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
Concurrent Cause Doctrine Does Not Apply When all Causes are Excluded
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Death by Drug Overdose is Excluded
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Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.
KEY POINTS
1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
3. Duty to Indemnify: The court could not determine at this stage whether the Plaintiff had a duty to ...
GEICO Sued Fraudulent Health Care Providers Under RICO and Settled with the Defendants Who Failed to Pay Settlement
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Default of Settlement Agreement Reduced to Judgment
In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)
Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...
ZIFL – Volume 29, Issue 14
Post 5118
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You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
This issue contains the following articles about insurance fraud:
The Historical Basis of Punitive Damages
It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.
The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.
You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf
Insurer Refuses to Submit to No Fault Insurance Fraud
...
Rulings on Motions Reduced the Issues to be Presented at Trial
Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.
CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
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 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
