claims Investigation in California

> In Gruenberg the Fifth Amendment Allows Insured to Refuse to Testify In California the Supreme Court ruled in Gruenberg v. Aetna Insurance Co., 9 Cal. 3d 566, 510 P.2d 1032, 108 Cal. Rptr. 480 (Cal. 06/11/1973) concluded when an … Continue reading

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>No Claim, No Standing, Case Dismissed

>Class Action Fails Because No Claim Made or Denied Creative lawyers work to find some way to take money from insurers who, by definition, are disliked by the public at large. Some have found effective a class action suit against … Continue reading

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>Anti-Stacking Statutes Do Not Always Apply in Connecticut

> Exceptions Exist to Anti-Stacking Statute  (c) 2010 by Barry Zalma  Stacking of multiple insurance policies and coverages is only allowed in some states. Others, like Connecticut have passed anti-stacking statutes to avoid the potential that stacking can be used … Continue reading

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>Fifth Amendment No Protection for Civil Plaintiff

A Civil Plaintiff May Not Assert the Fifth Amendment © 2010 Barry Zalma The Fifth Amendment to the U.S. Constitution protects an individual from being forced to testify in a manner that might incriminate him or her and subject the … Continue reading

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>Fraud Is

> What do you Do When Faced with an Inflated Claim? In California it is a felony to knowingly present or cause to be presented any false or fraudulent claim. [Penal Code Section 550] In Watts v. Farmers Insurance Exchange, … Continue reading

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>TANSTAAFL

> There Ain’t No Such Thing as a Free Lunch. I’m out of town today so this word of wisdom from Robert Heinlein is presented as a reminder to everyone.  Insurance is not free, it is a contract where you … Continue reading

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>When is a warranty only a representation?

>When is a warranty only a representation? Insurers who wish to use a breach of warranty to void a policy must be careful in the questions asked in an application for insurance and policy. First, the application must ask questions … Continue reading

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>When a State and City Government Steals from the US — Crime Pays

>Why Settle a Whistleblower Suit Cheap?  The whistleblower or Qui Tam lawsuit allows a private citizen to sue, on behalf of the Government, people involved in defrauding the government. If successful the whistleblower can receive a large percentage of the … Continue reading

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>Major Fraud Conviction Affirmed

>Insurance Crime Doesn’t Always Pay Insurance fraud is often difficult to prove. Prosecutors hate to bring to trial insurance fraud cases because many jurors are biased against insurance companies. It is prudent, therefore, to charge the fraud perpetrator with equivalent … Continue reading

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>Zalma on Rescission of Insurance in California

> Barry Zalma has produced the only detailed resource on the remedy of rescission of insurance in California. In 832 pages Mr. Zalma has provided the full text of almost every decision of the California courts of appeal and the … Continue reading

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>Are You Facing Bad Faith For Failure to Fulfill Regulations?

> Many states have joined with my home state of California by enacting Fair Claims Settlement Practices Regulations (“Regulations”). The Regulations are designed to establish minimum standards for claims settlement practices. If you fail to fulfill any of the “minimum” … Continue reading

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>Zalma’s Insurance Fraud Letter — December 15, 2010

> The last issue of Zalma’s Insurance Fraud Letter for 2010 wishes allclients, friends and subscribers a very Merry Chistmas, a belated Happy Hannukah, a pleasant Kwaanza and a peaceful Winter Solstice.The issue begins with our annual presentation of a … Continue reading

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>An Attack on Insurance

>The California Insurance Code contains the following definitions: § 22  Insurance     Insurance is a contract whereby one undertakes to indemnify another against loss, damage, or liability arising from a contingent or unknown event. § 23  Insurer; insured     The … Continue reading

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>U.S. judge rejects key part of Obama health care law

>Full decision is also available at http://online.wsj.com/public/resources/documents/121310virginiahcruling.pdf Judge Hudson said that the issue presented to him: is the authority of Congress to compel anyone to purchase health insurance. An enactment that exceeds the power of Congress to adopt adversely affects … Continue reading

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>U.S. judge rejects key part of Obama health care law

>U.S. judge rejects key part of Obama health care law Richmond, Va., federal judge Henry Hudson on December 13, 2010 issued a ruling finding part of President Barack Obama’s health-care law unconstitutional, according to early news reports in a 42 … Continue reading

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>Zalma on Rescission of Insurance in California

>Barry Zalma has produced the only detailed resource on the remedy of rescission of insurance in California. In 832 pages Mr. Zalma has provided the full text of almost every decision of the California courts of appeal and the federal … Continue reading

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>“Illegal Rescission” is an Oxymoron

>(c) 2010 — Barry Zalma An oxymoron is a rhetorical figure in which incongruous or contradictory terms are combined. Rescission is an equitable remedy that has existed since before the American Revolution and is an essential part of British and … Continue reading

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>Rescission for Misrepresentation on Application Upheld

>In Debby Mendez v. American General Life Insurance Company, Civil Action Number: 2:09-1155 (D.N.J. 11/29/2010) the District Court, District of New Jersey found that false statements by the applicant in a life insurance reinstatement application was sufficient to allow the … Continue reading

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Rescission for Misrepresentation on Application Upheld

Ini Debby Mendez v. American General Life Insurance Compan/iy, Civil Action Number: 2:09-1155 (D.N.J. 11/29/2010) the District Court, District of New Jersey found that false statements by the applicant in a life insurance reinstatement application was sufficient to allow the … Continue reading

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>Arson for Profit — A Novel

>Have you ever wondered why people burn down their homes? Did they intend to defraud their insurer to profit from an unsaleable house? Were they about to be foreclosed? Did they catch a spouse in bed with another? Were they … Continue reading

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Arson for Profit — A Novel

Have you ever wondered why people burn down their homes?br /br /Did they intend to defraud their insurer to profit from an unsaleable house? Were they about to be foreclosed?br /br /Did they catch a spouse in bed with another?br … Continue reading

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>Recent Insurance Fraud Conviction

>Foot Clinics Pay $2.2 Million to Settle Medicare Fraud Charges St. John’s Mercy Health System and St. John’s Health System Inc. reached a civil settlement with the U.S. attorney’s office in St. Louis. No charges were filed. The parent companies … Continue reading

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Recent Insurance Fraud Conviction

b style=”color: blue;”span style=”font-size: large;”Foot Clinics Pay $2.2 Million to Settle Medicare Fraud Charges/span/bbr /br /St. John’s Mercy Health System and St. John’s Health System Inc. reached a civil settlement with the U.S. attorney’s office in St. Louis. No charges … Continue reading

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>Insured Must Produce Tax Returns on Demand of Insurer

>Every first party property policy contains a provision requiring an insured to produce all relevant documents required to be produced by the Insurer and to appear for examination under oath [California Insurance Code § 2071; NY Standard Fire Insurance policy]. … Continue reading

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Insured Must Produce Tax Returns on Demand of Insurer

Every first party property policy contains a provision requiring an insured to produce all relevant documents required to be produced by the Insurer and to appear for examination under oath [California Insurance Code § 2071; NY Standard Fire Insurance policy]. … Continue reading

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>Pearl Harbor Day

>Sixty-nine-years ago today, seven months before I was born, the Empire of Japan attacked the United States at Pearl Harbor, Hawaii.  The attack was a failure of risk management since the military was enjoying a relaxing Sunday and were unprepared … Continue reading

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Pearl Harbor Day

span style=”font-size: large;”spanspan style=”background-color: black;”span style=”background-color: white;”Sixty-nine-years ago today, seven months before I was born, the Empire of Japan attacked the United States at Pearl Harbor, Hawaii.nbsp; The attack was a failure of risk management since the military was enjoying … Continue reading

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>What Is Insurance?

>I continue to be shocked that our government — The President, The U.S. Congress, the Governor of California and the California Legislature — cannot define the term “insurance” nor can overcome their belief that it is an entitlement. If you … Continue reading

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What Is Insurance?

I continue to be shocked that our government — The President, The U.S. Congress, the Governor of California and the California Legislature — cannot define the term “insurance” nor can overcome their belief that it is an entitlement.br /br /If … Continue reading

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When is an Appraiser Disinterested?

nbsp;span style=”font-size: large;”bAppointment of Appraisers In California/b/spanbr /span style=”font-size: large;”bbr //b/spanbr /div style=”text-align: justify;”The California Insurance Code, at § 2071 provides a method by which an insured and insurer may quickly, and informally, resolve disputes concerning the amount of loss. … Continue reading

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>When is an Appraiser Disinterested?

> Appointment of Appraisers In California The California Insurance Code, at § 2071 provides a method by which an insured and insurer may quickly, and informally, resolve disputes concerning the amount of loss. Although called “appraisal” it is really a contractual … Continue reading

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>Silica Criminal Fraud Case To Be Retried

>In February, 2010 two former claims employees at The Hartford admitted taking hundreds of thousands of dollars in payoffs from a Texas lawyer who is charged with trying to buy favorable insurance settlements for clients suing over industry-related health problems.  … Continue reading

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Silica Criminal Fraud Case To Be Retried

In February, 2010 two former claims employees at The Hartford admitted taking hundreds of thousands of dollars in payoffs from a Texas lawyer who is charged with trying to buy favorable insurance settlements for clients suing over industry-related health problems.nbsp; … Continue reading

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>Zalma’s Insurance Fraud Letter — December 1, 2010

> Invitation to Insurance Fraud Culver City CA – December 1, 2010   The Twenty third issue of the fourteenth year of the FREE Zalma’s Insurance Fraud Letter (“ZIFL”)  reports on the conviction of two adjusters for taking bribes in … Continue reading

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Zalma’s Insurance Fraud Letter — December 1, 2010

div style=”text-align: center;”bInvitation to Insurance Fraud/b/divdiv style=”text-align: center;”Culver City CA – December 1, 2010/divdiv style=”text-align: center;”nbsp;/divdiv style=”text-align: justify;”The Twenty third issue of the fourteenth year of the FREE Zalma’s Insurance Fraud Letter (“ZIFL”)nbsp; reports on the conviction of two adjusters … Continue reading

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