Thieves Compensation
Read the full article at https://www.linkedin.com/pulse/thieves-compensation-barry-zalma-esq-cfe and see the full video at https://rumble.com/vwcgcm-thieves-compensation.html and at
and at https://zalma.com/blog plus more than 4100 posts.
Barry Zalma, Esq., CFE presents videos so you can learn how insurance fraud is perpetrated and what is necessary to deter or defeat insurance fraud. This Video Blog of True Crime Stories of Insurance Fraud with the names and places changed to protect the guilty are all based upon investigations conducted by me and fictionalized to create a learning environment for claims personnel, SIU investigators, insurers, police, and lawyers better understand insurance fraud and weapons that can be used to deter or defeat a fraudulent insurance claim.
He was a good employee. He arrived for work every day on time. He did his job eight hours a day and never goofed off. He was loyal to his employer. His diligence got him raises and promotions.
In 2009 his boss came to him and said: “The recession has hit me hard. I can’t afford to keep paying you. You are laid off.”
He was shocked. He could say nothing. He could do nothing to keep his job. He packed up his personal belongings, said “goodbye” to his boss and left.
The next day, he went to the state office of unemployment. He filed the first claim in his life for unemployment benefits. He was ashamed, but had no choice.
Coming out of the unemployment office he met a pleasant man. Having nothing better to do, he accepted the man’s offer of a cup of coffee. They sat on a bus bench and talked about his troubles.
The man asked detailed questions about his job. He explained that the employer was not alone. Other people were suffering just like he was. He explained there was a way to tide him over better than unemployment insurance.
The employee was dumbfounded.
“Are you offering me a job?” he asked.
“No. I am only offering a way to make yourself some money without any effort.”
The solicitor outside the unemployment office received a flat $500 fee from the lawyer. The doctor, who billed $600 for the complete examination and evaluation, gave the lawyer $200 as the lawyer’s fee for the referral. Everybody did very well except the workers’ compensation insurer and the employer whose business was having enough difficulties without finding its workers’ compensation premiums increased.
The employee received a bonus on top of his unemployment benefits that was sufficient to carry him into his new job with a small nest egg.
Rather than burning a building, the person committing insurance fraud merely signs his name to a claim form. Although most insurance fraud is not a violent crime, the crime of insurance fraud has become so rampant that a task force akin to the one used to quell the Los Angeles riots of 1992 and 2019-2020 riots is needed. That such a task force was not generated after the 1992 riots I doubt it will be started after the 2020 riots and Presidential election.
© 2022 – 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 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.
Subscribe to “Zalma on Insurance” at https://zalmaoninsurance.locals.com/subscribe and “Excellence in Claims Handling” at https://barryzalma.substack.com/welcome.
You can contact Mr. Zalma at https://www.zalma.com, https://www.claimschool.com, [email protected] and [email protected] . Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.
You may find interesting the podcast “Zalma On Insurance” at https://anchor.fm/barry-zalma; you can follow Mr. Zalma on Twitter at; you should see Barry Zalma’s videos on https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg/featured; or videos on https://rumble.com/zalma. 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/
Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.
Posted on September 18, 2026 by Barry Zalma
See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html
In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.
The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.
Law
The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...
150 Months in Prison for Tax Fraud
Post 4846
Posted on September 17, 2026 by Barry Zalma
See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS
In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS
Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.
The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...
Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution
Post 5489
Posted on September 14, 2026 by Barry Zalma
Fraudster Refuses to Answer Questions About His Alleged Fraud
See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr
In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.
Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.
After Great American ...
Excellence in Claims Handling
Posted on October 29, 2026 by Barry Zalma
Common Problems in a Jewelers’ Block Policy Investigation
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This is a taste of the latest Excellence in Claims Handling Article for subscribers to my substack. Subscribe to my substack at https://lnkd.in/gmmzUVBy
The History of the Jewelers’ Block Policy
The ‘jewelers’ block policy’ had its origin about 1920, and since that time the policy and the proposal upon which it is based have become more or less standard.
The Inland-Marine Insurance Bureau, of which appellant is a member, prescribes contracts and proposals for such policies that are ...
Self Insurance is Excess Over Primary Insurance
Post 4572
Posted on October 29, 2026 by Barry Zalma
Employment Plan is Insurance Because it Transferred Risk and Contained Claim, Exclusion, and Priority Provisions.
In Ajay Kolli, & c. et al. v. Kaleida Health, 2026 NY Slip Op 06167, No. 72, New York Court of Appeals (October 22, 2026) Dr. Venkateswara Kolli treated a patient in 2011 while serving as an on-call, per diem physician for Kaleida Health. The patient later sued Dr. Kolli and Kaleida for medical malpractice.
In 2011, decedent Dr. Venkateswara Kolli treated a patient as part of his duties pursuant to an on-call, per diem physician employment agreement with defendant Kaleida Health. The patient subsequently sued Dr. Kolli and Kaleida. Dr. Kolli sought indemnity from his primary medical malpractice insurer, MLMIC Insurance Company (MLMIC), as well as his excess insurer Healthcare Professionals Insurance Company (HPIC).
The underlying medical malpractice action settled after Dr. Kolli’s death. Kaleida, MLMIC, and ...
RICO Suit Against Law Firm & Health Care Pros Fails
Posted on October 28, 2026 by Barry Zalma
UBER AND FEDEX FIGHT FRAUD
Racketeer Influenced and Corrupt Organizations Act (RICO) is Designed to Defeat Fraud Perpetrators
In Uber Technologies, Inc., et al. v. Simon & Simon P.C., et al., Civil Action No. 25-5365, United States District Court, E.D. Pennsylvania (October 13, 2026) Uber Technologies, Inc. and Federal Express Corporation sued attorney Marc Simon, his firm Simon & Simon, P.C., and several medical professionals and practices under the Racketeer Influenced and Corrupt Organizations Act (RICO).
They allege the defendants orchestrated a scheme to generate and litigate fraudulent personal injury claims arising from motor vehicle accidents involving Uber and FedEx drivers. Uber and FedEx incurred defense costs and paid settlements on some claims. The court earlier denied a motion to dismiss, finding proximate causation adequately pleaded. Fact discovery is set to close December 21, 2026.
Discovery showed Uber’s...
