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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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July 24, 2025
Prosecutors Use Omnibus Motion in Limine to Limit Trial

The Need For and Application of a Motion in Limine

Post 5153

Lawyers Present & Argue Motions in Limine to Control Trial Excess

See the full video at https://lnkd.in/gBv_pukH and at https://lnkd.in/gnX4tyXK, and at https://zalma.com/blog plus 5100 posts.

In United States Of America v. Scharmaine Lawson Baker, Criminal Action No. 24-99, USDC, E.D. Louisiana (July 7, 2025) Scharmaine Lawson Baker was charged with six counts of health care fraud. She pled not guilty, and her trial was scheduled.

BACKGROUND

Government’s Omnibus Motion in Limine

The Government filed an omnibus motion in limine which included several requests to exclude certain types of evidence and arguments.

Exclusion of Evidence and Argument Related to Specific Instances of “Good Deeds” and “Law-Abidingness”

The Government argued that such evidence is irrelevant and improper character evidence.
The Court granted the motion, stating that the defendant’s character is not an essential element of the charges.

Testimony About Defendant’s Own Hearsay Statements

The Government sought to preclude the defendant from introducing her own self-serving statements as inadmissible hearsay.
The Court deferred ruling on this request, requiring specific statements to be identified for admissibility assessment.

Use of Interview Reports to Impeach Government Witnesses

The Government requested to preclude the defendant from using interview reports to impeach witnesses unless the statements were verbatim or adopted by the witnesses.
The Court deferred ruling, requiring a factual determination on the nature of the statements.

Unopposed Motions in Limine

The Court granted several unopposed motions, including:

Exclusion of arguments suggesting selective prosecution.
Preclusion of comments on the Government’s failure to call a particular witness.
Exclusion of plea negotiations and related statements.
Exclusion of evidence blaming Medicare as the victim.
Exclusion of evidence related to harm or prejudice caused by the indictment.
Preclusion of arguments for acquittal based on reasons other than evidence and law.

DISCUSSION

Evidence And Argument Related To Specific Instances Of “Good Deeds” And “Law Abidingness”

The government argued that evidence and argument related to specific instances of “good deeds” and “law-abidingness,” including evidence of defendant’s legitimate billing or legitimate services, as circumstantial proof that she is not guilty, should be excluded. Defendant argued that honesty is a pertinent character trait to 18 U.S.C. § 1347, and defendant should not be precluded from introducing any character evidence.

Federal Rules of Evidence 404 states: “Evidence of a person’s character is not admissible to prove that on a particular occasion the person acted in accordance with the character or trait.”

Defendant was charged with six counts of health care fraud. Defendant’s character is not an essential element of the charges against her. Accordingly, the Court granted the government’s motion to exclude evidence and argument related to specific instances of “good deeds” and “law abidingness.”

Testimony About Defendant’s Own Hearsay Statements To Witnesses Or Other Third Parties

The government asked to preclude defendant from attempting to elicit or admit her own self-serving statements made to law enforcement agents, government investigators, or other witnesses as inadmissible hearsay. Defendant argued that granting the government’s motion would deny defendant the right to respond to inaccuracies, embellishments, and mischaracterizations introduced by the government through the defendant’s inculpatory statements.

Without viewing the statements that defendant seeks to admit, the Court could not rule on a blanket request to prohibit the introduction of defendant’s own statements.

Use Of Interview Reports Prepared By Law Enforcement Agents To Impeach Government Witnesses

The government sought to preclude defendant from introducing an interview report to impeach a witness as a prior inconsistent statement of anyone other than the report’s author. The Court could not issue a blanket ruling without first deciding whether the statements were verbatim, or whether the witnesses had subscribed to or otherwised adopted the statements as their own.

Evidence And Argument That The Defendant Should Be Acquitted For Reasons Other Than The Evidence And The Law

Jury nullification is not a right belonging to the defendant. Jury nullification is not desirable and that trial judges should exercise their power to prevent it when possible. The USDC categorically rejected the idea that, in a society, committed to the rule of law, jury nullification is desirable or that courts may permit it to occur when it is within their authority to prevent. Accordingly, the Court granted the government’s motion to preclude defendant from introducing evidence and argument that she should be acquitted for reasons other than the evidence and the law.

ZALMA OPINION

The government, faced with a well represented counsel seeking to avoid conviction for health insurance fraud, with evidence that is inappropriate. To protect the government’s case and to reduce irrelevant and useless testimony, the blanket motion in limine was partially successful and the trial judge will rule on other evidentiary attempts during trial when the evidence can be reviewed. The jury in the case will appreciate the limitations on presentation of inappropriate evidence by the defense.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:09:08
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September 18, 2026
Expert May Only Testify to What Experience Supports

Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.

Posted on September 18, 2026 by Barry Zalma

See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html

In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.

The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.

Law

The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

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September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution

Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

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October 19, 2026
Plaintiff’s Reading of the Policy is Plaintiff’s Reasonable Allegations Posted on October 19, 2026 by Barry Zalma CLASS ACTION THAT STATES A SIMPLE CLEAR AND PLAUSIBLE CAUSE OF ACTION SURVIVES Post 4868 In Sheila Marino v. Farmers New World Life Insura

Plaintiff’s Reading of the Policy is Plaintiff’s Reasonable Allegations

Posted on October 19, 2026 by Barry Zalma

Post 4868

CLASS ACTION THAT STATES A SIMPLE CLEAR AND PLAUSIBLE CAUSE OF ACTION SURVIVES

In Sheila Marino v. Farmers New World Life Insurance Company, No. 2:25-cv-02200-JNW, United States District Court, W.D. Washington, Seattle (October 13, 2026) defendant Farmers New World Life Insurance Company’s (“FNWL”) moved to dismiss Plaintiff Sheila Marino’s putative class action involving flexible universal life insurance.

Marino filed a putative class action in King County Superior Court alleging: (1) breach of contract, (2) breach of the implied covenant of good faith and fair dealing, and (3) violation of the Washington Consumer Protection Act (CPA).

She pleaded two theories: an “overcharge” theory and an “underpayment of interest” theory asked the Court to take judicial notice of historical Federal Funds Effective Rates.

THE LAW

Pleading Standard.

To survive a Rule 12(b)(6) motion, a ...

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October 22, 2026
John Madden and The US Patent and Trademark Office

Blockchain Fraud Detection Loses Protection

Posted on October 22, 2026 by Barry Zalma

John Earl Madden (April 10, 1936 – December 28, 2021) was an American Professional Football Coach and Sports Commentator in the National Football League Seeking Patent & Trademark Protection

BLOCKCHAIN FRAUD

Mr. Madden was more than football. He was working to establish a program called “Fraud Protection Systems, Methods, and Computer Programs for Blockchain Financial Transactions.”

In Ex parte John Madden, Appeal 2026-001497, Application 18/495,506, Technology Center 3600, United States Patent and Trademark Office, Patent Trial and Appeal Board (October 14, 2026)

The Examiner rejected claims several numbered claims under 35 U.S.C. § 101 as directed to an abstract idea without significantly more.

THE LAW

Section 101 makes patentable any new and useful process, machine, manufacture, or composition of matter.Laws of nature, natural phenomena, and abstract ideas are implicitly excluded.

THE PATENT TRIAL AND ...

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October 21, 2026
Supervisory Officials are not Individually Liable

Sovereign Immunity Defeats Suit Against Police Officers

Post 4866

Posted on October 21, 2026 by Barry Zalma

In Chad Lightfoot, et al. v. Progressive Direct Insurance Company, et al., Civil Action No. 26-434, United States District Court, E.D. Louisiana (October 9, 2026) Chad Lightfoot was involved in an Orleans Parish automobile accident in 2011 and filed claims with several insurers, including Progressive.

After a related civil dispute, Progressive counsel allegedly submitted a false affidavit stating that Lightfoot had fraudulently received a $50,000 payment. A New Orleans police detective relied on the affidavit to obtain an arrest warrant, and Louisiana State Police Lieutenant Alan Arcana allegedly reported that Lightfoot had received the payment. Lightfoot was arrested in 2015 and charged with theft, insurance fraud, and perjury.

Plaintiffs alleged that no record of the payment existed and that the criminal charges were dismissed on October 15, 2024.

Lightfoot and Geralyn Hawkins filed suit in October 2025 and ...

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