THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Posted on June 15, 2026 by Barry Zalma
ZIFL – Volume 30, Issue 12
June 15, 2026
Post number 5372
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th 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/ This issue contains the following articles about insurance fraud:
Go to Jail, Do Not Pass Go
Arsonist Who Tried to Defraud Insurer Failed to Avoid Jail
Arson is a Violent and Dangerous Crime Deserving Serious Punishment
The People of the State of New York v. Zef Gjurashaj, 2026 NY Slip Op 03320, No. 2023-03675, Ind. No. 70463/21, Supreme Court of New York, Second Department (May 27, 2026) the defendant owned a restaurant that was destroyed by fire on September 6, 2017. Prosecutors alleged that he and a codefendant conspired to intentionally set the fire in order to obtain financial benefit.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Conspiring to Burn a Vehicle for Insurance Money is a Crime
Police Chief’s Guilty Verdict Affirmed
Cumulative Evidence Sufficient to Prove Fraud
In United States of America v. Christopher Filline, No. 25-50049, United States Court of Appeals, Fifth Circuit (June 1, 2026) Christopher Filline, the police chief of Castroville, Texas, reported that his wife’s Lincoln Navigator had been stolen.
In truth, the vehicle had actually been burned on a remote road two days earlier.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Qui Tam Insurer Contended it was not Defrauded
Qui Tam Case Without Evidence to Prove Fraud Fails
To Prove Insurance Fraud the Qui Tam Plaintiff Must Allege and Prove Fraud
In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended parties in an automobile collision case involving a McLaren and a tour van. After that case settled for $25,000, the firm filed a qui tam action under California’s Insurance Frauds Prevention Act (IFPA) against Silver Bird Auto Leasing, LLC, X-Law Group, PC, and Filippo Marchino.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Insurer Sued Defendants for Submitting Thousands of Fraudulent Claims
Attempt at Intervention Fails
GEICO Should be Commended and Emulated for its Action Against Fraud Perpetrators
In Government Employees Insurance Co., et. al. v. Tarakchyan D.C., et al., Civil No. 24-cv-6952 (ZNQ)(JTQ), United States District Court, D. New Jersey (May 29, 2026) GEICO sued medical-provider defendants for allegedly submitting thousands of fraudulent insurance charges for unnecessary treatment.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Health Insurance Fraud Convictions
Case Update- Former Brookline Doctor Convicted of Health Care Fraud and Money Launderng
A former Brookline Massachusetts physician was convicted following a 10-day jury trial in federal court in Boston of health care fraud, money laundering, tax evasion and conspiring to defraud the Internal Revenue Service (IRS). Dr. Pankaj Merchia of Brookline, Massachusetts and Boca Raton, Florida was convicted on January 27, 2026 of one count of health care fraud, three counts of money laundering, two counts of tax evasion and one count of conspiracy to defraud the IRS.
Read the full article plus dozens of convictions and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Other Than Health Insurance Fraud Cases
Lawrence Man Sentenced to Probation for Phony Hit While Parked Claim
A Lawrence, Massachusetts man was placed on pretrial probation for one year on charges of motor vehicle insurance fraud and attempt to commit a crime. He was ordered to pay $756 in restitution. The Lawrence man reported to Mapfre Insurance Company that on December 10, 2021, his 2014 Subaru Forester was hit while parked causing damage to the driver side and bottom of the doors.
Physician’s Malpractice Insurance not Available When License Revoked
Applicant for Insurance is Obligated to Advise Insurer in Material Changes After Application Was Signed
Doctor Criminally Charged and License Suspended After Application Signed had Policy Rescinded for Failure to Advise Insurer of Change
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Barry Zalma, Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455.
Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders.
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...
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 ...
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 ...
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 ...
Alleged Defamatory Statements Must be Of and Concerning Plaintiffs
Posted on October 16, 2026 by Barry Zalma
To Prove Defamation the Statement Must be Of and Concerning the Plaintiffs
Post 4867
In Michael Moloney and Sergio Cantu v. United Services Automobile Association, No. 04-25-00519-CV, Court of Appeals of Texas, Fourth District, San Antonio (October 14, 2026) Michael Moloney and Sergio Cantu appealed from the trial court’s granting of a traditional motion for summary judgment in favor of United Services Automobile Association (“USAA”) on their defamation claim.
BACKGROUND
Moloney and Cantu sued USAA for defamation, alleging that they are the principals of Informed Roofing & Restoration, LLC (“Informed Roofing”), which is primarily engaged in the residential roofing repair and replacement business, and that an employee or agent of USAA had made false and defamatory statements to the San Antonio Police Department (“SAPD”) concerning them.
Specifically, Moloney and Cantu alleged that an employee of ...
ZIFL – Volume 30, Issue 20 Subscribe to ZIFL here https://lnkd.in/gfpn78FM
Posted on October 15, 2026 by Barry Zalma
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud.
ZIFL is published 24 times a year is written by Barry Zalma.
It is provided FREE to anyone who visits the site at https://lnkd.in/gVT5G9s
Six Insane Fraud Schemes the Trump Administration Has Uncovered Stealing from the taxpayer has now become a multi-billion-dollar industry in America. Obamacare has been a magnet for scammers.
Florida Insurance Agent Pleads Guilty in $300,000 Premium Finance Scheme
Daniel Raney, 41, who managed Raney Insurance and Raney Ventures in Pensacola, was arrested after AFCO Direct.
RIFE WITH FRAUD ALLOWS DEMANDS TO ESTABLISH RESTITUTION
Six Insane Fraud Schemes the Trump Administration Has Uncovered
Stealing from the taxpayer has now become a multi-billion-dollar industry in America – and the ...
