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:
Swoop & Squat Fails

The Only Solution to Fraud is to Take the Profit Out of the Crime

It Takes Courage to Fight the Fraudster

In Vivian Maritza Triana Marin, Sebastian Arroyave Penagos, and Daniel Arroyave Penagos v. Marc J. Paynter and Transport Marc Paynter Inc., No. 23-CV-6498, United States District Court, E.D. New York (July 10, 2026) Plaintiffs sued Defendants in diversity after a rear-end collision on the Whitestone Expressway in Queens, New York.

Commit Fraud and Suffer Consequences

Victims of Fraud Should Always Fight Back Proactively
Cross-Claim Against Fraudsters Successful

In Dual Diagnosis Treatment Center, Inc., et al. v. Health Net, Inc., et al., Health Net Life Insurance Company, B331260, California Court of Appeals, Second District, Third Division (July 16, 2026) a trial verdict in favor of Health Net and against Sovereign, a network of mental health and substance use disorder treatment centers, and Health Net, Inc., Health Net of California, Inc., Health Net Life Insurance Company, and Managed Health Network, Inc. (collectively, Health Net) was appealed to the California Court of Appeals.

More McClenny Moseley & Associates Issues

This is ZIFL’s forty-seventh installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana and what appears to be an effort to profit from what some Magistrate and District judges indicate may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana. This is truly becoming a never-ending story.

Texas-based MMA Law Firm PLLC moved to protect owner and attorney John Zachary Moseley from a litigation funder suit during the firm’s bankruptcy.

Trouble at Lloyd’s

According to Claims Magazine, Lloyd’s corporate offices have stated that former CEO John Neal breached its compliance rules.

The Lloyd’s investigation found that Neal failed to disclose the relationship with the group’s former corporate affairs director Rebekah Clement.

The Great Jewel Theft

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.

Read the full article and all 28 pages of ZIFL athttp://zalma.com/blog/wp-content/uploads/2026/07/ZIFL-08-01-2026.pdf

Health Insurance Fraud Convictions

EyePoint Pharmaceuticals to Pay $4.6 Million to Resolve False Claims Act Allegations

Eyepoint Pharmaceuticals, Inc., (EyePoint) headquartered in Massachusetts, has agreed to pay the United States $ 4,657,463.18 to resolve allegations that it violated the False Claims Act by paying kickbacks to certain Ambulatory Service Centers (ASCs) to induce those ASCs to purchase and dispense DEXYCU, an injectable drug approved for the treatment of ocular inflammation following cataract surgery, between January 1, 2019 and March 1, 2023.

The Real Cost of Fraud

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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. The names and places of this true crime story were changed to protect the guilty.

New Jersey Consumer Fraud Act Now Covers Insurance Brokers, Agents, and Producers

On July 15, 2026, the New Jersey Supreme Court issued a decision overturning lower court rulings that had shielded “semi-professionals” — including insurance brokers, agents, and producers, among others — from regulation and litigation under the New Jersey Consumer Fraud Act (NJCFA).

Insurer Proactively Works to Defeat Fraud

RICO and PIP Fraud Not Subject to Arbitration in New Jersey
The Only Way to Defeat Fraud is to Eliminate the Fraudster’s Profit 

In Allstate New Jersey Insurance Company, et al v. Carteret Comprehensive Medical Care, PC, d/b/a Monroe Comprehensive Medical Care, d/b/a Comprehensive Medical Care, d/b/a Fassst Sport, d/b/a Comprehensive Vein Care, Inimeg Management Company, Inc., et. al. Nos. A-74-24, A-75-24, A-76-24, No. 090337, Supreme Court of New Jersey (July 21, 2026).

Other Than Health Insurance Fraud Case

Nevada Businesswoman Sentenced to Prison for Fraudulent Scheme Seeking Millions in COVID-19 Tax Credits

Caused a Loss to the United States Exceeding $7 Million

Adonia Stiles, of Las Vegas, was a real estate agent, tax preparer, and clothing store owner.

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. He also serves as an arbitrator or mediator for insurance related disputes.

[email protected], http://www.zalma.com, http://zalma.com/blog

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Read the full article and all 28 pages of ZIFL athttp://zalma.com/blog/wp-content/uploads/2026/07/ZIFL-08-01-2026.pdf