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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May 04, 2022
True Crime of Insurance Fraud Number 66

Lucy and the Tsar

See the full video at https://rumble.com/v13emlt-true-crime-of-insurance-fraud-number-66.html?mref=16emn&mrefc=2 and at

See the full video at https://rumble.com/v13emlt-true-crime-of-insurance-fraud-number-66.html?mref=16emn&mrefc=2 and at

Lucy served as second officer on a 747 operated by Trans-Oceanic Airlines. Twice a week she flew from Dallas to Leningrad; with brief layovers in New York and Brussels. She had been a second officer for five years. Lucy was looking forward to promotion to first officer. She would be the second woman to command a 747 for Trans-Oceanic.

Her performance reviews were always exceptional. Never had Trans-Oceanic Airlines treated her differently than any other pilot. The glass ceiling seemed nonexistent.

Lucy, as a highly paid professional airline pilot, owned a beautiful 5000 square foot home in Dallas where she lived with her son, daughter and a full- time housekeeper/nanny. She was happy. Her future was unlimited. At forty years of age she was approaching the apex of her professional career.

Her layover in Leningrad was usually two days. Lucy would recover from the inevitable jet lag by visiting the great museums of the time of the Tsars. Her favorite was the Hermitage, which was once the Tsar’s summer palace.

To the museum she always brought along her Nikon single lens reflex camera that recorded each picture with very high resolution. She used the Nikon to photograph the magnificent treasures stolen by the Bolsheviks from the Tsar. The fast lens and digital enhancement allowed her to obtain images without using a flash. Lucy would spend evenings in her hotel sorting her photographs into categories on her lap top.

She had collections of close-up shots of Faberge royal Easter eggs; of oil paintings by Gaugin, Degas, Van Gogh and Picasso; and photos of fine works of art made by native Russian craftsmen unknown in the West.

Lucy converted the settlement check to US currency Travelers Checks. She placed the Travelers Checks in her overnight bag on the airplane. When she landed, as part of a well-known airline crew, her luggage was not inspected by the local customs officials. The Travelers Checks, better than cash, entered the new Russia without hindrance. Lucy immediately went to the dealer appointed by the Hermitage and purchased the Fabergé bird she lusted for paying only 200,000 US Dollars in Travelers checks.

With the remaining $50,00 she purchased two Fabergé silver cigarette cases and a small Picasso drawing in pencil signed and dated by the artist. The bird is displayed prominently over Lucy’s mantelpiece and she used the Fabergé cigarette case to hold note papers and a fountain pen.

Lucy was lucky. If anyone at Edward Lloyd’s Insurance Company had gone to the Dallas public library, they could have found similar photographs of the same items in any one of several books on the Hermitage collection housed at the library. They did not.

Lucy was promoted to Captain. She now commands a Trans-Oceanic 747 that flies three times a week nonstop from Dallas to London’s Heathrow airport.

She is starting a collection of photographs from the Queen’s Museum at Buckingham Palace.
ZALMA OPINION

It is time for the insurance industry to invest in a team of insurance claims professionals who know how to investigate a claim, interpret an insurance policy, and deal with a false and fraudulent claim to keep people like Lucy for enjoying a life of successful crime.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

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 practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and [email protected].

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Post 5407

Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma

See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv

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.

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.

After ...

00:12:33
July 20, 2026
Search Warrant Produces Evidence of Insurance Fraud

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Post 5397

Posted on July 20, 2026 by Barry Zalma

See the video and at https://lnkd.in/gNUs2XzT and at https://lnkd.in/g2MawyzX

Magistrate Issues a Search Warrant if there is a Fair Probability that Contraband or Evidence of a Crime will be Found in a Particular Place.

In United States Of America v. Frank Suess, et al., CRIMINAL No. 3:24-308, United States District Court, M.D. Pennsylvania (July 16, 2026) a federal grand jury indicted Frank Suess, Melissa Driscoll, and others in a 55-count health care fraud and anti-kickback prosecution arising from an alleged scheme involving medically unnecessary prescription “foot baths.”

As part of the investigation, the FBI obtained an August 19, 2022 warrant to search Driscoll’s Sterling Pharmacy Yahoo email account for emails from January 1, 2018 through December 31, 2020. Driscoll moved to suppress the resulting evidence, arguing that the warrant lacked probable cause, was overbroad, and rested on material misstatements and omissions.

LAW:

The ...

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July 17, 2026
The Great Jewel Theft

Fraud Shouldn’t Pay

Post 5396

See the video and at https://rumble.com/v7ctgmq-the-great-jewel-theft.html at https://youtu.be/aRbQ2sJfGwA

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 Insured purchased, for the first time in his life, a policy of Personal Articles Floater Insurance (PAF) scheduling $125,000 worth of ladies jewelry. He advised the insurer that the jewelry was always kept in a class E safe at his residence. He also told the insurer that he was employed full time as the owner of a gasoline service station and that he had never been canceled or suffered a previous loss.

One month after the policy was ...

00:09:42
9 hours ago
Plaintiff Sues Because State Employees Stigmatized Her

Day Care Owner Loses Subsidies Because She Criticized State

Post 5421

Posted on August 11, 2026 by Barry Zalma

First Amendment Right Will be Allowed to Go to Trial

In Betsey J. Grant v. Maine State Department Of Heath And Human Services, No. 1:25-cv-00490-JAW, United States District Court, D. Maine (August 6, 2026), Betsey J. Grant, a licensed childcare provider and operator of Tiny Tikes Daycare in Trenton, Maine, sued Maine DHHS and several employees after she publicly criticized DHHS before Maine’s Government Oversight Committee and alleged that officials retaliated against her.

She claimed DHHS imposed and extended a conditional license, published stigmatizing information, interfered with subsidies and program funding, removed her from a food program, rescinded an expansion grant, and used biased or falsified evidence in licensing proceedings. Following the March 10, 2023, GOC testimony, Ms. Grant alleges that foster children's subsidies (approximately $30,000) were withheld; she was removed from the ...

post photo preview
August 05, 2026
It Doesn’t Pay to Lie in an Application for Insurance

Rescission for Material Misrepresentation
Post 5418

Posted on August 5, 2026 by Barry Zalma

An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.

In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units. After an underlying personal injury action was filed, Union Mutual determined that the property actually contained three apartment units and rescinded the policies on the ground that the defendants had made a material misrepresentation in the applications.
LAW:

A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true ...

post photo preview
August 05, 2026
It Doesn’t Pay to Lie in an Application for Insurance

Rescission for Material Misrepresentation
Post 5418

Posted on August 5, 2026 by Barry Zalma

An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.

In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units.

LAW:

A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true facts been disclosed. To establish materiality as a matter of law, the insurer must submit documentation of its underwriting practices, such as manuals, guidelines, bulletins, or rules addressing similar risks.

DISCUSSION/ANALYSIS:

As a result, the...

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