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True Crime of Insurance Fraud Number 15  

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.  Monkey Business Costs Claimant  Some people are too smart for their own good. T

hey want to commit a  fraud but don\\u2019t know how. In so doing they hurt themselves rather than  profit.  When I was a young insurance adjuster, in 1972, the company I worked for  as an adjuster waiting to hear from the California Bar about the  results of the Bar Exam, my employer insured a homeowner who owned a  Capuchin monkey as a pet. The monkey was a friendly sort. He did not  like confinement to the house. He wanted to be out and about meeting and  greeting the world. 

 One day, when the insured was not looking, the monkey escaped her home.   He was a pet and did not want to run away. He just wanted out of the  house. His escape, therefore, led him to the roof of the next-door  -neighbor\\u2019s house.  The claimant, who for an injury of her type, could have easily talked me  into paying her $1,000 to $3,000 back in 1972, thought she had cheated  me by changing a $10.00 doctor bill to $100.00 bill. In so doing she  gained $90.00 by cheating and lost the opportunity for more than ten to  twenty times the fraud by simply being honest.  Her fraud was a success. The insurer did nothing. It reported the fraud  to no one. 

The insured owed the claimant much more than the $106.00 we  paid her. The claimant probably thought she committed a brilliant fraud.  This time the person actually damaged by the fraud was the claimant,  not the insurance company.  Adjusters must always keep in mind that when they receive an offer to  settle a claim for an amount that seems too good to be true there is a  very high probability that it is, in fact, too good to be true. 

 \\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.   You can contact Mr. Zalma at https://www.zalma.com, https://www.claimschool.com,  zalma@claimschool.com and zalma@zalma.com . Mr. Zalma is the first  recipient of the first annual Claims Magazine/ACE Legend Award.  You may find interesting the podcast \\u201cZalma On Insurance\\u201d at https://anchor.fm/barry-zalma;  you can follow Mr. Zalma on Twitter at; you should  see Barry Zalma\\u2019s videos on https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg/featured; or videos on https://rumble.com/zalma. Go to the Insurance Claims Library \\u2013 https://zalma.com/blog/insurance-claims\\u2013library/ The last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud-letter-2/