The Essential Resource for The Insurance Fraud Professional
Scott Strems, about whom ZIFL has reported earlier, a Florida attorney accused of causing great public harm through a “vast campaign of unprofessional, unethical, and fraudulent conduct,” by way of thousands of insurer lawsuits has lost his latest battle to overturn his suspension and now faces a petition for contempt over alleged violations of the order.
Ladera Ranch, California Self-Storage Management Company Fined for Unlicensed Activity
New SIU Regulations Effective October 1, 2020 – Are You Ready?
The California Department of Insurance (CDI) amended the Special Investigative Unit (SIU) regulations that are set to take effect October 1, 2020. (10 CCR 2698.30 et seq.) The new rules tighten the compliance requirements already in place. Some of the changes include:
- Stronger oversight on entities that insurers contract with – directly or indirectly – to perform SIU and antifraud duties;
- An increased emphasis on using patterns or trends as red flags for fraud;
- New guidelines for releasing information to the CDI’s Fraud Division;
- Guidelines around the written procedures used by the insurer’s SIU;
- A requirement to investigate all credible referrals of fraud;
- Enhanced requirements leading up to and in the reporting of fraud to the CDI’s Fraud Division;
- More detailed and strenuous requirements for training of insurer personnel;
- More detailed resources used by insurer claims and anti-fraud personnel;
- Requiring certain information in SIU Annual reports;
- Allowing insurers in holding company systems to reference holding company system SIU information in their SIU Annual Reports; and
- Setting forth additional details on the finalization and resolution of SIU examination by the CDI.
Health Insurance Fraud Convictions
Other Insurance Fraud Convictions
Guilty of Sawing Off Own Hand for Pay-Out Sentenced to Two Years in Prison
Guilty of Insurance Fraud – Go Directly to Jail
Artis Layson, appealed the judgment of the Lucas County Court of Common Pleas, finding that he committed a community control violation, insurance fraud, and sentenced him to continue serving community control with added conditions. In State of Ohio v. Artis Layson, Court of Appeals No. L-19-1204, 2020 Ohio 4336, Court of Appeals of Ohio Sixth Appellate District Lucas County (September 4, 2020) was asked to reverse his conviction.
© 2020 – 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 52 years in the insurance business. He is available at http://www.zalma.com and firstname.lastname@example.org.
Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.
Over the last 52 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.
Read posts from Barry Zalma at https://parler.com/profile/Zalma/posts