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ZIFL - 10/15/2022 available at  http://zalma.com/blog/wp-content/uploads/2022/10/ZIFL-10-15-2022-1.pdf  

Short teases about the articles in this issue can be read at  ZIFL-10-15-2022   Ethics & Insurance Fraud  Insurance fraud is a crime in most jurisdictions. In California it is a  felony subject to five years in prison upon conviction. By definition a  person who commits the crime of insurance fraud is not acting ethically.  In State v. Whitaker, 175 P.3d 136, 117 Hawai\'i 26 (Haw. App.  12/31/2007) 

Whitaker, after presenting a claim to his insurer, was  indicted, convicted, and sentenced for Insurance Fraud in violation of  Hawaii Revised Statutes (HRS) \' 431:10C\\u2011307.7(a)(1) and (b)(2) (2005),  and Attempted Theft in the Second Degree (Attempted Theft 2) in  violation of HRS \' 708\\u2011831(1)(b) (Supp. 2000) and HRS \' 705\\u2011500 (1993).  

RICO Judgment Allows Disgorgement Damages

Fraudsters Must Disgorge Profits of Crime - In Diane Creel and Lynn Creel v. Dr. Says, LLC, et al., Civil Action No. 4:18-CV-00615,  United States District Court, E.D. Texas, Sherman Division (September  27, 2022) the plaintiffs obtained a verdict against Defendants Dr. Yupo  Jesse Chang; MD Reliance, Inc.; Universal Physicians, PA; Dr. Says, LLC;  Office Winsome, LLC; and Yung Husan Yao (aka Angela Yao) for violations  of the civil Racketeer Influenced and Corrupt Organization Act (\\u201cRICO\\u201d)  and RICO conspiracy. The Court, after the verdict, needs to enter its  findings of fact and conclusions of law regarding equitable  disgorgement.  New California Fraud Statutes  SB 1040, authored by Senator Susan Rubio, authorizes the Insurance  Commissioner to order restitution from persons who sell insurance  without the necessary license from the Department of Insurance,  including \\u201cextended vehicle warranties\\u201d sold illegally through robocalls  and misappropriation of consumers\\u2019 and businesses\\u2019 premiums, among  other insurance scams.  Good News From the Coalition Against Insurance Fraud  Dead patients couldn\\u2019t stop Thomas G. O\\u2019Lear from billing taxpayers  $3.7M for fraudulent X-rays in the Indianapolis area. O\\u2019Lear ran a  portable-X-ray firm that zapped patients in nursing homes, skilled  nursing facilities and long-term care facilities. He billed for  thousands of X-rays that he and his business did not perform. That  included 151 X-rays on dates after the patients had died. He also billed  Medicare and Medicaid for services at nursing facilities on dates when  patients were either hospitalized and not on-site at the facilities.  O\\u2019Lear took multiple X-rays in one visit and falsely claimed that each  was done on a different day, requiring separate reimbursement for  transporting the portable equipment on each date. And he falsely billed  for multiple images of patients when only one image was done \\u2014 thus  requiring a higher reimbursement. O\\u2019Lear covered up his scheme by  forging medical records, falsifying X-ray images and forging signatures  of his employees and the doc he said had ordered X-rays.