Zalma’s Insurance Fraud Letter
Volume 26 Issue 1
The first issue of the twenty sixth year of publication is available as an Adobe .pdf document at with this issue and the December 15, 2021 issues of ZIFL here. The issue includes the following articles but you must go here to read the full articles and the full 24 page issue of Zalma’s Insurance fraud Letter.
State Farm & Allstate Fight Fraudsters With Qui Tam Suits
It Is Essential That Insurers Are Proactive Against Insurance Fraud
Insurance companies are the victims of billions of dollars every year from insurance fraudsters. They have found that states and police agencies are either unable or unwilling to prosecute those who defraud insurers. In The People ex rel. State Farm Mutual Automobile Insurance Company v. Sonny Rubin et al., G059509, California Court of Appeals, Fourth District, Third Division (December 14, 2021) State Farm has taken proactive steps by filing qui tam suits based on the California Insurance Fraud Protection Act (IFPA) that allows qui tam plaintiffs to file lawsuits on the government’s behalf and seek monetary penalties against perpetrators of insurance fraud.
Insurance Fraud Perpetrators are Annoying
People who commit insurance fraud believe that it is a crime without punishment because no one is hurt except an insurance company. They are wrong but refuse to accept the fact. As an example of how annoying an insurance criminal can be is Steve Ellis Karacson v. David Shaver, No. 21-12100, United States District Court, E.D. Michigan, Southern Division (November 23, 2021) who filed a pro se petition for writ of habeas corpus. Steve Ellis Karacson, (“Petitioner”), pursuant to 28 U.S.C. § 2254, challenges his conviction for insurance fraud and arson of an insured dwelling. Petitioner previously filed a petition for writ of habeas corpus before Judge Matthew F. Leitman which challenged the same conviction. The petition was held in abeyance while Petitioner exhausted additional claims in the state courts [Karacson v. Shaver, No. 4:20-CV-13100 (E.D. Mich. May 27, 2021)] Petitioner moved for Judge Leitman to reopen that case, claiming that he has now exhausted his state court remedies. Petitioner subsequently filed the instant petition, in which he again seeks habeas relief from the conviction that he challenged in the active petition before Judge Leitman.
ClaimSchool, Inc. – Insurance Education
Barry Zalma Presents What Your Insurance Organization Needs. Mr. Zalma’s presentations are practical, thought-provoking, entertaining and will fit easily into any budget. Enthusiastically committed to professionalism in insurance and insurance claims Mr. Zalma positively influences other insurance professionals through the spoken and written word.
Mr. Zalma specializes in clarifying the importance of insurance in a modern society and in making insurance understandable. He also provides everything needed by the insurance claims professional to complete the thorough investigation of a property, casualty or liability claim efficiently, equitably, empathetically and in good faith.
Insurer’s Summary Judgment Granted
US District Court judges often rely on the work of a Magistrate Judge to assist the District Judge in dealing with the volume of cases brought to the court. The Judge can accept, modify or reject the report made by the Magistrate Judge. In Sean Parsons v. Liberty Insurance Corporation, Civil Action No. 3:20-CV-1682-K, United States District Court, N.D. Texas, Dallas Division (December 1, 2021), United States Magistrate Judge David L. Horan, made recommendations to grant some, but not all, of the grounds stated by Liberty Insurance Corporation to dismiss the plaintiff’s complaint. Liberty objected to the Report and recommendations.
Where there are no objections to a Magistrate Judge’s Report and Recommendation, a District Court is to review the report for findings and conclusions that are either clearly erroneous or contrary to law. However, a District Court is required to review a Magistrate Judge’s Report and Recommendation in light of specific objections made by either party within ten days of receipt of the report.
Another Annoying Insurance Criminal Whose Motion for Early Release is Denied
A woman who faked the death of her husband, who cremated and buried a stranger as if he was her husband, and stole more than two million dollars from an insurer brought a motion to be released because of a claim of illness and cancer without evidence of being a person with cancer met a US District judge who, appropriately refused to buy her claim.
In United States of America v. Irina Vorotinov, No. 15-CR-0054(1) (PJS/HB), United States District Court, D. Minnesota (December 9, 2021) Irina Vorotinov pleaded guilty to mail fraud and engaging in a monetary transaction in criminally derived property. She was sentenced to 37 months in prison and two years of supervised release and ordered to pay $2,056,554.09 in restitution. Vorotinov was released from prison in August 2019 and began serving her term of supervised release.
Health Insurance Fraud Convictions
Medical Director of Long Beach Addiction Clinic in Connection to Four-Year Medi-Cal Fraud Scheme
Howard Wallace Oliver, M.D. medical director of West Coast Counseling Services — an addiction treatment facility in Long Beach, California that purported to serve patients with substance use disorders. From late 2009 through July 2013, West Coast Counseling stole more than $2.8 million from Medi-Cal by submitting fraudulent claims for services that were not performed or were not medically justified. Today, in Los Angeles County Superior Court, Oliver was sentenced to seven years, eight months in state prison. A restitution hearing is scheduled for December 29, 2021. Oliver has been in custody since September 15, 2021, when a jury returned a verdict of guilty on all the felony charges against him. The charges included Medi-Cal fraud, conspiracy, insurance fraud, grand theft, fraudulent claims, and four counts of tax evasion.
Other Insurance Fraud Convictions
Former Adjuster Sentenced to Three Years in Prison for Kentucky Crop Insurance Fraud.
Timothy Douglas Snedegar, 65, of Mount Sterling, Kentucky, an adjuster who helped Central Kentucky farmers file more than $2 million in fraudulent crop insurance claims was sentenced to three years in prison. Snedegar also is responsible for restitution totaling $2,294,693.
Snedegar worked as an independent insurance adjuster, examining claims of hail damage to crops. He admitted that in crop years 2012 through 2015, he did reports with false information on the amount of damage to tobacco crops, including photos of damage from other fields, and took kickbacks from insurance agents who were involved in the scheme. Snedegar helped file dozens of claims that he knew were false, according to his plea agreement.
A Series of Video Presentations and Text on Insurance Claims
Go to “Excellence in Claims Handling” and subscribe at https://barryzalma.substack.com/welcome and go to https://zalmaoninsurance.locals.com/subscribe subscribe to my locals account. See the introductory video at https://youtu.be/kLSSBG7kZy0 and at https://rumble.com/vrhaka-excellence-in-claims-handling.html
Professional Insurance Adjusting
At the turn of the century, insurers, in a search for profit, decimated their professional claims sta. They laid off experienced personnel and replaced them with young, untrained and unprepared people.
A virtual clerk replaced the old professional claims handler. Process and computers replaced skill and judgment.
Insurers intentionally forgot that the promises made by an insurance policy are kept by the professional claims person. A professional claims staff is a cost-effective method to avoid litigation.
Barry Zalma & ClaimSchool, Inc.
Go to Zalma Books – E-Books and Articles by Barry Zalma at the Insurance Claims Library where ClaimSchool publishes the ZIFL, several books and e-books written by Barry Zalma and sponsors Mr. Zalma’s speaking engagements.
Written by Barry Zalma and Published twice a month by
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