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ZIFL – Volume 29 No. 13 – July 1, 2025
Post 5111
Uber Technologies Inc. sued a group of lawyers, medical providers and rideshare drivers it claims staged car accidents, manufactured damages and received unnecessary medical procedures to take advantage of insurance policies in Florida, costing the rideshare giant “several million dollars” in legal fees.
Uber accused the group of conspiring to “generate an excuse to deliver unnecessary medical care, submit false insurance claims for recovery and file frivolous lawsuits to sue for non-existent damages” between 2023 and 2024. The five drivers named in the suit were “recruited with bribes to stage accidents,” Uber said in the federal suit filed in south Florida. The group recruited claimants who took their cars to designated body shops to manufacture the “false impression that the accidents resulted in injury,” the company said.
Read the full article and the full 19 pages of the issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/06/ZIFL-07-01-2025.pdf
Health Insurance Fraud Convictions
Fugitive Physician Sentenced to Prison in Medicare Fraud Scheme
Lilit Gagikovna Baltaian, 61, a Porter Ranch, California physician was sentenced June 12, 2025 in Los Angeles to 54 months in prison for health care fraud arising from her false home health certifications and related fraudulent billings to Medicare. She is a fugitive and was sentenced in absentia.
According to court documents Baltaian was a physician licensed to practice in California and an enrolled Medicare provider. From January 2012 to July 2018, she falsely certified patients to receive home health care from at least four Los Angeles area home health agencies. These certifications were used by the home health agencies to fraudulently bill Medicare. In some instances, Baltaian pre-signed blank, undated physician certification forms knowing that the home health agencies would falsify the forms to make appear that she had seen the Medicare beneficiaries and made clinical findings to support the need for home health care, when she had done neither. Baltaian received cash payments related to these referrals and also separately billed Medicare for signing the fraudulent certifications.
Read the full article and the full 19 pages of the issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/06/ZIFL-07-01-2025.pdf
Prisoner’s Loses Suit Against Sheriff for Failure to Exhaust Administrative Remedies
Creative Litigation Fails Because Crime Does not Pay
Prisoner Acting as His Own Lawyer Misses Prerequisite to His Suit
In this pro se prisoner case brought under 42 U.S.C. § 1983, United States Magistrate Judge Bradley W. Rath’s Report and Recommendation recommends that Defendants Sheriff John Ledbetter, Geneva Drummond, and VitalCore’s Motions for Summary Judgment be granted, that Plaintiff Monnie Villarreal’s Motion to Amend be denied as moot, and that the Court dismiss this case without prejudice for failure to exhaust administrative remedies.
In Monnie Villarreal v. Vitalcore, et al. No. 1:24-cv-99-HSO-BWR, United States District Court, S.D. Mississippi, (June 18, 2025) the District Judge adopted Magistrate Judge’s Report and Recommendation as the opinion of the Court.
Read the full article and the full 19 pages of the issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/06/ZIFL-07-01-2025.pdf
WHAT IS NEEDED TO DETER INSURANCE FRAUD?
To do so the insurers must train their staff to recognize the elements of both the crime of insurance fraud and the elements of the civil tort of insurance fraud. If well trained, insurance personnel collecting information about a potential insurance fraud, will know the type and quality of information that either a prosecutor or a civil defense lawyer will need to prove fraud was attempted.
Read the full article and the full 19 pages of the issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/06/ZIFL-07-01-2025.pdf
FRAUD CONVICTIONS FOR OTHER THAN HEALTH INSURANCE FRAUD
Founder of Lender Service Provider Convicted for Role in Multimillion-Dollar PPP Fraud Scheme
Stephanie Hockridge, a founder of the lender service provider Blueacorn, was convicted by a Federal Jury in connection with a scheme to fraudulently obtain tens of millions of dollars in COVID-19 relief money guaranteed by the U. S. Small Business Administration (SBA) through the Paycheck Protection Program (PPP).
Read the full article and the full 19 pages of the issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/06/ZIFL-07-01-2025.pdf
Bad Faith Set-Ups
Bad faith insurance claims are successful when a plaintiff can prove that the insurance company wrongfully denied an insurance claim and deprived the insured of the benefits of the contract of insurance without good cause. Bad faith insurance suits can arise in the context of any insurance policy.
Read the full article and the full 19 pages of the issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/06/ZIFL-07-01-2025.pdf
BARRY ZALMA
Barry Zalma, Esq., CFE, Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455
[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 the full article and the full 19 pages of the issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/06/ZIFL-07-01-2025.pdf
Coverage for Fraud Encourages Crime
Post 5166
Posted on August 12, 2025 by Barry Zalma
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Tandem Fund II, L.P. (“Tandem”) a venture capital firm, provided loans to Cuff, Inc. (“Cuff”), a startup company. Cuff failed as a business, and Tandem was never repaid on the loans. Tandem assigned the loans to Bijoux Corp. (“Bijoux”), which then initiated arbitration against Cuff and its CEO, Deepa Sood, for intentional misrepresentation and fraudulent concealment. The arbitration panel ruled in favor of Bijoux, awarding damages against Cuff and Sood.
In Tandem Fund II, L.P. v. Scottsdale Insurance Company, No. 23-16187, United States Court of Appeals, Ninth Circuit (August 4, 2025) Scottsdale argued that the award was uninsurable under California law, which prohibits insurance coverage for restitution of wrongfully acquired funds. The district court agreed with ...
Interrelated Acts Constitute a Single Claim
Post 5165
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In Yonah Rothman v. Complete Packaging & Shipping Supplies, Inc. and Mitchell Mankosa, Complete Packaging & Shipping Supplies, Inc. v. Arch Insurance Company, No. 22-CV-2821-SJB-ST, United States District Court, E.D. New York (August 4, 2025) dealt with the issue of parties seeking a partial judgment to be resolved on appeal.
Complete Packaging & Shipping Supplies, Inc. (“Complete”) and Arch Insurance Company (“Arch”) litigated disputes about coverage in relation to the Rothman employment discrimination action.
THE KEY ISSUES
Background:
Yonah Rothman filed a lawsuit against Complete and Mitchell Mankosa, alleging employment discrimination, underpayment, and wrongful termination. Rothman claims he was retaliated against for participating in a separate lawsuit brought by another employee.
Insurance Coverage Dispute:
Complete ...
Interrelated Acts Constitute a Single Claim
Post 5165
See the full video at https://lnkd.in/geriBpJT and at https://lnkd.in/gJxi77kg and at https://zalma.com/blog plus more than 5150 posts.
In Yonah Rothman v. Complete Packaging & Shipping Supplies, Inc. and Mitchell Mankosa, Complete Packaging & Shipping Supplies, Inc. v. Arch Insurance Company, No. 22-CV-2821-SJB-ST, United States District Court, E.D. New York (August 4, 2025) dealt with the issue of parties seeking a partial judgment to be resolved on appeal.
Complete Packaging & Shipping Supplies, Inc. (“Complete”) and Arch Insurance Company (“Arch”) litigated disputes about coverage in relation to the Rothman employment discrimination action.
THE KEY ISSUES
Background:
Yonah Rothman filed a lawsuit against Complete and Mitchell Mankosa, alleging employment discrimination, underpayment, and wrongful termination. Rothman claims he was retaliated against for participating in a separate lawsuit brought by another employee.
Insurance Coverage Dispute:
Complete ...
Rulings on Motions Reduced the Issues to be Presented at Trial
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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 ...
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
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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 ...
