Zalma's Insurance Fraud Letter - February 15, 2024 Zalma on Insurance

ZIFL Volume 28, Issue 4

The Source for the Insurance Fraud Professional
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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/


The current issue can be read in full at
http://zalma.com/blog/wp-content/uploads/2024/02/ZIFL-02-15-2024.pdf and
includes the following articles:

Do the Crime, Serve the Time
Chutzpah: After Pleading Guilty Fraudster Tried to Reduce his Sentence
by an Appeal

After pleading guilty, Armando Valdes appealed his 60-month sentence for
health care fraud, in violation of 18 U.S.C. § 1347. 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.

Read the full article in Adobe pdf format at
http://zalma.com/blog/wp-content/uploads/2024/02/ZIFL-02-15-2024.pdf

More McClenny Moseley & Associates Issues

This is ZIFL’s twenty fourth 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.

Read the full article in Adobe pdf format at http://zalma.com/blog/wp-

California Insurance Commissioner Lara Issues Consumer Fraud Alert As
Flood Recovery Begins In San Diego County

Following the recent flooding in San Diego which damaged and destroyed
hundreds of homes, businesses, and vehicles, Insurance Commissioner
Ricardo Lara put the Department of Insurance on alert for potential
fraud and illegal actions targeting flood victims.

Read the full article in Adobe pdf format at
http://zalma.com/blog/wp-content/uploads/2024/02/ZIFL-02-15-2024.pdf

Health Insurance Fraud Convictions
Guilty in Arkansas

Shaona Mizell, 52, of Paragould, Arkansas. in Pulaski County Circuit
Court on January 23, Mizell pleaded guilty to Medicaid Fraud, a class A
misdemeanor.

Read the full article in Adobe pdf format at
http://zalma.com/blog/wp-content/uploads/2024/02/ZIFL-02-15-2024.pdf

Arson and Restitution

CONVICTED ARSONIST MUST PAY RESTITUTION

A fire at a residential property destroyed several structures and made
nearly all of the owner’s personal property unsalvageable.

Insurance Fraud Attempt Defeated

THE HAWAIIAN, ATTEMPTED FRAUD DEFEATED BY A THOROUGH INVESTIGATION

The following is a fictionalized True Crime Story of Insurance Fraud
from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails
You Lose” situation for Insurers.

Read the full article in Adobe pdf format at
http://zalma.com/blog/wp-content/uploads/2024/02/ZIFL-02-15-2024.pdf

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.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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Go to X @bzalma; Read the full article in Adobe pdf format at
http://zalma.com/blog/wp-content/uploads/2024/02/ZIFL-02-15-2024.pdf




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