ZIFL Volume 29, Issue 6
The Source for the Insurance Fraud Professional
Post 5019
Read the full article at https://zalma.com/blog plus more than 5000 posts.
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Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th 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/ You can read the full issue of the March 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
This issue contains the following articles about insurance fraud:
Mold Fraud Case Defeated
I received the following in an email from Jennifer Herrick who used my Mold Books to help defeat what they believed were fraudulent mold claims. I felt it worth while to pass it on. I simply copied her e-mail.
Read the full article and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
American Insurers Need to Adopt and Implement Excellence in Claims Handling
Attempts to Obtain a Quarterly Profit Insurers Lose Multi-Year Profits
Insurers have, over the last three decades, decimated their professional claims staffs. Experienced claims adjusters were fired and replaced with young, untrained, unprepared people. A virtual clerk replaced the old professional claims handler. Software programs took over from the seasoned interviewer to analyze the right to claims proceeds. Hands-on human skill, empathy and judgment were removed from insurers contact with those to whom they promised to provide indemnity fairly, promptly and in good faith. Money was saved from the insurer’s expense column by paying lower salaries. Within three months of firing the experienced claims people gross profit increased for a quarter of a year or two quarters.
Read the full article and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
Heath Insurance Fraud Convictions
Arkansas Reports 6 Medicaid Fraud Convictions and 1 Civil Settlement
On March 11, 2025, Trey Franks, 28, of Jacksonville pleaded guilty to Abuse of an Endangered or Impaired Person (Exploitation), a Class ‘C’ Felony, and was sentenced to a five-year term of probation, and ordered to pay a $250 fine, court costs, and restitution in the amount of $867.89. Franks used an impaired person’s debit card to pay his credit card bills.
Read the full article, reports of dozens of convictions, and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
MORE MCCLENNY MOSELEY & ASSOCIATES ISSUES
This is ZIFL’s forty-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.
March 25, 2025 – $3 Million MMA Investor Sued with Allegations of Fraudulent Estimates
Read the full article and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
The Compact Book of Adjusting Liability Claims Fourth Edition
A Handbook for the Liability Claims Adjuster
The insurance adjuster is seldom, if ever, mentioned in an insurance policy. The strict wording of third party liability policies set the obligation to prove a claim that entitles the insured to defense or indemnity of a claim against the insured by an injured third party.
Read the full article and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
CONVICTIONS OF OTHER THAN HEALTH INSURANCE FRAUD
40 Fraudulent Insurance Policies Worth $20 Million
Maureen Wilson, of Owings Mills, Maryland was convicted by a federal jury for conspiracy to commit insurance fraud, and related charges for wire fraud, money laundering and filing false tax returns.
According to court documents, Wilson conspired with her husband James Wilson to defraud insurance companies by obtaining over 40 life insurance policies for applicants by misrepresenting their health, wealth and existing life insurance coverage. The total death benefits from these policies exceeded $20 million.
Read the full article and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
Deterring Insurance Fraud
Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number. No one knows the amount that is taken by insurance fraud because most attempts at insurance fraud succeed.
A New Book on Insurance Fraud and How the DOJ Deters and Defeats Insurance Fraud.
The book is now available as a Kindle book, a paperback and hardcover
Read the full article and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
BARRY ZALMA
Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455. Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome. Write to Mr. Zalma at [email protected]; https://www.zalma.com; https://zalma.com/blog.
He publishes daily articles at https://zalma.substack.com, Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/ to consider more than 50 volumes written by Barry Zalma on insurance and insurance claims handling.
Read the full article and the full 22 pages of the issue ZIFL at https://zalma.com/blog/wp-content/uploads/2025/03/ZIFL-03-15-2025.pdf
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
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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 ...
