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Zalma on Insurance
Lie to Your Insurer and You Will Lose
Coverage Limited to What the Insured Pays For at Inception. The Eleventh Circuit Court of Appeals was asked to resolve whether two residential homes destroyed by a fire while under construction were covered under an insurance policy issued by Travelers Property Casualty Company of America (“Travelers”) to its named insured, Talcon Group LLC (“Talcon”). Talcon is an underground utility contractor for sewer, storm drains, and treatment plants and never told Travelers it was building two residential buildings.
Go to Jail, Do Not Pass Go
Fraudster Must Serve Time and Lose His Residence to Pay Restitution. Armando Valdes appealed his 60-month sentence for health care fraud after he pleaded guilty. Valdes’s conviction and sentence arose out of his scheme to submit millions of dollars in fraudulent medical claims to United Healthcare and Blue Cross Blue Shield for intravenous infusions of Infliximab, an expensive immunosuppressive drug. These infusions, purportedly given to patients at Valdes’s medical clinic, Gasiel Medical Services (“Gasiel”), were either not provided or were medically unnecessary.
Waiver of Right to Appeal Effective
Insurance Agent Defrauded Clients by Taking Premium Money and Keeping it for Personal Expenses. Read the full article at https://lnkd.in/gSPcFmZq and see the full video at https://lnkd.in/gAsGv9Nq and at https://lnkd.in/gFSfVtdv and at https://zalma.com/blog plus more than 4690 posts.
Subrogation Must be Fair
Insurer May Never Subrogate Against its own Insured. Read the full article at https://lnkd.in/gr645uJf, see the full video at https://lnkd.in/gq2bsTb7 and at https://lnkd.in/g98hJHDV and at https://zalma.com/blog plus more than 4690 posts.
Zalma’s Insurance Fraud Letter – December 15, 2023
ZIFL – Volume 27 – Issue 24. Merry Christmas, Happy Hanukah, and May the Winter Solstice be Peaceful & Mild. This, the 24th issue of the 27th Year of ZIFL includes articles and reports relating to insurance fraud, including:
Activities of Lawyer in the Capacity of an Officer of Another Business Excluded
Associated Industries Insurance Company (AIIC) sued Howard Kleinhendler and his former law firm, Wachtel Missry LLP, seeking a declaration that it need not provide insurance coverage for either defendant in a lawsuit brought by Allan Applestein. Applestein sought damages for legal malpractice, breach of fiduciary duty, elder abuse, and fraud related to the 2017 sale of land in Virginia, known as the Fones Cliffs Land, to Kleinhendler’s company, the Virginia True Corporation.
Tardy Claim Allows Judgment for Defendant
Claim Against State Must be Filed in Accord with Statute. Read the full article at https://lnkd.in/gQ5kWitz and see the full video at https://lnkd.in/gMZeEa9e and at https://lnkd.in/gXUbA98m and at https://zalma.com/blog plus more than 4650 posts.
Never Assume You Are Insured
Contractor Needs Permission of Insurer to be Protected by an Owner-Controlled Insurance Program. Read the full article at https://lnkd.in/gZ2xYD6Y and see the full video at https://lnkd.in/gFy66VSy and at https://lnkd.in/gxPdArVA and at https://zalma.com/blog plus more than 4650 posts.
Zalma on Insurance
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Barry Zalma, Esq., CFE is a retired insurance coverage lawyer who blogs daily with digests of insurance cases and writes books and articles on insurance claims, insurance law, and insurance fraud.
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