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Zalma on Insurance

Fraud
Around the World
Good
News
The
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The
Phantom Rolls Royce
The
Case of the Art Flambee
Small
Time Fraud
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!
Who's
Cheating Whom
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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I Don't Need Your Stinkin'
License!
A Heads I Win, Tails You Lose Story
by Barry Zalma, Esq., CFE
The story that follows is based on fact
but is fiction. The names, places and descriptions have been changed
to protect the guilty. This story was written for the purpose of
providing insurers, those in the insurance business and the insurance
buying public sufficient information to recognize and join in the
fight against insurance fraud.
Yuri Gasparov was 19-years-old when he
entered the United States from the old Soviet Republic of Georgia.
Although still a teenager he was strong of will and body. In the old
Soviet Georgia he had made his mark as a thief, extortionist and
enforcer. He was 13-years-old when he first killed a man who refused
to pay half his earnings to the group Gasparov joined at when he was
11. When the Soviet Union fell, he emigrated to the U.S. He saw the
U.S., unlike the new Georgian Republic, as a place of opportunity for
his criminal skills.
Gasparov arrived at Los Angeles International Airport on an
immigrant's Visa claiming to be a persecuted Russian Jew. He was
unusual as an immigrant. There were gold bars weighing ten Kilograms
and 30 carats of "D" to "H" color diamonds in his
luggage. Yuri stepped off an Al Italia jet from the First Class Cabin
wearing an English suit cut by a Saville Row tailor, a Gold Rolex
President watch and Italian alligator leather shoes.
As he waited in the "Nothing to Declare" line at the Bradley
International Terminal women in the line openly stared. They saw a
handsome young man with long black hair, green eyes, an aquiline nose
and a neatly trimmed Van Dyke beard. They assumed he was an Italian
Actor come to try his hand at Hollywood. As a refugee Yuri was ushered
through Customs with alacrity. The Customs Officer, unaware of the
damage he was setting loose on the American Public passed him through
saying: "Welcome to the United States Mr. Gasparov."
A limousine was waiting to pick him up at the curb. The chauffeur held
the door for him as he entered the long, white, stretched Lincoln Town
Car welcoming him to the U.S. in Russian. Gasparov was driven to a
brick, three story house near Fairfax Boulevard and Highland (the old
"Jewish" neighborhood of Los Angeles) now occupied mostly by
Russian and Armenian immigrants. The house was the headquarters of his
group of Georgian criminals who had established themselves in Los
Angeles and preyed, mostly, on the immigrant community.
Gasparov had plans to improve on the extortion, strong-arm tactics and
violent crimes to increase the profits of the group. He expected to
live like a movie star or middle-eastern prince. He had studied the
United States, its system of government, its police agencies and its
attitude toward violent crime. Members of his group had been arrested,
and incarcerated, for violent crimes committed in the U.S. with
regularity.
Although they enjoyed their stays in American jails (compared to a
Gulag they felt American jail time was like a paid vacation in a nice
hotel) the profits of the group were diminishing.
Yuri Gasparov had convinced the boss in Georgia that it was necessary
to use the American system to make profit and leave the violent tried
and true methods of making a criminal profit perfected in the old
Republic of Georgia. The American system of civil justice was open to
the devious, the criminal and the unethical for instant wealth.
Within a week of his arrival in Los Angeles Yuri had converted his
gold and diamonds into the cash needed to capitalize the business he
intended to run for his own profit and that of his group. He was
introduced to two Russian and one Armenian medical doctors who
received licenses after taking an examination. They agreed readily to
write reports that they had treated accident victims and kick back
half of all billings. Gasparov found a lawyer who had grown up in
Yerevan, Soviet Armenia, and had passed the California Bar Examination
six months before. The lawyer, Hratch Casparian, was working as a
waiter at Cantor's Delicatessen because his language skills were weak
and his degree from the Thomas Jefferson College of Law in Burbank,
California was less than impressive. Gasparov made Casparian an offer
he could not refuse. He would set him up in a nice law office on
Wilshire Boulevard and help him operate a successful personal injury
law practice. Casparian agreed. Only a fool would have turned down the
offer.
Gasparov would bring clients to the new office and would pay Casparian
10 per cent of all the money earned by the law office. Yuri would act
as the office administrator and handle all the details of the
operation of the business.
Within two weeks of the meeting of Casparian and Gasparov over a
corned beef sandwich in Cantor's Deli, the Law Offices of Hratch
Casparian was opened at 3600 Wilshire Boulevard, Suite 1313, Los
Angeles, California. It was a 3,000 square foot suite paneled in honey
oak. Casparian's office was 20 feet by 20 feet, his desk was an
antique partner's desk with a green leather top. The remainder of the
office was occupied by five secretaries, and in small 10 foot by 12
foot offices, six insurance adjusters who would negotiate with the
insurance companies. Casparian showed his new office to his mother,
father, three brothers and two sisters. They admired his immediate
success. He knew nothing about the practice of law, had never drafted
a complaint, had never appeared in court, had never argued a motion or
in any way practiced law. He had studied hard at Thomas Jefferson and
passed the California Bar Examination on the first try. Casparian was
a licensed attorney. He had no idea what was needed to practice law.
What he did not know, basking in all the accouterments of immediate
success, that knowledge of the law or how to practice law, was
irrelevant to his success. All that was required of Casparian was to
hang his license on the wall and wait for the profits to roll in.
While the office was being set up Gasparov did more than cause to be
built a professional looking law office. Yuri recruited a staff of
cappers, Russian and Armenian immigrants with auto insurance and who
became accident facilitators for a fee. These people would become the
source of the client base of the Casparian law office.
On the day the office opened 32 personal injury plaintiffs signed
retainer agreements with the Casparian law office. None of them saw
Casparian. The secretaries and insurance adjusters obtained the signed
retainer agreements and insurance information. Form letters were
immediately sent to insurers for the "victims" of the
accidents who were making claims under uninsured motorist insurance
coverages. Insurers for the persons who were claimed to cause an
injury were contacted by telephone and mail with demands for
indemnity. Each of the "victims" immediately went to the two
doctors who had agreed to work with Gasparov.
By the third week of operation the Casparian law office was one of the
busiest law offices in Los Angeles. Three hundred claims had been
presented to insurers, medical bills attesting to treatment for
soft-tissue injuries to the neck and back were settled within the
first month of operation. The settlements averaged $6,000. For each
settlement Casparian was paid 10 percent, the capper who brought in
the business was paid $500 and the doctors were paid $500. The
remainder was kept by Gasparov.
Suits were never filed. Insurance companies, faced with cases of clear
liability, and an opportunity to settle for only two to three times
the medical bills presented jumped at the chance. Investigation, when
the insurers suspected fraud, were cursory and seldom established the
fraud.
The "victims" and "insureds" were all from the now
defunct Soviet Union.
They had scripts to follow when contacted by the insurance
investigator and stuck to their prepared story with conviction.
In the first year of operation the Casparian law office took in gross
revenues of $3,250,000. The first year Casparian received a salary of
$325,000 ($300,000 more than he was making at his last job) in cash.
No deductions for income taxes or Social Security were paid to the
state or federal authorities. He thought, since he was called in only
when the adjuster insisted on interviewing the "clients"
that he was a brilliant lawyer and businessman for protecting his
clients and obtaining excellent settlements for them. He did not know
- or refused to learn - that his "clients" were not injured,
that they never received medical treatment and that most had never
been involved in an accident. Casparian convinced himself that he had
achieved the American dream and was the most successful new lawyer in
the state of California.
Gasparov, as office manager, earned in that first year more than
$1,500,000. He was pleased but felt that the business could do better
and needed more clients for his law firm. He needed better injuries to
increase the average settlement from $6,000 to $15,000. He did not
want it to get higher because none of his cases were ever large enough
to make it cost-effective for the insurance companies to fight the
claim he presented.
His largest source of business was Miguel Coyote, an immigrant from El
Salvador who provided twenty or thirty El Salvadorian, Guatemalan and
Argentine immigrants (mostly illegal) to the Casparian law firm. For a
$500 fee per body Coyote trained the immigrants in the answers to give
to investigators and doctors. He had complete control over the
"victims" and threatened each with deportation for criminal
conduct if they turned on him. The "victims" who claimed
injury were paid by Coyote $50 each allowing him a net, $450 profit.
Yuri met with Coyote in the Wilshire Boulevard office:
"Miguel, my friend." Gasparov said in a conspiratorial
whisper. "We need to increase our flow of clients."
"But Yuri, I am already bringing to you every legitimate accident
involving a Central or South American."
"That's the problem. You only bring me people who have been in
accidents." "I thought that was what you wanted, Yuri. How
else can you make a claim?"
"You, my El Salvadorian friend, have no imagination." Yuri
responded with a smile curling on his thin lips as he brushed his
mustache with his forefinger. "I have available hundreds of
Russian and Armenian immigrants with auto insurance who are willing to
say they were in accidents with your clients for a fee of $25.00. I
need four times the number of your people to be the 'victims' and
clients of the Casparian law firm. Can you provide me with four
hundred or more 'victims?'" " Yes, but it may cost
more."
"How much more?"
"$750 each."
"You are a thief, Coyote."
"Of course."
"I will pay $600 for each body."
"$650."
"$625."
"We have an agreement. But, it is necessary that there be
evidence of the accident happening."
"I thought of that. Mikaelian's Body Shop in Glendale will give
us estimates, and photographs of broken cars, as if they were the cars
of our Russians and Armenians who will claim they were at fault. Your
South and Central Americans must find some way to damage the rear of
their cars since all the reports to the insurance companies will be
that they rear-ended the law firm client's cars." "That's
easy, we'll just back them into buildings or posts."
"Wonderful, get to work."
Within weeks new clients' cases were flowing into the Casparian law
firm at three times the rate as the first year of business. The three
doctors were, by their billing, treating over sixty patients a day.
Medical bills were forwarded to the Casparian law firm on behalf of
its clients of more than $100,000 a day. Profits increased
exponentially. Casparian, sitting in his office spent most of his time
watching daytime soap operas on the office television. The secretarial
staff and the staff of adjusters worked 10 hours a day negotiating
hundreds of claims a day. Everyone in the Casparian law firm was happy
and Gasparov had purchased, for cash, a four-bedroom house in
Brentwood.
Gasparov became greedy. He started to have his cappers, like Coyote,
stage accidents. People not involved with Gasparov or the Russian
community were forced into accidents by cars full of El Salvadorans
when the driver slammed on his breaks on the freeway.
An insurance investigator for Hercules Insurance Company began to
notice that the all of the clients of the Casparian law office went to
one of the same two doctors. He arranged a meeting with other members
of the International Association of Special Investigation Units. Each
pulled records relating to claims where one of the three doctors
treated the claimant. The hunch developed into a deep conviction.
The SIU staff created a database. It found that the doctors, by their
billing records, were billing for more than 80 hours of work a day.
Auto accident victims, although never making claim to the same insurer
twice, were involved in more than fifteen accidents a month.
The information was taken to the Major Fraud Division of the Los
Angeles District Attorney's office. In a task-force with the Fraud
Division, California Department of Insurance and the Los Angeles
Police Department, search warrants were issued for the files of the
law office and the offices of the two doctors. Records were gathered
and collated. Four months later arrest warrants were issued for
Casparian, the two doctors and each "adjuster" in the law
firm. Gasparov, the instigator and receiver of the profits, sold his
house in Brentwood when the search warrants were issued, moved to
Fresno, and started an office with a lawyer who had immigrated from
Kazakstan. Casparian was convicted of sixty-two counts of insurance
fraud and sentenced to five years in jail, suspended and actually
served sixty days in the Los Angeles County jail. His license to
practice law was revoked. The doctors were convicted of paying illegal
kickbacks and money laundering. They had their medical licenses
suspended for six months and were publicly reproved.
Gasparov's new law office in Fresno is a great success. His position
in the criminal organization has improved and he is now only third to
the boss in Georgia. Without the benefit of education, training or a
license, Yuri Gasparov made more money from the practice of law in
California than 99 percent of the lawyers in the state.
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