Fraud Isn’t Fun Anymore
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Posted on April 28, 2022 by Barry Zalma
See the full video at https://rumble.com/v12oc78-true-crime-of-insurance-fraud-video-number-63.html and at
Not everyone who commits insurance fraud is a hardened criminal. Not all perpetrators of insurance fraud do so to profit. Some, like the person who is the subject of this story, do it for fun.
Insurance investigators have an unearned reputation for brilliance in investigation. Movies and television paint insurance investigators as tough, highly intelligent, tenacious and almost impossible to fool. The average, contrary to the image created by television, insurance investigator is a 25-year-old graduate of a liberal arts college with little investigative experience.
The training received by insurance investigators, properly so, is directed to a determination of how much and how fast a claim should be paid. Their training in fraud detection is limited by the desire of the insurer to fulfill its obligation to pay claims fairly and promptly.
The Insured did not know about the lack of experience of the average insurance investigator. The Insured believed a person who could succeed at fraud would be brilliant. A successful fraud would be an exciting challenge.
He decided to attempt a fraudulent insurance claim. The Insured wanted the excitement in life he believed was his right to experience.
The broker, based on the excellent quality of the appraisals, had no difficulty insuring the schedule. With his connections in the Surplus Line Market the broker placed insurance with a Swiss Insurance Company he knew to be reinsured 100% by a South African reinsurer. The Swiss insurer bound coverage pending a favorable inspection of the art by an appraiser of its choice.
The Insured emptied his life’s savings and paid the required 10% installment on the $42,000 premium. He knew that the inspector would arrive soon. He did not have the rest of the premium or $1,400,000 in fine arts to show the inspector. It was necessary that the ABC Van and Storage facility be the victim of a burglary before the inspector arrived.
If the investigator had recognized the red flags, she would have interviewed each appraiser. If the appraisers had been interviewed, the falsity of the appraisals would have been discovered immediately and the claim could have been denied for fraud. Reports would have been made to the Fraud Division. The Insured may even have been arrested for Insurance fraud, violation of California Penal Code § 550. Instead, the insured, still bored, has a great deal more money than he could ever have earned working in a movie house.
(c) 2022 Barry Zalma & ClaimSchool, Inc.
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. He is available at https://www.zalma.com and [email protected].
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Read the full article at https://lnkd.in/ga89cGrV and see the full video at https://lnkd.in/gNxxW5vB and at https://lnkd.in/gmf8aSrE and at https://zalma.com/blog plus more than 4200 posts.
Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.
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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.
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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...
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Post 4846
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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.
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Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.
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Post 5489
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See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr
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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.
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Post 5543
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Post 4581
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In People Center, Inc. v. Deel, Inc., et al., No. 25-cv-02576-CRB (LJC), United States District Court, N.D. California (November 7, 2026) People Center, doing business as Rippling, and Deel compete in payroll and human-resource management software. Rippling alleges that Deel and its executives recruited Rippling employee Keith O’Brien, based in Ireland, to disclose confidential information and trade secrets.
THE IRISH SUIT
Rippling sued O’Brien in Ireland and Deel in the United States. O’Brien subsequently retained separate counsel, supplied an affidavit describing the alleged espionage, and entered into a Cooperation Agreement with Rippling. In exchange for his cooperation, Rippling agreed to provide financial assistance, indemnification, and conditional dismissal of the Irish proceedings. The agreement also permitted renewed proceedings or a monetary judgment upon a material breach.
The Irish proceedings against O’Brien were dismissed...
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Post 4580
If A Proposed Amendment Is Not Clearly Futile, Then Denial Of Leave To Amend Is Improper
In John Hancock Life & Health Insurance Company v. Caring Connections LLC, Arthur Feldheim, and Blime a/k/a Vera Feldheim, Civ. No. 25-7574 (MAS)(JBD), United States District Court, D. New Jersey (November 6, 2026) John Hancock sued Caring Connections LLC, Arthur Feldheim, and Blime a/k/a Vera Feldheim on June 5, 2025, asserting thirteen claims, including fraud, breach of contract, and aiding and abetting fraud.
On March 26, 2026, this Court entered an order granting Caring Connections’ motion to dismiss and granting in part and denying in part the Feldheims’ motion to dismiss. The dismissed claims were dismissed without prejudice, and John Hancock timely sought leave to amend.
They also argued that the New ...
