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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September 02, 2024
Zalma’s Insurance Fraud Letter – September 1, 2024

Zalma’s Insurance Fraud Letter – September 1, 2024

Read the full article at https://lnkd.in/gA9B3V9H; see the full video at https://lnkd.in/gy6ypdt8 and at https://lnkd.in/gaYFPuik and at https://zalma.com/blog plus more than 4850 posts.

ZIFL Volume 28 Number 17
Post 4864

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 https://lnkd.in/gVT5G9s This issue contains the following articles about insurance:

Some Claim “Insurance Fraud Cost Statistics Are a Fraud” Or Are They Just an Estimate?

In an article entitled Insurance Fraud Cost Statistics Are a Fraud by attorney Chip Merlin, published August 15, 2024. The often wrongfully cited estimate of $308.6 billion is an admittedly “make believe” estimate.

See the full article and the full 18 page edition of ZIFL at https://lnkd.in/g2dFi6Vt

Insurance Fraudster Who Represents Herself is Foolish

Convicted Felon Incompetently Seeks Shortened Sentence

More McClenny Moseley & Associates Issues

This is ZIFL’s thirty fourth 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.

See the full article and the full 18 page edition of ZIFL at https://lnkd.in/g2dFi6Vt

Seven Years in Prison for No Fault Fraud

Defendant Must Pay $46 Million Restitution in Installments

Health Insurance Fraud Convictions

Connecticut Dentists Pay $1.7 million to Settle False Claims Allegations

Convicted of a Variety of Fraud Schemes Including Insurance Fraud

See the full article and the full 18 page edition of ZIFL at https://lnkd.in/g2dFi6Vt

Convictions of Other Than Health Insurance Fraud

See the full article and the full 18 page edition of ZIFL at https://lnkd.in/g2dFi6Vt

State Passes New Bill to Pay Fraud Division Detectives Equal to Other State Detectives

Dealing With the Nervous Person During An EUO

When investigating fraud, the professional knows how to exploit the subject’s fear of being caught in an illegal act of deception and of suffering punishment.

See the full article and the full 18 page edition of ZIFL at https://lnkd.in/g2dFi6Vt

Go to my Interview on the Art of Adjusting Podcast & https://lnkd.in/gEP3h_Ma

00:10:17
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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...

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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 ...

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October 16, 2026

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 ...

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October 15, 2026
Zalma’s Insurance Fraud Letter – October 15, 2026

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 ...

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October 14, 2026
District Court has Wide Discretion in Sentencing

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 ...

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