LexisNexis® Legal Newsroom
Why Rescission is an Appropriate Remedy to Health Policies Acquired Fraudulently

The Los Angeles Daily Journal, on May 28, 2009, reported that a much-watched case against Blue Shield of California for revoking medical coverage of an injured policyholder ended abruptly when the plaintiffs, Cindy and Steve Hailey of Cypress, admitted that they "willfully" made crucial errors...

Anti-Fraud Legislation Headed to Texas Governor

Texas lawmakers took a huge step in curtailing the activities of today’s ambulance chasers by passing HB 148. The bill now on its way to Governor Perry for his signature makes it illegal for lawyers, chiropractors and other health professionals to solicit the victims of auto accidents or catastrophes...

Fraud by Insurers

Culver City CA – The vast majority of insurance fraud is perpetrated against insurance companies. However, as the economy becomes weaker and it becomes more difficult for insurers to make a profit, insurance fraud by insurers is increasing. Fly-by-night insurers open, charge low premiums, collect...

HEAT on Health Insurance Fraud

I am pleased to hear that Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius recognize that fraud is taking a great deal of money out of government programs. Perhaps someday they will expand their efforts to strike at fraud against private insurers who lose more...

Yes, We Have No Bananas – Nicaraguan Farm Workers’ Fraudulent Insurance Claims against Dole

Insurance fraud cases are not limited to attempts to defraud insurers directly. They are most often fraudulent claims brought against people who are insured. Some are small, fake fender benders while others deal with millions, if not billions, of dollars. In California multiple lawsuits have been filed...

Weekly Fraud Blotter – September 11, 2009

Each week, with the assistance of our long-time resident fraud expert Barry Zalma, the Insurance Law Center will be surveying what the media, state agencies, insurance companies, and others report in terms of insurance fraud. Just like a police blotter, our insurance fraud blotter lists recent arrests...

Weekly Fraud Blotter – September 28, 2009

Each week, with the assistance of our long-time resident fraud expert Barry Zalma, the Insurance Law Center will be surveying what the media, state agencies, insurance companies, and others report in terms of insurance fraud. Just like a police blotter, our insurance fraud blotter lists recent arrests...

International Insurance Fraud

Although the use of insurance fraud to fund terrorist organizations has been well known by those involved in attempts to reduce insurance fraud for decades, the mainstream media is beginning to wake up to the problem. For example, th e Washington Post reported that North Korean insurance managers prepared...

Insurance Fraud Blotter 11/1/2009 - Recent Arrests, Charges & Convictions

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of insurance fraud. Just like a police blotter, our insurance fraud blotter lists recent arrests, charges, and convictions. Insurance Fraud Blotter – November 1, 2009 21...

Can Social Networking Aid Underwriting?

By Mike Fitzgerald. My colleagues, Catherine Stagg-Macey and Craig Beattie, released a research report today titled " Leveraging Social Networks: An In-Depth View for Insurers ." They predict that "insurers will increasingly use public shared data to inform pricing decisions and aid...

“Millions for Defense and not a Dime for Tribute.” Attempted Fraud Fails

By Barry Zalma, Attorney and Consultant Insurers Must Never Pay a Fraud When I was a young adjuster the motto of the insurance industry was "Millions for Defense and not a Dime for Tribute." Fraud was known but not a large problem. Police officers, when advised of fraud, would investigate...

Insurer Avoids Liability for Agent’s Fraud

By Barry Zalma, Attorney and Consultant Contract between Agent and Insurer The relationship between insurance agents and brokers with insurers is based upon the contract between the insurer and the agent or broker. When the agent or broker breaches the contract with an insurer by defrauding an...

Bullivant Secures Jury Verdict, Court Awards Judgment under Counterclaim for First-Party Insurance Fraud

By John A. Bennett, Stuart D. Jones, Matthew E. Hedberg, Andrew E. Passmore, Attorneys, Bullivant Houser Bailey PC Following a two-month trial, Safeco Insurance Company of Oregon was awarded $9.977 million on its counterclaim for insurance fraud against a former insured, Sohail Masood. An August...

Trusted Insurance Broker Steals From Friends, Relatives and Fellow Congregants – Nine Years in Prison

Walter Marion Williams pleaded guilty to one count of mail fraud, in violation of 18 U.S.C. § 1341 , and was sentenced to a term of 108 months' imprisonment to be followed by 3 years of supervised release. Williams appealed from his sentence, which he argued was an unreasonable upward variance...

Free Zalma’s Insurance Fraud Letter May 1, 2012

By Barry Zalma, Attorney and Consultant In this, the ninth issue of the 16th year of publication Zalma's Insurance Fraud Letter (ZIFL), ZIFL reports on: 1. Barry Zalma reports on an interesting appellate decision that convicted a person for failing to advise his insurer that he intentionally...

Cadwalader Clients & Friends Memo: Important Court Decision For No-Fault Insurers: Federal Court Rejects Limitation on State Farm v. Mallela

We are pleased to inform you that our firm has obtained a very favorable and significant decision for no-fault insurers on an important issue of first impression. Specifically, on January 7, 2013, in the case of Allstate Ins. Co. v. Elzanaty , the United States District Court for the Eastern District...

Organized Crime Insurance Fraud Ring Busted by California Department of Insurance Investigators

A joint investigation with the Contra Costa District Attorney’s office led Department of Insurance investigators to the arrest of five individuals for allegedly running an insurance fraud ring throughout northern California and northern Nevada. The insurers’ losses are estimated between ...

Former Police Officer Pleads Guilty to Felony Insurance Fraud Over Mickey Mantle Baseball Cards

Keith Hooks, a former City of Tracy police officer, has pled guilty to felony insurance fraud after falsifying a claim for the loss of three Mickey Mantle collector baseball cards. The California Department of Insurance initiated an investigation in May 2012 based on a tip from California State Automobile...

Staged Auto Collision Schemes By Scam Artists Target Innocent Drivers – Endanger Other Drivers and Cost Public

Drivers should be alert for staged auto collisions that target innocent drivers. Last year 59.5 percent of all insurance fraud referrals received by the California Department of Insurance were for suspected automobile insurance fraud. In Los Angeles County alone, the Department of Insurance received...

Insurance Agent Secretly Adds Her Own Car To Client's Insurance Policy

The California Department of Insurance arrested Graciela Elena Paredes, aka, Graciela Elena Gaxiola, 36, of Corona, on October 17, 2013. Paredes was arrested on one felony count of insurance fraud for adding herself to a client’s auto insurance policy unbeknownst to the policyholder. This case...

Former Orange County Life Insurance Agent Arrested and Charged with Felony Elder Abuse

California Insurance Commissioner Dave Jones has announced that former life insurance agent, Myles Seishin Hanashiro, 47, was arrested and booked at Los Angeles County Jail on four felony counts of financial elder abuse. Acting as a licensed life insurance agent in 2005, Hanashiro sold a $100,000...

Sacramento Glass Harvesting Ring Files Over One Thousand False Windshield Chip Repair Claims

Insurance rip-off totals nearly $100,000 The California Department of Insurance Fraud Division today announced the arrest of three-of-six individuals suspected of running a glass harvesting ring—filing more than 1,000 false insurance claims for windshield repair totaling nearly $100,000....

Insurance Agent Issued Bogus Insurance Certificates to Dupe Clients

Rodger Edward Winkler, a property and casualty insurance agent, has been arrested and charged with numerous felonies including two counts of felony grand theft, three counts of felony insurance fraud, and one count of petty theft, for allegedly collecting insurance premiums from clients and issuing bogus...

Former Broker-Agent Charged with Multiple Felonies for Identity Theft and Forgery; More Victims Are Possible

Convicted felon uses stolen identity to secure credit card and submit bogus insurance applications Eugene Shy-Ren Hsu, a former insurance broker-agent, was arrested by California Department of Insurance officers and charged with multiple felony counts including o ne felony count of grand theft...

Dancing Hamster Arrested On Insurance Fraud Charges

Leroy Barnes of Los Angeles, known as one of the dancing hamsters in Kia commercials, was arrested on insurance fraud charges related to his alleged fraudulent collection of state disability insurance benefits. Barnes is suspected of deceiving his doctors about his employment status while he receiving...