Zalma’s Insurance Fraud Letter – November 1, 2024

ZIFL – Volume 28 Number 21

Post 4924
The Source for the Insurance Fraud Professional

Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/  This issue contains the following articles about insurance fraud:

Pill Mill Doctor’s Conviction Affirmed
HEALTH CARE FRAUD CONVICTION AFFIRMED
ACTING AS A DR. FEEL GOOD IS A FEDERAL CRIME

According to the Sixth Circuit Dr. David Jankowski’s medical clinics relied on several unusual billing and prescription practices, many of which were illegal and Jankowski fraudulently billed Medicare for services he did not provide and prescribed controlled substances to patients whose conditions did not call for such treatment, with some patients unlawfully trafficking their prescribed drugs.

In United States Of America v.  David Jankowski, M.D., No. 23-1404, United States Court of Appeals, Sixth Circuit (October 23, 2024) the Sixth Circuit disposed of the fraudsters claims on appeal.

Read the full article and all 18 pages of ZIFL here.

More McClenny Moseley & Associates Issues

This is ZIFL’s thirty sixth 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.

10/24/2024

MMA BANKRUPTCY HEARING TO DECIDE WHETHER TRUSTEE WILL BE APPOINTED

Injured While Drunk on the Job Gets Workers’ Compensation Benefits

An appellate court in New York has upheld a decision of the Workers’ Compensation Board in favor of an injured employee of an electrical contractor company because intoxication was not the sole cause of the accident.

Read the full article and all 18 pages of ZIFL here.

Man Bites Dog Story:
Fraudsters Arbitration Attempts Stopped
Arbitration Stayed for Suspected Chiropractors’ Fraudulent No Fault Medical Claims

Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-fraudsters-arbitration-attempts-zalma-esq-cfe-5yw6c

In Government Employees Insurance Company, (“GEICO”) v. Didier Demesmin, M.D., et al, No. 23-CV-6191 (ARR) (MMH), United States District Court, E.D. New York (October 23, 2024) GEICO sought to enjoin defendants Manuel A. Mendoza, D.C. and Mendoza Chiropractic Office PC (collectively the “Mendoza Defendants”) from pursuing certain “no-fault” insurance collection arbitrations or initiating new collections proceedings during the pendency of this lawsuit.

Read the full article and all 18 pages of ZIFL here.

Health Insurance Fraud Convictions
Louisiana Nursing Home Owner to Pay $8.2M for Misusing Assets During Ida

Bob Dean Jr a Louisiana nursing home owner and several companies he operated have agreed to an $8.2 million consent judgment to resolve allegations that they misappropriated and misused the assets and income of four nursing homes in Louisiana before and after Hurricane Ida’s landfall in August 2021.

Read the full article about dozens of convictions and all 18 pages of ZIFL here.

Officer Caught Aiding Criminals for Cash
Police Officer who took Bribes from Insurance Fraudster Convicted

Demarkco Johnson (“Johnson”), appealed his convictions for taking bribes about insurance fraud.

Read the full article and all 18 pages of ZIFL here.

Convictions of Other Than Health Insurance Fraud
Former Lake Forest Agent Convicted On 90 Counts Of Insurance Fraud After Stealing Nearly $200,000 In Premium Payments

Karen Marie Dondanville, 56, of Mission Viejo, California, a former Lake Forest insurance agent was convicted on 90 counts of insurance fraud after stealing nearly $200,000 in premium payments.

Read the full article and all 18 pages of ZIFL here.

The Need to Understand the Mutability of Memory

Investigators and lawyers believe what they are told by eye witnesses who describe what he or she says with conviction. However, every professional investigator or litigator must know that memory is not necessarily accurate because very few people have a perfect eidetic (photographic) memory. Memory is a fluid and often unreliable human function.

Read the full article and all 18 pages of ZIFL here.

Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455. 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. Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/; Go to X @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/ and GTTR at https://gettr.com/@zalma