Zalma on Insurance
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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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12 hours ago
Zalma’s Insurance Fraud Letter – November 1, 2026

ZIFL – Volume 30, Issue 21

Posted on November 2, 2026 by Barry Zalma

Subscribe to ZIFL Here https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

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 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/

DOJ, ATF, Law Enforcement Partners Conclude Operation Show Me Justice

435 Dangerous Offenders Arrested, 166 Illegal Firearms Seized, 81 Kg Illicit Drugs off the streets in St. Louis

The Department of Justice, BATF, U.S. Marshals Service (USMS), US Attorney Missouri announced the conclusion of Operation Show Me Justice.

DOJ Is Really Fighting and Prosecuting Fraud

Assistant Attorney General Colin M. McDonald Issues Memorandum on the National Fraud Enforcement Division’s Comprehensive Approach in the Fight Against Fraud

The White House Fraud Task Force

On March 16, 2026, President Trump signed Executive Order 14395, establishing the White House Task Force to Eliminate Fraud.

Health Insurance Fraud Convictions

Florida Man Pleads Guilty to Illegal Opioid Distribution Conspiracy

Jose Llerena, 49, of Miami, Florida, conspired with others, including Olushola Yusuf

“Tales From the Fraud Files” A Webinar A Virtual Lunch and Learn with Barry Zalma. Join us on Tuesday, November 17, 2026, from 12:30 to 1:30 PM ET for a lively, informal lunch and learn during International Fraud Awareness Week (November 15-21). Offered online via Zoom on Tuesday, November 17, 2026, from 12:30-1:30 p.m. A Zoom link will be emailed the Friday prior to the event. Questions? Contact Sarah Hart at [email protected]. Barry Zalma will speak from the Insurance Library, Date & Time, Tuesday, November 17, 2026, 12:30 – 1:30 PM, via Zoom, Free! https://insurancelibrary.org/a-virtual-lunch-and-learn-with-barry-zalma/

The USDOJ Is Really Working Against Fraud

Other Than Health Insurance Fraud Cases

Florida Man Sentenced to Prison for Tax Refund Fraud - Attempted to Obtain $4.2 Million from U.S. Treasury

NY City Sues Law Firm of Running Injury Claims Fraud Operation

(c) 2026 Barry Zalma & ClaimSchool, Inc.

Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe, Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; g; Go to the Insurance Claims Library – https://lnkd.in/gwEYk.

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What else you may like…
Videos
Posts
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 ...

00:05:23
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 ...

00:05:14
11 hours ago
Zalma’s Insurance Fraud Letter – November 1, 2026

ZIFL – Volume 30, Issue 21

Posted on November 2, 2026 by Barry Zalma

Subscribe to ZIFL Here https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

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 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/

DOJ, ATF, Law Enforcement Partners Conclude Operation Show Me Justice

435 Dangerous Offenders Arrested, 166 Illegal Firearms Seized, 81 Kg Illicit Drugs off the streets in St. Louis

The Department of Justice, BATF, U.S. Marshals Service (USMS), US Attorney Missouri announced the ...

October 30, 2026
Pleading Failed to State a Short and Plain Statement of the Claim.

Plaintiff Must Allege the Who, What, When, Where, and How requirements of Federal Rule of Civil Procedure

Post 4573

Posted on October 30, 2026 by Barry Zalma

In Texoma Cowboy Church, Inc v. Church Mutual Insurance Company, S.I., Civil Action No. 7:26-CV-00062-O, United States District Court, N.D. Texas, Wichita Falls Division (October 22, 2026) Plaintiff Texoma Cowboy Church, Inc. was insured by Defendant Church Mutual Insurance Company, S.I. under a policy covering its property at 919 U.S. Hwy 281, Wichita Falls, Texas, from May 28, 2024, to May 28, 2025. The policy carried a $309,250.50 deductible for windstorm and/or hail coverage.

FACTS

On or about April 5, 2025, a hail and windstorm allegedly damaged the property. ProNet confirmed hail impact on April 5, 2025, producing dents and panel separations on the roofing, but found that water intrusion and interior damage predated the storm. Defendant also obtained a third-party contractor bid.

After deductible and depreciation, it paid $626,607.67. Plaintiff contended the estimate and ...

October 30, 2026
Pleading Failed to State a Short and Plain Statement of the Claim.

Plaintiff Must Allege the Who, What, When, Where, and How requirements of Federal Rule of Civil Procedure

Post 4573

Posted on October 30, 2026 by Barry Zalma

In Texoma Cowboy Church, Inc v. Church Mutual Insurance Company, S.I., Civil Action No. 7:26-CV-00062-O, United States District Court, N.D. Texas, Wichita Falls Division (October 22, 2026) Plaintiff Texoma Cowboy Church, Inc. was insured by Defendant Church Mutual Insurance Company, S.I. under a policy covering its property at 919 U.S. Hwy 281, Wichita Falls, Texas, from May 28, 2024, to May 28, 2025. The policy carried a $309,250.50 deductible for windstorm and/or hail coverage.

FACTS

On or about April 5, 2025, a hail and windstorm allegedly damaged the property. ProNet confirmed hail impact on April 5, 2025, producing dents and panel separations on the roofing, but found that water intrusion and interior damage predated the storm. Defendant also obtained a third-party contractor bid.

After deductible and depreciation, it paid $626,607.67. Plaintiff contended the estimate and ...

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