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
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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
The Professional Claims Handler
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Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-8-barry-zalma-esq-cfe-zdwsc, see the full video at https://rumble.com/v70zl4s-the-zalma-philosophy-of-claims-handling-part-8.html and at https://youtu.be/MIYcF71ffRQ, and at https://zalma.com/blog plus more than 5200 posts.
Claims Commandment X – Thou Shall Not Pretend to be a Lawyer
Some experienced and professional claims people know the law in their area of expertise better than most lawyers.
Adjusters should be adjusters and leave lawyering to lawyers. Similarly, lawyers should be lawyers and never try to be adjusters.
Claims Commandment XI – Thou Shall Empathize With the Claimant
Everyone presenting a claim is unhappy, disturbed, shocked, injured and needs help.
Empathy is identification with and understanding of another’s situation, feelings, and motives. It is the ability to understand another person’s circumstances, point of view, thoughts, and feelings....
HOW TO CREATE AN EXCELLENCE IN CLAIMS HANDLING PROGRAM
See the full video at https://rumble.com/v70wb2i-the-zalma-philosophy-of-claims-handling-part-6.html and at https://youtu.be/tL5nDKPEs40 and at https://zalma.com/blog plus more than 5200 posts.
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This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry.
An Excellence in Claims Handling program begins with a statement in the insurer’s claims manual or statement of professionalism that it is dedicated to providing excellence in claims handling to every insured who presents a claim.
The excellence in claims handling program should include, at a minimum:
A series of lectures supported by text materials explaining:
A definition of insurance.
How to read and understand an insurance policy.
How to interview an insured, witness, or claimant.
How to assist an insured in the insured’s obligation to ...
The Professional Claims Handler
Post 5216
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-5-barry-zalma-esq-cfe-jde8c, see the full video at https://rumble.com/v70q4x8-the-zalma-philosophy-of-claims-handling-part-5.html and at https://youtu.be/6b9tZQsEkB4, and at https://zalma.com/blog plus more than 5200 posts.
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry.
Standards to be a Professional Claims Adjuster
The Insurance claims professional should be a person who:
1. Can read and understand the insurance policies issued by the insurer.
2. Understands the promises made by the policy.
3. Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
4. Are competent investigators.
5. Have empathy and recognize the difference between empathy and sympathy.
6. ...
The Professional Claims Handler
Post 5219
Posted on October 31, 2025 by Barry Zalma
An Insurance claims professionals should be a person who:
Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.
How to Create Claims Professionals
To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
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This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
