ZIFL – Volume 28 Number 14
Read the full article at https://lnkd.in/gbj6c5R5; https://lnkd.in/gj6gmEHf, See the full video at https://lnkd.in/gF3WAQVQ and at https://lnkd.in/gtShaQNc and at https://zalma.com/blog plus more than 4800 posts.
Zalma’s Insurance Fraud Letter – July 15, 2024
Post 4834
The Source for the Insurance Fraud Professional
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itor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D
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 about insurance:
Present as Real a Free and Imaginary Oral Estimate as Proof of Claim is Fraud
False Swearing & Fraud in Claim Presentation Voids Policy
Never Lie To Your Insurer About The Extent Of Damage
Too many people believe that having a claim disputed by an insurance company is an invitation to get rich by suing an insurance company. People and some lawyers believe they can do anything to get money from an insurance company to profit from a claim and if they are caught, they will still recover the true amount of the loss. The USDC in Illinois put the lie to that assumption and an insured, trying to inflate a claim with what turned out to be a fake bid, was sufficient to make the insured take nothing and order it to pay back to the insurer what was paid before the dispute.
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf
Criminal Investigation of Insurance Fraud Without Indictment Not Grounds for Stay of Civil Action
Fraud Bureau Investigates
Defendant Kith Furniture, LLC’s moved to stay the proceedings brought by Liberty Mutual in Liberty Mutual Fire Insurance Company v. Kith Furniture, LLC, No. 6:23-cv-01130-LSC, United States District Court, N.D. Alabama, Jasper Division (July 1, 2024) and the District Court resolved the dispute.
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf
More McClenny Moseley & Associates Issues
This is ZIFL’s thirty first 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.
May 24, 2024
In David Wynn v. Southern Fidelity Insurance Co, No. 2:22-CV-04641, United States District Court, W.D. Louisiana, Lake Charles Division (May 24, 2024) alleged damage to plaintiff’s home in Sulphur, Louisiana, during Hurricanes Laura and Delta. Plaintiff, who was then represented by counsel from the law firm of McClenny Moseley & Associates, filed suit in this court against Southern Fidelity Insurance Company on August 25, 2022, raising claims of breach of insurance contract and bad faith.
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf
Trucking Firm Owner’s Scheme to Lower Insurance Costs Guilty on Seven Counts
Tony Kirik, the owner of a New York trucking business who fabricated a supposedly independent Texas affiliate to circumvent his existing firm’s negative safety rating higher insurance costs was found guilty of conspiracy and fraud. On June 21, 2024 a jury in the U.S. District Court for the Western District of New York, following a three-week jury trial, found Kirik guilty on seven counts that include conspiracy, false documents, false statements, falsification of records, and concealment of material facts.
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf
More Prosecution is Needed to Deter Insurance Fraud
Thomas Orville McLaughlin II was convicted of committing a fraudulent insurance act, making a false information, and interfering with law enforcement. He appealed claiming several of the State’s exhibits were improperly admitted and that a defense witness was improperly excluded.
In State of Kansas v. Thomas Orville McLaughlin II, No. 124,221, Court of Appeals of Kansas (June 21, 2024) McLaughlin sought relief from his conviction for insurance fraud.
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf
Health Insurance Fraud Convictions
Pacific Toxicology Laboratories Agrees to Pay $1 Million to Resolve Allegations of Fraudulent Billing
Pacific Toxicology Laboratories (PacTox), has agreed to pay $1 million to resolve allegations that it submitted false claims for payment to Medicare for urine drug testing (UDT).
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf and dozens more reports of convictions.
Convictions of Other Than Health Insurance Fraud
Iowa Woman Sentenced for Pet Insurance Fraud
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf
Sarah Rahm, age 39, of Bondurant, Iowa made willful misrepresentations regarding her pet’s medical history and then falsified the onset date of a claimed medical condition in connection with an insurance claim, according to an investigation by the Iowa Insurance Division’s Fraud Bureau.
Read the full July 15, 2024 issue of ZIFL here.
UK Convicts Motorcycle Fraud Claims
Matthew Shaw lost his claim in the UK in a case called Shaw v Wilde, Case No: F90NlA2-1 a case that arose from a motorcycle accident that left Mr. Shaw with injuries to all four limbs. After receiving an interim payment of £150,000 from Hastings Direct, Mr Shaw pursued a £6.6 million claim, citing expenses for luxury vehicles and business class travel.
Hastings Direct and Keoghs achieved what is said to be the largest fundamental dishonesty verdict ever recorded in the UK, with £6.6 million saved by the insurance provider.
Read the full July 15, 2024 issue of ZIFL http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-07-15-2024.pdf.
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.
He publishes daily articles at https://zalma.substack.com, 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/ ; Go to X @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/ and GTTR at https://gettr.com/@zalma
ZIFL-07-15-2024.pdf
Read the full July 15, 2024 issue of ZIFL at https://lnkd.in/gj6gmEHf
Barry Zalma, Inc., 310-390-4455;
Convicted Criminal Seeks to Compel Receiver to Protect his Assets
Post number 5291
See the video at and at and at https://www.zalma.com/blog plus more than 5250 posts.
The Work of a Court Appointed Receiver is Constitutionally Protected
In Simon Semaan et al. v. Robert P. Mosier et al., G064385, California Court of Appeals, Fourth District, Third Division (February 6, 2026) the Court of Appeals applied the California anti-SLAPP statute which protects defendants from meritless lawsuits arising from constitutionally protected activities, including those performed in official capacities. The court also considered the doctrine of quasi-judicial immunity, which shields court-appointed receivers from liability for discretionary acts performed within their official duties.
Facts
In September 2021, the State of California filed felony charges against Simon Semaan, alleging violations of Insurance Code section 11760(a) for making...
When There are Two Different Other Insurance Clauses They Eliminate Each Other and Both Insurers Owe Indemnity Equally
Post number 5289
In Great West Casualty Co. v. Nationwide Agribusiness Insurance Co., and Conserv FS, Inc., and Timothy A. Brennan, as Administrator of the Estate of Pat- rick J. Brennan, deceased, Nos. 24-1258, 24-1259, United States Court of Appeals, Seventh Circuit (February 11, 2026) the USCA was required to resolve a dispute that arose when a tractor-trailer operated by Robert D. Fisher (agent of Deerpass Farms Trucking, LLC-II) was involved in a side-impact collision with an SUV driven by Patrick J. Brennan, resulting in Brennan’s death.
Facts
Deerpass Trucking, an interstate motor carrier, leased the tractor from Deerpass Farms Services, LLC, and hauled cargo for Conserv FS, Inc. under a trailer interchange agreement. The tractor was insured by Great West Casualty Company with a $1 million policy limit, while the trailer was insured by Nationwide Agribusiness Insurance Company with a $2 million ...
Opiod Producer Seeks Indemnity from CGL Insurers
Post number 5288
Read the full article at https://lnkd.in/guNhStN2, see the full video at https://lnkd.in/gYqkk-n3 and at https://lnkd.in/g8U3ehuc, and at https://zalma.com/blog plus more than 5250 posts.
Insurers Exclude Damages Due to Insured’s Products
In Matthew Dundon, As The Trustee Of The Endo General Unsecured Creditors’ Trust v. ACE Property And Casualty Insurance Company, et al., Civil Action No. 24-4221, United States District Court, E.D. Pennsylvania (February 10, 2026) Matthew Dundon, trustee of the Endo General Unsecured Creditors’ Trust, sued multiple commercial general liability (CGL) insurers for coverage of opioid-related litigation involving Endo International PLC a pharmaceutical manufacturer.
KEY FACTS
Beginning as early as 2014, thousands of opioid suits were filed by governments, third parties, and individuals alleging harms tied to opioid manufacturing and marketing.
Bankruptcy & Settlements
Endo filed Chapter 11 in August 2022; before bankruptcy it ...
Passover for Americans
Posted on February 19, 2026 by Barry Zalma
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lost the ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah. Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and wonder how did all these wonderful things come into being. Jews believe the force we call G_d created the entire universe and everything in it. Jews feel G_d is all seeing and knowing and although we can’t see Him, He is everywhere and in everyone.We understand...
Passover for Americans
Posted on February 19, 2026 by Barry Zalma
Read the full article at https://www.linkedin.com/pulse/passover-americans-barry-zalma-esq-cfe-5vgkc.
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lostthe ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah.
Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and ...
You Get What You Pay For – Less Coverage Means Lower Premium
Post number 5275
Posted on January 30, 2026 by Barry Zalma
See the video at and at
When Experts for Both Sides Agree That Two Causes Concur to Cause a Wall to Collapse Exclusion Applies
In Lido Hospitality, Inc. v. AIX Specialty Insurance Company, No. 1-24-1465, 2026 IL App (1st) 241465-U, Court of Appeals of Illinois (January 27, 2026) resolved the effect of an anti-concurrent cause exclusion to a loss with more than one cause.
Facts and Background
Lido Hospitality, Inc. operates the Lido Motel in Franklin Park, Illinois. In November 2020, a windstorm caused one of the motel’s brick veneer walls to collapse. At the time, Lido was insured under a policy issued by AIX Specialty Insurance Company which provided coverage for windstorm damage. However, the policy contained an exclusion for any loss or damage directly or indirectly resulting from ...
