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Attempt to Thwart Fraud Investigation Fails

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  • Barry Zalma
    Insurers in most states are compelled by state law to conduct thorough investigations of potential insurance fraud. The states, like New Jersey, that compel
    Message 1 of 1 , Oct 15, 2009
    Insurers in most states are compelled by state law to conduct thorough
    investigations of potential insurance fraud. The states, like New Jersey,
    that compel such investigations, provide a limited immunity to insurers who
    conduct such investigations and report suspected fraud to the state. They do
    not, however, allow an insurer to accuse its insureds of fraud without
    admissible evidence. Plaintiffs will attempt to use the fraud investigations
    conducted under state compulsion, was wrongful and evidence that insurers
    will do anything to avoid paying a legitimate claim.

    In the current issue of Zalma's Insurance Fraud Letter (ZIFL), Barry Zalma
    reports on a decision of Appellate Division of the New Jersey Superior Court
    where it held that an attempt to make investigation of a potential
    fraudulent claim by a vexatious litigant was defeated. Mr. Zalma noted that
    "The lesson learned from this case is that if an insured or claimant is to
    be accused of fraud or vexatious litigation the party making the accusation
    should have available, at the very least, a preponderance of evidence that
    proves the charge. Similarly, the insured that claims wrongdoing on the part
    of an insurer should have available, at the very least, a preponderance of
    the evidence establishing the wrongdoing charged and not rely on innuendo
    and argument."

    In addition ZIFL reports on the failure of an arson-for-profit scheme, more
    on banana cases arising out of fraudulent claims by banana workers in
    Nicaraugua, why a court of appeal affirmed an insurance fraud conviction and
    the success of the US Justice Department's Health Care Fraud Prevention and
    Enforcement Action Team (HEAT,) program that is continues to dent Medicare
    and Medicaid fraud. ZIFL continues to ask why HEAT has been limited to only
    work in one city at a time.

    ZIFL regularly reports on insurance fraud and lists convictions of insurance
    fraud perpetrators.

    ZIFL is available free at <http://www.zalma.com/> http://www.zalma.com
    Back issues of ZIFL are available for only $1.00 each at
    <http://www.zalma.com/ZIFL.HTM.> http://www.zalma.com/ZIFL.HTM. ZIFL
    continues its thirteenth year of publication dedicated to those involved in
    reducing the effect of insurance fraud. ZIFL is published 24 times a year by
    ClaimSchool. It is provided free to clients and friends of the Law Offices
    of Barry Zalma, Inc., clients of Zalma Insurance Consultants and anyone who
    subscribes at <http://www.zalma.com/> http://www.zalma.com Mr. Zalma also
    writes Zalma on Insurance where you can multiple articles on insurance
    issues and the ZIFL archives at

    Mr. Zalma is an internationally recognized insurance coverage and insurance
    claims handling expert witness or consultant. Mr. Zalma's law practice is
    limited to the representation of insurers and those in the business of
    insurance. He is available to provide advice and counsel concerning
    insurance fraud, first and third party insurance coverage issues, and bad

    To be on the FREE mailing list as a subscriber to ZIFL please go to
    http://www.zalma.com and insert your e-mail address in the box indicated and
    you will be automatically subscribed to the text version of ZIFL. ZIFL will
    be posted for a full month in pdf and full color FREE at
    <http://www.zalma.com/> http://www.zalma.com

    If you need additional information contact Barry Zalma at 310-390-4455.



    Barry Zalma
    Law Office
    Barry Zalma, Inc.
    Zalma Insurance Consultants
    4441 Sepulveda Boulevard
    Culver City, California 90230-4844
    (310) 390-4455
    Fax: (310) 391-5614
    <mailto:zalma@...> zalma@...
    <http://www.zalma.com> http://www.zalma.com


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