Zalma's Insurance Fraud Letter - November 1, 2020

ZALMA’S INSURANCE FRAUD LETTER
On or Before November 3, 2020 It is Imperative That Everyone Votes. I Have My Preferences and I Will Exercise the Right and Obligation to Vote. I Hope You All Will Do the Same.

Volume 24, Issue 21 – November 1, 2020; Subscribe to e-mail Version of ZIFL, it’s Free! Read last two issues of ZIFL here. Go to the Barry Zalma, Inc. web site here Videos from “Barry Zalma on YouTube” Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921A ClaimSchool™ Publication © 2020; Barry Zalma & ClaimSchool, Inc.; Go to my blog & Videos at: Zalma on Insurance; And at https://zalma.com/blog; Go to the Insurance Claims Library; Listen to the Podcast: Zalma on Insurance; Videos from Zalma on Insurance.

Multiple Acts of Insurance Fraud Must be Distinct

In State of New Jersey v. Randi Fleischman, 917 A.2d 722, 189 N.J. 539, Supreme Court of New Jersey (Decided March 19, 2007, Corrected March 26, 2007, pursuant to the New Jersey Code of Criminal Justice (Code), one can be charged with the offense of insurance fraud for knowingly making a false or misleading statement of material fact in connection with an insurance claim. That third-degree offense may be elevated to the second degree by aggregating five “acts” of insurance fraud, the total value of which exceeds $1,000.

OIG Most Wanted Fugitives

The Office of the Inspector General has created a webpage contains information about OIG’s most wanted health care fugitives. In all, they are seeking more than 170 fugitives on charges related to health care fraud and abuse. All the fugitives are available at https://oig.hhs.gov/fraud/fugitives/profiles.asp#thorsen.

Wisdom

“Facts do not cease to exist because they are ignored.” – Aldous Huxley

“Socialists desire to practice legal plunder, not illegal plunder. Socialists, like all other monopolists, desire to make the law their own weapon. And when once the law is on the side of socialism, how can it be used against socialism? For when plunder is abetted by the law, it does not fear your courts, your gendarmes, and your prisons. Rather, it may call upon them for help.” —Frederic Bastiat

“Some men are born mediocre, some men achieve mediocrity, and some men have mediocrity thrust upon them.” – Joseph Heller

“It pays to be obvious, especially if you have a reputation for subtlety.” — Isaac Asimov

“Truth does not become more true if the whole world were to accept it; nor does it become less true if the whole world were to reject it.” — Maimonides

“An election is nothing more than the advanced auction of stolen goods.” —Ambrose Bierce

Proof of Confession That Accident Was Staged Requires Summary Judgment

This case clearly established that the accident was staged and there was no reason for the trial court to refuse to allow it present the obvious and damning proof. More importantly, this case teaches that although insurers are obligated to cooperate with and provide everything its investigation reveal to the prosecution and the Fraud Division, but the obverse is not true. There is no reason why the prosecutors who obtained a confession from one of the co-conspirators should have forced the insurer to jump through litigation hoops to get the statement and continue defending a fraudulent suit. They should have shared that evidence immediately to assist the victim of the crime.

Health Insurance Fraud Convictions

48 Months in Prison for Health Care Fraud

Susanne “Suzi” Gawel was sentenced to 48 months in prison, one year of supervised release and ordered to pay $646,690.32 in restitution after conviction. Gawel worked as an office manager at a Fort Wayne company that sold durable medical equipment (DME) to clients across northern Indiana. Some of the company’s clients were Medicaid beneficiaries. Through her work, Gawel had access to Medicaid patient information, including patients’ names, addresses, dates of birth, Medicaid ID numbers and treating physician information.

Other Insurance Fraud Convictions

Consider Books to Show Your Appreciation to Your Insurer Clients or Claims Employees

© 2020 – Barry Zalma

https://zalma.com/zalmas-insurance-fraud-letter-2/Read last two issues of ZIFL here.

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Listen to the Podcast: Zalma on Insurance https://anchor.fm/dashboard/episodesZalma on Insurance

Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg/

Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

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