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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January 30, 2025
Failure to Profit From the Crime of Insurance Fraud Does not Excuse the Crime

CONVICTION FOR INSURANCE FRAUD AFFIRMED

Post 4984

UNSUCCESSFUL FAKE ACCIDENT STILL GOES TO JAIL

Read the full article at https://lnkd.in/gBvuyK3F, see the full video at https://lnkd.in/gWJAwz_h and at https://lnkd.in/gf9_pqzn and at https://zalma.com/blog plus more than 4950 posts.

THE PEOPLE v. STEPHEN R. JACKSON, H052419, California Court of Appeals, Sixth District (January 23, 2025) Jackson tried to have his felony conviction reduced to a misdemeanor because of Proposition 47.

FACTUAL BACKGROUND

In 1992, Jackson was charged by information with conspiracy to commit insurance fraud, causing or participating in a vehicular collision or any other vehicular accident for the purpose of presenting a false or fraudulent claim; presenting or causing to be presented a false or fraudulent insurance claim; presenting a false or fraudulent claim for loss or theft, destruction, damage, or conversion of the contents of a motor vehicle; and, preparing a false police report and authorization of medical records/employment records with intent to present it in support of a false or fraudulent claim. Jackson was convicted by plea of count 2, violation of Insurance Code section 1871.1, subdivision (a)(3), a felony, and placed on felony probation.

In 2024, Jackson filed an application to have his felony conviction designated as a misdemeanor

Proposition 47, approved in November 2014, makes certain drug-and theft-related offenses misdemeanors. Nothing in the relevant statute bases the punishment for the crime of participating in a vehicular collision for the purpose of presenting a false claim on the value of the property or claim at issue.

In addition to alleging that the value of the claim at issue in his conviction should make him eligible for relief under section 1170.18, subdivision (f), Jackson argued that he “was never given a check,” “never saw the check”, and that he “didn’t destroy any property or damage any property.”

ANALYSIS

Stephen R. Jackson’s appeal was based on his conviction for causing or participating in a vehicular collision to present a false or fraudulent claim. He argued that under Proposition 47, which reduces certain property theft crimes to misdemeanors when the value is $950 or less, his offense should also be reclassified since the value of the checks was under $950.

Key Points

1. Both before and after Proposition 47, Jackson’s offense was classified as a felony under Insurance Code section 1871.1 and current Penal Code section 550.
2. The legislature intended to treat causing or participating in a vehicular collision for the purpose of presenting a false claim as a felony, regardless of the value of the claim.
3. The punishment for Jackson’s crime does not depend on the claim’s value, unlike other offenses under Insurance Code section 1871.1 and section 550, which are misdemeanors if the claim is below certain amounts.

Conclusion

The trial court properly denied Jackson’s section 1170.18, subdivision (f) petition to redesignate his felony conviction for causing or participating in a vehicular collision or any other vehicular accident for the purpose of presenting a false or fraudulent claim as a misdemeanor.

ZALMA OPINION

The people of California did away with most of Proposition 47 but it was in effect when Jackson was convicted. However, since his crime, auto insurance fraud, is always a felony even if he was so incompetent he made nothing from his crime, he was properly convicted and the court refused to change his felony to a misdemeanor. There is no excuse for committing insurance fraud and even if the fraud failed to make any money for Jackson he committed the crime. Jackson was probably caught, tried and convicted because he was an incompetent criminal and must now continue to live with the shame of a felony conviction.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:21
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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...

00:03:10
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 ...

00:05:14
November 05, 2026
Convicted of Felony Fraud You Lose the Right to Vote

Payment of Fines & Completion of Probation Reinstates Right to Vote

Post 4576

Posted on November 5, 2026 by Barry Zalma

To Restore Voting Rights The Felon Must Pay Fines of $546.00

In Florida Supreme Court Mediator Ethics Advisory Committee, ETH F-26-377, No. F-26-377 (October 29, 2026) citizen unnamed and to Ron Desantis Governor, Cord Byrd the Secretary of State Florida Division of Elections provided an advisory opinion to a convicted felon about his right to vote:

To: [redacted] We received your request for an advisory opinion. You indicate that you have one or more felony convictions and request whether you are eligible to vote, including whether you have any outstanding legal financial obligations under section 98.0751, Florida Statutes, and, if so, a statement of the amount that must be paid to make you eligible to vote, and an explanation of how the amount was calculated.

The Division hereby responds to your request pursuant to its legal authority under section 106.23(2), Florida Statutes, and Florida ...

November 04, 2026
Castro Valdez Had an Available Administrative Appeal and Failed to Establish a Ground for Excusing

Administrative Review Permits the Agency to Apply its Expertise

Post 4574

In Erwin Jordan Castro Valdez v. Warden, Otay Mesa Detention Center, No. 26-cv-06147-BAS-JLB, United States District Court, S.D. California (October 30, 2026) Castro Valdez, a Cuban national paroled into the United States, was arrested on June 23, 2026, for alleged insurance fraud, grand theft, and making a false report to law enforcement. In his first habeas action, the district court ordered a bond hearing within fourteen days to determine whether the changed circumstances justified revoking his parole.

An Immigration Judge subsequently denied bond because of his pending state criminal case. Castro Valdez filed a second petition under 28 U.S.C. § 2241, challenging that determination and requesting immediate release without first appealing to the Board of Immigration Appeals (BIA).

LAW

According to the supplied text, § 2241 does not expressly require administrative exhaustion, but courts impose exhaustion as a prudential requirement. ...

November 03, 2026
Jury Found Prudential to be the Victim of Fraud

Insured’s Ordered to Pay Insurer for Fraud by the Insureds

Post 4573

Posted on November 3, 2026 by Barry Zalma

In The Prudential Insurance Company Of America v. Carol Gardina and George Gardina, No. 6:23-cv-1125-JSS-DCI, United States District Court, M.D. Florida, Orlando Division (October 22, 2026).

THE JURY TRIAL AND VERDICT

Plaintiff sued Defendants for numerous causes of action stemming from its allegations that Defendants fraudulently collected benefits under their long-term care insurance policies. Plaintiff's case proceeded to a nine-day jury trial, after which the jury found Defendants liable for fraudulent misrepresentation, fraudulent concealment, and civil conspiracy.

The jury also found Defendant Carol Gardina liable to Plaintiff for $1,930,129 in compensatory damages and Defendant George Gardina liable to Plaintiff for $12,496 in compensatory damages and $20 in punitive damages. Thereafter, the court entered judgment in Plaintiff's favor and awarded Plaintiff $1,930,129 in compensatory damages from...

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