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.
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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.
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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
see the full video at https://lnkd.in/gsxE-nPK and at https://lnkd.in/gGbQ9taM, and at https://zalma.com/blog plus more than 5100 posts.
Fraudulent Joinder of Defendant to Avoid Federal Court Fails
Post 5113
It Never Pays to Sue a Party Who Did Nothing Wrong
The Plaintiffs initiated this action in state court, asserting claims for breach of contract, bad faith, and constructive fraud/negligent misrepresentation against State Farm. They also brought claims for negligent procurement of insurance and constructive fraud/negligent misrepresentation against Tyler McCall and the Tyler McCall Insurance Agency, Inc .
In Justin Gamble and Brittany Gamble v. State Farm Fire And Casualty Company, et al., No. CIV-25-396-R, United States District Court, W.D. Oklahoma (July 2, 2025) State Farm removed the case to Federal Court and alleged that the McCall Agency was fraudulently joined to avoid removal.
KEY ISSUES
Fraudulent Joinder: State Farm removed the case, arguing that Mr. McCall and the McCall Agency were fraudulently joined ...
Attempt at Insurance Fraud Fails
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Post 5112
The following is a fictionalized True Crime Story from my experience of Insurance Fraud. This story explains why insurance fraud is a “Heads I Win, Tails You Lose” situation for insurers and those insured. The story is presented to help you to understand how insurance fraud in America is costing everyone who buys insurance.
Arson on Independence Day Resulted in Prison for the Arsonist
The insured had no respect for his insurance company. He expected them to pay any claim he presented. He expected no investigation. Other members of the same immigrant community had successfully committed arson fraud. It was so easy for others. He decided to burn his house down.
The insured thought he was highly intelligent. He planned his arson fire carefully. He arranged for his wife and children to spend the weekend with their cousins in Oakland. He got four ...
Earth Movement Exclusion Effective as Major Cause of Loss
One of Many Causes of Destruction of House was Earth Movement
Post 5111
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Anti-Concurrent Cause Language Required Claim Denial
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Terri Lawrence sued alleging that State Farm breached an insurance contract and acted in bad faith by failing to pay benefits under the contract. The case was removed to the United States District Court based on diversity jurisdiction, and the trial was set to begin on September 8, 2025.
In Terri Lawrence v. State Farm Fire..., No. C24-4008-LTS-MAR, United States District Court, N.D. Iowa, Western Division (June 25, 2025) the USDC applied anti-concurrent cause language to dismiss suit.
SUMMARY JUDGMENT
...
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 ...
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 ...
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...