ZIFL Volume 28 Issue 15
Post 4847
Read the full article at https://lnkd.in/gAxk_9sA, see the full video at https://lnkd.in/gJjA4797 and at https://lnkd.in/g6dA8eff, and https://zalma.com/blog.
Read the full issue of ZIFL and the full article here https://lnkd.in/gaFvcuTg
The Source for the Insurance Fraud Professional
Subscribe to ZIFL
Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th 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:
Guilty of Workers’ Compensation Fraud
Inflating On-The-Job Injury is Fraud
A jury found Waliullah Nazari guilty of two counts of making false and fraudulent statements for the purpose of obtaining workers’ Compensation benefits and seven counts of attempted perjury under oath.
In The People v. Waliullah Nazari, D081940, California Court of Appeals, Fourth District, First Division (July 18, 2024) the Court of Appeals affirmed the conviction because surveillance proved Nazari had lied to his physician and insurer.
Read the full issue of ZIFL and the full article here http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-08-01-2024.pdf
What is Insurance Fraud?
Insurance fraud is the most popular and perpetrated crime in the world next to, perhaps, tax fraud. The possibility of a tax-free profit, coupled with the commonly held belief (supported by actual arrest and conviction records) that criminal prosecution will not occur, is sometimes too difficult for normally honest people to resist.
Each year, the effect of insurance fraud runs to billions of dollars. It is estimated that insurance fraud takes between 33 and 38 percent of the premiums collected and annually drains as much as $300 billion or more from the assets of insurers in the United States.
Insurance fraud occurs when a person or entity makes false insurance claims in order to obtain compensation or benefits to which they are not entitled. Insurance fraud is committed in many forms, but regardless of the type, it is considered a serious crime in all jurisdictions.
Read the full issue of ZIFL and the full article here http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-08-01-2024.pdf
More McClenny Moseley & Associates Issues
This is ZIFL’s thirty third 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.
July 9, 2024
The law firm, Morris Bart filed a Complaint for Injunctive Relief and for Declaratory Judgment against MMA in the Eastern District of Louisiana years ago.
Health Insurance Fraud Convictions
Help to the DOJ From Whistleblower/Qui Tam Suits
$2.45 Million Health Care Fraud Settlement
Vista Clinical Diagnostics, LLC, for allegedly submitting or causing the submission of false claims to Medicare and Medicaid programs in North Carolina, Virginia, and Florida. These settlement funds will be returned to the Medicare and Medicaid programs.
From Jan. 1, 2017, through Dec. 31, 2021, Vista Clinical allegedly submitted or caused to be submitted reimbursement claims to Medicare and Medicaid by adding diagnosis codes into patients’ reimbursement submissions that had not been provided by those patients’ physicians.
Read the full issue of ZIFL and the full article including dozens of settlements and convictions here http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-08-01-2024.pdf
The Reasons for an Examination Under Oath
The EUO Is Not an Adversary Proceeding like a Deposition in a Lawsuit.
The Examination Under Oath (EUO) is an investigative tool made available to the insurer. It allows the insurer to delve deeply and under oath into all aspects of the policy and the loss. The testimony to be elicited is not constrained by rules of discovery or the Codes of Civil Procedure.
The only restraint on the EUO is reasonableness although some courts do not even include a reasonableness standard. Regardless, the person taking the EUO must always act reasonably while understanding that unlimited questions are allowed. Only irrelevant and unreasonable questions dealing with facts completely outside the policy, its acquisition or the loss are not favored.
Read the full issue of ZIFL and the full article here http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-08-01-2024.pdf
Barry Zalma
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. He practiced law in 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].
Read the full issue of ZIFL and the full article here http://zalma.com/blog/wp-content/uploads/2024/07/ZIFL-08-01-2024.pdf
Read the full issue at https://lnkd.in/gaFvcuTg
Formulaic Recitation Of The Elements Of Civil Conspiracy Are Insufficient
Post number 5320
See the full video at https://lnkd.in/gPACkgWq and at https://lnkd.in/gsaxij7D, and at https://zalma.com/blog plus more than 5300 posts.
In Hassan Fayad v. Liberty Mutual Insurance Company, et al., No. 2:25-cv-10930, United States District Court, E.D. Michigan, Southern Division (March 24, 2026) Plaintiff Hassan Fayad, the owner of several businesses providing transportation, diagnostics, testing, and therapy services, regularly billed insurance companies for these services, was arrested and tried for fraud, convicted, had the conviction overruled and sued the insurers and prosecutors he found responsible.
FACTUAL BACKGROUND
By January 2020, Liberty Mutual, Progressive, Allstate, and Esurance suspected fraudulent activity and filed a complaint with the Michigan Department of Attorney General (MDAG). The insurers alleged that Fayad and others billed Michigan auto insurance policies for profit without actually providing medically ...
Federal Courts Have Limited Jurisdiction
When all Parties Refuse Removal There is No Jurisdiction
Post number 5319
Read the full article at https://lnkd.in/gp6Z-JYY, see the full video at https://lnkd.in/gAum322y and at https://lnkd.in/gRPzCjmt and at https://zalma.com/blog plus more than 5300 posts.
In Beth Mayhew and Matthew Mayhew v. Vladimir Sadovyh, et al., No. 2:26-CV-04029-WJE, United States District Court, W.D. Missouri (April 6, 2026) Mayhew was involved in a trailer-truck accident with Vladimir Sadovyh, who was employed by Nova First, LLC and Globex Transport, Inc. Both companies owned the tractor-trailer involved.
FACTUAL BACKGROUND
Chubb and Mohave Transportation Insurance Company jointly issued an insurance policy covering Nova First, Globex, and Sadovyh, with EMA Risk Services acting as a third-party administrator.
Beth Mayhew sued Nova First, Globex, and Sadovyh for negligence in Missouri state court, and following a jury trial, a nuclear judgment was awarded to the Mayhews totaling ...
Ordinary Negligence is What Medical Professi0nal Liability Insures
Post number 5319
See the full video at https://lnkd.in/gxKjDztW and at https://lnkd.in/gnxkxS42, and at https://zalma.com/blog plus more than 5300 posts.
Sexual Conduct Exclusion Doesn’t Apply When Doctor Negligently Uses His Own Sperm
In Integris Insurance Company v. Narendra B. Tohan, No. AC 47222, Court of Appeals of Connecticut (April 7, 2026) Integris Insurance Company, a medical professional liability insurer, initiated a declaratory action to determine its duty to defend and indemnify Narendra B. Tohan, a physician licensed in Connecticut, in a separate negligence action alleging medical misconduct.
FACTUAL BACKGROUND
In 2019, Kayla Suprynowicz and Reilly Flaherty (civil action plaintiffs), who were strangers for most of their lives, discovered through a genetic testing company that they are half siblings.
INSURANCE POLICY
The policy defines “Professional Services” in relevant part as “any professional medical services within the ...
ZIFL – Volume 30, Issue 7 – April 1, 2026
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post number 5314
Posted on April 1, 2026 by Barry Zalma
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:
No One is Above the Law – Not Even a Police Officer
Police Officer Convicted for Fraud in Reporting an Accident Affirmed
Police Officer Should never Lie about Results of Chase
In State Of Ohio v. Anthony Holmes, No. 115123, 2026-Ohio-736, Court of Appeals of Ohio, Eighth District, Cuyahoga (March 5, 2026) a police officer appealed criminal conviction as a result of lies about a high speed chase.
Read the following article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-04-01-2026-1.pdf...
ZIFL – Volume 30, Issue 7 – April 1, 2026
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post number 5314
Posted on April 1, 2026 by Barry Zalma
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:
No One is Above the Law – Not Even a Police Officer
Police Officer Convicted for Fraud in Reporting an Accident Affirmed
Police Officer Should never Lie about Results of Chase
In State Of Ohio v. Anthony Holmes, No. 115123, 2026-Ohio-736, Court of Appeals of Ohio, Eighth District, Cuyahoga (March 5, 2026) a police officer appealed criminal conviction as a result of lies about a high speed chase.
Read the following article and the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-04-01-2026-1.pdf...
Posted on March 30, 2026 by Barry Zalma
Insurance Fraud, a Way to Reduce Violent Crime
Post number 5313
A Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story helps 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.
She Taught Her Customers The Swoop And Squat:
Recently the California Insurance Department’s Fraud Division arrested a young woman in Los Angeles County for operating an insurance fraud school. She advertised her classes in the “Penny Saver” an advertising sheet distributed free to the public and a print version of Facebook, X Craig’s list. She had operated for several years teaching methods of committing automobile insurance fraud. Only after a police officer enrolled in one of her classes was she arrested.
Her defense ...
