A Video On How an Individual Can Help the Government Defeat Fraud
How to Be a Whistleblower
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Posted on September 27, 2021 by Barry Zalma
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and at https://www.rumble.com/zalma
If an individual has knowledge that a false claim was submitted to the government, that person can elect to become a whistleblower and retain an attorney who will draft a complaint and a disclosure statement. The whistleblower will file these two documents under seal in US district court and send copies to the Department of Justice.
After the complaint is filed, the Justice Department has 60 days to investigate the allegations and determine whether it will join the lawsuit. If the Justice Department does join the lawsuit, it has the primary responsibility for prosecuting the case and can limit the whistleblower’s participation in the action. If the qui tam action is successful, the whistleblower’s share of the recovery will range from 15 to 30% depending on the extent of the individual’s investigation. The judge normally determines the percentage.
If the department decides not to participate, the whistleblower has the right to continue to pursue the claim on behalf of the US and will receive a higher portion of any recovery received.
The False Claims Act states that any person can file a qui tam action as long as they have direct and independent knowledge of the fraud and this knowledge was not obtained from a “public disclosure.” The definition of “person” includes not only individuals, but also businesses and state or local government entities. The most common plaintiffs in qui tam actions are employees of government contractors, healthcare organizations, and local, state, or federal government.
ZALMA OPINION
Police agencies and prosecutors seem loathe to file insurance fraud cases. It is important, therefore, that insurers, agents, brokers and claims handlers recognize the opportunities provided by the false claims act that can either force the prosecutor to join in or take the profit out of the fraud business.
© 2021 – Barry Zalma
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant 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 practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business.
He is available at http://www.zalma.com and zalma@zalma.com. Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award. Over the last 53 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to make it possible for insurers and their claims staff to become insurance claims professionals.
Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at https://www.rumble.com/zalma ; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ The last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud-letter-2/ podcast now available at https://podcasts.apple.com/us/podcast/zalma-on-insurance/id1509583809?uo=4