Insurance 101 – Chapter 16 Volume 88 – Insurer Is Required to Pay for Insurance Crimes

Insurer Is Required to Pay for Insurance Crimes

Insurers are compelled by statute and regulation to maintain Special Fraud Investigation Units and a detailed anti-fraud program. The California Department of Insurance audits insurers regularly to ensure that each insurer works hard to investigate and seek prosecution of the crime of insurance fraud. Simultaneously, the same Department of Insurance punishes insurers for not paying claims rapidly or for not treating insureds or claimants fairly. Courts and juries will assess punitive and exemplary damages against insurers who accuse their insureds of fraud.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

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Insurance 101 – Chapter 16 Volume 87 – Is the Fight Against Fraud Being Lost?

Is the Fight Against Fraud Being Lost?

Fraud is taking more money every year from the insurance-buying public. Insurers complain that the local district attorneys and police agencies give a low priority to the crime. Insurers must defeat this metastasizing crime before its growth eats away any chance insurers—and their shareholders— have of making a profit.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

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Insurance 101 – Chapter 16 Volume 86 – Insurers as Victims of Fraud

Insurers as Victims of Fraud

In State v. Cross, No. E2001-02724-CCA-R3-CD (Tenn. Crim. App. 08/12/2002), the Tennessee Court of Criminal Appeals was faced with a defendant who claimed that an insurer, for purposes of criminal restitution, could not be the victim of a crime. The basis of the conclusion was that the insurer’s obligations to pay were contractual and not as a result of the direct acts of the criminal against the victim.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

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Insurance 101 – Chapter 16 Volume 85 – Participation of the Victim in Investigations

Participation of the Victim in Investigations

One recent case demonstrates how the victim’s cooperation can lead to a successful prosecution. In Int’l Bus. Machs. Corp. v. Brown, 857 F. Supp. 1384 (N.D. Cal. 1994), IBM brought suit against individual and corporate defendants accused of defrauding the company. Suspicious of some of its employees, IBM had cooperated with local police in a successful sting operation. At the time of the civil suit, a criminal prosecution arising from the sting was ongoing. The civil defendants sought a stay in the civil proceedings pending the outcome of the criminal trial, arguing that by participating in the sting, IBM and the police engaged in misconduct.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

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Insurance 101 – Chapter 16 Volume 84 – Victims in the Criminal Process

Victims in the Criminal Process

Prosecutors often rely on crime victims as crucial sources of information and may choose to make use of victim information and resources in making prosecutorial decisions. While prosecutors represent the government (not the crime victims) prosecutors must consider the victim’s interests. Prosecutors report that justice will not, and possibly cannot, be served by separating the prosecutor from victims.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

 

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Insurance 101 – Chapter 16 Volume 83 – More on the Discretion of the Prosecutor

More on the Discretion of the Prosecutor

urts are loathe to interfere with prosecutors’ judgments. The criminal defendant tries to challenge a prosecutor’s (or an entire prosecutor’s office) participation in an insurance fraud prosecution. The standard for prosecutorial disqualification is understandably very high. Efforts to disqualify prosecutors should not be allowed to interfere with the broad discretion afforded to prosecutors in the criminal process.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

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Insurance 101 – Chapter 16 Volume 82 – Discretion of the Prosecutor

Discretion of the Prosecutor

In the criminal justice system, the prosecutor bears responsibility for determining what crimes will be prosecuted. The legal system has traditionally allowed wide discretion to criminal prosecutors in the enforcement process. The Government retains broad discretion as to whom to prosecute.

The following video was adapted from my book, “Insurance Claims A Comprehensive Guide” Published by the National Underwriter Company and is available at the Zalma Insurance Claims Library

Legal Disclaimer

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

 

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