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 ...
Inadequately Briefed Issues Defeats Appeal
Post 4852
Issues on Appeal Must be Adequately Briefed
Posted on September 25, 2026 by Barry Zalma
In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.
According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair. The defendant denied negligence and alleged comparative negligence. After a two-day jury trial in November 2023, the jury returned a defense verdict.
The trial court denied Ojekwe’s motion to set aside the verdict and for a new trial, and he appealed.
LAW
A trial court’s refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of ...
Inadequately Briefed Issues Defeats Appeal
Post 4852
Issues on Appeal Must be Adequately Briefed
Posted on September 25, 2026 by Barry Zalma
In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.
According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair.
LAW
Refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of discretion.
Appellate claims receiving only cursory treatment, without record citations, supporting authority, or legal analysis, are inadequately briefed.
DISCUSSION
Improper opening remarks.
Defense counsel referred to Ojekwe’s national origin,...
Psychiatrist Who Was Convicted of Fraud Asked the First Circuit to Reduce his Punishment
Post 4851
Posted on September 24, 2026 by Barry Zalma
Fraud to Private and Public Health Insurers Doesn’t Pay
In United States v. Gustavo Kinrys, Nos. 24-1592, 24-1716, United States Court of Appeals, First Circuit (September 21, 2026) Gustavo Kinrys, a Massachusetts psychiatrist, submitted fraudulent claims to private and public health insurers from 2015 through 2018, including bills for more than 1,000 sessions when he or the purported patient was outside the country. When insurers requested supporting records, he delayed through a fictitious office manager and created false documentation.
A jury convicted Kinrys on fourteen counts. The district court imposed a 99-month sentence, calculated intended loss at slightly more than $19 million based on billed amounts, ordered $6,537,309.59 in restitution, and ordered $6,527,391.19 in forfeiture.
At sentencing, the district court calculated Kinrys’s base offense level to be ...
