Zalma Books

A Resource for the Insurance Professional

 

E-Books, Articles and Blog Available From Barry Zalma

 

New E-Books by Barry Zalma

MOM & The Taipei Fraud

A short novel dealing with a massive fake burglary of a Beverly Hills, California residence in hopes of garnering enough money to pay off debts and avoid deportation back to the Republic of China on the island of Taiwan.

Follow the investigation of Marion Orpheus Montague (MOM) as he uncovers the fraud and provides defenses needed to save the insurers he represented $7 million.

If it does not upload please e-mail zalma@zalma.com and I will personally send you a copy of the e-mail in pdf format.

 

Random Thoughts on Insurance - Vol. II

Since 2010 I have been writing a blog post at least five days a week. This e-book is a collection of those posts that reveal my interest in insurance case law. Some of the cases reviewed were important. Some were of first impression. Others will be totally unimportant. All were interesting to me and I hope are interesting to the reader. This e-book is more than 900 pages of my review of interesting cases in 2012 and 2013.

Now only $9.95.

After you purchase please wait for the e-book to upload from PayPal. If it does not upload please e-mail zalma@zalma.com and I will personally send you a copy of the e-mail in pdf format.

 

 

 

 

Zalma on Insurance Fraud - 2013

Insurance Fraud Is Epidemic

Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number because most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year.

Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected until they become greedy and the fraud becomes so obvious it cannot be ignored.

No one will ever place an exact number on the amount lost to insurance fraud but everyone who has looked at the issue knows – whether based on their heart, their gut or empirical fact of convictions for the crime of insurance fraud – that the number is enormous.

When insurers and governments put on a serious effort to reduce the amount of insurance fraud the number of claims presented to insurers and the pseudo-insurers drops logarithmically.

It is the purpose of this E-book to provide information to those who are engaged in the effort to reduce insurance fraud. It will explain the elements of the crime and the tort to claims personnel. It will provide information for the lawyers representing insurers so that they can adequately advise their clients who are victims of the crime of insurance fraud. It will provide information for the prosecutors and their investigators about what is required to prove the crime.

By including the full text of decisions from courts of appeal and supreme courts across the country the reader can understand what happens after the investigation is completed in order to better complete the investigation. It allows claims personnel and their lawyers to understand what errors they might make that would cause a defeat or a not guilty verdict.

The full text of appellate opinions dealing with insurance fraud and weapons available to insurers to defeat insurance fraud will give each person involved with information not available elsewhere. The E-book can be taken into court in a laptop, a tablet computer or even a smart phone for reference when needed even in the midst of a trial.

 

 

Zalma on Insurance - 2013

 The Complete Authority on Property & Casualty Insurance Updated Daily by the Zalma on Insurance Blog

In over 1180 pages Zalma on Insurance - 2013 provides information on the following subjects important to every person involved in insurance, insurance claims, insurance coverage and allegations of insurance bad faith.

The earnings of almost every civil lawyer in the United States are funded by the insurance industry. Insurance can best be described as the mother’s milk of the law profession. The civil defense lawyer is paid by an insurer for each hour he or she works. The civil plaintiffs’ lawyer is usually paid by taking a percentage of any judgment entered in favor of the plaintiff, which judgment is usually paid by the defendant’s insurer. In almost every situation in which a civil lawyer practices the funds for that work comes, either directly or indirectly, from insurance. Consequently, lawyers must use their wits and energies to avoid or to pursue litigation to the benefit of the client. Both sides understand that an insurer will eventually pay one or both sides in the dispute. Insurance is important to every civil dispute and even some that fall within the criminal courts.

Every lawyer retained to prosecute or defend a civil suit should begin the representation with a serious effort to find insurance coverage for the benefit of the client or the defendant the client is suing. A lawyer that does not know the law of insurance is litigating with duct tape firmly self-placed across his or her mouth. The Table of Contents follows:

Introduction; Chapter 1 The History of Insurance; Chapter 2 The Contract of Personal Indemnity; Chapter 3 Construction of Insurance Contracts; Chapter 4 Differences between Property and Liability Policies; Chapter 5 Rescission of Insurance Policies; Chapter 6 Duties of the Insured and the Insurer; Chapter 7 Conditions, Warranties, and Exclusions; Chapter 8 Fortuity; Chapter 9 Trigger of Coverage; Chapter 10 Appraisal; Chapter 11 Independent Counsel and the Law of Unintended Consequences; Chapter;  12 Fraud and False Swearing; Chapter 13 Subrogation; Chapter 14 “Other Insurance” Clauses; Chapter 15 Mold and Fungi ; Chapter 16 Punitive Damages; Chapter 17 Preemption and the Power to Control Insurance; Appendix 1 The California Standard Fire Insurance Policy; Appendix 2 Definitions; Appendix 3 Insurance Fraud Statutes.

If you wish to purchase the E-Book or Article click on the "Buy Now" button and you will be referred to PayPal where you can pay with a credit card or your PayPal account. The e-book should upload automatically.

Only $9.95

 

 

Getting the Whole Truth
 

Interviews happen everywhere; they are performed by almost everyone. Everyone has, at some point in his or her life interviewed another person. Gathering accurate information is as important to the insurer, the retail sales organization, the manufacturer, or the corner grocery store as it is to the mother who wants to know where her children have been and what they have done. Interviewing is also very much an art, and the most effective interviews are conducted by those who are knowledgeable and skilled in this art.

We live in a time when information is essential to survival. Accurate information is the lifeblood of any business, and those who wish to compete must have intelligence about the marketplace and its competitors. The gathering of accurate information is essential, too, to businesses potentially faced with fraud, embezzlement, the dangers of employee dishonesty or what personnel are doing to fulfill assignments from management. News organizations like Reuters, UP, AP, and others are designed to provide credible and useful information to those who need it. News reporters – if they are to be effective – must be consummate interviewers. If news is not gathered in a reliable fashion by skilled interviewers, it will be useless and the news organization will lose all credibility. In the same way, police officers, lawyers, insurance adjusters and private investigators must be effective interviewers who also understand the techniques for obtaining useful and believable information.

Any person who is curious and applies one or more of the techniques set out in this ebook will obtain more information than his or her competitors. The purpose of this ebook is, indeed, to help anyone learn how to get the truth about anything from anyone. If you have a need to obtain information from another person you need “Getting the Whole Truth”. “Getting the Whole Truth” is available from Specialty Technical Publishers at http://www.stpub.com/Getting-the-Whole-Truth_p_254.html.

This 200-page eBook is designed to help human resources, law enforcement, legal, and insurance professionals get the whole truth through the interview process.

Successful and effective interviews require preparation and skill.  With humor – and the insight gained from years of experience – Mr. Zalma delivers step-by-step commentaries and examples that have real-life, practical applications.  Read this book to learn interview techniques such as:

bullet Pre-interview information gathering and other preparation.
bulletIdentifying the many personality types the interviewer may encounter.
bulletUsing the right approach with each personality type
bulletDeveloping rapport with the interviewee.
bulletCollaborating with the person interviewed to seek only the truth.
bulletVerifying evidence after the interview.
bulletAccounting for contentious issues such as false memory syndrome.

Getting the Whole Truth can be purchased from Specialty Technical Publishers for just $50. STP also offers the following publications by Barry Zalma: Insurance Claims: A Comprehensive Guide, Construction Defects: Litigation and Claims and Mold: A Comprehensive Claims Guide.

 

 

 HEADS I WIN, TAILS YOU LOSE


© 2013

Barry Zalma

This E-book started as a collection of columns insurance consultant, expert witness and insurance lawyer Barry Zalma wrote and published in the magazines "Insurance Journal," "Insurance Week," and "The John Cooke Insurance Fraud Report." It now contains 87 fictional stories on how insurance fraud is perpetrated by changing the names and places of the incident to protect the guilty.

Since the last edition I have added more stories that were published in my twice monthly newsletter, Zalma’s Insurance Fraud Letter which is available free to anyone who clicks the link and a brief analysis of the California Special Investigation Unit Regulations. In addition the e-book has been totally rewritten correcting typographical and syntax errors.

The title, "Heads I Win, Tails You Lose" is meant to describe insurance fraud as it works in the United States. Whenever a person succeeds in perpetrating an insurance fraud everyone who buys insurance is the loser. If the fraud succeeds the insurer must charge more premium to cover the expense of defending the fraud and payment of funds to the fraud perpetrator. If the fraud fails the insurer must still charge more premium to cover the expense of defending the fraud.

Everyone, except the lawyers and fraud perpetrators, lose.

It Takes Courage to Fight Insurance Fraud

The legislatures of the various states, the United States Congress, the National Association of Insurance Commissioners, The National Insurance Crime Bureau and insurance industry groups have finally decided that the war against insurance fraud is worth fighting. Until the states, the local police agencies, the district attorneys, the United States Attorneys, and the Attorneys General of the various states join in the battle it will be fought to a stalemate. The insurance industry cannot successfully fight insurance fraud alone.

On the state level the effort has begun. California, and many other states, have forced the insurance industry to pay money into a special fund to create a Fraud Division, California Department of Insurance or Fraud Bureau whose only duty is to investigate and prosecute insurance fraud perpetrators. Proposition 103 and Special Fraud Investigation Unit Regulations forced insurers to pay monies into another fund to pay prosecutors to prosecute the crime of insurance fraud and to create their own special fraud investigation units. Defrauding an insurance company is a felony in most states.

All of these actions suggest that the Legislatures have concluded that insurance fraud is draining away the wealth of their states into the pockets of criminals yet they wish to pass the buck to insurers to do the investigations. California, by statute, state that it is the public policy of the state that insurance fraud must be stopped.

Insurance industry sources estimate insurance fraud from lows of $80,000,000,000 ($80 billion) a year to highs of $200,000,000,000 ($200 billion) a year. Regardless of which, if any, estimate is accurate the amount of money going to insurance criminals is staggering and approaches no less than 3% to 10% of premium collected.

What has been the result of these new statutes? Are insurance criminals going to jail? Have there been scores of arrests? Have the courts been inundated with prosecutions? No. The prosecution of an insurance fraud is as rare as snowfall on the on the Island of Oahu.. It happens, but not in the numbers that the extent of the crime would suggest. Convictions are even more rare. Prosecutors complain that insurance companies do nothing. The statutes compelling insurers to form fraud investigation units usually have no penalties if the insurer fails to establish such a unit [California imposed regulations that imposes a $5,000 fine for failure to establish a Special Investigation Unit or to train its integral anti-fraud personnel and other states are following that lead.]

Heads I Win, Tails You Lose is available for only $9.95.

After you make a payment through PayPal, please wait for the article to upload to your machine.  If you have a problem with the purchase please write to me at zalma@zalma.com.

 

New E-Book: Zalma on California SIU Regulations

Zalma On California SIU Regulations is an e-book designed to assist California insurance claims personnel, claims professionals, independent insurance adjusters, special fraud investigators, private investigators who work for the insurance industry, the management in the industry, the attorneys who serve the industry, and all integral anti-fraud personnel working with California admitted insurers to comply with the requirements of California SIU Claims Regulations.

By statute, the state of California requires all admitted insurers to maintain a Special Investigative Unit (an "SIU") that complies with the requirements set forth in the Special Investigative Unit Regulations (the "SIU Regulations") and that the insurer must train all integral anti-fraud personnel to recognize indicators of insurance fraud. Since almost every employee of an insurer who approaches a claim qualifies as "integral anti-fraud personnel" they must all be trained annually.

It is necessary, therefore, that insurance personnel who are engaged in any way in the presentation, processing, or negotiation of insurance claims in California be familiar with the SIU Regulations imposed by the state on all insurers doing business in the state and be in a position to prove to the California Department of Insurance that the SIU Regulations have been complied with and all integral anti-fraud personnel have been trained.

In addition to explaining the SIU Regulations the appendix contains an outline for the training required.

Only $9.95.
 

 

 Zalma on California Claims Regulations - 2013

The E-book has been updated to include the modifications made to the Regulations to be effective March 30, 2013.

Now only $9.95

 

  Zalma on Rescission of Insurance In California - 2013

Now only $9.95

 Random Thoughts On Insurance -- A Collection of Posts From The Blog, Zalma on Insurance  

Now only $9.95

 Murder and Insurance Fraud Don't Mix - A Novella

Now Only $5.00

Murder & Old Lace - A Novella

Now Only $5.00

Arson for Profit - A Novel

Newly revised and rewritten for 2013, a novel, based on reality, about how a thorough investigation by professional claims adjusters, investigators and a claims lawyer defeated an arson-for-profit scheme and kept insurance claims funds from supporting terrorists,

Now Only $9.95

 

The last two digital issues of Zalma’s Insurance Fraud Letter (ZIFL) is available for download.

Subscription and access to ZIFL is free. If you are a subscriber the pdf version of ZIFL the current issue is delivered by attachment to an e-mail. If you are not a subscriber or don’t want the pdf just click the button below and choose to download either the text or Adobe Acrobat .pdf format.  

Sign Up For E-Mail Version of Zalma's Insurance Fraud Letter

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Updated April 17, 2014

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