ZIFL – Volume 29, Issue 9
Posted on May 1, 2025 by Barry Zalma
See the full video at https://www.youtube.com/watch?v=pi0yFHFseG8 and at https://rumble.com/v6ss2an-zalmas-insurance-fraud-letter-may-1-2025.html
Post 5063
Happy Law Day
Law Day, held annually on May 1, is a national day set aside to celebrate the rule of law. Law Day provides an opportunity to understand how law and the legal process protect our liberty, strive to achieve justice, and contribute to the freedoms that all Americans share.
Read the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
The Source for the Insurance Fraud Professional
Subscribe to the e-mail Version of ZIFL, it’s Free!
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 May 1, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/04/
ZIFL-05-01-2025.pdf.
This issue contains the following articles about insurance fraud:
FRAUD DOESN’T PAY – IT COSTS
INSURANCE FRAUDSTER MUST PAY INSURER FULL RESTITUTION
Plaintiff Liberty Insurance Corporation (“Liberty”) issued a homeowners insurance policy to Defendant Jack Strunk that was active when his home was damaged by fire. Strunk made two insurance claims: one for fire damage and another for alleged theft of certain personal property after the fire. Strunk sued Liberty for the payment of the alleged damages. That case was removed to federal court and ultimately settled by Liberty paying $100,000 to Strunk.
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
It is not Nice to Lie to Your Insurer
Material Misrepresentation on Application Provides a Defense to Claim
Lies on Application for Insurance Eliminates Coverage for a Claim
Magna Tyres USA, LLC appealed the summary judgment in favor of Coface North America Insurance Company and against its complaint of breach of contract and request for a declaratory judgment. In Magna Tyres USA, LLC v. Coface North America Insurance Company, No. 24-13036, the United States Court of Appeals, Eleventh Circuit (April 10, 2025) determined the effect of a material misrepresentation on an application for insurance.
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
Health Insurance Fraud Convictions
Two Former Laboratory Sales Executives Sentenced To Federal Prison For Roles In Health Care Kickback Conspiracy
Stephen Kash, 51, of Winnie, Texas was sentenced to 18 months in federal prison and ordered to forfeit $779,773.70 in criminal proceeds. Courtney Love, 46, of Dallas, was sentenced to 12 months and one day in federal prison and ordered to forfeit $217,268.75 in criminal proceeds. The sentences were imposed by U.S. District Judge Jeremy D. Kernodle on April 24, 2025.
The two former laboratory sales executives were sentenced to federal prison for conspiring to violate the Anti-Kickback Statute.
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.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.
Velawcity Allegedly Committed Barratry on Behalf of Lawyers
To Be Sued for Barratry in Texas the Court Must Have Jurisdiction
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
CONVICTIONS OF OTHER THAN HEALTH INSURANCE FRAUD
Defense Contractor’s Longtime Associate Pleads Guilty to Conspiracy to Defraud the United States
Thomas G. Ehr worked for or on behalf of a co-conspirator, a defense contractor who owned 50% of a business that supplied jet fuel to U.S. troops in Afghanistan and Middle East. Ehr was hired to manage several music television and entertainment projects funded with proceeds from this business. Over time Ehr played a role in several of his co-conspirator’s other investments, including a $60 million real estate investment in Tulum, Mexico, and a $50 million fuel infrastructure project.
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
The Insured Must Produce Tax Returns If the First Party Insurer Demands Production
Every first party property policy contains a provision requiring an insured to produce all relevant documents required to be produced by the Insurer and to appear for examination under oath [California Insurance Code § 2071; NY Standard Fire Insurance policy].
Although there is no absolute privilege that protects tax returns and related documents from discovery, “due to the sensitive information contained therein and the public interest to encourage the filing by taxpayers of complete and accurate returns, their production should not be routinely required.” See Mitsui & Co. v. Puerto Rico Water Resources Authority, 79 F.R.D. 72, 80 (D.P.R. 1978).
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
How to Interview
The interview is an essential form of fact gathering for every type of human interaction. Interviews happen everywhere; they are performed by almost everyone. Interviewing is also an art, and the most effective interviews are conducted by those who are knowledgeable and skilled in this art.
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
Barry Zalma, Esq., CFE, Barry Zalma, Inc.,
4441 Sepulveda Boulevard
CULVER CITY CA 90230-4847
310-390-4455
[email protected], http://www.zalma.com, http://zalma.com/blog
Read this article and the full 22 page issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/04/ZIFL-05-01-2025.pdf
Anti-Public Adjuster Clause Is Effective in New York
Post number 5301
Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster
In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.
FACTS
NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...
Anti-Public Adjuster Clause Is Effective in New York
Post number 5301
Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster
In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.
FACTS
NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...
Proof of Highly Contaminated Water is Required for Extra Payments
Post number 5300
Read the full article at https://www.linkedin.com/pulse/acting-your-own-lawyer-foolish-barry-zalma-esq-cfe-mbg0c, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Acting as Your Own Lawyer is Foolish
Evidence of Breach of Contract Survives Dismissal of All Other Charges
In Lee Lifeng Hsu and Jane Yuchen Hsu v. State Farm Fire And Casualty Company, C. A. No. N24C-09-020 CLS, Superior Court of Delaware (February 27, 2026) a claim to State Farm who paid approximately $61,000 after assessments but denied coverage for additional items including ceramic tiles, the kitchen floor ceiling, underlayment plywood, and numerous personal property items resulted in suit by the Hsu’s acting in pro per.
Facts
Lee Lifeng Hsu and Jane Yuchen Hsu (“Plaintiffs”) purchased a homeowners’ insurance policy from State Farm Fire...
Insurance Condition Requires Following the Intent of the Parties
Post number 5307
Principles of Contract Interpretation Compels Reading Contract as Written
Read the full article at https://www.linkedin.com/pulse/portable-storage-containers-buildings-barry-zalma-esq-cfe-fkg1c and at https://zalma.com/blog.
In Eastside Floor Supplies, Ltd. v. SCS Agency, Inc., Hanover Insurance Company, et al., No. 2024-01501, Index No. 609883/19, 2026 NY Slip Op 01488, Supreme Court of New York, Second Department (March 18, 2026)
In May 2019, a fire damaged business personal property belonging to the plaintiffs, which was stored in portable storage containers at their Manhattan premises. At the time of the fire, the plaintiffs were insured under a businessowners insurance policy (BOP) issued by the defendant Hanover Insurance Company which provided general coverage for business personal property, and which included a specific extension for “Business Personal Property Temporarily in Portable Storage Units” (the portable storage ...
ERISA Saves Fraudulent Claims Suit
Post number 5306
Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.
Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity
In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.
FACTUAL BACKGROUND
United and Oxford, who administer both ERISA and ...
ERISA Saves Fraudulent Claims Suit
Post number 5306
Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.
Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity
In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.
FACTUAL BACKGROUND
United and Oxford, who administer both ERISA and ...
