The Resource for the Insurance Claims and Insurance Fraud Professionals
Barry Zalma
Dec 15, 2023
Read the full article at https://lnkd.in/gBhj_4Vs and sthe full video at https://lnkd.in/g2DKPfye and at https://lnkd.in/gkbzw3xE and at https://zalma.com/blog plus more than 4690 posts.
ZIFL – Volume 27 – Issue 24
Merry Christmas, Happy Hanukah, and May the Winter Solstice be Peaceful & Mild
Post 4690
ZIFL-12-15-2023
See the full video at https://rumble.com/v419744-zalmas-insurance-fraud-letter... and at
This, the 24th issue of the 27th Year of ZIFL includes articles and reports relating to insurance fraud, including:
Former Root Marketing Exec Pleads Guilty to Taking Over $10 Million From the Insurer
Brinson Caleb “BC” Silver, former chief marketing officer for insurtech Root, has pleaded guilty to stealing more than $10 million from his former employer and violating court orders.
According to the U.S. Attorney’s Office for the Southern District of Ohio, Silver, 43, of Culver City, California, pleaded guilty to one count each of wire fraud and contempt of court and has agreed to pay more than $10.2 million in restitution. A prison sentence of 24-51 months has been recommended.
Read the full issue of ZIFL at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.pdf
More McClenny Moseley & Associates Issues
This is ZIFL’s twentieth 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.
December 8, 2023 – History of MMA Issues
Read the full issue of ZIFL at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.pdf
The Insurance Examination Under Oath
A Tool Available to Insurers to Thoroughly Investigate Claims
The insurance Examination Under Oath (“EUO”) is a formal type of interview authorized by an insurance contract. It is taken under the authority provided by a condition of the insurance contract that compels the insured to appear and give sworn testimony on the demand of the insurer or find his, her or its claim rejected for breach of a condition. A notary and a certified shorthand reporter are always present to give the oath to the person interviewed and record the entire conversation.
Read the full issue of ZIFL at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.pdf
Health Insurance Fraud Convictions
Doctor and Wife Admit Genetic Testing Kickback and Bribery Scheme
Yitzchok “Barry” Kurtzer, 63, and his wife, Robin Kurtzer, 62, both of Monsey, New York, a Pennsylvania doctor, and his wife admitted to their roles in schemes to solicit and receive kickbacks and bribes in exchange for ordering genetic tests.
Read the full issue of ZIFL and about dozens of fraud convictions at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.pdf
What is Needed to Deter Insurance Fraud?
To do so the insurers must train their staff to recognize the elements of both the crime of insurance fraud and the elements of the civil tort of insurance fraud. If well trained, insurance personnel collecting information about a potential insurance fraud, will know the type and quality of information that either a prosecutor or a civil defense lawyer will need to prove fraud was attempted.
Some estimates indicate that more money goes out fighting fraud than is saved. Others show that every dollar spent by insurers to defeat fraud save the insurer as much as seven dollars in fraudulent claims. Although insurance fraud is a crime in almost every jurisdiction in the United States it is seldom prosecuted.
Read the full issue of ZIFL at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.pdf
Other Insurance Fraud Convictions
North Carolina Insurance Agent Can’t Appeal Sentence in $700,000 Fraud
Glenda Taylor-Sanders, of Charlotte, North Carolina, a former insurance agent who pleaded guilty to defrauding trucking company clients and a premium finance company of hundreds of thousands of dollars cannot challenge her sentence and restitution order, a federal appeals court decided.
Read the full issue and dozens of convictions at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.pdf
Fraud After Catastrophes
Over the past few decades fraud has become an ever escalating problem. It is part of the CODB equation and quickly becomes just one more cost to be passed on to the insurance buying public. When a catastrophe hits everyone suffers. The victims of the catastrophe suffer. The insurers whose staff is not adequately trained to investigate and adjust claims and recognize fraud compounds the suffering of the victims and costs the insurer.
Read the full issue of ZIFL at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.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
Zalma on Insurance
Insurance, insurance claims, insurance law, and insurance fraud .
By Barry Zalma
, 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.
Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/ 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 Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg, Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ and GTTR at https://gettr.com/@zalma
Read the full issue of ZIFL at http://zalma.com/.../uploads/2023/12/ZIFL-12-15-2023.pdf
Barry Zalma, Esq., CFE, is available at http://www.zalma.com and [email protected]
Who’s on First? State or Federal Court
Post 5222
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Conflict Between State & Federal Court Requires Abstention
See the video at https://lnkd.in/gtS6CpUX and at https://lnkd.in/gQEAeyHc,
Conflict Between State & Federal Court Requires Abstention
Hector David Campoverde was injured at a Brooklyn construction site in 2015. Campoverde was an employee of Vazquez Bro Restoration Inc., a subcontractor for C.C.C. Renovation Inc., which was itself a subcontractor for general contractor L&M Builders Group LLC. In Starr Indemnity & Liability Company v. Scottsdale Insurance Company, No. 24-CV-3309 (PKC) (TAM), United States District Court, E.D. New York (September 30, 2025) was asked to determine whether one or more of the involved insurers is obligated to indemnify Campoverde, and in what order Camporverde can receive indemnity, from one or more insurer.
Underlying Incident:
Campoverde sued the ...
National Flood Policy Bars Late Filed Suit
Post 5221
Read the full article at https://www.linkedin.com/pulse/one-year-suit-limitation-defeats-filed-two-years-zalma-esq-cfe-olr0c, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
No Excuse for Late Flood Suit After Claim Denial
In Domenico D’ambrosio, Michele D’ambrosio v. American Bankers Insurance Company Of Florida, No. 2:25-cv-155-KCD-NPM, United States District Court, M.D. Florida, Fort Myers Division (October 7, 2025) this is an insurance dispute stemming from Hurricane Ian. Plaintiffs Domenico and Michelle D’Ambrosio submitted a flood claim that Defendant American Bankers Insurance Company of Florida will not pay. To recover the funds allegedly owed, Plaintiffs sued for breach of contract.
Defendant’s moved to dismiss under Fed.R.Civ.P. 12(b)(6). Defendant presses one ...
ZIFL – Volume 29, Issue 21
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post 5220
Read the full article at https://lnkd.in/gRMJpi4s, see the video at https://lnkd.in/gwGSd6ZA & at https://lnkd.in/gbDiuFJy, and at https://zalma.com/blog plus more than 5200 posts.
See the video at & at https://rumble.com/v711hr0-zalmas-insurance-fraud-letter-november-1-2025.html
See the full 18 page issue of ZIFL at ZIFL-11-01-2025
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing 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/
Conviction for Health Insurance Fraud Upheld
Physician Conspired with Bonavilla to Effect Health Insurance Fraud
Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on ...
The Professional Claims Handler
Post 5219
Posted on October 31, 2025 by Barry Zalma
An Insurance claims professionals should be a person who:
Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.
How to Create Claims Professionals
To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
