ZIFL Volume 29, Issue 7
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gQM9yR3n and at https://lnkd.in/gZDkH7RU, and at https://zalma.com/blog plus more than 5000 posts.
April 1, 2025
Post 5035
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/ You can read the full issue of the April 1, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf.
This issue contains the following articles about insurance fraud:
Lawyers Sanctioned for Tricking a Witness With a False Document
The United States District Court Eastern District Of Texas Marshall Division, Civil Action No. 2:23-CV-00160-JRG in a case entitled Cognipower, LLC v. Samsung Electronics Co., Ltd et al, a report was filed by David Folsom, Special Master a motion for sanctions filed by Samsung.
One of the bases of the decision reached by the Mr. Folsom was the requirement that lawyers are required to deal fairly and in good faith with their adversaries and act honorably in all their actions.
Read the full article and the full 20 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf
Guilty of Forgery Affirmed
8 Years in Prison for Forgery to Establish Non-Existent Counseling
Jail House Lawyer Fails
In The People Of The State Of Illinois v. Robert A. Moylan, 2025 IL App (3d) 230248-U, No. 3-23-0248, Court of Appeals of Illinois (March 11, 2025) Robert A. Moylan was found guilty of seven counts of forgery for signing and delivering false documents stating that his clients had successfully completed court-ordered counseling services.
Moylan was sentenced to an aggregate term of eight years’ imprisonment. He appealed, claiming several errors by the court, including the denial of his motions to suppress eavesdrop recordings and evidence seized from his offices, and the denial of his request for a public defender at sentencing.
Read the full article and the full 20 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf
Staged Accident is One Where Claimed Collision Was Intentional
Evidence Needed to Use Staged Accident Claim as Defense
In State Farm Fire And Casualty Company v. Felix A. Quinones, et al, INDEX No. 152505/2021, 2025 NY Slip Op 30754(U), MOTION SEQ. No. 002, Supreme Court, New York County (March 7, 2025) State Farm, sought to disclaim coverage for medical treatment provided to the defendants, who were involved in an automobile collision on February 26, 2020.
The court granted the plaintiff’s motion for summary judgment in part, declaring that State Farm has no obligation to pay claims submitted by Grand Medical Supply Corp. due to Quinones’s failure to appear for examinations under oath (EUOs). However, the court denied the plaintiff’s motion for summary judgment on the basis that the collision was staged, citing insufficient evidence.
Read the full article and the full 20 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf
Heath Insurance Fraud Convictions
$5 Million False Claims Act Settlement With Providers Of Programs For Adults With Developmental Disabilities
Community Options, Inc. and New York Affiliate admit Billing Medicaid for Services Without Accurate and Adequate Supporting Documentation and Failing to Report and Return Overpayments to Medicaid.
Read the full article and the full 20 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf
MORE MCCLENNY MOSELEY & ASSOCIATES ISSUES
This is ZIFL’s forty-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.
The proposed settlement agreement in the MMA bankruptcy raises several red flags of which all legal professionals should take serious notice.
March 19, 2025
Disproportionate Fee Allocation to EAJF
Read the full article and the full 20 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf
CONVICTIONS OF OTHER THAN HEALTH INSURANCE FRAUD
Miami Insurance Broker Sentenced to 3.5 Years in Condo Premium Finance Scheme
Heleonel Gonzalez, known as Leo, a Miami insurance broker was sentenced to 41 months in prison by a federal judge and more than $5 million in restitution for defrauding a Georgia credit union by obtaining loans for condominium associations’ premium financing, then using the loans for personal gain.
BARRY ZALMA
Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Write to Mr. Zalma at [email protected]; https://www.zalma.com; https://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.
Read the full article and the full 20 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf
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Read the full article and the full 20 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-04-01-2025.pdf
Interpleader Protects All Claimants Against Life Policy and the Insurer
Who’s on First to Get Life Insurance Proceeds
Post 5184
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Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://lnkd.in/gRthzSnT; Go to Barry Zalma on YouTube- https://lnkd.in/g2hGv88; Go to the Insurance Claims Library – https://lnkd.in/gwEYk.
Interpleader Protects All Claimants Against Life Policy and the Insurer
In Metropolitan Life Insurance Company v. Selena Sanchez, et al, No. 2:24-cv-03278-TLN-CSK, United States District Court, E.D. California (September 3, 2025) the USDC applied interpleader law.
Case Overview
This case involves an interpleader action brought by the Metropolitan Life Insurance Company (Plaintiff-in-Interpleader) against Selena Sanchez and other defendants (Defendants-in-Interpleader).
Key Points
Plaintiff-in-Interpleader’s Application:
The Plaintiff-in-Interpleader...
A Claim by Any Other Name is not a Claim
Post 5182
It is Imperative that Insured Report Potential Claim to Insurers
Read the full article at https://lnkd.in/gfbwAsxw, See the full video at https://lnkd.in/gea_hgB3 and at https://lnkd.in/ghZ7gjxy, and at https://zalma.com/blog plus more than 5150 posts.
In Jeffrey B. Scott v. Certain Underwriters At Lloyd’s, London, Subscribing To Policy No. B0901li1837279, RLI Insurance Company, Certain Underwriters At Lloyds, London And The Insurance Company, Subscribing To Policy No. B0180fn2102430, No. 24-12441, United States Court of Appeals, Eleventh Circuit (August 25, 2025) the court explained the need for a claim to obtain coverage.
Case Background:
This appeal arises from a coverage dispute under a Directors & Officers (D&O) insurance policy. Jeffrey B. Scott, the plaintiff-appellant, was terminated from his role as CEO, President, and Secretary of Gemini Financial Holdings, LLC in October 2019. Following his termination, Scott threatened legal action against Gemini, and ...
A Claim by Any Other Name is not a Claim
Post 5182
It is Imperative that Insured Report Potential Claim to Insurers
Read the full article at https://lnkd.in/gfbwAsxw, See the full video at https://lnkd.in/gea_hgB3 and at https://lnkd.in/ghZ7gjxy, and at https://zalma.com/blog plus more than 5150 posts.
In Jeffrey B. Scott v. Certain Underwriters At Lloyd’s, London, Subscribing To Policy No. B0901li1837279, RLI Insurance Company, Certain Underwriters At Lloyds, London And The Insurance Company, Subscribing To Policy No. B0180fn2102430, No. 24-12441, United States Court of Appeals, Eleventh Circuit (August 25, 2025) the court explained the need for a claim to obtain coverage.
Case Background:
This appeal arises from a coverage dispute under a Directors & Officers (D&O) insurance policy. Jeffrey B. Scott, the plaintiff-appellant, was terminated from his role as CEO, President, and Secretary of Gemini Financial Holdings, LLC in October 2019. Following his termination, Scott threatened legal action against Gemini, and ...
Barry Zalma: Insurance Claims Expert Witness
Posted on September 3, 2025 by Barry Zalma
The Need for a Claims Handling Expert to Defend or Prove a Tort of Bad Faith Suit
© 2025 Barry Zalma, Esq., CFE
When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.
On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive ...
The Need for a Claims Handling Expert to Defend or Prove a Tort of Bad Faith Suit
© 2025 Barry Zalma, Esq., CFE
When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.
On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive and became a consultant and expert witness for lawyers representing insurers and lawyers ...
APPRAISAL AWARD SETS AMOUNT OF DAMAGES RECOVERED FROM INSURER
Post 5180
See the full video at https://rumble.com/v6yd2z0-evidence-required-to-prove-breach-of-contract.html and at https://youtu.be/2ywEjs3hZsw, and at https://zalma.com/blog plus more than 5150 posts.
It’s a Waste of Time to Sue Your Insurer if You Don’t Have Evidence
Evidence Required to Prove Breach of Contract
Read the full article at https://www.linkedin.com/pulse/evidence-required-prove-breach-contract-barry-zalma-esq-cfe-rfelc, see the full video at https://rumble.com/v6yd2z0-evidence-required-to-prove-breach-of-contract.html and at https://youtu.be/2ywEjs3hZsw, and at https://zalma.com/blog plus more than 5150 posts.
It’s a Waste of Time to Sue Your Insurer if You Don’t Have Evidence
In Debbie Beaty and Jonathan Hayes v. Homeowners Of America Insurance Company, No. 01-23-00844-CV, Court of Appeals of Texas, First District (August 26, 2025) Debbie Beaty and Jonathan Hayes filed a claim under their homeowner’s insurance policy with Homeowners of ...
