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
Motion for Summary Judgment Requires Evidence Establishing Defenses
Post 5223
Read the full article at https://www.linkedin.com/pulse/motion-summary-judgment-fail-because-insurer-failed-zalma-esq-cfe-jhfsc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
In Michael Tillema, Kim Til- Lema v. Meridian Security Insurance Company, No. SA-24-CV-00661-JKP, United States District Court, W.D. Texas, San Antonio Division (October 7, 2025) Plaintiffs Michael Tillema and Kim Til-Lema claimed coverage from Meridian Security Insurance Company for benefits for alleged wind and hail damage from a storm on April 26, 2022.
Meridian Security Insurance Company denied the claim, citing inspection reports and weather data indicating no hail event occurred on the alleged date. Plaintiffs hired an independent contractor, who also found no hail within one mile of the property on the ...
Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers
Post 5222
Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
Proactive Victim of Fraud Defeats Health Care Providers
In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.
FACTUAL BACKGROUND
Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.
Plaintiff also ...
Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers
Post 5222
Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
Proactive Victim of Fraud Defeats Health Care Providers
In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.
FACTUAL BACKGROUND
Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.
Plaintiff also moved...
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
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 ...
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 ...
