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 criminals.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
Insurance Fraud is a Violent Crime
Murder for Insurance Proceeds Results in Life in Prison
It Is Not Nice to Break Your Wife’s Neck to Collect her Life Insurance So You Get Life In Prison
Insurance fraudster and murder Kenneth Russell Moyer appealed the trial court’s denial of his petition for resentencing under Penal Code section 1172.6. Moyer took issue with the jury’s conclusion he was a beneficiary on his wife’s insurance policy, his counsel’s failure to properly litigate this issue at his first trial and argued his appellate counsel’s conclusion that he is ineligible for relief under section 1172.6 constituted ineffective assistance of counsel.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
Health Insurance Fraud Convictions
Texas Insurance Fraudster Given Prison Sentence and $350K Fine
Mayela Saby Cantu was sentenced by a federal judge because the McAllen woman reportedly helped commit property and title fraud schemes to 24 months in prison and three years of supervised release.
Chief U.S. District Judge Randy Crane also ordered Cantu to pay $350,000 in restitution.
Read about dozens of convictions and the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
Insurance Fraudsters are not Nice – They Are Criminals
Lawyers Attempt to Protect Assets of their Clients Charged with Insurance Fraud From Seizure by State Fails
In The People v. David M. Browne et al., B332304, California Court of Appeals, Second District, Seventh Division (May 6, 2025) found criminal defense lawyers in contempt.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
Before the Interview Begins
Every professional knows that the art of the interview cannot be learned exclusively from the printed word. Conversely, experience alone, without the knowledge and application of general principles, is no assurance of an interviewer’s professional development. The adept professional must not only know what these principles are, but how and when to apply them. Even the simplest technique will occasionally succeed. If the interviewer is to succeed, he or she must know the necessary background information, possess a thoroughly prepared attitude, and, above all, have a plan.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
MORE MCCLENNY MOSELEY & ASSOCIATES ISSUES
This is ZIFL’s forty-sixth 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.
McClenny, Moseley & Associates & the FBI
The FBI’s New Orleans Division is actively investigating McClenny, Moseley & Associates (MMA), now known as MMA Law Firm, for alleged fraud related to hurricane litigation, primarily targeting Southeastern Louisiana homeowners after Hurricane Ida in 2021.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
From Steven Badger of Zelle LLP
More About Attorney Eric Dick
Mr. Badger reported on LinkedIn that: “Another lawsuit has been filed against Eric Dick by one of his homeowner clients. This lawsuit, filed in Tarrant County, alleges legal malpractice, breach of fiduciary duty, and fraud. Interestingly, the lawsuit alleges that Mr. Dick and his law firm “fraudulently claimed they have incurred expenses and sought the same from Plaintiffs’ settlement funds.” Lawyers have to be very careful with the expenses they subtract from their clients’ settlement proceeds. It will be enlightening to see what expenses Mr. Dick charged his clients in this appraisal matter. I also wonder if Mr. Dick charged his usual 45% contingency fee. I have previously raised the question of whether charging a 45% contingency fee in a matter resolved in appraisal is an “unconscionable fee” under Rule 1.04 of the Texas Disciplinary Rules of Professional Conduct.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
CONVICTIONS OF OTHER THAN HEALTH INSURANCE FRAUD
New Jersey Woman Sentenced to Prison for Forced Labor and Other Federal Crimes
Bolaji Bolarinwa, 51, of Moorestown, previously was found guilty of two counts of forced labor, one count of alien harboring for financial gain and two counts of document servitude following a two-week trial before U.S. District Judge Karen M. Williams in Camden federal court. Judge Williams imposed the sentence in Camden federal court.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
Disaster Fraud Schemes
Since the wildfires struck Los Angeles this year homeowners and business people, and their insurers, will face attempts to defraud the public who the victims of the fires and their insurers face attempts at fraud, including the following forms of fraud generally attempted after a catastrophe:
1. False or exaggerated claims by policyholders.
2. Claims made by people who did not have property in the area of hurricane damage.
3. Misclassification of flood damage as wind, fire, or theft.
4. Claims filed by individuals residing hundreds of miles outside the disaster-zone.
5. Bid-rigging by contractors, falsely inflating the cost of repairs.
6. Contractors requiring upfront payment for services, then failing to perform the agreed upon repairs.
7. Unlicensed public adjusters making promises that they could not fulfill.
8. Charity fraud scams designed to misappropriate funds donated for disaster relief.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
The Tort of Bad Faith & Insurance Fraud
The logarithmic growth of insurance fraud in the state of California, and other states that have allowed tort damages for bad faith breach of insurance contracts, may be directly traced, in part, to the judicial creation of the tort of bad faith. Before the tort of bad faith, insurers with a reasonable belief that an insured was presenting a fraudulent claim would refuse to pay it and file a suspected fraudulent claim report with the Department of Insurance Fraud Division or Fraud Bureau. Persons perpetrating the fraud would, in most cases, accept the refusal as a cost of doing business and went on to the next fraudulent claim.
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
BARRY ZALMA
Barry Zalma, Esq., CF, Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455
Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
Happy Law Day
ZIFL – Volume 30, Issue 9 – May 1, 2026
Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-may-1-2026-barry-zalma-esq-cfe-2tywc, see the video at at and at https://zalma.com/blog plus more than 5300 posts.
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
ZIFL – Volume 30, Issue 9 – May 1, 2026
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year and is written by Barry Zalma.
DOJ Creates National Fraud Enforcement Division
Will the Feds Take on Insurance Fraud? Possibly as Part of a National Anti-Fraud Effort
On April 7, 2026, the Acting Attorney General, Todd Blanche, issued a memorandum establishing the Department of Justice National Fraud Enforcement Division (NFED). The memo describes an ambitious, but perhaps redundant, vision for this ...
When Abalone Died As a Result of Multiple Causes The Efficient Proximate Cause Requires Payment
Post number 5345
Read the full article at https://www.linkedin.com/pulse/efficient-proximate-cause-doctrine-saves-claim-barry-zalma-esq-cfe-yndlc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
In American Abalone Farms, LLC v. Star Insurance Company et al., H052643, California Court of Appeals, Sixth District (April 27, 2026) the Court of Appeals dealt with an insurance coverage issue that required application of the efficient proximate cause doctrine.
FACTS
American Abalone Farms, LLC ("American Abalone" ) operates an aquaculture farm in Santa Cruz County, California, raising abalone in tanks. In August 2020, the CZU Lightning Complex Fires led to a prolonged power outage and road closures near the farm. As a result, the farm’s water pumps failed, causing the death of most of the ...
Breach of a Specific Condition Precedent Is a Complete Defense
See the video at and at and at https://zalma.com/blog plus more than 5300 posts.
In United Services Automobile Association and State Farm Mutual Automobile Insurance Company v. Anthony Wenzell, 2026 CO 25 (Colo. Apr. 27, 2026) Anthony Wenzell was rear-ended in a car accident. He had a significant prior 2014 accident that required back surgery.
Wenzell claimed underinsured-motorist (UIM) benefits under three policies: (1) the tortfeasor’s liability policy, (2) his own primary UIM policy with State Farm, and (3) an excess UIM policy issued by USAA (under his brother’s policy, which contained an “other insurance” clause making USAA’s coverage excess over any collectible insurance).
After receiving the claims, both USAA and State Farm repeatedly requested that Wenzell execute comprehensive medical-release authorizations so they could obtain his full medical records and ...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
What Must be Done after Notice of a Claim is Received by the Insurer
Read the full article at https://lnkd.in/gzvvdkMZ and at https://zalma.com/blog.
Below you will read from this post until you reach the the end of this blog post as the free part of an Excellence in Claims Handling post. To read the full article and receive all articles for members of Excellence in Claims Handling you should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the subscription link below.
A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...
