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
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 ...
