IN THIS ISSUE DECEMBER 2017 VOL 13 ISSUE 12
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How To Do A free Background Check Online Payment Of Appraisal Award Defeats Bad Faith Claim Miami Homeowner Fails In Attempt To Collect $178,200 In Fraudulant Water Damage Claims New York DFS Fines Underwriters At Lloyd’s Of London, et al, $1.47 Million
A.M. Best To Host London Conference To Examine The Latest Updates To Rating Criteria & Methodology
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How To Respond To A Cyber Breach
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Georgia Busts CPA For Insurance Fraud
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Innovative Uses Of Social Media To Combat Insurance Fraud, Improve The Insurance Experience
Florida Keys Insurance Agent Charged With Fraud and Grand Theft
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Unbelievable Vintage Ads - Another In Our Series Of Ads From The 30s, 40s, 50s & 60s.
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IRMI Energy Risk & Insurance Conference To Feature Hank Watkins of Lloyd’s North America
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Don’t Make Me MADD! The Insider Advisor Fields A Question Of Blood Alcohol Level And Buying Jewelry...
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USI Insurance Services Announce The Closing Of The Acquisition Of Wells Fargo Commercial Insurance Business
Washington Insurance Agent Faked Own Workers’ Comp Injury
California Insurance Commissioner Jones Sets Perfect Example Of A Disingenuous Progressive
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California Father And Son Sentenced in $400,000 Workers’ Comp Scam
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Insurance Fraud Fail Compilation - Hilarious Video Collection of Just How Far People Will Go To Fake Insurance Claims
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eith B. Daniels, Jr., J.D. is a graduate of the University o f Wisconsin Law School and a US Army veteran and resides in the Greater MinneapolisSaint Paul area. He has been involved with cyberliability and internet security issues for about 20 years working with Lloyd’s of London and several domestic insurance companies and their insureds.
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DECEMBER 2017
TECHNOLOGY
HOW TO DO A FREE BACKGROUND CHECK
S
Really Cool Info - by Kim Komando
uppose a new guy moves into your neighborhood. Let’s call him Bobby Smith. Before his moving van is even unpacked, Bobby introduces himself. He’s friendly and good-humored, and he says you should come over for a barbecue sometime.
more streamlined. But you might be just as easy to investigate.
Start with Google Google is the easiest place to begin your search. Just enter the person’s full name in quotation marks, in this case, “Bobby Smith.” There are plenty of Bobby Smiths out there, so you’ll want to narrow your search using other information, such as what city he lives in. If he just moved to your neighborhood from Cincinnati, you’ll want to include that city instead of your own.
But there’s something off about him. So you decide to find out more about him— his career, his past, anything suspicious. But short of hiring a private investigator, what can you find out? A lot, actually. You’d be amazed how much public information is tangled up in the web. No matter how hard we might try to disguise our past, much of our lives has been digitized and archived, just waiting to be discovered. This is a double-edged sword, of course. If you want to find information on other people, that process has never been DECEMBER 2017
So what can you learn about someone? Here’s how you can get the dirt on Bobby, for free.
It’s a great idea to look yourself up and erase what you don’t want readily accessible. Click here to learn how to remove your personal information from the most popular people search sites.
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If Bobby likes to make friends, a bunch of different social media sites may pop up: Facebook, Instagram, LinkedIn, Pinterest, and scores of others. Many people make their social media profiles invisible to non-
See Kim Komando Pg 44 www/underwritersinsider.com
5
CLAIMS & THE LAW
PAYMENT OF APPRAISAL AWARD DEFEATS BAD FAITH CLAIM Expert Analysis & Commentary by Barry Zalma, Esq., CFE There can be no Tort of Bad Faith if there is no Breach of Contract
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hen a first party property insurer disagrees with its insured on the amount of loss the policy allows the dispute to be resolved by a type of arbitration called “appraisal.” An appraisal award can be made a judgment and establishes the amount of loss and nothing else. If the amount of loss established by an appraisal award is paid the promises made by the policy are kept in full. The tort of bad faith exists when an insurer wrongfully deprives the insured of the benefits promised by the policy. In Oscar
Ortiz v. State Farm Lloyds, No. 04-17-00252-CV, Fourth Court of Appeals San Antonio, Texas, https://www.saul.com/sites/ default/files/sites/default/files/ documents/2017-04-17-00252-
Ortiz submitted a claim to State Farm for damage to his property resulting from wind and a hailstorm. After inspecting the property, State Farm determined Ortiz sustained $723.53 in damages to his property and informed Ortiz that no payment Join Barry Zalma’s Blog: would be made for the claim http://www.zalma.com/blog since the damage amount did not exceed Ortiz’s deductible. After a second inspection, State Farm found some additional damage cv.pdf (November 8, 2017) Oscar but the damage total still did not Ortiz claimed to the appellate exceed Ortiz’s deductible, so no court that the trial court erred payment was made. in granting summary judgment in favor of State Farm Lloyds on On April 14, 2015, Ortiz sued Oscar Ortiz’s Texas Insurance State Farm asserting contractual Code and common law bad faith and extra-contractual claims. claims following State Farm’s On August 4, 2015, State Farm payment of an appraisal award. invoked the appraisal process provided in Ortiz’s insurance policy, and Ortiz’s lawsuit was BACKGROUND abated pending the completion
Barry Zalma, Esq., CFE, practiced law in California for more than 43 years as an insurance coverage and claims handling lawyer. He now limits his practice to service as an insurance consultant and expert witness specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He founded Zalma Insurance Consultants in 2001 and serves as its only consultant. 6
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of the appraisal process. On December 15, 2015, an appraisal award was issued in the amount of $9,447.52. On December 30, 2015, State Farm paid Ortiz $4,243.93, representing the actual cost value of the loss minus the deductible and recoverable depreciation. State Farm recognized that Ortiz would be entitled to the depreciation after he made the repairs.
With regard to an insured’s common law bad faith claim evidence showing a bona fide dispute about the insurer’s liability on the contract does not rise to the level of bad faith. Instead, in order to defeat a summary judgment on a common law bad faith claim, the insured had the burden to raise a genuine issue of material fact that the insurer failed to timely investigate the claim or On February 24, 2016, State the insurer committed some act, Farm filed a motion for so extreme, that it would cause summary judgment asserting its injury independent of the policy payment of the appraisal award claim. estopped Ortiz from maintaining a breach of contract claim. State Farm further asserted the payment of the appraisal award also precluded Ortiz’s extra-contractual claims. The trial court granted summary judgment in favor of State Farm, and Ortiz appealed. ANALYSIS
1. As a general rule, an insured cannot recover policy benefits as damages for an insurer’s statutory violation if the policy does not provide the insured a right to receive those benefits. 2. An insured who establishes a right to receive benefits under the insurance policy can recover those benefits as actual damages under the Insurance Code if the insurer’s statutory violation causes the loss of the benefits.
The tort of bad faith is often abused by insured’s unhappy with the resolution of their claim. This case is a perfect example since the insured sued and continued his bad faith claims after being paid, in accordance with the policy conditions, everything the insurer owed under the contract.”
An insurer’s payment of an appraisal award entitled the insurer to summary judgment on its estoppel defense to an insured’s contractual claims unless the insured raised an issue of fact as to a ground for setting aside the appraisal award. Texas law clearly holds the discrepancy between the initial estimate and the appraisal award cannot be used as evidence of breach of contract. DECEMBER 2017
timely paid all covered damages determined by the appraisal award, the insured’s statutory bad faith claims were foreclosed.
With regard to the insured’s statutory bad faith claims under the Texas Insurance Code and DTPA statutory bad faith claims are based on the same wrongful conduct underlying the insured’s common law bad faith claim, there can be no liability on the statutory claims if there is no merit to the common law bad faith claim. Since State Farm Table of Contents
3. Even if the insured cannot establish a present contractual right to policy benefits, the insured can recover benefits as actual damages under the Insurance Code if the insurer’s statutory violation caused the insured to lose that contractual right. 4. If an insurer’s statutory violation causes an injury independent of the loss of policy benefits, the insured may recover damages for that injury even if the policy does not grant the insured a right to benefits, and, See Zalma Page 41 www/underwritersinsider.com
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NEWS
MIAMI HOMEOWNER FAILS IN ATTEMPT TO COLLECT $178,200 IN FRAUDULANT WATER DAMAGE CLAIMS Every Five Years Beginning in 2005, Renee De La Maza Made Another Claim To Different Insurors For The Same Water Damage
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IAMI, Fla. – Chief Financial Officer (CFO) Jimmy Patronis and the Florida Department of Financial Services (DFS) announced today the recent arrest of Renee De La Maza for insurance fraud and grand theft following her attempt to file a damage claim against a new insurance policy after already receiving a $60,000 insurance payout from her former insurance provider for the same damages. Maza’s insurance provider became suspicious of her recent claim-filing activities and referred Maza’s insurance claims to investigators with DFS’ Bureau of Insurance Fraud for an in-depth review. Investigators confirmed Maza initially filed an insurance claim in
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The Underwriter’s Insider
2005 with her previous insurance provider after her home received water damages from Hurricanes Katrina, Rita and Wilma. Shortly after the claim was filed, Maza received more than $60,000 to make the appropriate repairs to her home.
Maza submitted another claim to the new insurance provider in August 2015 for alleged water damages for the same areas listed in Maza’s July 2015 claim. However, this time she filed her claim for an estimated $178,200 in damages.
Five years later, Maza filed a supplemental claim for damages that were not previously included in her claim from 2005. However, the 2010 claim of damage was denied based on similarities to the damages already reported in the 2005 claim. The insurance company noted Maza made very few repairs to the home following the 2005 claim.
The Bureau’s investigation revealed Maza’s prior claims for damages were never disclosed to her new insurance provider and the claims she made in 2015 were almost identical to the claims she made in 2005 and 2010. This led investigators to believe the 2015 claims were fictitious and filed in an attempt to fraudulently collect an additional insurance payout.
The investigation went on to show that in 2015, Maza created a new policy with a different insurance provider and she filed an insurance claim for wind and rain damage that allegedly occurred in July 2015. Maza submitted a proof of loss to her insurance company for approximately $43,500 in damages. Maza’s insurance company offered to repair the alleged damages, but Maza chose not to accept the option of repair. Maza’s claim was denied after refusal of repair. Table of Contents
Maza was arrested October 30, 2017, by DFS’ Bureau of Insurance Fraud detectives and was charged with filing a false and fraudulent insurance claim, application fraud and grand theft for endeavoring to steal $178,200 from her insurance company. This case is being prosecuted by the Office of State Attorney Katherine Fernandez Rundle and if convicted, Maza could face up to 60 years in prison. DECEMBER 2017
NEWS
NEW YORK FINES UNDERWRITERS AT LLOYD’S OF LONDON, CLEMENTS & COMPANY AND UNITED NATIONS FEDERAL CREDIT UNION $1.47 MILLION Settlement with DFS Establishes New Licensed Program to Ensure UN Employees Are Fully Protected under New York Law
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ew York Financial Services Superintendent Maria T. Vullo today announced that the Department of Financial Services (DFS) has entered into a consent order with Clements & Company, Underwriters at Lloyd’s of London, and the United Nations Federal Credit Union (UNFCU) for offering, marketing and underwriting an unlicensed credit and debit card-based life insurance program for UNFCU members. The order requires the parties to pay a total of $1.47 million in fines for unlicensed life insurance business and to establish an insurance program with a DFSlicensed insurer. The insurance program offered guaranteedissue term life insurance to UNFCU’s members in more than DECEMBER 2017
210 countries and territories. A total of more than 4,300 policies were sold, including to 804 members listing New York as their primary location. “DFS is taking this action to ensure that consumers receive the unparalleled protections provided by New York Insurance Law,” Superintendent Vullo said. “This case is emblematic of how licensing and regulatory oversight is necessary to protect consumers from improper schemes. We appreciate that these companies have now committed to maintaining coverage for U.N. employees and alumni, and are especially pleased that DFS licensee, Monitor Life Insurance Company of New York, has stepped up to take on these policies.”
renew a policy regardless of the insured’s health; nor were the policy rates sufficient to support the program, as required by New York Insurance Law. To bring the program into compliance and ensure that U.N. workers and alumni maintain their coverage for years to come, DFS is requiring the parties to transfer the business over to a New York-licensed insurer, Monitor Life Insurance Company of New York. Prior to this settlement, the program had been running at a severe loss and was unsustainable.
To ensure a smooth transition of consumers to the new program, DFS is requiring that the parties provide numerous notices to affected certificate holders, as well as reporting to DFS on the number of certificate holders The insurance offered and that have transitioned to the sold to UNFCU members did new program. not meet New York standards for policies sold by insurers UNFCU members who purchased approved by DFS. For example, unlicensed life insurance through the policies did not provide this program and have questions for the mandatory “conversion should contact Clements at 800privilege” under which insurers 693-1087 or CPS2@clements. are required to update or com; or DFS at 800-342-3736. Table of Contents
www/underwritersinsider.com
9
NEWS
A.M. BEST TO HOST LONDON CONFERENCE TO EXAMINE THE LATEST UPDATES TO RATING CRITERIA AND METHODOLOGY
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ONDON--(BUSINESS WIRE)--A.M. Best will host its annual Insurance Market Briefing – Europe & Methodology Review Seminar on Wednesday, 15 November, from 8:30 a.m. to 4:00 p.m., at ETC Venues St. Paul’s in London. The briefing will be held from 8:30 a.m. to 1 p.m., and the seminar will run from 2:00 p.m. to 4:00 p.m. The conference will provide a platform for leading A.M. Best rating analysts and industry experts to discuss the impact of prevailing economic and political conditions and rating trends for (re)insurers in key segments of the European (re)insurance sector and the London Market.
conducted by A.M. Best. A panel of senior industry spokespersons will deliberate on the global reinsurance sector’s strains and opportunities, including the impact of insurance-linked securities (ILS) on the sector. The annual Methodology Review Seminar will examine the latest updates to rating criteria and will provide attendees with a better understanding of the modifications recently made to Best’s Credit Rating Methodology
(BCRM) and the proprietary Best’s Capital Adequacy Ratio (BCAR) model. Registration can be made online at http://www.ambest.com/ events/imbeurope/. Enquiries can be addressed to events@ambest. com. A.M. Best is the world’s oldest and most authoritative insurance rating and information source. For more information, visit www. ambest.com.
Image Credit: Creative Commons
Jon Hancock, Performance Management Director, Lloyd’s of London will deliver the keynote address on the topic: Performance Management in a changing world. This year’s market briefing will also offer thematic sessions on issues of protectionism, Brexit, M&A and reinsurance trends based on insurance market intelligence and research as 10
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DECEMBER 2017
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11
THE LAAIA 2017 TRADE FAIR CLICK IMAGE BELOW TO VIEW
ANALYSIS
HOW TO RESPOND TO A CYBER BREACH Timely Tips From A Cyber Security Expert By Keith B. Daniels, Jr., J.D.
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ata breaches have become a regular part of the news. Yahoo advises that 3 billion email accounts have been breached. Anthem announces that more 75 million accounts including private health information have been breached. Equifax, one of the big 3 credit reporting agencies, advises that more than 143 million accounts have been breached revealing almost all personal data of close to half the US population. That is on top of Target, TJ Maxx, Home Depot and numerous others in the past few years. Now, just as the Christmas shopping season is about to kick off, Uber (which may carry home many Christmas party revelers),
announced that it was breached a year ago and that 57 million user and driver accounts were breached, and it paid $100,000 to the hackers to delete the data. It is dubious as to whether that occurred.
directions or instructions of what to do next? Find out what information was stolen. Was it your name, your account number, social security number, password or what? You may feel calmed to find out that your stolen information was Data breach is not only a large encrypted. Don’t be! The thieves company worry. Individuals can likely have broken the encryption also be a victim of a data breach. If already, so move on. you, as an individual or company, find your data breached, here are 2. Change your passwords. Don’t some steps you should take: make it easy. Don’t use common names like your name, kids, pets, 1. If you learn that your financial schools, or anything that your institution or any company you do friends or strangers can deduce business with has been breached, from your social media accounts, contact the “breach” company etc. Don’t keep a copy on a sticky as soon as possible. That means note on or by your computer. Keep a contact the company whose data list of your passwords in a safe place. was breached. Try to determine With different accounts having what is the damage and what are they going to do. Do they have any See Respond To Cyber Breach Pg 40
K
eith B. Daniels, Jr., J.D. is a graduate of the University of Wisconsin Law School and a US Army veteran and resides in the Greater Minneapolis-Saint Paul area. He has been involved with cyberliability and internet security issues for about 20 years working with Lloyd’s of London and several domestic insurance companies and their insureds. Keith is available for speaking engagements. He can be reached at keith@mycybercounsel. com or 715-379-6511. 14
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DECEMBER 2017
NEWS
GEORGIA BUSTS CPA FOR INSURANCE FRAUD Earle Turner Sr. Is Accused Of Taking Out 19 Life Insurance Policies On Elderly Clients Without Their Knowledge.
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tlanta, GA – Insurance Commissioner Ralph Hudgens announced that Earle Turner, Sr., 67, of McDonough was arrested today by Special Fraud Investigators from the Georgia Department of Insurance (GADOI). Turner, a Certified Public Account was taken into custody at his DeKalb County business and charged with 19 counts of insurance fraud, 11 counts of identity fraud, and one count of theft by deception. Turner is accused of falsifying multiple life insurance applications and collecting over $11,000 in death benefits. "Apprehending this suspect is a victory for all Georgia insurance consumers," said Commissioner Hudgens. "Insurance fraud results in higher costs for us all."
Mutual of Omaha of suspected fraudulent activity by Earle Turner, Sr. Mutual of Omaha indicated that they discovered three life insurance policies in their system with Turner named as the beneficiary. The insurer contacted the individuals listed as the policyholder, and each stated they had not applied for life insurance through the company and had not authorized Turner to do so on their behalf. Following a 6‐month investigation, GADOI Special Fraud Investigators found that Mr. Turner had taken out life insurance policies on nineteen elderly adults without their knowledge or approval and received approximately $11,345.70 in death benefit payouts on five of the policies.
According to the investigation, in May 2017, the Georgia Department Investigators also determined of Insurance was notified by that Mr. Turner used the personal information he Watch WSBRadio Video of Turner’s Arrest obtained from preparing his victim’s taxes to file the fraudulent policies. If convicted, Turner could face up to 10 years in state prison. DECEMBER 2017
“We have found no evidence that this suspect has an insurable interest in any of these individuals,” said Deputy Insurance Commissioner Jay Florence. “Fortunately our investigators stopped this scheme before more policies were submitted without the consumer’s knowledge.”
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Earle Turner Sr., 67
This investigation was conducted with assistance from Mutual of Omaha’s Corporate Investigation Unit. Commissioner Hudgens would like to thank the DeKalb County Police Department for providing support in the arrest of the suspect. The case will be prosecuted by the DeKalb County District Attorney's Office. www/underwritersinsider.com
15
NEWS
INNOVATIVE USES OF SOCIAL MEDIA TO COMBAT INSURANCE FRAUD, IMPROVE THE INSURANCE EXPERIENCE of their lives on social media that contradict the basis of their claim, such as semi-pro athlete playing well in local sports leagues while collecting workers' compensation benefits.
approaches place considerable emphasis on interconnectivity between online information platforms such as social media, traditional websites, and public EW YORK, Nov. 17, 2016 / record databases. But with one PRNewswire/ -- QBE North billion new social media posts America, an operating division of global insurer QBE "Finding new methods to fight appearing every two days*, Insurance Group Limited, has fraud helps keep insurance the massive volume of social released a new white paper titled premiums down for everyone," media content is also its biggest "Innovations in Using Social Media said Dan Franzetti, Chief Claims challenge. To cope with this flood to Fight Insurance Fraud, Improve Officer, QBE North America. of information, cutting-edge "Some studies suggest that as carriers are now deploying big Service." much as 10 percent of all property data analytical tools. Stories abound of how social and casualty claims could media has opened an entirely have fraudulent elements, and "There is an increasing array of new channel of communication leveraging the power of social powerful tools to help make for scammers willing to commit media helps us more effectively sense of all the data," said Brian fraud, but insurance companies and precisely identify instances of Wilson, VP, Special Investigations are increasingly turning the fraud to drive the cost out of the at QBE North America. "Textmining software parses and tables by using social media to system." analyzes unstructured text-based detect fraudulent claims. The paper notes several examples of The white paper notes that the information. Social customer claimants publicly sharing facts most recent and best service relationship management tools search millions of social media posts and platforms to find activity related to recent claims. Predictive modeling helps spot suspicious activities before fraudulent claims are paid. Social network analysis sifts through large amounts of data to uncover hidden relationships among people, places, locations, accounts or virtually any other type of entity. Lastly, the very best
New White Paper from QBE North America
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See Combat Insurance Fraud Pg 35 16
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DECEMBER 2017
Lend A Helping Hand Florida Needs You Click Here To Donate
DECEMBER 2017
Insurance Agents Helping The Community The LAAIA has set up a fund to help those who were hit the hardest by Hurricane Irma. Help us by clicking on the link and donate whatever you can (no amount is too small)
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17
NEWS
FLORIDA KEYS INSURANCE AGENT CHARGED WITH FRAUD AND GRAND THEFT
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EY LARGO, Fla. – CFO Jimmy Patronis and the Florida Department of Financial Services (DFS) announced the recent arrest of Richard Joseph Girard, a licensed insurance agent and owner of A-Rated Insurance Group. Girard allegedly submitted a policy application for property insurance for a Key Largo client but provided fictitious supporting documentation that falsified the age of the roof of the property.
condition of the property’s roof and structure, allowing him to obtain the insurance policy and receive a commission of $1,528. Girard was arrested and booked into Plantation Key Detention Center without incident on November 13, 2017, and has been charged with insurance fraud, uttering forged instruments, forgery and grand theft.
This case will be prosecuted by the Monroe County State Attorney’s Richard Joseph Girard, 38 October 2016. However, in order Office and if convicted, Girard As a result, Citizens Insurance for the policy to be accepted could face up to 20 years in prison. accepted the application, initiated and to receive his commission, a policy and Girard received Girard used older photos and Once formal charges have been commission on the successful an older inspection report from brought forth, DFS’ Division of insurance sale. a previous property on the new Insurance Agents and Agency application form. By doing so, Services will suspend Girard’s Following the acceptance of Girard concealed the actual insurance license. the insurance application, Citizens Insurance suspected the application submitted by Girard may have been fraudulent and referred the matter to investigators with DFS’ Bureau of Insurance Fraud. As a result of the investigation, DFS investigators confirmed Girard submitted an inspection report and policy application for a property located in Key Largo, FL 18
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(800) 229-2009 ext 3 Mention code UWI sales@accuagency.com Request more info at http:/ /accu.agency/UWI www/underwritersinsider.com Table of Contents
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THE INSIDE TRACK - BREAKING NEWS “Mad Mike Hughes” Denied Rocket Flight
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ad Mike Hughes, 61, is an interesting fellow, being a card-carrying member of the Flat Earth Society as well as a self-
Image Credit: Creative Commons
Credit: Mike Hughes Facebook
described rocketman. It is not known if Hughes was attempting to certify the Earth as flat or he was just wanting to see it from altitude, but his planned launch from California’s Mojave Desert has been cancelled by those spoilsports over at the Bureau of Land Management. The BLM believes private rocket launches on public land are inappropriate. The rocket, and launcher, designed to reach 1800’ and steam powered, was hand built by Hughes from spare parts and an old RV at a cost of $20,000. 20
The Underwriter’s Insider
Hughes had planned on parachuting back to earth as the rocket reached it’s maximum height.
WA Insurance Agent Sentenced
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fter pleading guilty, A Lake Stevens, WA insurance agent will spend 60 days behind bars plus restitution for faking a workers comp knee injury - while running his insurance agency! 53-year-old James Kooy received $233,000 in comp payments from the Washington State Dept. of Labor during the period he claimed he was too injured to work due to a knee injury. Kooy was started collecting benefits in 2008 for an injury he sustained while working as a heavy equipment operator, but it is unknown how or when he got into the insurance business. Records showed he was listed as halfowner and registered agent of the By The Lake insurance agency which earned $800K in revenues during the period. Table of Contents
His Heart’s Not In It...
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linicians involved in a study have recently noticed potential heart damage in the heart muscle of male triathletes: “Although we cannot prove the exact mechanism for the development of myocardial fibrosis in triathletes, increased systolic blood pressure during exercise, the amount and extent of race distances and unnoticed myocarditis could be cofactors in the genesis of the condition,” according to the study’s lead author, Dr. Jitka Starekova. “The clinical relevance of these scars is currently unclear [but] they might be a foundation for future heart failure and arrhythmia [irregular heartbeat].” Well, that’s my last triathlete competition.
CVS To Acquire Aetna
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n one of the largest M&As of the year, CVS has agreed to acquire Aetna for about $69 billion. The combination of the one of the largest drug-store chains DECEMBER 2017
THE INSIDE TRACK - BREAKING NEWS with one of the country’s largest health care insurors would create a new and interesting juxtaposition of
interests in the healthcare/ pharmaceutical industry. If the deal goes through, CVS will be purchasing Aetna for about $207 per share, $145 of that in cash. According to analysts, a big driver to this deal was Amazon’s purported entry into the United States’ pharmacy business which must have been giving CVS much cause to contemplate it’s future strategies.
Image Credit: Creative Commons
Ring In Lake Prompts Insurance Buy
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n Austin, Texas, there’s a restaurant, the Gnarly Gar, with an outdoor deck overhanging a portion of the lake that’s 74 ft. deep. Hanna Austin had removed her wedding ring while eating on that deck last month while her husband accidentally brushed the ring to the floor where it fell DECEMBER 2017
through the cracks in the deck. Fortunately, an Austin scuba diver, Robert Weiss, found the ring on the bottom. Took him only 10 minutes. The first thing Hanna and her husband did after leaving the restaurant, was to add a jewelry amendment to their homeowners policy.
She Just Wanted His Insurance Info!
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hen Jazmine Davis, 24, found herself in a minor vehicle accident with 27-year old Andre Crew, she approached him for his insurance info. According to The Sacramento Bee, it didn’t go well: “He didn’t respond,” Davis told the station. “He just had a blank face.” Davis decided to try to take a picture of Crew’s vehicle tags instead, police say, when Crew suddenly hit the gas and tried to pin her between the two stopped vehicles. Davis was forced to leap onto the hood of Crew’s Table of Contents
car to avoid being crushed between the vehicles when Crew turned and began driving down the road again - with Davis still on top of his car, police say. He drove for a short time before attempting to hit yet another car to try to throw her off the hood of the vehicle, Davis told investigators. “It was in his eyes,” she told Fox 5. “I could tell when he accelerated he was going to try to crash his car to get me off the hood.” She dived off before that happened - and ended up with a broken toe and swollen leg, according to the station.” Crews was charged with multiple traffic and criminal offenses.
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21
NEWS/OPINION
CALIFORNIA INSURANCE COMMISSIONER JONES SETS A PERFECT EXAMPLE OF A DISINGENUOUS PROGRESSIVE The Trump Administration Has Proposed Eliminating The Requirement That Obamacare Policies Provide “Free” Contraceptives. Far-Left CA Commissioner Davey Jones Issues Sputtering-Mad Press Release / Progaganda Piece Loaded With Lies & Misstatements By Ron Manera, Senior Editor
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alifornia’s Insurance Commissioner Davey Jones - already taking heat from other state insurance commissioners for interjecting himself into climate change politics has found a new way to foist his politics on California insureds trying to keep their health insurance costs under control. Let’s dissect the press release First, in order to dramatize the Trump Administration’s proposal, Jones dishonestly conflates the cost of contraceptives with access to contraceptives. Nothing in the current proposal would effect any women’s access in any way - only removing the mandate that they be provided free of cost by insurers. The cost? As little as $15 per month... In fact, Jones is telling a whopper every time he uses the word “access” in his diatribe. Have women lost access to sun-tan lotion or lipstick or hair color or perfume or margaritas or iPhones? None of those items are covered under any insurance policy . Jones claims his “declaration,” referenced in the press release provides “overwhelming evidence of immediate harm from Trump’s order.” 22
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Here, direct from his declaration is his “overwhelming evidence:” “CDI staff and I heard from women who said that prior to contraceptives being available without co-pays or deductibles, there were months when they had been unable to afford to fill their prescriptions for contraceptives.”
You kidding Davey? One unsupported, anecdotal sentence in your own declaration establishes “overwhelming evidence?” In fact, Jones has only established that some women may have to prioritize contraceptives if they wish to participate in recreational sex.
CALIFORNIA SEEKS INJUNCTION TO BLOCK TRUMP CONTRACEPTIVES RULE
Insurance Commissioner Dave Jones’ court declaration provides overwhelming evidence of immediate harms from Trump order denying women access to contraceptives November 10, 2017
SACRAMENTO, Calif. — "Thanks to the Affordable Care Act, health insurance policies must cover contraceptives without any co-pays or deductibles. President Trump's new rule would allow employers to interfere with women's constitutionally protected right to make their own health care decisions by allowing employers to deny women access to contraceptives. Access to contraceptives is key to giving women control over their reproductive health which in turn impacts all aspects of their lives. I have talked with women who could not always afford to fill their prescriptions before the ACA made contraceptives available without cost. We will not stand by and let President Trump get in the way of women being able to make fundamental decisions about reproductive health care for themselves. President Trump's rule, if allowed to stand, will deprive women of their rights, while increasing the number of unintended pregnancies and abortions. Every resource at our disposal should be used to fight President Trump's unconstitutional infringement upon a women's access to contraceptives." Table of Contents
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Jones, who according to the CDI’s website, “began his career as a legal aid attorney, providing free legal assistance to the poor,” one would presume, has, at some point, read the U.S. Constitution, yet he smugly asserts that the Trump a d m i n i s t r a t i o n ’s proposal is an “unconstitutional infringement upon a women’s access to contraceptives.”
is no mention of contraceptives in the U.S. Constitution. For Jones to assert a constitutional mandate for insurers to provide free contraceptives borders on the ridiculous.
own $15 per month on her own birth control will require “Every resource at our disposal... to fight President Trump’s unconstitutional infringement upon a women’s access to contraceptives.”
Progressives like Jones don’t seem to understand, that even under the present ACA, contraceptives were not “available without cost.” It’s just that taxpayers or other insureds were footing the bill.
Except women will have access, it’s not a constitutional issue and those “resources” Jones wants to squander to advance his far-left political agenda belong to the taxpayers!
Jones illustrates a bad Dave Jones, habit of liberals - that of Jones must see himself CA Insurance finding “constitutional as a super hero, holding Commissioner rights” for any back the tide of inevitable government-provided benefit they health-care reform where the may find useful to promote at the terrible, frightening prospect of time. It goes without saying there a woman having to spend her DECEMBER 2017
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Editor’s Note: Since our reportage went live, the CA Dept. of Insurance substantially amended their press release from the original copy published here... www/underwritersinsider.com
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WORKERS’ COMP NEWS This Month’s Workers’ Comp Fraud Story Sponsored By MyPEOAgency.
CALIFORNIA FATHER AND SON SENTENCED IN $400,000 WORKERS’ COMP SCHEME
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ALINAS, Calif. — Jaime Rosario Del Real, 61, and son Israel Del Real, 37,both pleaded guilty to four felony counts for their role in a $400,000 insurance fraud scheme denying workers’ compensation insurance and medical care for injured workers.
in jail, 10 years felony probation, and ordered to pay $382,951 in restitution. This case was prosecuted by the Monterey County District Attorney’s Office.
“Business owners are responsible for the safety and care of their employees,” said Insurance Commissioner Dave Jones. “Employers who fail to The father and son duo were sentenced to 250 days carry workers’ compensation insurance or pay for
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the medical care for injured workers violate the law and put their employees at risk. Our detectives and the Monterey County District Attorney’s team succeeded in taking another dishonest employer out of the underground marketplace.� Doing business as Del Real Produce and Packing and Del Real Packing, LLC, the Del Reals worked as farm labor contractors providing laborers for picking and packing lettuce for growers in Monterey County and Yuma Arizona. After receiving information from an insurer, Department of Insurance detectives found the Del Reals had concealed injuries their workers sustained and refused to pay for medical treatment or provide other benefits the injured workers were entitled to. Jaime Rosario Del Real, 61
The investigation also revealed that over a five year period, the Del Reals lied more than 20 times in order to obtain reduced insurance premiums. As part of their premium theft the Del Reals kept two sets of Employment Development Division (EDD) forms, with different employees and a different number of employees listed, which allowed the Del Reals to evade paying payroll taxes. Israel Del Real, 37
DECEMBER 2017
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THE STORY OF THE F-117 NIGHTHAWK - THE 1ST STEALTH AIRCRAFT - FASCINATING!
UNBELIEVABLE VINTAGE ADS
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othing illustrates the changes in our national culture better than vintage ads from the Mad Men era or earlier - many of which would be considered over-the-top sexist, politically incorrect or just plain
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his ad isn’t even that old, but at the time it came out, it was apparently still possible to convince folks that a Pall Mall cigarette was the best defense against a sore throat. Even Santa was smoking the foul things great message for the kids!
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NEWS
IRMI ENERGY RISK & INSURANCE CONFERENCE TO FEATURE HANK WATKINS OF LLOYD’S NORTH AMERICA Mr. Watkins brings a wealth of knowledge on emerging risks and the insurance industry.
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allas, TX, November 15, 2017—International Risk Management Institute, Inc. (IRMI®), is pleased to announce our distinguished keynote speaker for the IRMI Energy Risk & Insurance Conference (ERIC), to be held March 6–7, 2018, in Houston.
As an industry leader with a premier market and more than 30 years of experience in the insurance industry, Mr. Watkins brings a wealth of knowledge on emerging risks and the insurance industry. He will share his unique insights on how recent and future global catastrophes will impact On Tuesday, March 6, join us for the economy and how insurance the Opening General Session, will continue to play a key role featuring Hank Watkins, president in enhancing risk mitigation and of Lloyd’s North America. Mr. improving economic resilience to Watkins is responsible for catastrophes. Lloyd’s operations and market development activities in the For more information on the United States and Canada, IRMI Energy Risk & Insurance including offices in Atlanta, Conference, please visit https:// Boston, Chicago, Dallas, Frankfort w w w.irmi.com/conferences/ (Kentucky), Los Angeles, Montreal, e n e r g y - r i s k - i n s u r a n c e New York, Toronto, and the US conference/. Virgin Islands.
DECEMBER 2017
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About IRMI: Since 1978, International Risk Management Institute, Inc. (IRMI), has been the premier authority and educator for risk management, insurance, and legal professionals. IRMI simplifies the management of risk by publishing resources for technical content and providing continuing education, certifications, and conferences. For more information, visit IRMI. com.
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“The Final Authority on Everything!” WARNING!
The Advisor has been known to be politically incorrect and may send certain Millennials scurrying to their safe space. Also not recommended for Progressives who are easily offended. Please read at your own risk.
Don’t Make Me MADD!
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went to a party with my girlfriend over Thanksgiving and had about 4 beers before leaving. I was pretty sure I was well below the legal limit (I’m 220lbs) and no where near drunk, but I was sleepy and wanted to stop and pick up a cup of coffee. My GF said, “don’t bother,” because I will still be drunk but just a “wide-awake drunk.” Settle an argument. Doesn’t a cup of coffee or a No-Doz help if you’ve had a couple of drinks and have to drive home? - T.T. Tallahassee, FL
ADVISOR
your blood alcohol level, assuming that you drank the four 12oz beers over a two hour period, would still have only given you a .03 blood alcohol level - well under the .08 considered legally drunk in most venues - but you could have easily been fatigued and sleepy. The Advisor believes it has been Mothers Against Drunk
Drivers that has been responsible for disseminating the tired old line about “wideawake drunks.” They may also be responsible for hundreds of deaths due to sleepy drivers who took their bad advice. Ask yourself this: Would you rather be sharing the road with a wide-awake drunk a falling-asleep drunk? In a perfect world, no one will
According to one online blood alcohol calculator, 30
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Image Credit: Creative Commons
drink and drive. In the real Watch This... world, it happens. For those foolish enough to drive had decided to buy my impaired - and for those may wife a nice watch for just be drowsy - I’m hoping they stop and have a couple Christmas so I went to the of cups of strong black coffee mall and visited several jewelry stores. Every single before proceeding. one of these stores had Why would MADD offer worked really hard to hide such bad advice? MADD, the price of every watch, in in our opinion, has become fact, every piece of jewelry politicized and radicalized into in the display case. What a group of neo-prohibitionists is the gosh-darned point who will not rest until they of this? Do they think this have lowered the legal BAC encourages men to stop and to 0.0. MADD’s real agenda ask questions? It encouraged seems to be anti-alcohol, not me to leave the jewelry store anti-drunk driving and the and go to Home Depot to group’s founder has resigned buy her a table saw. (She’s been asking about new lawn over this very issue.
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furniture) What gives? J.L. Douglasville, GA I think you have asked the question of the year J.L. and one every guy, at least, can relate to. This lame retail practice, a jewelry store certainty, is apparently intended to cause you to stop and engage the jewelry salesperson who can then look at you pitifully while explaining you will not be able to purchase that Raymond Weil watch on your pathetic $150 budget. For male shoppers at least, the Advisor believes hidden jewelry store pricing may be the chief reason male gift buyers would rather eat mud than shop for jewelry. www/underwritersinsider.com
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220/440 Lic. Ins Agent Needed - Boca
FREE CLASSIFIED RULES: Submit all ads online at: www.underwritersinsider. com/classifieds. Ads must be less than 501 characters plus a title line. Eligible free classifieds include help wanted, position wanted, personal ads, agency for sale/purchase, or the one-time sale of an item or items. Place Ad HERE! REGULAR CLASSIFIED RULES: Submit all ads online at: www.underwritersinsider. com/classifieds. Only $1.00 per word, including title line and response info. Payment must be received prior to print date. Ads run 3 mo.
Insurance Agent With 220 License We are looking for Insurance Agent with License 220 In Kissimmee, Florida Are Full Time on Agency. Please call 407-847-2539 for Interview Ask for Alex Ramos alexinsurance@aol.com 17-6
Help us expand our Agency (From Home)!! We are seeking an energetic professional to work parttime in a virtual capacity assisting us with recruiting and supporting professional sales agents across the United States and Canada.For detailed information on our company and this non-sales virtual opportunity please contact us today with the following link http://apply. harvardbenefits.com/269541 16-10
FREE CLASSIFIEDS! HELP WANTED — POSITION WANTED 4 — SALE ITEMS
CLICK HERE! 32
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440 or 220 in Boca Raton, Part Time or Full Time Experienced or Trainee; Agent and Customer Service Rep in family owned agency in Boca Raton. Full or Part time. (Flexible Hours) Personal Lines CSR; salary plus bonus. Commercial Agent; 50% commissions and residual. Most important Florida markets and several national markets available. We can compete with the “Big Boys” with our national affiliations. Email your resume to agencyops@gmail.com. or FAX to: 561-416-7221. EOE 17-2
Tampa Area Commercial Producer Agency Established 2006 seeks Outside Commercial Producer. Cutting Edge tech! Generous Comp and Possible Equity Buy In. Experience and FL 220 a must! Resume’ to info@nusurance.com 16-10
Agent/CSR wanted, Ft. Lauderdale Area
Independent P&C agency is seeking to employ a licensed agent and/or csr, with experience in nonstandard and standard auto, homeowners, commercial auto and property insurance. Fulltime position M-F 9am - 6pm and every other Saturday 9am - 3pm. Must have a GREAT attitude and know how to be a team player. Email resume to Marlinsii@aol.com. 17-11
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Looking for inside / outside lic. experienced sales rep. Must know QQ/QF, Semcat and other software packages. Efax resume to 561-829-2055. Great office. 16-11
Inside P&C Insurance Saleperson-NJ 1-3 years experience needed for a P&C Licensed saleperson. Leads, incentives and $40,000 base salary & benefits all provided in a convenient Parsippany modern location. jimb@mgainc.net 17-11
440 or 220 Needed in Tampa
Needed Agent or Customer service rep, must have knowledge of personal lines and have a great personality for established Family owned agency. Send resume. idcccorp@msn.com 17-10
Licensed P&C Sales & Service agent: Tampa, FL
We are seeking the right sales and service person to be a part of our team which is focused on continuing to grow a 24 year insurance Agency. If you are an experienced licensed professional who is proficient in sales of home, auto, flood, umbrella and other personal lines of insurance and who is also diligent in following up after the sale with quality customer service, we could be your professional home. info@danceferrentino.com 17-11 DECEMBER 2017
Outside Ins Sales Rep - Must be licensed South Palm Beach Co. Need home based / office outside insurance sales rep. Must have experience cold calling, networking grps and referrals a must. Most know how to type up and prepare a property commercial risk including acords, loss runs, etc. Pls email resume to: jonathandrausch@hotmail.com 16-11
Fresh out of School Insurance Sales Person Needed
We are doing a cooperative hiring with one of our carriers. Must be energetic, sales and commission motivated. It is a 2 yr salary with a transition to 100% commission, there is unlimited growth potential based on how good you are. Must be able to travel for 3 weeks of training to Philadelphia. Interview process is lengthy, but once we find the right person we are ready to go! larrytalbert@talbertservices.com 17-11
Help us to expand our Agency (From Home)!! We are seeking a super energetic and motivated professional to work in a virtual capacity assisting us with recruiting and supporting professional sales agents across the United States and Canada. For detailed information on our company and this non-sales virtual opportunity please contact me at: Nicole.lang@harvardbenefits.com Nicole.lang@harvardbenefits. com
Experience Commercial CSR Wanted Duluth GA We are a mid sized agency, looking to add to our family environment insurance agency. We are not related but have a great time together. Voted Best in Gwinnett for 7 yrs in a row. Best in Duluth 2 yrs. Must be able to handle a large volume of direct bill accounts. Multicarrier experience and Hawksoft Agency use is a plus. Bilingual is also good but not a requirement.
larrytalbert@talbertservices.com 17-11
Looking to buy a P&C agency in PB county. Please call
Growing MGA is looking for a highly motivated & responsible individual. Duties include managing accounts from our distribution channel --- quoting, binding and servicing multiple lines of business. Incredible opportunity for someone looking to learn and grow in a company. Send resumes to info@ everiskpro.com 17-4
SUBMIT YOUR FREE CLASSIFIED AD HERE
561-584-0732
Efax: (561) 829-2055 17-3
Now Hiring All Positions Independent Agency Hollywood, FL Independent agency in Hollywood, FL. We are hiring for all positions, commercial & personal lines agent/account manager/processors/receptionist/bookkeeper. 220/440 experience preferred but not required.
220-440 Agent for Port St. Lucie Agency (PT-FT ?) Please fax your information to: (772)879-1002 or e-mail to: amerinsur@aol.com Thank You... amerinsur@aol.com 17-11
cpenate@newmanins.com 16-11
16-12 DECEMBER 2017
BROWARD COUNTY ENTRY LEVEL ACCOUNT MANAGER
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NEWS
USI INSURANCE SERVICES ANNOUNCES THE CLOSING OF THE ACQUISITION OF WELLS FARGO COMMERCIAL INSURANCE BUSINESS
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ALHALLA, N.Y., (GLOBE and individuals with a full range “This strategic transaction is NEWSWIRE) -USI of property & casualty, employee the result of hard work from Insurance Services (“USI”) benefits, personal risk, program the outstanding teams of both announced on December 4th the and retirement solutions. companies,” said Perry Pelos, head closing on the acquisition of Wells Together, our combined ONE of Wells Fargo Wholesale Banking. Fargo Insurance Services “I also want to recognize the USA (“WFIS”), formerly part extremely talented team This strategic of Wells Fargo & Company of professionals who are (“Wells Fargo”) (NYSC:WFC). transaction is the leaving Wells Fargo to join This purchase includes USI. I’m confident they will result of hard work from the the Insurance Brokerage continue to be successful as and Consulting, Employee they serve clients’ insurance outstanding teams of both Benefits and Property & needs as part of this strong companies. I also want to Casualty national practices industry leader.” of WFIS, along with its recognize the extremely talented Safehold Special Risk, Small team of professionals who are About USI Business Insurance, Student SI is a one of the Insurance, Individual leaving Wells Fargo to join USI.” largest insurance Health and Private Risk brokerage and Management Insurance business consulting firms in the world, lines. Terms of the transaction Advantage delivers a superior delivering property and casualty, were not disclosed. industry platform which employee benefits, personal risk, integrates the USI Omni program and retirement solutions “With the combined strength Knowledge Engine™ with an to large risk management clients, of our two market leading industry leading Network of middle market companies, companies, USI is one of the expertise, delivered through an smaller firms and individuals. largest and strongest insurance Enterprise process to customize Headquartered in Valhalla, New brokerage and consulting firms in different and better solutions, York, USI connects together the world,” said Michael J. Sicard, resources and service for each over 6,000 industry leading chairman and CEO, USI Insurance client, with positive, measureable professionals across more than Services. “We serve large risk results. We are thrilled to join 150 offices to serve clients’ local, management clients, middle together with the tremendous national and international needs. market companies, smaller firms, professionals of Wells Fargo USI has become a premier Insurance Services.”
U
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insurance brokerage and consulting firm by leveraging the USI ONE Advantage®, an interactive platform that integrates proprietary and innovative client solutions, networked local resources and expertise, and enterprisewide collaboration to deliver customized results with positive, bottom line impact. USI attracts best-in-class industry talent with a long history of deep and continuing investment in our local communities. For more information, visit usi.com. About Wells Fargo & Company
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ells Fargo & Company (NYSE: WFC) is a diversified, community-based financial services company with $1.9 trillion in assets. Wells Fargo’s vision is to satisfy our customers’ financial needs and help them succeed financially. Founded in 1852 and headquartered in San Francisco, Wells Fargo provides banking, insurance, investments, mortgage, and consumer and commercial finance through more than 8,400 locations, 13,000 ATMs, the internet (wellsfargo. com) and mobile banking, and has offices in 42 countries and territories to support customers who conduct business in the global economy. With approximately 268,000 team members, Wells Fargo serves one DECEMBER 2017
in three households in the United States. Wells Fargo & Company was ranked No. 25 on Fortune’s 2017 rankings of America’s largest corporations. News, insights and perspectives from Wells Fargo are also available at Wells Fargo Stories.
risk and better enable insurance companies to suggest safety measures that could prevent loss. Finally, social media information can help the insurance company learn of developments that warrant updates in coverage, such as a home renovation project that requires builders' risk insurance.
Continued From Page 16
QBE's new white paper on leveraging social media to fight insurance fraud and improve customers' insurance experience is available on QBE North America's website's Insights page.
COMBATING INSURANCE FRAUD service providers have the ability to actively monitor for changes in the subject's profile or internet activity, while assuring a high confidence level in the results by removing false positive findings." Beyond fighting fraud The paper also notes that forwardthinking carriers are continuing to expand the ways social media can help improve the customer experience, such as: After a natural disaster, monitoring social media can help insurance companies identify the most affected areas and thus more quickly deploy loss mitigation and recovery resources. Similarly, social media information may reveal situations of increased Table of Contents
About QBE QBE North America (QBE NA) is part of QBE Insurance Group Limited, one of the largest insurers and reinsurers worldwide. QBE NA reported Gross Written Premiums in 2015 of $4.6 billion. QBE Insurance Group's 2015 results can be found at www.qbena. com. Headquartered in Sydney, Australia, QBE operates out of 37 countries around the globe, with a presence in every key insurance market. QBE NA, headquartered in New York, conducts business through its property and casualty insurance subsidiaries. QBE insurance companies are rated "A" (Excellent) by A.M. Best and "A+" by Standard & Poor's. Additional information can be found at www.qbena.com, or follow QBE North America on Twitter. www/underwritersinsider.com
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NOTABLE QUOTES IN THE NEWS
SAY WHAT? I’m With Her? Not...
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ImageAttribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)
ver since we started this Archie Bunker thing in the early ‘70s, making fun of white working people, we kissed them goodbye. You make fun of people, you look down on them, they get the message. You call them ‘deplorables,’ they hear it. You bet they hear it. You say they cling to their guns and religion? ‘Oh yeah? I cling to my religion. OK. I’m a little person, and you’re a big person. Thank you, I’ll be voting for the other guy this time.” Uber-liberal Chris Matthews, host of MSNBC’s Hardball in a C-SPAN clip noted by The Washington Examiner. It seems everyone on the planet has figured out why Hillary lost the election - except Hillary - who is still wandering from talk show to talk show asking, “What Happened?” You and the Democrat Party happened Hillary. Now go home and be quiet.
It’s Absent Fathers - Not The System
I
it had as much to do with their fathers not being in their lives as it did to do with any system. Now I was doing just as much as they were, but they went further. I just didn’t get caught, but they kept going down that road and then they were in the hands of the system. But it’s about the formative years. You’re not born a criminal.” Wise words from Academy Award-winning actor Denzel Washington urging the AfricanAmerican community to take responsibility for the outcome of their young men - rather than blaming it on the “system.”
“Your DNA is an abomination”
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ntologically speaking, white death will mean liberation for all. To you good-hearted liberals, apathetic nihilists and rightwing extremists: Accept this death as the first step toward defining yourself as something other than the oppressor. When I think of all the white people I have ever encountered … there is perhaps only a dozen I would consider decent.”
f a young man doesn’t have a father figure, he’ll Texas State junior Rudy Martinez, go find a father figure. It condemning so-called “white privilege” in starts at the home. It starts a University Star column. Surprisingly, the at home. It starts with how column was criticized by the President of you raise your children. So the university as racist and divisive while the you know I can’t blame the concept of anti-White racism is becoming system. It’s unfortunate that we make such easy work for them. I grew up a perfectly acceptable point of view on more with guys who did decades [in prison], and and more college campuses. 36
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Florida’s Chief Financial Officer Jimmy Patronis responding to the news that Florida Workers ear White people, please take Comp rates will be decreasing by 9.5%. a step back, this isn’t brownpeople-answer-white-people’sPamela Anderson Bucking The Tide questions-hour, we’re asking specifically for submissions from POC. As being told hen I came to Hollywood, of no seems to be a difficult concept for some course I had a lot of offers to of y’all I await your emails about the Irish, do private auditions and things that made how the term white fragility is mean (great absolutely no sense, just common sense: example of white fragility) and how we need don’t go into a hotel room alone; if someone to view people through a color-blind lens answers the door in a bathrobe, leave. (just lol). You will 100% not get a response!!!” You know, common sense. Hollywood is very seductive, and people want to be Progressive Evergreen State College has a famous. I think this narrative of ‘victim student newspaper with a blatantly racist blaming’ and ‘lack of solidarity’ is trying to section in its opinion pages described as “for coerce me (and others) into consensus on people of color by people of color.” The smug something that should be debated and quote is from a recent issuu, apparently with discussed broadly. There are also a lot of the full approval of the administration - in self-protection courses. There is even a well order to address the White Privilege problem known story of suffragettes learning martial and stuff... One can only imagine the universal arts and protection when doing activism for outrage and condemnation should this had right to vote. So this is not victim blaming been a column entitled For White People by but looking at the issue from the angle of White People. women being aware of certain problems and how to spot them and fight them. It is totally hypocritical to ignore this. And it is Florida Comp not helping anyone to ignore the realities in Rates Down the society we live in. This exactly what I am saying is a problem with the contemporary lorida’s job “victimhood feminism”! The people who creators will no subscribe to that notion tolerate and doubt appreciate actually expect women to talk about the this significant cost savings, stories of abuse and experiences with a step that will support our creeps. But they would NOT tolerate a state’s growing economy,. woman with her own opinion. So pathetic.” I’m pleased to see the cost of business going down, and A surprisingly articulate Pamela Anderson, as the Legislature looks at Baywatch babe and Playboy centerfold in Jimmy Patronis our workers’ compensation a recent one-on-one interview with NBC’s system, I will be working with them on Megan Kelly. proposals to lock in these lowering rates.”
“Dear White People”
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BACK ISSUES
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ANALYSIS Continued From Page 14
HOW TO RESPOND TO A CYBER BREACH different password rules you likely will have different passwords for different accounts. I know this is not easy. We have been overwhelmed by passwords in the modern world. But, our looking for an easy solution is just opening a door for hackers to go through. Good news for humans, however, has come from the National Institute of Standards and Technology, which for years insisted passwords should be random numbers, letters and symbols, has now reached a different conclusion. NIST now suggests that you create a not easy to copy “passphrase” which hopefully can stand up of 16 to 64 characters. NIST has concluded that a phrase such as “ilikefuchsiaastronauts” (suggested by Kim Komando as befitting herself) if you haven’t told the world your favorite color at age six was fuchsia and your childhood goal was to be an astronaut is easy to remember and about as strong a passphrase as can be. 3. Call the credit bureaus right 40
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away (TransUnion, Experian and, yes, Equifax). Advise them you have been a victim of identity theft and they will place a fraud alert on your file. 4. Call your banks (or credit unions) and credit cards companies. Doing so will lock your accounts and prevent further transactions. Notifying them immediately will normally release you from any liability for the charges. Do so immediately. Waiting even a few days, or even minutes can result in you incurring large amounts of damages.
may want to wait until you have a complete picture of what has happened. 6. Obviously, it is important to document everything you do and everyone you talk to. Written records are gold. Memory is flawed. 7. Get a copy of your credit report to see if something unusual is on your credit. If there is something unusual, include that in your police report and with your report to the FTC. If you have not gotten your free annual credit reports, you can do so at www.annualcreditreport.com. 8. Consider subscribing to an ID Theft Recovery program. There are several you might wish to consider. Just run a google search for ID Theft Recovery and you will find several to choose from ranging in price and services from free and limited to more costly and broad.
5. You may be urged to contact the police and get a police report. However, you may want to wait until you are confident that it is not just a single discrete event. You want to get the full amount of your damages in the police report. You should also file a report with the Federal Trade Commission (FTC). However, like with the police, you Table of Contents
Unfortunately, you cannot prevent identity theft entirely. The breached companies may have sophisticated IT people and employ high-level breach response services, but you may be in for some surprises with the terms and conditions in the fix offered to you by many of the big companies. They have experience alerting you, but rarely will they do anything to help you protect or recover control of your identity. DECEMBER 2017
NEWS For example, what has Equifax or Continued From Page 7 Home Depot or any of the dozens of others who have been breached done for you? Future credit monitoring for a year or two is nice but not going to do much once your information has escaped to 5. An insured cannot recover somewhere in the clouds. any damages based on an insurer’s statutory violation if the insured It would be nice if everyone would had no right to receive benefits or could afford proper identity theft under the policy and sustained no coverage. Hopefully, with some injury independent of a right to research, you can find a plan for the benefits. right price that gives you exactly the recovery protection you need at If Ortiz seeks to rely on an insured’s a price you can afford. In any case, ability to recover policy benefits even if you were to buy identity the insured can only recover if theft coverage, the best protection the insurer’s statutory violation caused the loss of the benefits or is being aware of what is going on the loss of the insured’s contractual in your accounts and being alert to right to policy benefits. Because irregularities that may occur. the payment of the appraisal award satisfied Ortiz’ right to In my opinion, given the many receive benefits under his policy breaches that have occurred, and, therefore, there was no loss believing we can create walls of benefits or loss of a contractual around our private data to keep it right to policy benefits, he has no protected is not going to work. The right to further damages. gates have been opened too many times and too much has escaped Because State Farm promptly already. However, it is possible to paid the appraisal award and mitigate the damage and the best Ortiz did not raise any ground guard is ourselves with some help for setting aside the appraisal from law enforcement, the FTC and award, summary judgment was properly granted on Ortiz’ breach if you buy it, from an identity theft of contract claim. Because Ortiz program. failed to present evidence of an act so extreme that it caused I would like to thank Eran Sinai, injury independent of his policy President and CEO of ID Cyber claim, summary judgment was Center who has contributed to this properly granted on his common article. law bad faith claim.
ZALMA
DECEMBER 2017
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ZALMA OPINION The tort of bad faith is often abused by insured’s unhappy with the resolution of their claim. This case is a perfect example since the insured sued and continued his bad faith claims after being paid, in accordance with the policy conditions, everything the insurer owed under the contract. Some day, courts of appeal will recognize the error of their creation of a tort for breach of contract and go back to allowing only contract damages and rely on regulators to punish insurers who violate the covenant of good faith and fair dealing.
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COMMEDIENE OWEN BENJAMIN’S REMARKABLE POLITICAL INSIGHT He Explains Why He Hates “The Left” But Merely Disagrees With Liberals. We Could All Learn A Lesson From This Short Monoloque
HERE INSURANCE FRAUD FAIL COMPILATION We’re not sure where these awkward intentional accidents occurred, (Russia?) but if you drive there, you’d better have a dash cam!
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To Visit Insider Sponsors, simply click on the Sponsor’s ad! DECEMBER 2017
NEWS
ESURETY NAMED TO CIO APPLICATIONS’ TOP 25 INSURANCE TECHNOLOGY COMPANIES
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RLANDO (Nov. 15, 2017) In its award summary, CIO editors said, -- eSURETY and its online Applications surety bond underwriting “eSURETY has been serving as platform has been recognized as a backbone of the surety bond a Top 25 Insurance Technology industry for 20 years -- transforming Company by CIO Applications. Each traditional surety systems through innovation and year, the magazine’s editorial team technology, evaluates the myriad technology compliance measures, saving both time and money.” solutions available in the insurance eSURETY’s The publication praised eSURETY’s arena and cloudautomated, showcases those that are proven to based platform allows r u l e s - b a s e d decision engine be the most robust, customers worldwide and its ability to cost-effective and to apply for a bond, deliver against flexible. an underwriter’s secure a quote, make need for clarity, eSURETY’s cloudpayment and complete simplicity, based platform allows customers the bond, all within t i m e l i n e s s , information worldwide to a minute or two and gathering or apply for a bond, retention and cost secure a quote, in the applicant’s efficiency. make payment own language and and complete the “We like to say our bond, all within currency. “ platform includes a minute or two and in the applicant’s own language the bells and whistles many clients and currency. Throughout the don’t even know they need yet,” life of a bond, eSURETY’s system said eSURETY CEO Daniel Buckles. automatically generates a PDF for He pointed to the platform’s tools every transaction and embeds for security and compliance, electronic signatures and seals as credit card processing, credit required. An optimized database connectivity, hosting services and contains records for an agency’s business intelligence as examples complete book of business to of eSURETY’s advantages beyond support easy analysis and reporting. initial risk assessment. “Knowing DECEMBER 2017
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that CIO Applications noted our comprehensive approach, we’re particularly thrilled to have the external validation this award represents,” Buckles added. About eSURETY (eSURETY.net): Founded in 1998, eSURETY is a privately held company that provides a cloud-based automated surety bond underwriting system. The eSURETY platform allows surety agents to create and issue a variety of new bonds exclusively online while satisfying the most demanding corporate and regulatory compliance requirements for 30% of the top 30 surety bond companies.
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TECHNOLOGY Continued From Page 5
KIM KOMANDO
Click here to scour more than 60 sites ranging from social media to news outlets. Check out your neighbors
friends. To see details, you may have to send him a connection request. Remember, though, many people don’t use their real names online. If you find Bobby’s online alias, (Smirk Bob, perhaps), you may find that Bobby uses the same screen name for his other social media accounts. Finally, run a Google image search to locate pictures of Bobby. You might find out that Bobby is a champion swimmer. You might also find out that he was arrested for a DUI. A one-stop information
shop
for
Afterward, try PeekYou. Instead of locking in on keywords, PeekYou looks for links that are likely associated with the people you’re looking for online. When it finds information, PeekYou indexes all the links in one place for easy browsing. You can quickly see an overview of just about anyone. You can also search by categories, such as Interests, Work, School, City, Phone, and Email. You’ll be surprised by what you find. 44
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So what happens if Bobby doesn’t introduce himself, and you have no idea what his name is. All you have to do is enter your address, and this site will pull up a map of your block. You can click on houses to see publically available information about the people living around you. Instead of rooting through his mailbox, which is illegal, click here for an online phone book that uses modern socialnetworking technology. Find out where photos were taken If you’ve never heard of The Beat, prepare to be amazed. As you may know, lots of digital photos are embedded with “meta-data,” including where the photo was taken. The Beat combines those “geotags” with Google Street View, so you can see what publically posted photos were shot in your neighborhood. The internet doesn’t get more
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vivid than this: an album of images taken on your block by people you may never have met. Adding to the anxiety are the privacy issues that The Beat raises. So be careful about the photos you post, especially if you’ve used geotags to indicate where those shots were snapped. Click here to see photos taken in your neighborhood. Check the sex offender registry The bottom line is this: You want to make sure Bobby isn’t a threat, and one of the most frightening threats is a convicted sex offender. With the Dru Sjodin National Sex Offender Public Website, all you have to do is enter a ZIP code and run a search to see a list of convicted offenders in your area. You see a picture of the person and their home and work addresses. In some cases, you’ll also see a risk level. Click here to check if a sex offender lives in your area. If all goes well, you’ll find that Bobby is an upstanding citizen with a clean record and a lot of worthy friends. But it never hurts to double-check. DECEMBER 2017
NEWS One word of warning: always take the information with a grain of salt. People search sites can accidentally combine separate people in one profile. If there’s another Bobby Smith from Cincinnati, he owner and operator of two defunct Miami home the system might confuse the health agencies was two, making you believe your neighbor is actually someone sentenced today to 80 months in prison for her role in a $74 else. million conspiracy to defraud Want to hear more about the Medicare program.
OWNER OF 2 MIAMI HOME HEALTH AGENCIES SENTENCED TO 6 YEARS+
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online research techniques? Be sure to listen or download my podcasts, or click here to find it on your local radio station. You can listen to the Kim Komando Show on your phone, tablet or computer. From buying advice to digital life issues, click here for my free podcasts.
Copyright 2017, WestStar Multimedia Entertainment. All rights reserved. Learn about all the latest technology on the Kim Komando Show, the nation’s largest weekend radio talk show. Kim takes calls and dispenses advice on today’s digital lifestyle, from smartphones and tablets to online privacy and data hacks. For her daily tips, free newsletters and more, visit her website at Komando.com DECEMBER 2017
Sila Luis, 59, of Miami, Florida, was sentenced by U.S. District Judge Marcia G. Cooke of the Southern District of Florida. Judge Cooke also ordered the defendant to pay $45 million in restitution and to forfeit the gross proceeds traced to the offense. Luis pleaded guilty on June 28, to one count of conspiracy to commit health care fraud. As part of her guilty plea, Luis admitted that, between January 2006 and June 2012, she and her co-conspirators agreed to, and actually did, operate LTC Professional Consultants Inc. (LTC) in order to fraudulently bill the Medicare program for home health care services, including diabetic injections, skilled nursing visits, physical therapy, and other treatments and services. Professional Home Care Solutions Inc. was another home health agency under Luis’s ownership and control that was Table of Contents
involved in the conspiracy. Luis further admitted that she and her co-conspirators enlisted and paid patient recruiters kickbacks and bribes in exchange for the referral of Medicare beneficiaries to LTC. Had Medicare known that Luis paid bribes and kickbacks to attract beneficiaries to her facilities, Medicare would not have paid any claims submitted on behalf of those beneficiaries. Judge Cooke determined at sentencing that Luis was responsible for an intended loss of $74 million to the Medicare program. Luis was charged along with Elsa Ruiz, 49, and Myriam Acevedo, 68, both of Miami, Florida, in an indictment returned on Oct. 3, 2012. Acevedo pleaded guilty in May 2013 to conspiracy to pay health care kickbacks and payment of kickbacks in connection with a federal health care benefit program. She was sentenced to 60 months in prison and ordered to pay $27 million in restitution. Ruiz pleaded guilty to conspiracy to commit health care fraud. She was sentenced to 80 months in prison and ordered to pay $45 million in restitution. www/underwritersinsider.com
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BECOME A CERTIFIED EXPERT IN CORPORATE PROPERTY INSURANCE AND A CERTIFIED EXPERT IN CORPORATE LIABILITY INSURANCE Now available from Illumeo and Barry Zalma!
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veryone involved in insurance – either as an insurer or as an insured – requires excellence in claims handling. Businesses need to deal with insurers who have an excellence in claimshandling mandate. Insurers who wish to profit need an excellence in property and/or liability claims-handling program. Everyone in business needs an insurer who has an excellence in property or liability claims-handling program in effect. Two comprehensive programs enabling insurance professionals to become Certified Expert in Corporate Property Insurance and/ or Certified Experts in Corporate Liability Insurance are available from Illumeo.com and https://www.illumeo.com/curriculum/certifiedexpert-corporate-property-insurance and https://www.illumeo.com/ curriculum/certified-expert-corporate-liability-insurance. The programs are complete courses of study providing education and training to allow insurance professionals, after completing the individual classes, to become a Certified Expert. The programs cover everything an employee, an officer, or a director of a corporation needs to know about the need to acquire proper insurance and to resolve any claim presented by the corporation to the insurer. Major topics of study include, but are not limited to: the importance of insurance; how to acquire insurance and understand an insurance policy; the methods used by insurers to investigate claims; the various types of insurance that corporations need; the duties and obligations of a public adjuster; and how The full curriculum of the courses and other courses from Barry Zalma are available at http:// www.ilumeo.com by entering in the search bar the word “zalma.”
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