ZIFL Volume 28, Issue 11
https://lnkd.in/g4ZCBiis, See the full article at https://lnkd.in/g2VXQMY3, https://lnkd.in/g4ZCBiis, see the full video at https://lnkd.in/gga7T4QM and at https://lnkd.in/gADfWipg and https://zalma.com/blog plus more than 4800 posts.
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
The Source for the Insurance Fraud Professional
Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th 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/ This issue contains the following articles:
The Scope of Loss
When dealing with a potential fraudulent first party-property loss it is essential that the investigation into the claim is through and prompt. To do a thorough investigation of a property loss it is essential that the insured and the company’s adjuster agree to a complete scope of loss so that the investigation into the amount of the loss is prepared and agreed to in immediately.
In a loss to structures or contents the scope of loss is generated at the first meeting between the adjuster and the insured. The scope of loss is where both parties agree on the categories of property damaged.
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
More McClenny Moseley & Associates Issues
This is ZIFL’s twenty ninth 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.
April 26, 2024 – MMA Generated Lawsuits Dismissed
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
Insureds are Made More Equal Than Insurers
California Court of Appeals Extends Meaning of Statute to Make Insured More Powerful than Insurers at EUO
As George Orwell explained in his novel “Animal Farm” we are all equal, but some are more equal than others. In Vladimir Myasnyankin v. Nationwide Mutual Insurance Company, A166946, A167445, California Court of Appeals, First District, Fifth Division (January 30, 2024) the Court of Appeals decided, over the dissent of the Presiding Judge that the insured in a disputed claim is more equal than the insurer.
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
New Book
The Compact Book of Adjusting Property Claims – Fourth Edition
In Kindle, paperback and hardback formats, The Compact Book of Adjusting Property Claims, Fourth Edition is now available for purchase here and here. The Fourth Edition contains updates and clarifications from the first three editions plus additional material for the working adjuster and the insurance coverage lawyer.
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
Health Insurance Fraud Convictions
The federal prosecutors and courts have been busy prosecuting health insurance fraud.
Doctor, One of Top Prescribers of Opioids in Massachusetts, Is Sentenced
Dr. Olarewaju James Oladipo, of Canton, a Massachusetts, an orthopedic surgeon who prosecutors say was one of the top prescribers of opioid drugs in the state was sentenced in federal court in Boston for his role in a health care fraud scheme.
Oladipo was sentenced by U.S. District Court Judge Allison D. Burroughs to 16 months in prison, followed by one year of supervised release. In December 2023, Oladipo was convicted by a federal jury of 10 counts of health care fraud.
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
New Book Now Available from Barry Zalma
Property Investigation Checklists: Uncovering Insurance Fraud, 14th Edition
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
Other Insurance Fraud Convictions
Tennessee Man Sentenced to Over 3 Years in Federal Prison for Crop Insurance Fraud
David Garrett Manion, 61, of Lafayette, Tennessee, was sentenced to 3 years and 6 months in federal prison, followed by 3 years of supervised release, and was ordered to pay $3.5 million in restitution for defrauding the federal crop insurance program.
According to court documents, Manion was convicted for defrauding the federal crop insurance program between 2016 and 2022. Manion also has a prior 2016 conviction for defrauding the federal crop insurance program. As part of that 2016 case, Manion agreed to a five-year debarment from the federal crop insurance program administered by the United States Department of Agriculture Risk Management Agency.
While that case was being resolved, however, Manion devised a scheme under which other family members applied for and received crop insurance for tobacco that was farmed by and belonged to Manion. In addition to $3.5 million in criminal restitution, Manion agreed to pay the Risk Management Agency nearly $5.5 million to resolve other outstanding issues.
Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
(c) 2024 Barry Zalma & ClaimSchool, Inc.
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Read the article and the full 26 page issue here in Adobe pdf format http://zalma.com/blog/wp-content/uploads/2024/05/ZIFL-06-01-2024.pdf.
Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.
Go to X @bzalma; Go to the Insurance Claims Library – https://lnkd.in/gwEYk
Read the article and the full 26 page issue here in Adobe pdf format https://lnkd.in/g2VXQMY3.
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 ...
