ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
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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
Jury’s Findings Interpreting Insurance Contract Affirmed
Post 5105
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Madelaine Chocolate Novelties, Inc. (“Madelaine Chocolate”) appealed the district court’s judgment following a jury verdict in favor of Great Northern Insurance Company (“Great Northern”) concerning storm-surge damage caused by “Superstorm Sandy” to Madelaine Chocolate’s production facilities.
In Madelaine Chocolate Novelties, Inc., d.b.a. The Madelaine Chocolate Company v. Great Northern Insurance Company, No. 23-212, United States Court of Appeals, Second Circuit (June 20, 2025) affirmed the trial court ruling in favor of the insurer.
BACKGROUND
Great Northern refused to pay the full claim amount and paid Madelaine Chocolate only about $4 million. In disclaiming coverage, Great Northern invoked the Policy’s flood-exclusion provision, which excludes, in relevant part, “loss or damage caused by ....
Failure to Name a Party as an Additional Insured Defeats Claim
Post 5104
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Contract Interpretation is Based on the Clear and Unambiguous Language of the Policy
In Associated Industries Insurance Company, Inc. v. Sentinel Insurance Company, Ltd., No. 23-CV-10400 (MMG), United States District Court, S.D. New York (June 16, 2025) an insurance coverage dispute arising from a personal injury action in New York State Supreme Court.
The underlying action, Eduardo Molina v. Venchi 2, LLC, et al., concerned injuries allegedly resulting from a construction accident at premises owned by Central Area Equities Associates LLC (CAEA) and leased by Venchi 2 LLC with the USDC required to determine who was entitled to a defense from which insurer.
KEY POINTS
Parties Involved:
CAEA is insured by Associated Industries Insurance Company, Inc. ...
Exclusion Establishes that There is No Duty to Defend Off Site Injuries
Post 5103
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Attack by Vicious Dog Excluded
In Foremost Insurance Company, Grand Rapids, Michigan v. Michael B. Steele and Sarah Brown and Kevin Lee Price, Civil Action No. 3:24-CV-00684, United States District Court, M.D. Pennsylvania (June 16, 2025)
Foremost Insurance Company (“Foremost”) sued Michael B. Steele (“Steele”), Sarah Brown (“Brown”), and Kevin Lee Price (“Price”) (collectively, “Defendants”). Foremost sought declaratory relief in the form of a declaration that
1. it owes no insurance coverage to Steele and has no duty to defend or indemnify Steele in an underlying tort action and
2. defense counsel that Foremost has assigned to Steele in the underlying action may withdraw his appearance.
Presently before the Court are two ...
Professional Health Care Services Exclusion Effective
Post 5073
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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 ...
A Heads I Win, Tails You Lose Story
Post 5062
Posted on April 30, 2025 by Barry Zalma
"This is a Fictionalized True Crime Story of Insurance Fraud that explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help everyone to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime."
Immigrant Criminals Attempt to Profit From Insurance Fraud
People who commit insurance fraud as a profession do so because it is easy. It requires no capital investment. The risk is low and the profits are high. The ease with which large amounts of money can be made from insurance fraud removes whatever moral hesitation might stop the perpetrator from committing the crime.
The temptation to do everything outside the law was the downfall of the brothers Karamazov. The brothers had escaped prison in the old Soviet Union by immigrating to the United...
Punitive Damages Must Be Added to Gross Income for Tax Purposes
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This blog post is just a taste of the full article that is only available to subscribers to Excellence in Claims Handling. Anyone can subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.
A TASTE OF EXCELLENCE IN CLAIMS HANDLING
The stated purpose of punitive damages is to punish a wrongdoer civilly to deter the wrongdoer and others from acting wrongfully. Insurance Bad Faith litigants dream of large punitive damage awards as a bonus and revenge upon the insurer that did not treat them fairly.
Punitive damages may be awarded where there is substantial harm and where there is none. [Restatement (First) of Torts § 908 cmt. c (Am. L. Inst. 1939); see also ...
