Zalma on Insurance
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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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May 04, 2022
True Crime of Insurance Fraud Number 66

Lucy and the Tsar

See the full video at https://rumble.com/v13emlt-true-crime-of-insurance-fraud-number-66.html?mref=16emn&mrefc=2 and at

See the full video at https://rumble.com/v13emlt-true-crime-of-insurance-fraud-number-66.html?mref=16emn&mrefc=2 and at

Lucy served as second officer on a 747 operated by Trans-Oceanic Airlines. Twice a week she flew from Dallas to Leningrad; with brief layovers in New York and Brussels. She had been a second officer for five years. Lucy was looking forward to promotion to first officer. She would be the second woman to command a 747 for Trans-Oceanic.

Her performance reviews were always exceptional. Never had Trans-Oceanic Airlines treated her differently than any other pilot. The glass ceiling seemed nonexistent.

Lucy, as a highly paid professional airline pilot, owned a beautiful 5000 square foot home in Dallas where she lived with her son, daughter and a full- time housekeeper/nanny. She was happy. Her future was unlimited. At forty years of age she was approaching the apex of her professional career.

Her layover in Leningrad was usually two days. Lucy would recover from the inevitable jet lag by visiting the great museums of the time of the Tsars. Her favorite was the Hermitage, which was once the Tsar’s summer palace.

To the museum she always brought along her Nikon single lens reflex camera that recorded each picture with very high resolution. She used the Nikon to photograph the magnificent treasures stolen by the Bolsheviks from the Tsar. The fast lens and digital enhancement allowed her to obtain images without using a flash. Lucy would spend evenings in her hotel sorting her photographs into categories on her lap top.

She had collections of close-up shots of Faberge royal Easter eggs; of oil paintings by Gaugin, Degas, Van Gogh and Picasso; and photos of fine works of art made by native Russian craftsmen unknown in the West.

Lucy converted the settlement check to US currency Travelers Checks. She placed the Travelers Checks in her overnight bag on the airplane. When she landed, as part of a well-known airline crew, her luggage was not inspected by the local customs officials. The Travelers Checks, better than cash, entered the new Russia without hindrance. Lucy immediately went to the dealer appointed by the Hermitage and purchased the Fabergé bird she lusted for paying only 200,000 US Dollars in Travelers checks.

With the remaining $50,00 she purchased two Fabergé silver cigarette cases and a small Picasso drawing in pencil signed and dated by the artist. The bird is displayed prominently over Lucy’s mantelpiece and she used the Fabergé cigarette case to hold note papers and a fountain pen.

Lucy was lucky. If anyone at Edward Lloyd’s Insurance Company had gone to the Dallas public library, they could have found similar photographs of the same items in any one of several books on the Hermitage collection housed at the library. They did not.

Lucy was promoted to Captain. She now commands a Trans-Oceanic 747 that flies three times a week nonstop from Dallas to London’s Heathrow airport.

She is starting a collection of photographs from the Queen’s Museum at Buckingham Palace.
ZALMA OPINION

It is time for the insurance industry to invest in a team of insurance claims professionals who know how to investigate a claim, interpret an insurance policy, and deal with a false and fraudulent claim to keep people like Lucy for enjoying a life of successful crime.

(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 http://www.zalma.com and [email protected].

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What else you may like…
Videos
Posts
September 18, 2026
Expert May Only Testify to What Experience Supports

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...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

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 ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

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 ...

00:05:14
September 25, 2026
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair. The defendant denied negligence and alleged comparative negligence. After a two-day jury trial in November 2023, the jury returned a defense verdict.

The trial court denied Ojekwe’s motion to set aside the verdict and for a new trial, and he appealed.

LAW

A trial court’s refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of ...

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September 25, 2026
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair.

LAW

Refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of discretion.

Appellate claims receiving only cursory treatment, without record citations, supporting authority, or legal analysis, are inadequately briefed.

DISCUSSION

Improper opening remarks.

Defense counsel referred to Ojekwe’s national origin,...

September 24, 2026
Restitution Sentence Affirmed

Psychiatrist Who Was Convicted of Fraud Asked the First Circuit to Reduce his Punishment
Post 4851

Posted on September 24, 2026 by Barry Zalma

Fraud to Private and Public Health Insurers Doesn’t Pay

In United States v. Gustavo Kinrys, Nos. 24-1592, 24-1716, United States Court of Appeals, First Circuit (September 21, 2026) Gustavo Kinrys, a Massachusetts psychiatrist, submitted fraudulent claims to private and public health insurers from 2015 through 2018, including bills for more than 1,000 sessions when he or the purported patient was outside the country. When insurers requested supporting records, he delayed through a fictitious office manager and created false documentation.

A jury convicted Kinrys on fourteen counts. The district court imposed a 99-month sentence, calculated intended loss at slightly more than $19 million based on billed amounts, ordered $6,537,309.59 in restitution, and ordered $6,527,391.19 in forfeiture.

At sentencing, the district court calculated Kinrys’s base offense level to be ...

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