Insurance Fraud by Insurance Professionals
Read the full article at https://www.linkedin.com/pulse/how-insurance-fraud-destroyed-family-barry-zalma-esq-cfe and see the full video at https://rumble.com/vxcwbq-how-insurance-fraud-destroyed-a-family.html and at
and https://zalma.com/blog plus more than 4100 posts.
Posted on March 14, 2022 by Barry Zalma
See the full video at https://rumble.com/vxcwbq-how-insurance-fraud-destroyed-a-family.html and at
Bill and Libby were very successful insurance brokers. From their offices in Walnut Creek, California, the Bill and Libby Agency generated $100 million in premium volume for fourteen different insurers with whom they held an agency appointment. They were one of the biggest retail insurance agencies in northern California.
Success brought the good life. They owned a six thousand five hundred square foot mini-mansion in the hills of Oakland. They built the house over a lot purchased from a victim of the great Oakland Hills fire storm. Bill and Libby furnished the house with antiques and antique replicas. On every wall Libby hung her collection of ceramic plates and fine art prints. On every shelf sat Lladro sculptures, Hummel figurines and limited-edition sculptures and plates depicting English country scenes. Their daughter, Sassy, had a glass display case in her bedroom with a collection of more than 200 antique or collectible dolls.
The home was destroyed by fire. After minimal investigation established that fraud might have been attempted, the already six inches thick with invoices and estimates of repair costs were photocopied and delivered to L.G.L. Eagle. Eagle, appeared to be the twin brother of Gabby Hayes — with teeth was an effective and experienced insurance lawyer.
After submitting to an examination under oath Libby corrected her denials to an admission of fraud because her lawyer did not want her prosecuted for perjury.
Eagle reviewed the items for which Bill and Libby returned the money in detail. He found that some items he knew were fraudulent were not admitted to being fraudulent while some items he thought were legitimate were admitted to be false. He advised Secure and Stable to cash the check since the fraud had not been cured.
Libby continued to lie to herself and her husband in an attempt to reduce her wrongdoing. He recommended that the entire claim be denied, that the policy be declared void for fraud, and that the full amount paid on the void policy be demanded. If payment was not made instantly he further recommended that Secure and Stable file a suit in U.S. District Court under the Racketeer Influenced and Corrupt Organization Act (RICO) demanding three times the amount paid as punishment.
Secure and Stable could not allow insurance professionals who attempted to defraud their own insurer to profit from a crime against their profession.
A business built on the idea of Uberrima fides (utmost good faith) will not do business with people who have proven they cannot be trusted.
© 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 ...
Posted on September 18, 2026 by Barry Zalma
Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.
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...
Insurer’s Insistence on Keeping Premium Defeats Claim of Voidance for Breach of Condition
Posted on September 16, 2026 by Barry Zalma
Post 4845
After USAA Learned Ford Had Sold The BMW, It Did Not Attempt To Revoke The Policy And Refund The Amount Ford Had Paid For Coverage and was Estopped or Waived it Right to Revoke Coverage
In Lisa White v. USAA Insurance Agency Incorporated, et al., No. CV-24-00378-PHX-KML, United States District Court, D. Arizona (September 10, 2026) Dezmond Ford purchased a USAA automobile policy covering a 2013 BMW for August 7 through December 27, 2020, and apparently paid the full premium.
Ford later sold the BMW to Jack Eddia without notifying USAA, but kept the policy active to avoid a coverage gap. Eddia obtained title and registration and, on November 1, 2020, struck and killed Lisa White’s son while driving the BMW. USAA had accepted premiums through the accident date and, after learning of the sale, did not refund the premium attributable to the post-sale period. White obtained a $3.75...
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Posted on September 1, 2026 by Barry Zalma
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in educing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
This issue contains the following articles about insurance fraud:
Long Island Rep. Laura Gillen Is Taking Aim At Criminals Who Have Been Caught Staging Car Accidents.
Time for a Federal Crime of Insurance Fraud
The accidents may be shams, but the felonies would be real. On Thursday, Gillen (D-NY) introduced the Stop Auto Fraud Act of 2026, which would make the “crash for cash” practice a federal offense punishable by up to 10 years behind bars, with sentence enhancements for smash-ups causing injury or death.
Rep. Laura Gillen is hoping her bipartisan bill will become law to give prosecutors a federal crime to prosecute cash for crash ...
