The Underwriter's Insider March 2014 by The Underwriter's Insider

Features 5 Advertising 9 Kim Komando

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18 Inside Track

9 10

23 Insider Advisor

11 12

24 Classifieds

26 Say What? 28 Back Issues

News Houston Insurance Agent Sentenced To Ten Years in Prison NJ Doctor Who Provided Spa Services Pleads Guilty in Medicare Fraud “Real Time Eddie” Heads To Nashville To Show Appreciation For Participating Carriers 10 Great Apps For Your New Tablet Computer - Kim Komando Not an Insured? Not Covered! Expert Analysis & Commentary Barry Zalma, Esq. QQSolutions Appoints New Execs To Management Team Obama’s Autocratic Making of Law by Fiat - OP/ED by Spencer A. Lehmann, RHU Morpheus Completes Fifth FreeFlight at NASA’s Space Center Shuttle Landing Facility

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North Carolina & Florida Cooperate on Insurance Fraud Arrest

Lance Armstrong Attempts to Block Insuror From Reopening Arbitration Ordering $12 M in Bonuses

Mississippi’s Insurance Commissioner Mike Chaney Honored Louisiana Commissioner Jim Donelon Appoints Jeff Zewe Director of Fraud Prevention

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News 20 21 21 23

Florida Announces 14 Arrests in MultiMillion Dollar Insurance Fraud

Marco Rubio Blasts Tom Harkin For Fawning Over Cuba’s Communist Regime

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Florida Arrests 12 in “Operation Leaky Pipes” Fraud Investigation Florida Arrests Two in P.I.P. Fraud Charges Pop-up Offering “Free Security Scan” DON’T Click Here! - The Insider’s Advisor

America Grows Weaker Under President Obama As Russia’s Putin Flexes His Military Muscle NASA Employs Super Computer To Redesign Every Aspect of Tommorrow’s Commercial Aircraft Judge Jeanine Thrashes President Obama’s Lawless “Executive Directive” Power Grab $500 Million Medical & Worker’s Comp Fraud Uncovered in California

Appeals Court Upholds $163 Million Judgment Against “Scareware” Virus Scan Marketer

American Hennessey Venom GT Hits 270.49 MPH - French Bugati Veyron Now in 2nd Place

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Sponsors 6 8 11 15 14 18 22 22 23 25 32 33 35 37 38

Modern Insurance Consultants H.O.P.E. QQ Solutions St. James Insurance Company A.D. Bankers & Company NASA - Eclipse Agency Mgt. Accu-Auto SLB Group Encore HR Personnel Solutions Orrin R. Beilly, Esq. Barry Zalma, Esq. The Towing & Rental Group FYI Georgia View & News Orrin R. Beilly - Florida Lawyer Financemaster

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HOUSTON INSURANCE AGENT SENTENCED TO TEN YEARS IN PRISON

OUSTON – McKinley Shumate, 59, of Houston was sentenced to ten years in prison for Misapplication of Fiduciary Property in Harris County 180th District Court on August 26. Shumate was a licensed insurance agent who misappropriated over $250,000 from several insurance customers and a premium finance company between 2006 and 2008. When Hurricane Ike hit Houston in 2008, Shumate had two customers who owned commercial and residential properties damaged by the storm. Because he had taken their premium money but had not purchased insurance for them, these customers had to pay out of pocket for the repairs caused by the storm. The repairs exceeded $200,000 and one of the properties went into foreclosure. Shumate’s insurance agent license was revoked by the Texas Department of Insurance (TDI) subsequent to the criminal offense. In addition to the prison term, the Harris County Court recommended that the Texas Department of Corrections order Shumate to

pay approximately $469,000 in restitution as a condition of parole. With the cooperation of the Harris County District Attorney’s Office, the TDI Fraud Unit conducted the criminal investigation.

NJ DOCTOR WHO PROVIDED SPA SERVICES PLEADS GUILTY IN MEDICARE FRAUD SCHEME

r. Chang Ho Lee, 68, of Palisades Park, N.J., pleaded guilty today to health care fraud and agreed to forfeit more than $3.4 million in fraud proceeds. Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Loretta Lynch of the Eastern District of New York, Assistant Director in Charge George Venizelos of the FBI’s New York Field Office and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement. According to court documents, Lee, who is a medical doctor, and two

Top Bank Product Now Available to Independent Agents The #1 life product sold in banks is now available to independent insurance agents! Exclusive opportunity, easy sale, 10 minute underwriting. Call John or Matt at 800-3595102 or email Info@ LifeAgents.com others recruited patients by offering free lunches and recreational classes and provided them with spa services, such as massages and facials, then falsely billed Medicare for more than $13 million using those patients’ Medicare numbers. Lee and the others billed Medicare for physical therapy, lesion removals and other services that were neither medically necessary nor provided. The scheme took place at three clinics: URI Medical Center and Sarang Medical PC in Flushing, N.Y., and 999 Medical Clinic in Brooklyn, N.Y. Lee received more than $3.4 million through the submission of the fraudulent claims. Lee is scheduled to be sentenced by United States District Judge Raymond J. Dearie of the Eastern District of New York on June 13, 2014. At sentencing, he faces a maximum sentence of 10 years in prison and approximately $3.4 million in mandatory restitution. The Underwriter’s Insider

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REAL TIME EDDIE HEADING TO NASHVILLE

"As users of Real Time and Download, we understand the value these tools bring our agencies and brokerages," explained NetVU member Joyce Sigler, CISR, CPIW, CPIA, NcAM, vice president and corporate secretary at Jones & Wenner Insurance Live Appearance Agency in Fairlawn, Ohio and coScheduled to Honor chair of the Real Time/Download Real Time Carriers Campaign. A survey of agency and brokerage employees found EARL RIVER, N.Y. (March 4, that Real Time and Download save 2014) -- Real Time Eddie, users, on average, up to an hour a the official mascot of day. the industry-wide Real Time/ Download Campaign, is packing "As an association of users, we his bags and preparing to travel wanted to honor our business to Nashville. He'll be there to help partners who help us serve agency management system customers better by allowing us users show their to streamline appreciation our operations," for insurance Sigler added. "At carriers and the same time, others who help we wanted to independent make it as easy agents and as possible for our members to brokers by offering enhanced learn what carriers are offering that interface functionality. can help them in their own offices."

Eddie will make a special afternoonlong live guest appearance at the Network of Vertafore Users (NetVU) "Get Real" Exhibitor Showcase at the Gaylord Opryland Resort & Conference Center on Thursday, March 6. The NetVU "Get Real" initiative is designed to provide a focused time and place for insurance companies to demonstrate their Real Time and Download offerings to Vertafore agency management system users. The event takes place on the opening day of NetVU's annual conference. www.underwritersinsider.com

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to arrange for "Eddie" to visit your event, contact Liz Kittell at liz@ Aartrijk.com or (402) 209-3284. About the Real Time/Download Campaign: Launched in 2007, the Real Time/Download Campaign (GetRealTime.org) is dedicated to improving the competitiveness of the independent agency distribution channel. The campaign isn't advocating a specific technology, but a workflow approach that frees up more time for agencies to sell, process and service business. Most agents can leverage tools already contained in their agency management systems or comparative raters.

"Eddie is a highly visible and loveable character that is absolutely passionate about improved efficiency in the independent agency channel," explained Real Time/Download Campaign Director Liz Kittell. "He is really looking forward to being in Nashville, greeting and high-fiving conference attendees, and having his photo taken with many of his Campaign participants include long-time friends and supporters agents, brokers, carriers, and new ones, as well." technology providers, user groups, and agent and industry For more information about the associations. Real Time/Download Campaign or

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MAR 2014 A Publication of AdMax Corp Corporate Offices P.O. Box 31551 Palm Beach Gardens, Florida 33420 561.718.0745 info@underwritersinsider.com © Entire Contents 2014 AdMax Corp

To best navigate The Insider, begin with the Table of Contents and select your topic. On the bottom of most pages is a Table of Contents link that will immediately return you for your next topic selection. EVERY SPONSOR AD LINKS DIRECTLY TO THE SPONSOR’S WEBSITE. CLICK ON ANY AD TO VISIT OUR FINE SPONSORS!

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enough for you, download Sky 10 GREAT APPS View, which gives you a dizzying view of the heavens—stars, and constellations, all FOR YOUR NEW TABLET planets, nicely labeled. Poke around

Really Cool Info - by Kim Komando

f you’re new to the world of tablets, it’s not surprising that you might not know where to start. You’ll hear a lot of talk about “apps.” Apps are applications. Think of them as software programs customized for your tablet.

want it to do. Right now, here are 10 to get you started. I’ve tried to balance three considerations - usefulness, the wow factor, and unlocking your tablet’s possibilities.

and you can even find the International Space Station, 200 miles up!

Flipboard

One thing you’ll quickly discover is that there’s a lot of stuff out there to read! What you really need, though, is a way to easily read the news you choose. This Google Earth is a delightful and easy-to-use They are available though an There is no app with a greater app that brings together the already installed app you’ll find Gee Whiz factor! Google Earth is news sources you select as well on your tablet. It’s the “App Store” a massive collection of satellite as Facebook posts, Instagram photos, YouTube videos and on iPads or the “Google Play” on photos, seamlessly stitched Android tablets. Microsoft calls together. The result? You have the anything else you’d like, all in a fun and responsive magazine format. theirs the “Windows Store.” ability to zoom all over our Earth, swooping in to see everything As time goes on, Kindle from your childhood you’ll find the home to the Taj Mahal. apps that get For regular book reading, the tablet to Google Sky there’s no cleaner reader than do what the Kindle app. It’s available on View y o u every platform you can think of, including smartphones. And the If the earth Kindle reader keeps your place for i s n ’ t you, too, no matter what you’re reading it on.

Netflix or Hulu Those beautiful screens are there for a reason. Netflix and Hulu give you great movies and TV shows to watch on them.

See Kim Komando Pg 33 www.underwritersinsider.com

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NOT AN INSURED — NOT COVERED

Expert Analysis & Commentary by Barry Zalma, Esq.

irst party property insurance is a contract of personal indemnity. It does not follow the ownership of the property. It is a personal contract between the insurer and the persons named in the policy.

The Named Insured on the Declarations Page of the Policy lists MPDS Memphis. Section I of the Policy governs “Property Coverages.” Section II governs “Comprehensive Business Liability.”

FACTS In Priore v. State Farm Fire & Casualty Co., 99692, 2014Ohio-696 (indeterminate Barry Zalma, Esq., CFE is a California attorney 02/27/2014) the Ohio Court specializing in insurance coverage, insurance of Appeal, Michael A. Priore claims handling and fraud who serves as appealed the trial court’s order a consultant and expert for insurers and policyholders. He founded Zalma Insurance granting summary judgment Consultants in 2001 and serves as its senior in favor of State Farm Fire and consultant. He recently published an e-book, Casualty Company (“State “Getting The Whole Truth,” which is available Farm”). MPDS Memphis, Ltd. at his Web site, www.zalma.com. Go to Zalma Books at http://www.zalma.com/zalmabooks. (“MPDS Memphis”) is a limited htm. liability corporation that was formed for the specific purpose of owning a 120-unit the Property. To ensure that MPDS apartment building known as the Memphis could obtain financing Emerald Overlook Apartments from the bank, Priore personally (“the Property”). The Property guaranteed the loan making him is owned by MPDS Memphis. personally liable to the lender. Priore is a 50 percent owner and the managing member of MPDS Beginning in 2000, State Farm Memphis. A mortgage on the insurance agent, Rocky Robinson, Property was issued in the amount began serving as an insurance of 17 million and was secured by agent for properties in which Priore had some involvement. In 2004, Robinson procured the Join Barry Zalma’s new Blog: insurance policy that is the subject http://www.zalma.com/blog of the instant case (“the Policy”). 10

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On February 29, 2008, the roof on the Property failed due to excessive weight of accumulating snow and ice. As a result, some of the apartment units flooded. On March 1, 2008, MPDS Memphis filed an insurance claim with State Farm seeking coverage for the roof, for internal property damage, and for lost rental income. Dissatisfied with State Farm’s handling of its insurance claim, MPDS Memphis and its property manager, Windsor Realty and Management, Inc., filed suit against State Farm on February 19, 2010, in the Cuyahoga County Court of Common Pleas. The complaint alleged breach of contract, breach of the covenant of good faith, breach of fiduciary duty, negligent misrepresentation, and simple negligence. State Farm removed the case to federal court on the basis of diversity jurisdiction (“the federal case”). See Zalma Pg 31 The Underwriter’s Insider

QQSOLUTIONS APPOINTS NEW EXECUTIVES TO ITS MANAGEMENT TEAM TO DRIVE COMPANY’S CONTINUED DYNAMIC GROWTH QQSolutions, the leading provider of cloud-based agency management systems for independent insurance agencies nationwide, has named three new executives to its management team. Jim Garrett was named as Senior Director of Software Development, Dan Lanphere as Senior Director of Sales, and Edward Patience as Director of Marketing.

of QQSolutions stated,“Jim, Dan, and Edward each bring to QQSolutions extensive and successful experience in technology product leadership. Jim will focus on the continued development of QQCatalyst® and QQWebRater, while Dan and Edward will build

QQSolutions, the leading provider of cloud-based agency management systems for independent insurance agencies nationwide, has named three new executives to its management team. Jim Garrett was named as Senior Director of Software Development, Dan Lanphere as Senior Director of National Sales, and Edward Patience as Director of and execute effective sales and Marketing. marketing programs to help make independent insurance agencies Reporting to Chief Operating aware of our superior products and Officer, Michael Stebel, the three services.” executives will be responsible Bios: for executing QQSolutions’ product development, sales, and Jim Garrett, Senior Director marketing strategies to help drive of Software Development, the company’s continued dynamic is responsible for software growth. development across all of QQSolutions’ products. Garrett Mark Malis, Chief Executive Officer www.underwritersinsider.com

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has over eighteen years of experience leading teams and developing commercial software. Prior to joining QQSolutions, he spearheaded the development of award-winning software now used by over 80,000 customers in the medical, dental, and veterinary

industries. He has served as a voting member on committees for the standardization of medical diagnostic imaging and on the curriculum advisory board for two college Computer Science departments. Garrett holds multiple certifications as a developer, systems architect and technical trainer.

See QQSolutions Page 39 11

OBAMA’S AUTOCRATIC MAKING OF LAW BY FIAT New Liberal Mantra: “You’re a racist if you don’t agree with Obama.”

OP/ED BY SPENCER A. LEHMANN, RHU

irst, the last: I voted for Obama, term one, and realized upon his immediately starting crafting Obamacare that I had been had by as good an articulate and eloquent snake-oil salesman as I have ever seen, along with so many millions of other Americans. Obama had lied with an arrogant impunity about being the most transparent president in history. He has been anything but.    When he began to hold secret closed door meetings with “Big Pharmacy,” the Unions, NEA, AMA, Hospital Associations, and paid bribes in the form of Earmarks to Senators Blanche Lincoln, Ben Nelson, and Mary Landrieu to buy their votes for ACA, I was amazed at his ability to lie with such ease. Worse, as I read the majority of the 2,700 pages of the PPACA, and realized that 900 of the pages were IRS law tax code, became furious. This wasn’t a health Care Reform law; this was a new Tax increase on the American Middle and Upper Middle Class.

I had convinced several friends to vote for this duplicitous and dishonest bag of wind, and coming from the health insurance profession, have seen many colleagues harmed by this law, as well as friends and family.   There is no doubt in my mind whatever that this president, this autocratic socialist philosophical politically minded fluff of a man, who has accomplished nothing of note whatever in his “do nothing” life (I vetted him after I saw what he was doing, and shame on me!), should be impeached. Spencer A. Lehmann is a Registered Health Underwriter (RHU), whose company, Lehmann/Wood & Associates, Inc., specializes in Group and Individual Long Term Care insurance and Medicare Supplemental Coverage. Mr. Lehmann retired from his company in 2005 and now spends his time writing on Health Care Insurance and Political Issues, both of which have encompassed over 40+ years of his life. He has been an actively involved member of the National Association of Health Underwriters (NAHU) since 1978, and serves on the Board of Directors of several Charitable Organizations’ helping Special Needs Children, and Inner-City Children to experience and participate in the world of the Arts and Music. In his free time he plays golf with his wife, Fran, who usually wins.

That isn’t likely to happen.   The question why, comes up often. It is obvious to anyone paying attention that Obama has not only obviated his responsibility to the Congress, but to the Constitution which he swore to uphold when he as inaugurated, both times.   The most overriding reason that has been mentioned is precisely the reason that he quotes as being the reason his ratings are so low: Because he is Black. And that is disgusting.   I don’t see color, and yet have been accused of being racist because I don’t like Obama. Nonsense!   I voted for Obama,

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term one. America voted for Obama twice! That he uses the race card as his excuse for having low ratings is beyond insulting, it is the action of a whiner who has refused to take responsibility and accountability for lying to America to an egregious degree, on a plethora of issues, ranging from Obamacare, to Benghazi, to the IRS, to the NSA, to...you name the issue. It is appalling that this Black man, elected twice to the highest office in the land, complains about his being Black. We aren’t. It is egregious in its disingenuous and deceitful manipulation of the truth, that Obama supporters and the MSM accuse those of us who raise our concerns about Barack Obama of being racists who hate Obama because he is Black. No, we don’t. We are angry with him for lying to America as if he is a pathological liar, incapable of telling the truth. This man appears to be devoid of ethics and integrity.   So you bet I’ll call Obama out for the person he has proven himself to be. He is, without question, the most deceitful, deceptive, disingenuous,

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dangerous, and dishonest president in the history of our country. It has been suggested by some that others, “Higher up”, as the conspiracy theory goes, are pulling his strings. In other words, he’s the puppet to someone else’s puppet master. Regardless of whoever may be pulling his strings, if anyone, he is pulling plenty of strings himself.    His actions have been anti-American, anti-Israeli, anti-Our Allies, and pro our enemies.    As a result of his lack of courage, and his lack of military expertise and abilities, he has endangered our troops. Not only did he miss that 3:00 AM Phone call, so did Hillary Clinton, and then they both lied about it from the first moment they opened their mouths. Hillary Clinton actually lied to Congress about it, and then resigned her position as Secretary of State before she could be impeached. Too damn bad. She has yet to be held to account for her egregious actions that resulted in the deaths of our people in Libya, as with Obama. Their day to be held accountable must come.

politics. It pains me to see how Obama and his Chicago-style gang of political thugs have been destroying America to a degree that our enemies could only dream of doing.   This year, in the Midterm Elections, we will have an opportunity to turn things around, if the Republicans can take the Senate.    Speaking of parties I am belong to neither. I have been both (a D in the early 70’s, and an R in the 90’s). I don’t like either party; and think they’re both equally corrupt. We are in desperate need of dramatic political reform, including Term Limits and laws that mandate that the members of Congress are obligated to live under the laws that they make for all of US. Period. No special class of privilege. Serve their terms and then back to the real world.      Now to the issue of Barack Obama behaving as if he is the first American monarch in the history of our country. This wannabe king, has been making law by fiat, as though his very presence in the Oval Office grants him the privilege of

My career and avocation has been health insurance and

See Spencer Page 38

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MORPHEUS COMPLETES FIFTH FREE-FLIGHT

he fifth free-flight test of 10, 2014, at NASA Kennedy Space a Morpheus prototype Center’s Shuttle Landing Facility. lander was conducted Feb. The 74-second test began around 1

p.m. EST with the Morpheus lander launching from the ground over a flame trench and ascending at 42 feet per second to 467 feet, more than 160 feet higher than its last test. Morpheus then flew forward, covering 637 feet in 30 seconds before descending and landing on a dedicated pad inside the automated landing and hazard avoidance technology (ALHAT) hazard field. Morpheus landed on target. There is one more test planned before the ALHAT system is installed on the vehicle, but the date of that flight has not yet been set. Morpheus tests NASA’s automated landing and hazard avoidance technology and an engine that runs on liquid oxygen and methane, or “green” propellants.

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NORTH CAROLINA AND FLORIDA COOPERATE ON INSURANCE FRAUD ARREST

ALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Stacy Lasondo Jackson, 39, of 6917 Nichols Creek Drive, Jacksonville, Fla.; she was charged with ten counts each of insurance fraud and obtaining property by false pretense. Department of Insurance criminal investigators allege that between January and May 2013, while living in Fayetteville, N.C., Jackson obtained several thousand dollars www.underwritersinsider.com

from multiple i n s u r a n c e companies by filing fraudulent insurance claims for damage to her automobile and motorcycle. Investigators allege that, in many instances, the same vehicle damage was reported more than once or did not actually occur.

Jackson was arrested on similar charges in Florida on Dec. 20, 2013. With the assistance of the Jacksonville Sheriff's Office and the Florida Department of Financial Services Division of Insurance Fraud, she was extradited to Cumberland County, N.C., on Feb. 25, where she was arrested by N.C. Department of Insurance c r i m i n a l investigators and placed under a N. Carolina Insurance Commissioner $10,000 bond. Wayne Goodwin

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MISSISSIPPI’S INSURANCE COMMISSIONER MIKE CHANEY NAMED ONE OF TOP 100 INSURANCE PROFESSIONALS OF 2013 Reappointed to Chair Key NAIC Leadership Committee

ACKSON – Mississippi Commissioner of Insurance Mike Chaney has been named one of the top insurance professionals of 2013 by Insurance Business America Magazine. The introduction of the magazine’s special January/February issue of Hot 100 Insurance Professionals of 2013 states that every person on the list “brought their A-game to the job – and then gave a little more.” Chaney has the distinction of being the only State Insurance Commissioner on a list that is comprised of company presidents, CEO’s and experts; a governor; state and national legislators; and industry information executives. “I am especially honored to be included on such a prestigious list, ” Chaney said, “In Mississippi we have tried to set sound policies and procedures that benefit not only the business community but also protects the consumers of Mississippi and it’s good to see others recognize that.” His leadership and dedication to resolving issues facing insurance regulators has also led the officers of the National Association of

Insurance Commissioners (NAIC) to once again choose Mississippi Insurance Commissioner Mike Chaney to a key leadership position. For the fourth consecutive year, Chaney has been named chairman of the NAIC’s influential Property and Casualty Insurance (C) Committee by the leadership of the national group. The NAIC is the organization of state insurance regulators for all 50 of the United States, Washington D.C., and five US territories.

and North Dakota Insurance Commissioner. The Property and Casualty Committee deals with insurance issues and regulations for catastrophe insurance, crop insurance, earthquakes, terrorism, title insurance, workers’ compensation, surplus lines and risk retention, among many other issues. The mission of the committee is to monitor and respond to regulatory issues associated with property and casualty insurance including their delivery and cost. The committee has four task forces that report to it and eight working groups to assist with deliberations.

Because of its geographic location, Mississippi has to deal with the threat of not only Mike Chaney hurricanes, but Mississippi Insurance Commissioner also tornadoes, “Commissioner Chaney’s flooding and earthquakes. leadership at the NAIC—and particularly in the Property and “It is my honor to once again serve Casualty Committee—is an asset as chairman of this prestigious to state insurance regulation. I’m NAIC committee. There are many pleased that he’s agreed to serve a property and casualty challenges fourth term as committee chair,” this committee faces, we have said Adam Hamm, NAIC President worked hard in previous years

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and I welcome the opportunity to continue that work,” Chaney said. “I believe the NAIC leadership’s faith in me is grounded in the hard work and expertise the Mississippi Insurance Department continues to demonstrate when dealing with catastrophic losses and other property and casualty issues. This position and my other committee memberships give us the ability the better address insurance problems that affect all Mississippians and be at the forefront of finding solutions to those problems.” In addition to the chairmanship of the property and casualty committee, Chaney will also serve the NAIC as a member of the Health Insurance and Managed Care (B) Committee, the Financial Condition Committee (E), the NAIC/State Government Liaison Committee, the Senior Issues Task force and the Antifraud Task Force

LOUISIANA COMMISSIONER DONELON NAMES JEFFREY ZEWE DIRECTOR OF LOUISIANA AUTOMOBILE THEFT AND INSURANCE FRAUD PREVENTION AUTHORITY

ommissioner of Insurance Jim Donelon announced today that Jeffrey Zewe has been appointed to the position of Director of the Louisiana Automobile Theft and Insurance Fraud Prevention Authority (LATIFPA) at the Louisiana Department of Insurance (LDI). Zewe’s appointment is effective immediately. “We are very pleased to have Jeff join the Department and lead the efforts of the auto theft and insurance fraud prevention authority,” said Donelon. “His

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background in both legal and legislative work makes him a good fit to lead the agency in continuing its mission to deter and reduce vehicle theft and insurance fraud throughout Louisiana.” Zewe received his Bachelor of Arts degree in Political Science from the University of New Orleans and his Juris Doctorate from the Loyola University of New Orleans College of Law. He is a member of the Louisiana State Bar Association, the Jefferson Parish Bar Association, the American Bar Association and the American Political Science Association. Before joining the LDI, Zewe worked in the private sector as an attorney and also served as a Legislative Assistant. Created during the 2004 Louisiana Regular Legislative Session, LATIFPA is a public agency housed within the LDI’s Division of Insurance Fraud. Through statewide partnerships with law enforcement agencies, public awareness campaigns and various education initiatives, LATIFPA works to combat motor vehicle theft, insurance fraud and other criminal acts. 17

Breaking Industry News

eigh Ann Pusey, president and CEO of the American Insurance Association (AIA), announced today that Marjorie Berte plans to retire on March 31. Ms. Berte joined AIA in January 2011 as vice president for state affairs, Western region, and has been responsible for overseeing AIA’s government affairs efforts in Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Oregon, Utah and Washington.

illis Group Holdings the global risk advisor, insurance and reinsurance broker, has appointed Sara Benolken as the firm’s Global Industry Leader for Technology, Media and Telecommunications (TMT ). Benolken, an insurance industry leader who has specialized in advising Willis’s TMT clients since joining the firm in 2007, will lead the fifth industry group designed to seamlessly connect Willis industry experts with product and geography leaders around the world. The new global industry groups focus on the unique needs of clients within each sector while providing them access to the full range of insurance products and risk management services that define Willis as the analytical broker.

nsurance brokerage Brown & Brown Inc. has named R. Andrew Watts as executive vice president, treasurer and chief financial officer. Mr. Watts’ appointment as executive vice president and treasurer are effective immediately. He reports to J. Powell Brown, president and CEO of Brown & Brown, the broker said Monday in a statement. Mr. Watts will succeed current Treasurer and CFO Cory Walker when he retires in March, according to the statement.

ccording to a report in the Huffington Post,

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“Researchers swabbed the rinds and flesh of 76 lemons from 21 restaurants collected during 43 visits and found that a whopping 70 percent of them produced microbial growth. The samples were collected as soon as the beverage (either soda or water) was served, before drinking or touching, and while the researchers couldn’t pinpoint the exact origins of the microorganisms, they speculated that they may have come from the restaurant employee or raw meat or poultry contamination, among other sources. “Although lemons have known antimicrobial properties, the results of our study indicate that a wide variety of microorganisms may survive on the flesh and the rind of a sliced lemon,” the authors wrote in

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their report. “Restaurant patrons ow, there is a “death test.” should be aware that lemon Scientists have developed slices added to beverages may a simple blood test which is an include potentially pathogenic excellent predictor of whether a microbes.”” [MORE] person is five times more likely to die in the next five years. The ccording to a February test measured the levels of four story in Property & Casualty biomarkers in the body, apparently 360, “Lawyers for giving a measure of frailty. Lance Armstrong One researcher, Dr. Johannes went to court in Kettunen said, “What is Dallas on Friday especially interesting is that to try to block a these biomarkers reflect sports insurance the risk for dying from very company from different types of diseases re - opening such as heart disease or an arbitration cancer. They seem to be signs decision forcing of a general frailty in the body,” the firm to pay $12 million in bonuses to the disgraced cyclist. nsurance Thought & Leadership. Dallas-based SCA Promotions com: “In January 2013, LIMRA said that Armstrong lied for reported that 90% of industry years about using performance- executives it had surveyed believe enhancing drugs and has sued that insurance companies will to re-open the 2006 arbitration continue to form strategic alliances decision made before he finally with “non-traditional organizations” admitted to doping.” to expand distribution. The example cited was MetLife’s trial ccording to a story in alliance with 200 Wal-Mart stores. Business.Com, “The threat Then Accenture’s “Customerof cyber hacking, underscored by Driven Innovation Survey” found the credit card breach at Target, is that more than two-thirds of now so great that US businesses customers would consider are rushing to buy insurance purchasing home, auto and life coverage against the expense of insurance from businesses other being hacked, or losing sensitive than insurers—23% were open customer information. One to purchasing from online service in three companies now has providers like Amazon or Google insurance to specifically protect (which acquired auto insurance against such losses. Last year, aggregator BeatThatQuote.com cyber insurance polices sold to way back in 2011 in the UK). retailers, hospitals, banks, and Amazon has proven leadership other businesses jumped 20 as an e-commerce distributor, percent, according to Marsh LLC, while Google is seen primarily as a New York insurance brokerage an information organization, so I firm that tracks the market.” would like to elaborate exclusively

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on the compelling reasons for insurers and Amazon to create a distribution model to match everevolving customer demands.” [MORE]

roperty Casualty 360: “The Florida Highway Patrol (FHP) reports there were 78,000 hit-andrun crashes in the state in 2013— an 8% increase from 2012. These crashes involve people leaving the scene of an accident causing injury or property damage, says the Herald. These incidents caused more than 17,000 injuries and 154 deaths, according to the FHP. Lynne McChristian of the Insurance Information Institute believes there could be a correlation between those findings and the fact that one in four drivers in Florida aren’t insured, says the Herald. “They bolt when they have an accident because they are already breaking the law by not having insurance, and then they have caused an accident on top of it,” says McChristian.”

arget reported that it had $61 million in expenses related to the massive cyber-breach during the 2013 holidays - but a $44 million cyber insurance payment softened the blow considerably. Shares are up after the store posted losses in 2013 4th quarter.

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FLORIDA ANNOUNCES 14 ARRESTS AFTER INVESTIGATION KNOWN AS ‘OPERATION FLAMES AND FLOODS’ EXPOSES MULTIMILLION DOLLAR INSURANCE FRAUD

ALLAHASSEE - CFO Jeff Atwater today announced the arrests of 14 individuals following a joint investigation between the State Fire Marshal’s Office and the Miami-Dade Police Department’s Arson Unit. “Operation Flames and Floods,” as it was termed upon its inception in November 2012, exposed an extensive scheme to defraud several insurance companies by staging fire and water damage claims to residential homes in Miami-Dade County, Lehigh Acres and Naples. The losses exceeded several million dollars after 13 homes were set on fire and five more reported extensive water damage.

Espinosa Sr. was arrested prior to today during the operation’s initial phase as a result of a federal indictment. The remaining arrests occurred this morning and afternoon. A second public adjuster and a plumber were also among the people arrested for allegedly instructing

As a result of the fraud, the following insurance carriers paid out more than $7.6 million in reported losses: American Integrity Insurance Company, American Bankers Insurance Company, Citizens Property Insurance Corporation, Northern Capital Insurance Company, Northern Point Insurance, Gulf Stream Property & Casualty, Southern Oak Insurance Company, State Farm, and Universal Property & Casualty. These cases are being prosecuted by Miami-Dade County State Attorney Katherine Fernandez Rundle.

“These devious acts of fraud hurt all Floridians by driving up the cost of insurance, which takes money out of the pockets of hard-working, law-abiding Floridians,” said CFO Jeff Atwater. “I am extremely proud of the work of our State Fire Marshal’s Office, and I am thankful for the support of the Miami-Dade Police Department’s Arson Unit and Miami-Dade County State Attorney Katherine Fernandez Rundle for helping us bring these individuals to justice.” Public 20

adjuster

Jorge

• Jorge Espinosa Sr. (Public Adj) • Carolina Esponosa (Public Adj) • Roberto Suarez • Pedro H. Lezcano, Sr. • Argelio Menendez • Jesus Martinez • Lazaro Delgado • Liset Corrales • Francisco Pineiro-Gonzalez • Daniel Perez • Francisco Centurion • Abel Gutierrez • Daney Perez • Ernesto O’Reilly

homeowners about how to file fraudulent insurance claims. The 13 cases of arson were staged to resemble electrical, kitchen and vehicle-related fires occurring within the home or garage, while those involving water damage blamed flooding on water supply lines or clogged sewer lines. “Through insurance fraud, scammers reach into the wallets Upon their arrest, the following of every Floridian, every day,” individuals were transported to said Miami-Dade State Attorney Fausto Miami-Dade County Jail: Katherine Fernandez Rundle.

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FLORIDA ARRESTS 12 IN ‘OPERATION LEAKY PIPES’ FRAUD INVESTIGATION

ALLAHASSEE- CFO Jeff Atwater today announced that the ongoing insurance fraud investigation known as ‘Operation Leaky Pipes’ has led to the arrests of 12 Miami residents. The investigation uncovered a scheme between a licensed public adjuster and a plumber to coach homeowners on how to file fraudulent insurance claims for pre-existing or non-existent water damage. The homeowners filed fraudulent claims in an attempt to claim money for home remodeling.

face the consequences,” said CFO Atwater. “Our team will continue to do everything in our power to fight the fraud and abuse that drives up the cost of insurance for all Floridians.”

Both men have also provided sworn statements detailing all of the fraudulent claims filed with their assistance.

“The National Insurance Crime Bureau works with its 1,100 member A tip and a subsequent companies and law enforcement investigation led by Florida to identify, investigate, and deter Department of Financial Services’ insurance fraud that impacts Division of Insurance Fraud (DIF) the American public,” said NICB detectives, in partnership with the Director Dennis Russo. National Insurance Crime Bureau, unraveled the scheme that Jose DIF detectives obtained sworn Nino, public adjuster, and Boris confessions from all 12 named Diaz, plumber, were operating. Both homeowners. They were arrested “These 12 individuals tried to cheat were arrested after being caught and transported to the Miami Dade the system and now they have to during an undercover operation. County Jail for processing.

FLORIDA ARRESTS TWO ON P.I.P. FRAUD CHARGES

ALLAHASSEE – CFO Jeff Atwater today announced the arrests of Leonardo F. Marquez Garcia and Dayleann Marie Vallejo-Ruiz, of Miami and Orlando respectively, on charges of insurance fraud. An investigation by the Department of Financial Services’ Division of Insurance Fraud revealed that Garcia would do supposed ‘initial examinations’ on crash victims and refer them to the Injury Rehabilitation Center for physical therapy treatments. Vallejo-Ruiz, the owner of the clinic and a licensed massage therapist, had patients sign blank treatment forms that were sent to the insurance company

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requesting payment for services never provided. “This kind of deceit and abuse hurts all Floridians in the form of higher premiums,” said CFO Atwater. “I am proud of my team for putting a stop to this fraud and for their continuing success keeping other fraudsters off our streets.” Allstate insurance company received bills for the alleged medical treatments purportedly provided between February 3 and March 16, 2012, on two crash victims. Leonardo F. Marquez Garcia submitted requests for payment for his initial examinations claiming his

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services were provided on behalf of Global Rehabilitation Center, Inc., 15271 NW 60th Avenue, Suite 106, Miami Lakes, Florida, which is not an Area of Critical Need facility and where Leonardo F. Marquez Garcia, an Area of Critical Needs Doctor, was not licensed to practice medicine. Therefore, Garcia was additionally charged with the unlicensed practice of medicine for operating outside the scope of his license. The investigation is ongoing and additional arrests are expected. The case is being prosecuted by the Orange County State Attorney’s Office, and each defendant faces up to 15-20 years in prison if convicted. 21

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“The Final Authority on Everything!” “Free” Security Scans

ne of our office computers was recently hit with a scam that began with a big yellow warning that the computer was infected by multiple viruses and we needed to pay $59.95 to begin a “scan” that would find and fix the problem. Fortunately, our IT guy got rid of the page in a hurry but perhaps you could warn others that might end up sending money to these crooks. Thanks! J.R. Birmingham, AL

ADVISOR

software, the program tells you that your problems are fixed. The reality: there was nothing to fix. And what’s worse, the program now installed on your computer could be harmful. Scammers have found ways to create realistic but phony “security alerts.” Though the “alerts” look like they’re being generated by your computer, they actually are created by a con artist and sent through your Internet browser.

These programs are called The best advice we could find on “scareware” because they exploit the subject comes directly from the a person’s fear of online viruses and security threats. The scam FTC’s website: has many variations, but there are Messages telling you to install and update security software for your computer seem to be everywhere. So you might be tempted by an offer of a “free security scan,” especially when faced with a pop-up, an email, or an ad that claims “malicious software” has already been found on your machine. Unfortunately, it’s likely that the scary message is a come-on for a rip-off.

some telltale signs. For example: you may get ads that promise to “delete viruses or spyware,” “protect privacy,” “improve computer function,” “remove harmful files,” or “clean your registry;” you may get “alerts” about “malicious software” or “illegal pornography on your computer;” you may be invited to download free software for a security scan or to improve your system; you could get popups that claim your security software is out-of-date and your computer is in immediate danger; you may suddenly encounter an unfamiliar website that claims to have performed a security scan See ADVISOR Page 35

The free scan claims to find a host of problems, and within seconds, you’re getting urgent pop-ups to buy security software. After you agree to spend $40 or more on the www.underwritersinsider.com

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2-20 or 20-44 Agent Needed In Pembroke Pines, FL

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Comm.P&C Producer Central Florida Commercial Insurance sales from a retail agency / broker or direct writer with a proven track record. Must have 3 to 10 years experience, 220 license, with an industry focus or mix of targeted niches. Must have aggressive sales skills and credible business relationship development abilities. Central Florida. Michael@einsgroup.com 10-8

INSURANCE BOOK OF BuSINESS WANTED Looking for seasoned, quality book in SE Florida. 35 year veteran will slowly ease your exit or quick buyout - your terms. Email: Appropriaterisk@gmail.com 10-11

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We are looking 220 Insurance Agent License in Kissimmee Florida. A detail-oriented professional with excellent timemanagement, organization and computer skills High school diploma or equivalent (GED) with a valid state driverâ&#x20AC;&#x2122;s license and reliable insured transportation. Currently posses an active 220 License Call us at 407-847-2539 10-9

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CSR 440 or 220 Agent N Miami area Looking for a 2-20 agent or CSR Bilingual ( English-Spanish ), Excelent on Customer service Email resume to jamie@ jmendezandassociates.com 10-1

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Great opportunity for the agent looking for the opportunity to be paid by production rather than salary. Our Pembroke Pines office is looking the right people to write commercial and/or personal lines. Email cr2dome1@ gmail.com for more information. 10-7

Roswell, GA Premium Finance Sales Opportunity Are you ready to take your sales career to the next level? Est. in 1984 and based in Roswell, GA, Advanced Insurance Systems Inc. is a fast paced, high growth technology company that develops and markets premium finance software throughout N. America. While working mostly insidesales in our Roswell office, you will be challenged by the development of new business and the on-going support for existing clients. Help move sales opportunities through demos, proof of concept and responding to requests for information and proposals. Resumes to:

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Experienced 2-20 Commercial Agent in Boca Raton, FL Great opportunity for the experienced Agent looking for the opportunity to be paid well by production, rather than salary. Our office in Boca Raton is looking for a results oriented commercial agent. Compensation will be far higher than industry standards, including renewals. Contact email address with resume and cover letter: agencyops@gmail.com 10-11 The Underwriterâ&#x20AC;&#x2122;s Insider

Experenced Commercial Lines CSR-Tampa Area Established large Independent Agency seeks experienced Commercial Lines CSR. Duties include all aspects of customer service incl. telephone calls from customer and underwriters, issue COI, Auto ID Cards, Evid. of Prop. Market new and renewal policies, prepare proposals, process invoices, binders, policies, endorse., audits, recommend., etc. This position requires a minimum of 4 years of commercial account handling. Knowledge of AMS360 management system will be a plus. Contact: susank@adcock-insurance.com 10-8

P&C Carrier Asst. Controller Upper NY State Stat/GAAP - solid yellow book required.Company will negotiate relocation at offer. Great area to raise a family. Enjoy all outdoor sports - hunting, fishing, hiking, water sports, skiing. Contact: Jeanine Drahota Lost Dutchman Search 480-563-7676 jkd@lostdutchmansearch.com 10-7 â&#x20AC;&#x153;The only real difference between a tax man and a taxidermist is that the taxidermist leaves the skin.â&#x20AC;? - Mark Twain

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International property & casualty insurance skills including professional lines, directors & officers too. Manage, marketing servicing and be a resource for multinational or domestic P&C Programs. Carrier or Broker background preferred. Selfstarter, foreign language skills a plus. NY/NJ/CT area Contact: Michael@einsgroup.com 10-8

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Experienced CSR Wanted - New Port Richey area Experienced Commercial Lines CSR wanted for Roe Insurance, Inc in New Port Richey, Fl. 34655. Applied Systems experience required, will service approx 250 small C.L. clients, mostly in the nonprofit industry. Contact: greg@roeins.com 10-6

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CSR Wanted Jacksonville, FL Small agency needs permanent CSR in the Jacksonville, Florida area, will train-contact lloydwd@comcast.net or call(904)724-2550 11-3 25

SAY WHAT? “ Notable Quotes You May Have Missed!

Goodbye Bright Eyes

“

When the spirit of the people is lower than at any other time during this Depression, it is a splendid thing that for just 15 cents, an American can go to a movie and look at the smiling face of a baby and forget his troubles.” - President Franklin D. Roosevelt, remarking on the remarkable child actress who sang and danced her way into the heart of America, Shirley Temple - who died at 85 on 2/10/2014.

ut generally speaking you get past the next election by changing your policies, by announcing new initiatives, but not by wantonly changing the law lawlessly. This is stuff you do in a banana republic. It’s as if the law is simply a blackboard on which Obama writes any number he wants, any delay he wants, and any provision. It’s now reached a point where it is so endemic that nobody even notices or complains. I think if the complaints had started with the first arbitrary changes — and these are not adjustments or transitions. These are political decisions to minimize the impact leading up to an election. And it’s changing the law in a way that you are not allowed to do. - Charles Krauthammer, author and pundit on Obama’s recent executive directives.

Something happened because none of the things he promised . . . transparency, a government that would reconsider the war on terror and these programs . . . none of that happened, none of it. The man stunned us with a lack of spine. He’s a weak man. On everything, he backed down. I was stunned.” - Film director Oliver Stone, burning the last of his Obama bridges in a speech to a Washington D.C. discussion group in February - bitterly disappointed that the man he voted for twice; the most liberal president America has ever suffered from - was not liberal enough. Stone had previously referred to Obama as a “snake” at a discussion group Tokyo last month.

On The Side of Tyrants

Stuff You Do In a Banana Republic

The Heartbreak of Oliver Stone

“

I heard him also talk about these great doctors that they have in Cuba, and I have no doubt they’re very talented; I’ve met a bunch of them. You know where I met them? In the United States, because they defected. Because, in Cuba, doctors would rather drive a taxicab or work in a hotel than be a doctor. How come I never read about boatloads of refugees going to Cuba? Why have close to one and a half million people left Cuba to come here, but the only ones who leave here to move there are fugitives from the law and people who steal money from Medicare? But you want us to reach out and develop friendly relationships with a serial violator of human rights, who supports what’s going on in Venezuela and Sen. Marco Rubio every other atrocities on the planet? On issue after issue, they are always on the side of the tyrants ... And this is who we should be opening up to — why don’t they change? We, as the freest nation on earth, are looked to by people

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in [Venezuela] to stand by them in their moment of need, when they clamor for freedom and liberty and human rights. They look for America to be on their side. I would suggest to my colleagues, the next time they go to Cuba, ask to meet with the Ladies in White. Ask to meet with Yoani Sanchez. Ask to meet with the dissidents and the human rights activists that are jailed and repressed and exiled. Ask to meet with them. I bet you’re going to hear something very different than what you got from your hosts on your last trip to the wonderful Cuba, this extraordinary socialist paradise. Because it’s a joke. It’s a farce.” - Florida Senator Marco Rubio (R) responding to the comments of Sen. Tom Harkin (D-IA) fawning over the Cuban communist regime after a recent visit. One has to wonder at the naivete of Progressives and their historical and ongoing sympathies with communist and socialist dictatorships.

barbarism. I have never written before asking to please forward onwards, so that as many as possible can understand radical Islam and what awaits the world if it is not stopped. - Dr. Arieh Eldad of the Hadassah Ein Kerem University hospital in Jerusalem urging the world to adapt a reality-based view of radical Islam and the terrorist threat.

While Our Naive President Twiddles His Thumbs, The World Grows More Dangerous As America Grows Weaker

“

We have created a leadership vacuum in the world, and it is being filled by the Putins of the world, by people without our values or our interest, and it’s to the detriment of the United States and our friends and allies around the world. It is the United States that’s injected that instability into This is a civilizational conflict, or rather a the world equation. So, the thing we have got to persuade other countries of is that we get peace war between civilization & barbarism. through strength as Eisenhower said. If we want peace, we have to be prepared for war and that it is was instrumental in establishing the Israeli U.S. weakness that has shaken the world.” - Former National Skin Bank, which is the largest in the Secretary of Defense Donald Rumsfeld speaking with world. The National Skin Bank stores skin for every Fox’s Greta Van Susteren regarding the power vacuum day needs as well as for war time or mass casualty created across the globe by the weakness emanating situations. This skin bank is hosted at the Hadassah from Washington D.C. as evidenced by the Russian Ein Kerem University hospital in Jerusalem where I mischief occurring in the Ukraine. was the Chairman of plastic surgery. This is how I was asked to supply skin for an Arab woman from Meanwhile, Back at the Pentagon... Gaza , who was hospitalized in Soroka Hospital in Beersheva, after her family burned her. Usually, The current fiscal environment has demanded such atrocities happen among Arab families when that we take another look at these costs, which the women are suspected of having an affair. We supplied all the needed Homografts for her would represent $170.2 billion, or roughly onetreatment. She was successfully treated by my third of the fiscal year 2014 budget request. In friend and colleague, Prof. Lior Rosenberg and this budget, the department is submitting a new discharged to return to Gaza . She was invited for package of military compensation proposals, regular follow-up visits to the outpatient clinic in including a modest slowing of the growth of Beersheva. One day she was caught at a border military pay by implementing a 1 percent pay crossing wearing a suicide belt. She meant to raise for service members in 2014.” - Obama’s Secty explode herself in the outpatient clinic of the of Defense Chuck Hagel, proposing to shrink the U.S. hospital where they saved her life. It seems that her military to it’s smallest size in 74 years - as China builds family promised her that if she did that, they would a massive navy and an emboldened Vladimir Putin forgive her. This is only one example of the war moves to reconstitute the Soviet Union. What happens between Jews and Muslims in the Land of Israel. when you promote a far-left community organizer to It is not a territorial conflict. This is a civilizational commander and chief of the most powerful peaceconflict, or rather a war between civilization & keeping force the world has ever known.

“

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February 2014

January 2014

December 2013

November 2013

October 2013

September 2013

August 2013

July 2013

June 2013

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May 2013

April 2013

March 2013

February 2013

January 2013

December 2012

November 2012

October 2012

September 2012

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MUST WATCH: JUDGE JEANINE THRASHES OBAMA’S LAWLESS POWER GRAB

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Continued from Page 10

ZALMA In the federal case, the district court granted summary judgment to State Farm on all claims. MPDS Memphis appealed to the Sixth Circuit arguing that the district court erred in granting summary judgment on its claims for breach of contract and breach of the covenant of good faith. The Sixth Circuit affirmed the district court on MPDS’s bad faith claim. MPDSMemphis, Ltd. v. State Farm Fire & Cas. Co., 6th Cir. No. 11-4416, 2013 U.S. App. LEXIS 8501 (Apr. 24, 2013). After determining that the record was too muddled on the breach of contract claim, the Sixth Circuit reversed summary judgment on that claim and instructed the district court to afford “MPDS Memphis an opportunity to present its remaining breach of contract claims and then determine whether these claims are supported by evidence sufficient to withstand summary judgment.”

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ANALYSIS

Coverages section of the Policy. As a Named Insured on the An insurance policy is a contract. Declarations Page, MPDS Memphis is covered When interpreting under the entire an insurance “When multiple Policy. Because contract, the interests in real the plain court must honor and ordinary the intent of the property insure the meaning of parties. A court property they should the Policy presumes that d e m o n s t r ates the parties’ intent all ascertain that their that Priore is not is reflected in the interests are protected covered under language that the Property by asking the insurer is found in the C o v e r ages policy. The court’s to name them as an section of the inquiry begins and Policy, the trial ends by looking insured. They also have court correctly to the plain and the right to purchase g r a n t e d ordinary meaning separate insurance to s u m m a r y of the language judgment in used in the policy protect their interest.” favor of State unless another Farm on the meaning is clearly declaratory apparent from the contents of the policy. If the court judgment action. determines that the language in the policy is clear, it may look no further than the writing itself to Reformation find the intent of the parties. If the language is clear, then there are no genuine issues Priore argues in the alternative of material that if he is not covered under the fact to be Property Coverages section of the d e t e r m i n e d , Policy, then the Policy should be and the trial reformed in such a way so that he court should is covered under that section of order summary the Policy. Although unambiguous judgment. insurance policies are usually enforced as written, where there is clear and convincing evidence The Policy is of a mutual mistake in the policy, clear. Priore is we may employ the equitable tool not insured of reformation to deviate from the under the Proper t y See Zalma Pg 35

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Experts and Consultants for Insurance Disputes 4441 Sepulveda Boulevard Culver City, California 90230 310-390-4455 zalma@zalma.com http://www.zalma.com

Consultation from Zalma Insurance Consultants (ZIC) can save you or your client thousands of dollars in the defense or prosecution of an insurance dispute. ZIC provides expert advice and counsel insurers and plaintiffs’ counsel find indispensable. Consultation from ZIC can save you, your counsel or client hundreds of hours of investigative and legal work. ZALMA INSURANCE CONSULTANTS is a service of Barry Zalma, Inc. a California professional corporation. Barry Zalma is an internationally recognized expert on insurance coverage, insurance claims handling, insurance bad faith, insurance fraud detection, the defeat of false and fraudulent claims, Barry Zalma, Esq. insurance claims handling, and the resolution of insurance disputes. As a consultant, expert witness, lawyer, author, mediator or arbitrator he serves all parties who need consultation or expert testimony on matters relating to insurance coverage, insurance claims handling, insurance fraud and the tort of bad faith. Barry Zalma founded Zalma Insurance Consultants to help resolve any insurance claim problem faced by you or your clients that do not need Mr. Zalma’s services as a lawyer. His experience and skill as a consultant and expert witness can make the difference before a jury or other trier of fact. For more than 44 years as a claims person and insurance coverage attorney, Barry Zalma has represented insurers, advised insurers on claims handling, interpreted coverages and testified as an insurance coverage, insurance bad faith, insurance claims handling and insurance fraud expert on behalf of insurers and policyholders in state and federal courts.

Expert Testimony

Zalma Insurance Consultants serves insurers, policyholders, underwriters, brokers, agents, adjusters, public insurance adjusters, lawyers and any person involved in an insurance dispute. Because he is an attorney licensed to practice law in the state of California M r. Zalma may be prohibited by California case law from acting as a consultant or expert witness and, therefore, refuses to serve in any situation where a past client of his law firm, Barry Zalma, Inc. is adverse to anyone seeking his services.

Y ou can obtain M r. Zalma’s C.V . at http://www.zalma.com and his e-book publications http://www.zalma.com/zalmabooks.htm and blogs daily at Zalma on Insurance, http://zalma.com/blog.

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good app to work with. Adobe’s Photoshop Express does the job. It’s a (very) lite but extremely useful version of its famous highend product, Photoshop. You’ll Netflix requires a streaming find it gives you the tools you subscription; the movie selection need to lighten backgrounds, is so-so, but the TV back catalog adjust colors and crop photos. is pretty extensive. Hulu has some free stuff for casual users; Sketchbook Express its subscription service unlocks a lot of good films and a big array of TV shows too, including recent episodes of Saturday Night Live, the Daily Show, and Law & Order. Continued From Page 9

KIM KOMANDO

Tablets can showcase the artist inside all of us. Right now, it seems many of the most acclaimed drawing and painting apps work on Apple products with one exception. Sketchbook Express, available for both Apple and Android tablets, has a dense See Kim Komando Pg 39

Evernote Evernote takes your notes and puts them in the cloud, so they’re accessible from any other device you care to sync to it. Text, photos, and even audio, Evernote can handle it. If you are trying to get organized, this will help you make it happen.

Skype You might have heard about “Skyping,” but might not understand exactly what that means. Skype is a quick and easy way to have video chats with friends and family all over the word. Best of all, your calls are free. Download the app and sign up for an account. Then start hunting for friends!

Photoshop Express Tablets are a great place to edit pictures. All you need is a www.underwritersinsider.com

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500 MILLION DOLLAR MEDICAL AND WORKERS’ COMP FRAUD CONSPIRACY UNCOVERED IN CALIFORNIA CA businessman charged with leading sophisticated insurance fraud operation

dollars," said California Insurance Commissioner Dave Jones. "This is one of the largest workers' compensation fraud cases in the history of the Department OS ANGELES, Calif. - A of Insurance-our successful multi-year investigation investigation of this complex into a sophisticated criminal scheme underscores criminal fraud ring has uncovered our commitment to bring law the largest case of insurance fraud breakers to justice regardless of in department history and led to who they are." Michael Drobot, 69, of Corona Del Mar who built a complex Drobot was the owner/operator of conspiracy billing approximately Pacific Hospital in Long Beach and 150 insurance companies more used the hospital to orchestrate than $500 million for medical the elaborate fraud scheme procedures over five years. that involved illegal kickbacks in exchange for thousands of patient Today U.S. Attorney André Birotte referrals from other medical announced the details of the professionals. Drobot's scheme investigation, which was initiated largely targeted the workers' as joint investigation by the compensation system with nearly Department of Insurance and FBI 90 percent of the medical billings in 2009 and quickly expanded to for workers' compensation cases. include the U.S. Attorney's office, IRS and other law enforcement As the ring leader, Drobot paid agencies. Today's announcement other medical professionals as also includes details of a plea much as $15,000 in kickbacks agreement struck with Drobot for each lumbar fusion surgery to cooperate with the ongoing and $10,000 for cervical fusion investigation. surgery. The kickback payments were concealed through bogus "Insurance fraud is a multicontracts with the doctors, billion dollar drain on California's chiropractors, and other medical economy, which results in professionals and funded by higher insurance premiums inflating prices for medical for California businesses and equipment and establishing shell consumers. The co-conspirators companies to hide his actions, lined their pockets by ripping while billing insurers for the off insurance companies to the inflated equipment and implants tune of hundreds of millions of

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and medical procedures. The investigation revealed Drobot inflated prices by as much as ten times the actual price-charging $40,000 for spinal hardware purchased for only $4,000.

More than $63.7 million recovered for California consumers in 2013

ACRAMENTO, Calif. - The California Department of Insurance announced that during 2013 it recovered more than $63.7 million for consumers through consumer complaint investigations and market conduct examinations of insurance companies.

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Continued from Page 23

“Cancel,” or even the “x” at the top right corner of the screen. Some scareware is designed so that any of those buttons can activate the program. If you use Windows, and prompts you to download press Ctrl + Alt + Delete to open your Task Manager, and click new software. “End Task.” If you use a Mac, press Scareware purveyors also go to Command + Option + Q + Esc to great lengths to make their product “Force Quit.” and service look legitimate. For example, if you buy the software, If you get an offer, check out the you may get an email receipt program by entering the name with a customer service phone in a search engine. The results number. If you call, you’re likely can help you determine if the to be connected to someone, but program is on the up-and-up.

ADVISOR

that alone does not mean the Good Security Practices company is legitimate. Regardless, remember that these are wellorganized and profitable schemes Check that your security software is active and current: at a designed to rip people off. minimum, your computer should have anti-virus and anti-spyware How Do the software, and a firewall. You can Scammers Do It? buy stand-alone programs for each element — or a security suite Scareware schemes can be quite that includes these programs sophisticated. The scam artists — from a variety of sources, buy ad space on trusted, popular including commercial vendors websites. Even though the ads look and your Internet Service Provider. legitimate and harmless to the The security software that was website’s operator, they actually installed on your computer when redirect unsuspecting visitors to a you bought it generally works fraudulent website that performs a for just a short time — unless bogus security scan. The site then you pay a subscription fee to causes a barrage of urgent pop-up keep it in effect. Visit http:// messages that pressure users into security.getnetwise.org/tools/ downloading worthless software. search for a list of security tools from legitimate security vendors What to Do selected by GetNetWise, a project of the Internet Education If you’re faced with any of the Foundation. warning signs of a scareware scam or suspect a problem, shut down Make it a practice not to click on your browser. Don’t click “No” or any links within pop-ups. www.underwritersinsider.com

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ZALMA

terms of the written instrument and to correct the mistake. A court may also reform a policy in the case of a unilateral mistake that affects the insurance policy to such an extent that the contract is not ‘a correct integration of the agreement of the parties. Generally, a court should not reform an insurance policy where the party seeking reformation has failed to fulfill his duty to read the policy. Reformation is an equitable principle, and equity only aids the vigilant. Priore asserts that the Policy should be reformed because both Priore and State Farm had understood and intended that State Farm would issue a policy that covered Priore under the Property Coverages section of the Policy. Priore argues that, contrary to this intention and understanding, State Farm failed to list Priore as a Named Insured under the Policy. Priore admits he never read the Policy. Because Priore is not covered under the Property Coverages section of the Policy, Priore cannot demonstrate that State Farm breached any obligation to Priore. Because Priore is not covered under the Property Coverages section of the Policy, State Farm could not owe a fiduciary duty to Priore with regard to that section of the Policy, and so Priore could not prevail on a bad faith claim against State Farm. See Zalma Pg 37 35

APPEALS COURT UPHOLDS $163 MILLION JUDGMENT AGAINST ‘SCAREWARE FREE VIRUS SCAN” MARKETER

n a victory for the Federal Trade Commission in its efforts to protect consumers from spyware and malware, a federal appeals court has upheld a district court ruling that imposed a judgment of more than $163 million on Kristy Ross for her role in an operation that used computer “scareware” to trick consumers into thinking their computers were infected with malicious software,

and then sold them software to “fix” their non-existent problem.

the FTC had charged Ross and six other defendants with conning consumers into buying software In October 2012, in addition to the to remove malware supposedly imposing monetary judgment, the detected by computer scans. The U.S. District Court for the District of other defendants either settled the Maryland permanently prohibited charges or had default judgments Ross from selling computer security entered against them. software and any other software that interferes with consumers’ To learn more about these kinds computer use, and from any form of scams, read the FTC’s “Free” of deceptive marketing. In 2008, Security Scans.

AMERICAN HENNESSEY VENOM GT FASTEST ALMOST-PRODUCTION CAR DOCUMENTED AT 270.49 MPH! FRENCH BUGATI VEYRON NOW IN 2ND PLACE

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Continued from Page 35

ZALMA Priore argued that the agent, Robinson, was a fiduciary and that, as such, he owed Priore a higher duty of care – a duty not only to provide the specific coverage that Priore requested, but also to advise Priore of the various types of coverage that Priore might need. Although the law recognizes a public interest in fostering certain professional relationships, such as the doctor-patient and attorneyclient relationships, courts have determined that the relationship between an insurance agent and client does not rise to the same level of importance. Although a fiduciary relationship may be created out of an informal relationship where both parties mutually understand that they have entered into a special trust or confidence, the situation in this case is nothing more than an ordinary business relationship between insurance agent and client, and that the insured was in the best position to know how much coverage it needed.

coverage on the Property. In fact, Priore never asked Robinson for general advice about the scope of his personal coverage under the Policy. In other words, Priore and Robinson’s relationship was a typical client and insurance agent relationship. Robinson was not a fiduciary and did not owe a heightened duty to probe Priore about obtaining additional personal coverage under the Policy. Priore’s negligence claim against Robinson fails as a matter of law.

ZALMA OPINION

Priore, as a 50% owner of MPDS Memphis insurance existed to protect the property against covered losses. MPDS Memphis is a “person” in the eyes of the law and the only insured. That a shareholder of MPDS Memphis had an interest in the property – because of his cosigning a loan – did not make him an insured. He had an insurable interest that was not insured. He could have purchased a separate policy to cover his interest. He did not. When MPDS Memphis bought insurance to protect its interest in the property, which was 100%, Viewing the evidence in the light it did not ask to separately insure most favorable to Priore, the court Priore and Priore did not ask that concluded that Priore requested he be insured. personal coverage for liability and that Robinson obtained When multiple interests in real such coverage for Priore. The property insure the property they record further establishes that should all ascertain that their Priore did not ask Robinson that interests are protected by asking he be personally covered for the the insurer to name them as an Property, nor did he ask Robinson insured. They also have the right any questions about personal to purchase separate insurance www.underwritersinsider.com

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to protect their interest. Priore did neither and attempted to get a coverage that did not exist by making multiple arguments and accusing the insurer of bad faith. His ploy failed. If the federal court finds coverage his interest will be protected.

In general, the art of government consists of taking as much money as possible from one party of the citizens to give to the other. Voltaire (1764)

Continued From Page 13

the Democrats in future years, “JUDICIAL WATCH CONTINUES just as the move by Senator Harry LAWSUIT AGAINST OBAMACARE Reid, changing the rule requiring LAWLESSNESS a supermajority to pass legislation http://www.breitbart.com/Big- in the Senate, is now changed to obviating his responsibility to the Government/2014/01/29/Judicial- a simple 51% vote. Should the Congress, and most importantly, to Watch- Continues- Challenge - Republicans take control of the the American People. against-Obama-Lawlessness   Senate in 2014, and there is every likelihood they will, the Senate There are several, if not a multitude “Were Obamacare delays illegal?” Democrats may regret that foolish of lawsuits headed to the h t t p : / / w w w. b a n k r a t e . c o m / move by Harry Reid literally one Supreme Court, some that address f i n a n c i n g / i n s u r a n c e / w e r e - year after he made that historical specifically his overreaching in obamacare-delays-illegal/   change. making law by fiat, and obviating the Congress in doing so.   The These are just a few of the results   Further muddying these waters latest to be filed is specifically on a Google search of the issue.  Of is the generally accepted notion addressing this latest Employer important note is that Elena Kagen, that Justice Roberts, in granting Mandate delay, as it should. That an Obama appointee, has already his tortured decision regarding Obama is using Executive Orders spoken out publicly against the Individual Mandate, was (EO’s) and delaying these mandates Obama in his overuse of the EO wrong, especially as the mandate for purely political reasons has ruse to make law by fiat. As has is completely ineffective. While it become glaringly obvious: Sonia Sotomayor, another Obama is considered by the Supremes in appointee, on the ACA’s rulings that decision to be a tax, it cannot “Appeal Filed in Lawsuit regarding the Catholic Church be enforced by property liens or Challenging Obama Delay of and mandated coverage for Birth any other form of collection, short Obamacare Employer Mandate” Control Pills.   There is a plethora of deducting it from an IRS refund. http://www.judicialwatch.org/ of lawsuits winding their way to Pretty ridiculous as a means of press-room/press-releases/appealthe Supremes for adjudication on “forcing” the public to play. It filed-aca/ many separate EO’s this Monarch doesn’t and they won’t. wannabe has issued, that do in  “Business Owner Files Suit Against fact, change the law, a privilege Yes, the PPACA is the law. And yes, Obama Admin Over Employer only granted to Congress on Obama has changed the law so Mandate Delay: Congressionally made law.   often and with political malice and http://www.thenewamerican. aforethought, designed specifically com/usnews/constitution/ While I agree that the Administrative to manipulate the outcome of item/16659-business-owner-filesProcedure Act (“APA”) has granted elections to the benefit of the suit-against-obama-admin-overstrong powers to a president, I Democratic Party, that the PPACA employer-mandate-delay   don’t think that the APA is going is no longer the law that Congress to be held inviolable, as the Abuse passed and Obama signed in 2010. “Lawsuit Seeks to Stop Obama’s of Power by Obama has been so It is now a “different animal”, and it Mandate Delay: ‘President Has No obviously recorded, and is being so is my guess that Obama’s constant Right to Change Law strongly questioned, even by those changing of the law, for strictly h t t p : / / w w w. n e w s m a x . c o m / in his own party.   egregious reasons, will come back Newsfront/obamacare-lawsuitsto bite him in the ass. We will see president-mandate/2013/10/09/ Remember, what Obama has done how that all turns out. id/530126 today can come back to haunt

SPENCER

The Underwriter’s Insider

In the meantime, we have Midterm Elections, that if they prove successful for the GOP, may render all of this moot, should the amendments to that law be successful in the 2015 Congress, and Obama chooses to not go down in history as the worst president under whom America has ever suffered. Continued From Page 38

QQSOLUTIONS Daniel Lanphere, Senior Director of National Sales, leads the QQSolutions sales team and brings to the company over sixteen years of sales leadership experience in technology, software, data, and service solutions. He has held sales and sales management positions at NCR Corporation, WorkFlow One, and LexisNexis. Lanphere has a passion for building customer-focused teams that partner with their clients. He has a diverse background that includes inside and outside sales, sales management, operations management and business resource management within several different industries. Lanphere earned his BA from the University of Dayton, where his focus was Communications and Management. Edward Patience, Director of Marketing, is responsible for all aspects of QQSolutions’ corporate and product marketing communications, as well as www.underwritersinsider.com

its partner programs. Patience brings more than twenty years of technology marketing experience in commercial software solutions. He has a broad background in product marketing, brand development, social media and technology sales, working with established and start-up technology companies in e-commerce, healthcare, mobile technologies and supply chain management. Patience earned his Bachelors of Business Administration degree, with a focus in Information Technology, from Wilfred Laurier University, in Waterloo, Ontario.

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KIM KOMANDO

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