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.
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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 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>
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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
The Professional Claims Handler
Post 5218
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-8-barry-zalma-esq-cfe-zdwsc, see the full video at https://rumble.com/v70zl4s-the-zalma-philosophy-of-claims-handling-part-8.html and at https://youtu.be/MIYcF71ffRQ, and at https://zalma.com/blog plus more than 5200 posts.
Claims Commandment X – Thou Shall Not Pretend to be a Lawyer
Some experienced and professional claims people know the law in their area of expertise better than most lawyers.
Adjusters should be adjusters and leave lawyering to lawyers. Similarly, lawyers should be lawyers and never try to be adjusters.
Claims Commandment XI – Thou Shall Empathize With the Claimant
Everyone presenting a claim is unhappy, disturbed, shocked, injured and needs help.
Empathy is identification with and understanding of another’s situation, feelings, and motives. It is the ability to understand another person’s circumstances, point of view, thoughts, and feelings....
HOW TO CREATE AN EXCELLENCE IN CLAIMS HANDLING PROGRAM
See the full video at https://rumble.com/v70wb2i-the-zalma-philosophy-of-claims-handling-part-6.html and at https://youtu.be/tL5nDKPEs40 and at https://zalma.com/blog plus more than 5200 posts.
Post 5217
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.
An Excellence in Claims Handling program begins with a statement in the insurer’s claims manual or statement of professionalism that it is dedicated to providing excellence in claims handling to every insured who presents a claim.
The excellence in claims handling program should include, at a minimum:
A series of lectures supported by text materials explaining:
A definition of insurance.
How to read and understand an insurance policy.
How to interview an insured, witness, or claimant.
How to assist an insured in the insured’s obligation to ...
The Professional Claims Handler
Post 5216
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-5-barry-zalma-esq-cfe-jde8c, see the full video at https://rumble.com/v70q4x8-the-zalma-philosophy-of-claims-handling-part-5.html and at https://youtu.be/6b9tZQsEkB4, and at https://zalma.com/blog plus more than 5200 posts.
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.
Standards to be a Professional Claims Adjuster
The Insurance claims professional should be a person who:
1. Can read and understand the insurance policies issued by the insurer.
2. Understands the promises made by the policy.
3. Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
4. Are competent investigators.
5. Have empathy and recognize the difference between empathy and sympathy.
6. ...
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 ...
