Zalma on Insurance

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True Fraud

A Christmas Fable of Fraud

Organized Waste

Help! I’ve Fallen & Broken My Glasses.

Louie the Switch

I Don't Need Your Stinkin' License!

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Miscarriage Manipulation for Money

US Supreme Court Restrains Punitive Damages

Barry Zalma, CFE, is an insurance coverage attorney. He is the founder of Barry Zalma, Inc., a California law firm whose practice emphasizes the representation of insurers and those in the business of insurance.

Mr. Zalma is the author of Insurance Claims: A Comprehensive Guide, published by Specialty Technical Publishers, Vancouver, BC at http://www.stpub.com  The Truth, The Whole Truth & Nothing But The Truth, Property Claims 2nd Edition and Liability Claims and all course books used by ClaimSchool, Inc. in its training programs.  He is also the author of  three books published by Thomas Investigative Publishing, and numerous articles for insurance trade publications and law journals.

Mr. Zalma writes the monthly Zalma's Insurance Fraud Letter which is available, FREE, from ClaimSchool, Inc. and over the internet at http://www.zalma.com

Specialty Technical Publishers has published "Mold: A Comprehensive Claims Guide" by Culver City lawyer Barry Zalma. The book is the only comprehensive guide to cover all issues relating to claims of damage by mold or fungal infestations. It is an essential tool for every person who owns real property, manages real property, for all risk managers, realtors, property inspection companies, insurance agents and brokers, insurance claims people, and lawyers who represent property owners or insurers. It is available at http://www.stpub.com or by calling 1800-251-0381

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Help! I’ve Fallen & Broken My Glasses.

A Heads I Win, Tails You Lose Story

by Barry Zalma, Esq., CFE
The claimant wore thick lens plastic eyeglasses. He literally fell into a life of fraud.

One day the claimant was walking past a fine restaurant when he fell and broke the frames of his glasses. The manager saw him fall. She rushed out, helped him to his feet and checked his physical condition.

He thought he was uninjured but the frames of his glasses had broken at the bridge.

The restaurant manager, fearful of a lawsuit, offered him lunch on the house and asked the cost of the frames. When he told her $80.00, she went to the register and brought him four crisp twenty-dollar bills. The claimant could not believe his good fortune. It was so easy. From that day on he made a good living from many small frauds.

His method was simple and unique. No particular individual was severely harmed by his fraud. Wherever he went he carried with him the broken pair of eye glasses. He would walk into a restaurant in an area far form where he lived. He would hold his broken glasses in one hand and walk up to the cashier squinting. He would say: “I tripped over your carpet, fell and broke the frames on my glasses. They cost $80.”

One of two things would always happen:

(1) A manager of the restaurant would take four twenty-dollar bills out of the cash register, apologize, buy the claimant lunch and send him on his way; or

(2) the manager took a formal report for the restaurant's insurance company. In either event the claimant would profess he only wanted replacement of his glasses. He told the Manager or the adjuster that he would forget any possible personal injuries he may have suffered.

If they did not pay him on the spot, an insurance adjuster would issue a check instantly. No adjuster would take a chance on a lawsuit if he could settle a claim for $80.00.
The claimant would stop and collect his $80 in five to seven restaurants a day. He would seldom buy a meal.

He would also, on a small portable typewriter, write letters to various restaurants and other businesses whose names and addresses he got from the telephone book. He would write simply: “I tripped and fell in your lobby and broke the frames of my glasses. Enclosed is the bill from my doctor for replacement. Please send me your check for $80.”
He would send out twenty such letters a day to businesses at random. At least five would merely send him an $80 check in the return mail.

With his earnings, all of which were tax free, the claimant bought a three-bedroom condominium on the west side of town. He furnished the condo well. Soon he was driving a new Mercedes 300 SEC.

He eventually bought a word processor. He used it with a mailing list he purchased from a credit card company of all its vendors, to send out mass mailings of his $80 demand. On good days he would receive ten to twenty $80 checks from varying businesses.

He quickly used up the businesses in his community. He sold his condominium and bought a motor home. He moved from city to city staying in no location no more than sixty days.

He would still be doing this multiple fraud if he had learned to spell. The Claimant’s letters always misspelled the word “frames” as “frams.” This misspelling lent a certain amount of credibility to the claims he was presenting. However, one bright adjuster, about to write his fifth check for broken glasses “frams,” remembered that the four other claimants that he had paid (with different names) misspelled frames the same way. The adjuster refused to pay.

He reported the scheme to the local police and the insurance fraud bureau. Neither showed any interest in such a petty theft. They refused to prosecute. They even refused to investigate to determine whether they should prosecute. It was just too small.

The claimant had to leave that city rather quickly. The adjuster spread the word to all the adjusters he knew to watch out for the broken “frams.” The claimant's cash flow dwindled to almost nothing.

Somewhere in North Dakota or Kansas the claimant is still making a healthy living by reporting to honest business people that he has broken the frames on his glasses.
Eighty dollars seems a small amount to avoid a lawsuit. The claimant, with multiple eighty dollar claims, would average, in the two months he would limit himself to any community, $2500 a day. His collections were either in person or by mail. He almost never bought a meal.

He was small stuff and no one wanted to bother with. Yet he stole, in his own small way, more than $600,000 a year. He took long vacations from his job. He stayed in the best resorts. He lived the good life because an $80 fraud is just too small for the police to bother investigating.

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