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True Crime & Insurance Fraud Number 22 

https://zalma.com/blog

Barry Zalma, Esq., CFE presents videos so you can learn how insurance  fraud is perpetrated and what is necessary to deter or defeat insurance  fraud. 

This Video Blog of True Crime Stories of Insurance Fraud with the  names and places changed to protect the guilty are all based upon  investigations conducted by me and fictionalized to create a learning  environment for claims personnel, SIU investigators, insurers, police,  and lawyers better understand insurance fraud and weapons that can be  used to deter or defeat a fraudulent insurance claim.  

THE JEWELER & FRAUD  

The jeweler was not an intelligent man. He had tried a manufacturing  jewelry business ten years before and failed.  After his jewelry business failed, he operated a sandwich shop but  stayed near the jewelry business. He located his shop in the basement of  a building dedicated to jewelers in Seattle, Washington. He was fairly  successful and made an adequate living. He still had stored in the  garage of his house his old jewelry table, some molds and a large safe.  One morning, when business at the sandwich shop was slow, he sat down  with a customer to have coffee. They spoke of old times when the jeweler  made fine rings. The customer and the jeweler both came from Yerevan in  Armenia. They talked about growing up under the shadow of Mount Ararat.  They talked about the difficulties of surviving the capitalist society  of Washington state. The friend was a wholesale diamond dealer. The  diamond dealer\\u2019s sales dropped 75% during the 2008-2009 recession.  As they drank their Greek coffee, they discussed how an acquaintance,  after a robbery, had easily collected $500,000 from his insurer. They  were surprised that his insurer took his books and records on face  value. They knew that their acquaintance operated a cash business whose  records were kept only to deceive the United States Government.  By their third cup of coffee the jeweler and his friend conceived a  method to create instant wealth. Their plan was simple. It would take  advantage of the insurer\\u2019s need to deal fairly and in good faith with  its insureds.  

Eventually the one-million-dollar claim settled for a total payment by  the insurer of $750,000. The insurer saved 250,000. The insured got  $750,000 more than he had lost and netted, $740,000.  He had no reason to refuse to sign a general release. Of course, when he  agreed, the insurer and its adjuster were convinced that they were  victims of a fraud they could never prove.  The adjuster was convinced that the claim was fraudulent because, in his  experience, no legitimate insured, suffering a million-dollar loss,  would agree to reduce his claim by 25%. Such knowledge was not  comforting nor could it be presented in evidence at any court. 

 \\xa9 2022 \\u2013 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.  He practiced law in California for more than 44 years as an insurance  coverage and claims handling lawyer and more than 54 years in the  insurance business.  Subscribe to \\u201cZalma on Insurance\\u201d at https://zalmaoninsurance.locals.com/subscribe and \\u201cExcellence in Claims Handling\\u201d at https://barryzalma.substack.com/welcome.