Zalma on Insurance
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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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June 16, 2025
Zalma’s Insurance Fraud Letter – June 15, 2025

ZIFL – Volume 29, Number 12

The Source for the Insurance Fraud Professional

Read the full article at https://lnkd.in/g3cETykR, see the full video at https://lnkd.in/gNCv_PVN and at https://lnkd.in/gfgweM9r, and at https://zalma.com/blog plus more than 5050 posts.

Subscribe to the e-mail Version of ZIFL, it’s Free! https://lnkd.in/gfpn78FM

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 https://lnkd.in/gVT5G9s You can read the full 25 page issue of the June 15, 2025 issue at https://lnkd.in/gTWZUnnF

Read this article and the full 25 page issue of Zalma’s Insurance Fraud Letter Here https://lnkd.in/gnNk7mFd

Fraud is a Crime that Should Never Pay

Aric Lynn Holloway II (plaintiff), appealed the stipulated order of dismissal in favor of defendant-appellee, Citizens Insurance Company of the Midwest (defendant).

In Aric Lynn Holloway II, et al v. Memberselect Insurance, No. 367611, Court of Appeals of Michigan (May 29, 2025) the plaintiff unsuccessfully attempted to convince the Court of Appeals to allow his fraud to succeed.

Read this article and the full 25 page issue of Zalma’s Insurance Fraud Letter Here https://lnkd.in/gnNk7mFd

Health Insurance Fraud Convictions

Louisiana Man Pleads Guilty to $3.8 Million Durable Medical Equipment Fraud Scheme

Michael L. Riggins, 62, of West Monroe, Louisiana pleaded guilty June 5, 2025 in connection with a five-year scheme to submit millions of dollars in fraudulent claims to Medicare.

Read this article and the full 25 page issue of Zalma’s Insurance Fraud Letter Here https://lnkd.in/gnNk7mFd

MORE MCCLENNY MOSELEY & ASSOCIATES ISSUES

This is ZIFL’s forty-eighth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana.

Morris Bart Law Firm files MSJ against MMA

The law firm Morris Bart moved for summary judgment in the adversary proceeding it brought against MMA in the MMA bankruptcy.

In The United States District Court For The Southern District Of Texas, Houston Division.

FRAUD CONVICTIONS FOR OTHER THAN HEALTH INSURANCE FRAUD

Five Men Plead Guilty for Their Roles in Global Digital Asset Investment Scam Conspiracy Resulting in Theft of More than $36.9 Million from Victims

Joseph Wong, 33, of Alhambra, California; Yicheng Zhang, 39, of China; Jose Somarriba, 55, of Los Angeles; Shengsheng He, 39, of La Puente, California; and Jingliang Su, 44, of China and Turkey, were part of an international criminal network that induced U.S. victims, believing they were investing in digital assets, to transfer funds to accounts controlled by co-conspirators and that laundered victim money through U.S. shell companies, international bank accounts, and digital asset wallets. The five men pleaded guilty for their roles in laundering more than $36.9 million from victims of an international digital asset investment fraud conspiracy that was carried out from fraud centers in Cambodia.

BARRY ZALMA, Inc.
Barry Zalma, Esq., CFE
Barry Zalma, Inc.
4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847
310-390-4455, [email protected]; Subscribe to “Excellence in Claims Handling” at href=”https://lnkd.in/g8K26Dn5>
[email protected], http://www.zalma.com, http://zalma.com/blog; Subscribe to “Excellence in Claims Handling”

at href=”https://barryzalma.substack.com/subscribe.”> “Excellence in Claims Handling” at

href=“https://barryzalma.substack.com/subscribe.”> a href=“https://barryzalma.substack.com/subscribe.”>

Go to the podcast Zalma On Insurance at https://anchor.fm/barry-zalma, Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/ Follow Mr. Zalma on Twitter at https://twitter.com/bzalma

Go to Barry Zalma videos at Rumble.com at https://rumble.com/c/c-262921, https://gettr.com/@zalma, Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg, Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/

Read this article and the full 25 page issue of Zalma’s Insurance Fraud Letter Here.

Read this article and the full 25 page issue of Zalma’s Insurance Fraud Letter Here https://lnkd.in/gnNk7mFd

00:08:19
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1 hour ago
Crime Doesn’t Pay – Allstate to Have Judgment Against Fraudsters

Fraud Perpetrators Will Have Judgment Entered in Favor of Insurer They Defrauded
Post 5155

See the full video at https://lnkd.in/gGP7BYSU and at https://lnkd.in/gi4GEGeG, and at https://zalma.com/blog plus more than 5150 posts.

Allstate Effectively Proactive Against Insurance Fraud

Plaintiffs Allstate Insurance Company and other Allstate companies (collectively, “Plaintiffs”) sued seeking redress for losses incurred due to an alleged insurance fraud scheme. Plaintiffs alleged that Defendants Toshner, Lacey Davies, Michael Trinh, Roadside Response, LLC, and Responsible Billing, LLC’s (collectively, “Defendants”) submitted false reimbursement claims for hazardous material cleanups that were never actually performed, were unnecessary, or did not involve an Allstate insured.

In Allstate Insurance Company, et al. v. Daniel Toshner, et al., No. 1:24-CV-27-RP, United States District Court, W.D. Texas, Austin Division (July 9, 2025) Allstate moved for default to be entered against the defendants.

...

00:06:02
1 hour ago
Plaintiff Must be an Insured to Sue Insurance Company

When Plaintiff Gives Up Court Must Grant Summary Judgment

Post 5154

It is Contumacious to Sue an Insurer if You are Not Insured

See the full video at https://lnkd.in/ggmMWkcN and at https://lnkd.in/gJXMDYxG, and at https://zalma.com/blog plus more than 5100 posts.

Defendant American National filed a motion for summary judgment because Plaintiff is not a named or third-party beneficiary of the Policy. Defendant contends that because Plaintiff is not covered by the Policy, Plaintiff cannot prove that Defendant breached the Policy or demonstrated bad faith under La. R.S. 22:1973 and 22:1892. In support of this contention, Defendant argued that the Policy only covers the “Named Insured/Mortgagee” of the property, Magee Holdings, LLC, and that the Policy does not name Plaintiff as an insured or a third-party beneficiary.

In Hannah Guillotte v. American National Property And Casualty Company, Civil Action No. 23-00931-BAJ-RLB, United States District Court, M.D. Louisiana (July 16, 2025) Plaintiff, the ...

00:06:32
July 25, 2025
Plaintiff Must be an Insured to Sue Insurance Company

When Plaintiff Gives Up Court Must Grant Summary Judgment

Post 5154

It is Contumacious to Sue an Insurer if You are Not Insured

See the full video at https://lnkd.in/ggmMWkcN and at https://lnkd.in/gJXMDYxG, and at https://zalma.com/blog plus more than 5100 posts.

Defendant American National filed a motion for summary judgment because Plaintiff is not a named or third-party beneficiary of the Policy. Defendant contends that because Plaintiff is not covered by the Policy, Plaintiff cannot prove that Defendant breached the Policy or demonstrated bad faith under La. R.S. 22:1973 and 22:1892. In support of this contention, Defendant argued that the Policy only covers the “Named Insured/Mortgagee” of the property, Magee Holdings, LLC, and that the Policy does not name Plaintiff as an insured or a third-party beneficiary.

In Hannah Guillotte v. American National Property And Casualty Company, Civil Action No. 23-00931-BAJ-RLB, United States District Court, M.D. Louisiana (July 16, 2025) Plaintiff, the ...

00:06:32
July 16, 2025
There is no Tort of Negligent Claims handling in Alaska

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 ...

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May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

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 ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

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 ...

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