Zalma’s Insurance Fraud Letter – May 15, 2023
Barry Zalma
May 16, 2023
Read the full article at https://lnkd.in/gY-E_Vh3 and see the full video at https://lnkd.in/gUwp4Vz9 and at https://lnkd.in/gb4Dncfy and at https://zalma.com/blog plus more than 4500 posts.
Issue Number 10 of the 27th year of publication of Zalma’s Insurance Fraud Letter provides in Adobe pdf format including the following articles. You can read the full 20 page issue at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Millions for Defense: Not a Dime for Tribute
Staged Accident Eliminates Coverage
In a no-fault auto insurance matter brought in New York, State Farm Fire and Casualty Company, as the plaintiff insurer established prima facie entitlement to summary judgment by:
1 submitting the examination under oath transcript of defendant insured Lesie Merle, in which she testified that she primarily garaged the car involved in the accident in Far Rockaway, New York, rather than in Connecticut;
2 the affidavit of its underwriter Christina Ardito, who establishes that such misrepresentation to plaintiff of the car’s location was material.
You can read the full 20 page issue at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
More McClenny Moseley & Associates Issues
This is ZIFL’s sixth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana and what appears to be an effort to profit from what some Magistrate and District judges indicate may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana.
You can read the full 20 page issue at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Prison for 195 Years
Arson Investigators May Testify as Experts as to Cause and Origin of Fire
Following NFPA Guidelines Establishes Expertise Defendant, Todd N. Perkins, appealed twenty-eight criminal convictions stemming from a jury’s verdict finding that he intentionally caused a building explosion. He challenged the trial court’s denial of a hearing to determine the reliability of the bases for the arson investigators’ opinions. In The People of the State of Colorado v. Todd N. Perkins, No. 20CA0882, 2023 COA 38, Court of Appeals of Colorado, Division A (May 4, 2023) the Court of Appeals dealt with claims of incompetent fire cause experts.
You can read the full 20 page issue at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Good News From the Coalition Against Insurance Fraud
Dam Ngoc Luong ran her own temporary workers agency and found out that, though her workers were temporary, insurance fraud is not. The Dorchester woman is now pleading guilty to a host of fraud charges. Prosecutors allege: From 2015 through 2019, Luong owned and operated Four Seasons Temp, Inc. When collecting payments from her temporary employment agency business clients, Luong cashed most of the checks rather than depositing the funds into her business account.
You can read the full 20 page issue including multiple reports of insurance fraud convictions at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Hard Fraud
Those who try to put fraud in more than one category move from soft fraud to what they call “hard fraud.” Hard fraud is considered a fraud or attempted fraud that is premeditated and intentionally committed.
It is considered “hard fraud” because the person perpetrating the fraud did so intentionally and the claim was made for the sole purpose of defrauding the insurer rather than a fraud of opportunity. Of course, fraud is always an intended act or failure to act that damages another. The differentiation exists because some fraud perpetrators are honest people tempted to “cheat a little” when a real claim appears while hard fraud perpetrators intend to do the crime even before a loss is reported. Both have committed the crime or cheated an insurer but soft fraud perpetrators are nicer than those who perpetrate hard fraud.
You can read the full 20 page issue at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Health Insurance Fraud Convictions
California Man Convicted of Health Care Kickback Conspiracy
Steven Donofrio, 49, was convicted by a jury on May 5, 2023, following a two-week trial before U.S. District Judge Robert W. Schroeder, III. Donofrio, a Temecula, California, man has been found guilty of federal violations related to a health care kickback scheme in the Eastern District of Texas.
You can read the full 20 page issue including multiple reports of insurance fraud convictions at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Other Insurance Fraud Convictions
Crop Insurance Fraud Conviction
James Garrett, age 68, was sentenced to 18 months in federal prison, followed by two years of supervised release, and ordered to pay $1,045,544 in restitution to the United http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
States. Levi Garrett, age 44, was sentenced to 24 months in federal prison, followed by two years of supervised release, and ordered to pay $279,396 in restitution to the United States. Chief Judge Roberto A. Lange, U.S. District Court, has sentenced the two Sully County, South Dakota, men convicted of False Statements in Connection with Federal Crop Insurance. The sentencing took place on January 30, 2023.
You can read the full 20 page issue including multiple reports of insurance fraud convictions at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Arson for Profit
Arson is probably the dumbest form of insurance fraud. With modern municipal fire departments arson fires seldom totally destroy the premises, evidence is always left for arson investigators to review, and firefighters and the public are exposed to danger of injury and death and, as a result, judges have little mercy for an arsonist. Arsonists hoping to make a profit from a fire seldom sit back and accept their punishment when they are convicted.
You can read the full 20 page issue including multiple reports of insurance fraud convictions at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
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 [email protected]
Over the last 55 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.
Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455; Subscribe to Zalma on Insurance at locals.com https://zalmaoninsurance.local.com/subscribe
Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Go to the podcast Zalma On Insurance at https://podcasters.spotify.com/pod/show/barry-zalma/support Write to Mr. Zalma at [email protected]; http://www.zalma.com; http://zalma.com/blog; I publish daily articles at https://zalma.substack.com, Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921; Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ to consider more than 50 volumes written by Barry Zalma on insurance and insurance claims handling.
You can read the full 20 page issue at http://zalma.com/blog/wp-content/uploads/2023/05/ZIFL-05-15-2023.pdf
Barry Zalma
Barry Zalma, Esq., CFE is available at http://www.zalma.com and [email protected]
Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455;
Subscribe to Zalma on Insurance at locals.com
Subscribe to Excellence in Claims Handling at https://lnkd.in/gNm9EWKJ.
You can read the full 20 page issue at https://lnkd.in/gJwkcP5q
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 ...
Alleged Defamatory Statements Must be Of and Concerning Plaintiffs
Posted on October 16, 2026 by Barry Zalma
To Prove Defamation the Statement Must be Of and Concerning the Plaintiffs
Post 4867
In Michael Moloney and Sergio Cantu v. United Services Automobile Association, No. 04-25-00519-CV, Court of Appeals of Texas, Fourth District, San Antonio (October 14, 2026) Michael Moloney and Sergio Cantu appealed from the trial court’s granting of a traditional motion for summary judgment in favor of United Services Automobile Association (“USAA”) on their defamation claim.
BACKGROUND
Moloney and Cantu sued USAA for defamation, alleging that they are the principals of Informed Roofing & Restoration, LLC (“Informed Roofing”), which is primarily engaged in the residential roofing repair and replacement business, and that an employee or agent of USAA had made false and defamatory statements to the San Antonio Police Department (“SAPD”) concerning them.
Specifically, Moloney and Cantu alleged that an employee of ...
ZIFL – Volume 30, Issue 20 Subscribe to ZIFL here https://lnkd.in/gfpn78FM
Posted on October 15, 2026 by Barry Zalma
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud.
ZIFL is published 24 times a year is written by Barry Zalma.
It is provided FREE to anyone who visits the site at https://lnkd.in/gVT5G9s
Six Insane Fraud Schemes the Trump Administration Has Uncovered Stealing from the taxpayer has now become a multi-billion-dollar industry in America. Obamacare has been a magnet for scammers.
Florida Insurance Agent Pleads Guilty in $300,000 Premium Finance Scheme
Daniel Raney, 41, who managed Raney Insurance and Raney Ventures in Pensacola, was arrested after AFCO Direct.
RIFE WITH FRAUD ALLOWS DEMANDS TO ESTABLISH RESTITUTION
Six Insane Fraud Schemes the Trump Administration Has Uncovered
Stealing from the taxpayer has now become a multi-billion-dollar industry in America – and the ...
Sentence for Stealing from Veterans Administration Reasonably Considers State Insurance Fraud & Arson Convictions
Post 4863
Posted on October 14, 2026 by Barry Zalma
In United States Of America v. Anthony Curtis Brewer, No. 26-10745, United States Court of Appeals, Eleventh Circuit (October 8, 2026) Anthony Curtis Brewer became the fiduciary for an incapacitated recipient of Department of Veterans Affairs survivor benefits and agreed to use her funds solely for her care and support without commingling them with his own.
The VA determined that he misused $67,232.33 and removed him as fiduciary in 2022. Brewer pleaded guilty to theft of more than $1,000 in government property under 18 U.S.C. § 641. At sentencing, the district court attributed $53,567 in loss to him, producing an advisory Guidelines range of 15 to 21 months.
Citing the victim’s vulnerability, Brewer’s attempts to avoid responsibility, and his other fraudulent conduct — including state convictions for arson and insurance fraud — the court ...
