There’s been quite a few sink holes in the news and so I wasn’t surprised to hear of another one. Claimant called to say he lost his brand new Lexus in a sink hole and asked to be paid its value. I told Claimant that we’d need to arrange a time to examine the sink hole and attempt to tow the car out of it. Claimant said it was impossible, because the sink hole had completely closed up and swallowed the car. I insisted we’d need to go to the location of the sink hole. Claimant hung up and we never heard from him again. The Lexus is still insured under the policy.
Submitted By: SoftKitty on February 21, 2017
Claimant is a Youtube star and was filming a segment where he was going up to stranger’s doors and giving them shocking fake news or funny gags to capture their expressions. When walking on a stranger’s porch for this purpose, part of his gag was jumping up and down on the porch. When he did so, a board broke and he fell, cause a sprained ankle and other injuries. He threatened suit against our insured (the stranger), claiming the porch was unsafe. We were close to paying the claim, but hadn’t been able to reach our insured. When we did, he provided a photograph of the large sign that had been placed on the porch railing: “Warning: porch board is loose. Enter through the back door.” We denied the claim.
Submitted By: Insanity on February 17, 2017
He was a customer who wanted to buy a gun. She was a store manager who balked, finding the man erratic, threatening and potentially dangerous.
Their tense interaction at a Big 5 Sporting Goods store in Downey prompted police to step in, according to a lawsuit.
Delilah Rios claims that after company officials overruled her and released a weapon to the customer, she resigned. In the civil suit filed this week, she alleged wrongful termination and violation of labor laws, among other claims.
“She feared for her safety and felt that money meant more to Big 5 Corporation than public safety or employee safety,” according to the lawsuit. “She felt she could not work at a company where she would be forced to release firearms to people who should not have guns.”
A spokesman for the El Segundo-based company did not respond to a request for comment.
In her suit, Rios said the problem began Jan. 21, 2015, when she assisted a middle-aged man who wanted to purchase a firearm. The customer passed a newly instituted safety test, but stormed into the “restricted area” of the store when she was processing his payment, retrieved his identification and credit card and left, she claims.
Two days later, he returned and said he wanted “any crappy old gun,” selecting a 12-gauge shotgun, the suit says. While filling out a federally required form documenting the sale, he reportedly relied on a friend’s assistance. When Rios told him he was legally required to complete the form alone, the customer became agitated, the lawsuit said. He later accused her of selling him the wrong weapon and returned the next day to select another model, she alleges.
After the mandatory 10-day waiting period elapsed, he came to the store on the night of Feb. 4, 2015, but Rios claims in her suit the store was busy — she was working at the cash register for an employee on break — and that she did not have enough time to release the firearm.
“I paid for it, and you need to give me my [expletive] gun,” he said, according to the lawsuit. He left after she threatened to call police, she said.
Later that evening, she claims in her lawsuit that she found unused ammunition on the floor in the aisle where the man had lingered, but it was not a type sold by Big 5. She said in the court papers that she became concerned the customer was bringing in live ammunition for the exact firearm he wanted to pick up.
She claims she reported the incident to corporate management and, against her opposition, a supervisor’s response was to call the customer and ask him if he brought in the ammunition.
The next day, the man returned and became irate and yelled loudly as she approached, she said in her suit. “You again. I … hate people like you. People like you should not exist,” he said, according to the suit. “I hope you get fired.”
She claims she was afraid and told him that she would not hand over the firearm. She said she offered a refund, but he refused to leave.
Rios alleges two off-site supervisors questioned why she could not just release the gun. Another manager who was on his day off eventually came and, with police present, handed over the gun along with a $25 gift card, according to the lawsuit.
Afterward, Rios claims she reported the incident to human resources and asked to work at a different store. She said her request was denied, and she resigned. She had worked for the company for eight years, according to the suit.
Written by Matt Hamilton LA Times
Submitted By: admin on February 15, 2017
We received a property claim for a Mosque that we insure. A woman broke several windows and then wrapped pieces of bacon on the doors.
This has been determined to be a hate crime and the woman that did was was found and arrested. We will of course be covering all damage to the windows as this was covered on the policy.
Submitted By: laird on February 15, 2017
THE 2016 DARWIN AWARDS
You’ve been waiting for them with baited breath, so without further ado, here are the 2016 Darwin Awards:
In Detroit, a 41-year-old man got stuck and drowned in two feet of water after squeezing head first through an 18-inch-wide sewer grate to retrieve his car keys.
A 49-year-old San Francisco stockbroker, who “totally zoned when he ran”, accidentally jogged off a 100-foot high cliff on his daily run.
While at the beach a 21 year old male, dug an 8 foot hole for protection from the wind and had been sitting in a beach chair at the bottom, when it collapsed, burying him beneath 5 feet of sand. People on the beach used their hands and shovels trying to get him out but could not reach him. It took rescue workers using heavy equipment almost an hour to free him. Jones was pronounced dead at a hospital.
A 24 year old male was killed as he fell through the ceiling of a bicycle shop he was burglarizing. Death was caused when the long flashlight he had placed in his mouth to keep his hands free rammed into the base of his skull as he hit the floor.
A 26 year old male, was killed as he won a bet with friends who said he would not put a revolver loaded with four bullets into his mouth and pull the trigger.
After stepping around a marked police patrol car parked at the front door, a man walked into H&J Leather & Firearms intent on robbing the store. The shop was full of customers and a uniformed officer was standing at the counter. Upon seeing the officer, the would-be robber announced a hold-up and fired a few wild shots from a target pistol.
The officer and a clerk promptly returned fire, and several customers also drew their guns and fired. The robber was pronounced dead at the scene by Paramedics. Crime scene investigators located 47 expended cartridge cases in the shop. The subsequent autopsy revealed 23 gunshot wounds. Ballistics identified rounds from 7 different weapons. No one else was hurt.
A 47 year old male and his wife Bonnie were bored just driving around at 2 A.M. so they lit a quarter stick of dynamite to toss out the window to see what would happen. Apparently they failed to notice that the window was closed.
This dummy had been drinking with several friends when one of them said they knew a person who had bungee-jumped from a local bridge in the middle of traffic. The conversation grew more excited, and at least 10 men trooped along the walkway of the bridge at 4:30 AM. Upon arrival at the midpoint of the bridge, they discovered that no one had brought a bungee rope.This dummy, who had continued drinking, volunteered and pointed out that a coil of lineman’s cable lay nearby. They secured one end around this man’s leg and then tied the other to the bridge. His fall lasted 40 feet before the cable tightened and tore his foot off at the ankle. He miraculously survived his fall into the icy water and was rescued by two nearby fishermen. His foot was never located.
AND THE WINNER IS
Zookeeper who fed his constipated elephant 22 doses of animal laxative and more than a bushel of berries, figs, and prunes before the plugged-up pachyderm finally got relief. Investigators say ill-fated male, 46, was attempting to give the ailing elephant an olive oil enema when the relieved beast unloaded.
The sheer force of the elephant’s unexpected defecation knocked him to the ground where he struck his head on a rock as the elephant continued to evacuate 200 pounds of dung on top of him. It seems to be just one of those freak accidents that proves..poop happens
Submitted By: Burt on February 15, 2017
Claimant sued the bar and the super bowl team who lost when she became angry at an interception, dropped her beer onto the floor, causing injury to her foot from broken glass. The complaint was never properly served on the football team and she settled with the bar’s insurance carrier for a small sum. Don’t invite this Claimant to your Super Bowl party!
Submitted By: SoftKitty on February 9, 2017
NYSSA — Heavy snow has caused dozens of onion storage sheds in eastern Oregon and Idaho to collapse, resulting in as much as $100 million in damage.
About 50 onion buildings collapsed under the weight of up to 40 inches of snow, reported The Capital Press. The general manager of Owyhee Produce in Nyssa, Oregon, said three of the company’s storage sheds and a building housing one of its packing lines have collapsed.
“It’s an absolute catastrophe,” said Shay Myers, the Owyhee manager. He estimated that the total damage to the onion industry in southwestern Idaho and Malheur County, Oregon, could be near $100 million.
The region’s 300 onion farmers produce more than 1 billion pounds of Spanish big bulb onions annually, or about 25 percent of the nation’s big bulb storage onions. A big chunk of last year’s harvest, however, was lost in the building collapses. Once the onions are exposed to the cold and freeze, they are no good.
The production loss has dramatically increased the price of onions. A 50-pound bag of yellow jumbo onions was about $3.50 before the collapses and is now nearly $10.
Partners Produce co-owner Eddie Rodriguez said his company has lost four buildings, including its main packing line in Payette, Idaho.
“They’re still going down as we speak,” he said. “Now, it’s just happening everywhere. The snow is heavy and there’s too much of it.”
Onion industry leaders have asked state and local representatives to help find assistance for the region. An estimated 150 buildings have been destroyed.
“I’ve personally seen at least 40 collapsed buildings, probably more,” said state Rep. Cliff Bentz, an Ontario Republican. “It really looks like they were hit by a bomb. It’s really shocking.”
U.S. Sens. Ron Wyden and Jeff Merkley, both Democrats, have asked the federal government to begin a process that would result in a federal disaster for Malheur County and other counties harmed by the severe winter. That would make farmers and businesses eligible for low-interest loans, insurance relief and other disaster aid.
Submitted By: admin on February 3, 2017
investigation into what is being billed as one of the largest workers’ compensation insurance fraud schemes uncovered in the county’s history has swept up additional medical professionals throughout Southern California.
Chiropractors, a radiologist, a pain management physician, a medical equipment provider and others are accused in 13 new indictments of playing varying roles in a bribery scheme that bought and sold patients like commodities, the District Attorney’s Office said Thursday. The investigation uncovered nearly a half-million dollars in kickback payments resulting in millions of dollars in fraudulent workers’ compensation insurance claims, authorities said.
The indictments come as the investigation into the scheme continues to expand. The first wave of arrests occurred in November and involved federal charges.
On Wednesday, more than 100 law enforcement officers in three counties served early morning arrest and search warrants at seven locations, authorities said. Nine people have been arrested and two remain at large.
According to prosecutors, a group of recruiters would entice workers — many of them seasonal workers who lived abroad at times — to file workers’ compensation claims. The recruiters were identified as Fermin Iglesias and Carlos Arguello, who operated Providence Scheduling, Medex Solutions, Prime Holdings International and Meridian Rehab Care, and administrator Miguel Morales.
They would advertise in the U.S. and Central America via flyers or cards stuck on windshields to contact a call center if a worker has been injured on the job and needs help filing a claim, said Assistant U.S. Attorney Alana Robinson.
The recruiters would then refer the patients to specific doctors in Southern California, who would in turn prescribe certain medical tests and treatment — such as chiropractic, MRIs, pain management, echo cardiograms and even sleep studies — to companies in return for kickbacks, she said. The bribes were usually $50 to $100 per patient, court records show.
The bribes were done without the patients’ knowledge.
“It was all predetermined even before the patient came along,” Robinson said at a news conference Thursday.
The treatment was then billed to various insurance companies, including Liberty Mutual and Hartford.
Chiropractors would be required to fill a monthly quota of referrals or their patient pipeline and bribes would be cut off, authorities said. In one instance, San Diego chiropractor Steven Rigler was warned that he’d fallen $60,000 behind in referrals for procedures and he’d be cut out of the operation unless he wrote the organization a $20,000 to $30,000 check, according to the latest federal indictment.
Rigler has already pleaded guilty, as well as San Diego workers’ compensation attorney Sean O’Keefe.
One of the clinics implicated is Crosby Square Chiropractic, where Rigler worked, which has offices in San Diego, Escondido and Calexico, prosecutors said. Other medical professionals indicted are chiropractors Amir Khan of Orange and David C. Nguyen of Huntington Beach, and pain management Dr. Phong H. Tran of Irvine. Dr. Ronald Grusd of Los Angeles, who was charged federally last year, is also included in a new state indictment.
Authorities called the scheme especially sophisticated, involving intelligent professionals who knew how to cover their tracks.
“But these criminals got greedy,” said District Attorney Bonnie Dumanis, referring to the enterprise’s effort to expand throughout Southern California.
The FBI, the lead agency on the case, used an undercover agent to infiltrate the scheme, said Eric Birnbaum, special agent in charge of the FBI in San Diego.
Deputy Commissioner George Mueller of the state Department of Insurance said health care fraud is the most costly kind of insurance fraud in California — costs that get passed down to employers and taxpayers.
firstname.lastname@example.org (619) 293-1391 ? Twitter @kristinadavis
Copyright © 2017, The San Diego Union-Tribune
Submitted By: loser on February 3, 2017
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