Zalma's Insurance Fraud Letter - July 15, 2022

ZIFL - Volume 26, Number 14

THE COURTS ARE BACK CONVICTING FRAUD PERPETRATORS WITH VIGOR - READ ABOUT THE CONVICTIONS IN THIS ISSUE OF ZIFL!

The July 15, 2022 issue contains articles available FREE at Subscribe to e-mail Version of ZIFL, it’s Free!  and  Read last two issues of ZIFL here.

Greg Lindberg Gets a New Trial

Jury Instruction Misled Jury by stating that an “Official Act” Existed as a Matter of Law

Greg E. Lindberg and John D. Gray were convicted of honest services fraud and federal funds bribery in connection with a series of payments and offers of payment, in the form of campaign contributions, made to Mike Causey, the elected Insurance Commissioner for North Carolina. The jury found that these payments were made in exchange for Causey assigning a different Deputy Commissioner to oversee the affairs of Lindberg’s insurance companies.

In United States Of America v. Greg E. Lindberg, Nos. 20-4470, 20-4473, United States Court of Appeals, Fourth Circuit (June 29, 2022) the Fourth Circuit granted a new trial.

Criminal Lawyers Should be Disbarred

Lawyer Convicted of Insurance Fraud Only Suspended for Two Years

Insurance fraud is considered, universally, as a crime of moral turpitude. Regardless, the New York State Bar was only asked to join with the New Jersey State Bar who suspended a lawyer, after he was convicted for insurance fraud and other wrongful conduct, for two years rather than being disbarred.

In the Matter of Neal Meredith Pomper, an attorney and counselor-at-law. (Attorney Registration No. 1726363); 2022 NY Slip Op 04173; No. 2021-02031; Supreme Court of New York, Second Department (June 29, 2022)

Chutzpah: Admit Fraud & Claims Fraud Exclusion is Ambiguous

Insured Convicted of Fraud But Still Sought UIM Benefits

“Chutzpah” is a Yiddish term meaning “unmitigated gall” where, for example, a defendant convicted of murdering his parents asks for clemency because he is an orphan.

Kevin Muir made a claim for underinsured motorist benefits after being injured in an auto accident that fit the definition of Chutzpah. His insurance company denied the claim because Muir had admittedly previously made fraudulent statements in an effort to obtain personal injury protection benefits related to the same accident and was convicted of a crime relating to the claim. Although the policy, like all insurance policies, excluded claims related to fraud, Muir still sued the insurance company after it denied his claim. The insurer filed a motion for summary judgment and the district court dismissed Muir’s lawsuit.

In Kevin Muir v. Cincinnati Insurance Company, 2022 UT App 80, No. 20210289-CA, Court of Appeals of Utah (June 24, 2022) the Court of Appeals found the fraud exclusion clear and unambiguous.

Good News From the Coalition Against Insurance Fraud

Land Rovers and a Porsche piled up in Tanya Parrish Grant’s garage after she falsely billed Medicare more than $50M for back braces and other rehab equipment. The Raleigh, N.C. woman included 422 dead people in her bills. She paid firms in India and Pakistan to give her lists of Medicare patient names and personal identifiers. The lists came from overseas call centers that contacted Medicare patients to ask if they needed the equipment. Grant’s firms — Carolina Rehab Produces and Atlantic Brace — then billed Medicare. She charged Medicare without physician orders, and without shipping products. Even when patients received equipment in the mail and returned the equipment, Grant didn’t reimburse Medicare for the stuff. When audited by Medicare contractors, Grant forged physician orders if no orders existed in her files. She used the money to buy a home near Raleigh; a townhome in Ft. Lauderdale; a Porsche; and several Land Rovers. She also amassed more than $1M in cash and investments. Grant pled guilty and will spend up to 10 years in prison when sentenced later this year.

Rapper Pleads Guilty to $1.2 Million Covid Fraud

Rapper Nuke Bizzle bragged in a YouTube music video about getting rich by ripping off $1.2 million from the COVID relief program.

The rapper, whose real name is Fontrell Antonio Baines, 33, agreed to plead guilty to federal fraud and firearms charges after he bragged in a YouTube music video that he got rich by ripping off the COVID-19 unemployment fund, prosecutors announced Wednesday.

Health Insurance Fraud Convictions

Jury Convicts Doctor Of Health Care Fraud Scheme

Harold Bendelstein, 71, of Queens, New York was convicted by a federal jury for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed.

Zalma on Insurance at Locals.com

Create a Staff of Professional Claims Handlers

In addition to the free materials, for a paid subscription of only $5 a month or $50 a year to Zalma on Insurance at Locals.com you or your staff of claims personnel can receive important, more detailed and informative information needed by everyone interested in insurance, insurance claims, insurance law or insurance fraud.

Each video will run from five to twenty minutes and can be viewed by each claims person with a first cup of coffee or glass of orange juice once or multiple time if desired.

Another Florida Insurer in Financial Trouble

Florida’s Capacity Insurance Gets Downgraded, Stops Writing New Business

AM Best reportedly withdrew its financial strength rating for Sunrise, Florida-based Capacity Insurance, and the company has stopped writing new business.

Other Insurance Fraud Convictions

Anthony Onyeka Okeke tricked Allianz Insurance and QBE Insurance into paying insurance claims for four vehicles after he staged or fabricated a series of crashes.

Okeke is a man linked to a defunct Queensland, Australia tech-support business has been found guilty of defrauding insurance companies of more than $40,000 and trying to dishonestly get more than $30,000.

True Crime Stories of Insurance Fraud
There are now available at https://rumble.com/zalma more than more than 81Video True Crime Stories of insurance fraud.

Over the last 54 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

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. 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, Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; 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