Zalma on Insurance
Education • Business
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.
Interested? Want to learn more about the community?
April 24, 2025
Conviction of Health Insurance Fraud Sustained

Double Jeopardy Claims Fails Because There was no Second Prosecution for the Same Offense

Post 5057

See the full video at https://lnkd.in/dHta_-yp and at https://lnkd.in/ddck47wm and at https://zalma.com/blog plus more than 5050 posts.

Posted on April 24, 2025 by Barry Zalma

Tariq M. Abdulaziz was charged with larceny in the first degree by defrauding a public community, health insurance fraud, and failure to appear. The charges of larceny and health insurance fraud were tried to the court, and Abdulaziz was found guilty of health insurance fraud.

In State Of Connecticut v. Tariq M. Abdulaziz, No. AC 45916, Court of Appeals of Connecticut (April 8, 2025) the Court of Appeals found that Abdulaziz had submitted false claims for face-to-face services to the Department of Social Services’ Medicaid program while he was in Texas.

The trial court acquitted him of larceny in the first degree due to the state’s failure to prove the value of the wrongfully obtained property exceeded $2000 and the court found him guilty of health insurance fraud, as he had presented false statements to the insurer with the intent to defraud.

The court sentenced Abdulaziz to three months of incarceration, execution suspended, and eighteen months of probation. The state filed a motion to correct an illegal sentence, arguing that the court should apply the sentencing provisions for larceny in the second degree. The court partially granted the motion and resentenced Abdulaziz to three months of incarceration, execution suspended, and one year of probation.

The defendant claimed that the trial court violated the double jeopardy clause and his constitutional right to due process. The court rejected these claims and affirmed the conviction of health insurance fraud.

ANALYSIS

The United States Supreme Court has explained that the fifth amendment guarantee against double jeopardy gives rise to three separate constitutional protections.

It protects against:

1. a second prosecution for the same offense after acquittal.
2. a second prosecution for the same offense after conviction.
3. multiple punishments for the same offense.

The defendant’s present claim invokes the first of these protections under the collateral estoppel branch of double jeopardy jurisprudence.

The defendant contends that the court’s findings on the ”intent to defraud or deceive” and the ”material[ity]” elements of health insurance fraud cannot be reconciled with his acquittal on the larceny charge because these elements both require that the ”alleged fraud concern something of value.”

The Court of Appeals concluded that the trial court did not, as the defendant claims, find ”that no value . . . was proven.” In fact, the court expressly found that ”some value [was] proven,” which is precisely what the defendant claims the court was required to do.

The nature of the services the defendant and the recipients’ other providers and supporters were offering were supposed to be home and community based. It simply is not reasonable or logical to conclude that they could, or would, be offering these types of services from Texas, on 114 separate occasions, particularly when in-person, face-to-face meetings without the service recipient present are ”highly unusual.”

Instead, the reasonable and logical view of the evidence presented supports the court’s finding that at least some of the face-to-face services for which payment was sought and obtained were not performed at all, and thus the defendant was properly convicted of health insurance fraud.

The judgment was affirmed.

ZALMA OPINION

It takes a great amount of Chutzpah to claim that a health care provider in Texas did “face to face” treatment with a patient in Connecticut. It is not ”highly unusual” as the defendant claimed, it is impossible. He was convicted of insurance fraud for claiming face to face treatment and had the unmitigated gall to claim he did the impossible and the court was wrong because he was acquitted of a similar, but different crime. The Court of Appeals took dozens of pages to explain why it affirmed the trial court who was kind enough to keep the defendant out of jail. I would hope more insurance fraud perpetrators are sentenced to serve a long time in prison.

(c) 2025 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

Subscribe to my substack at https://lnkd.in/gmmzUVBy
Go to X @bzalma; Go to the Insurance Claims Library – https://lnkd.in/gwEYk

00:07:03
Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
8 hours ago
PROSECUTING ATTORNEYS ARE IMMUNE FROM SUIT

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 ...

00:08:00
April 09, 2026
Everyone Must Agree to Removal to Federal Court

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 ...

00:04:01
April 09, 2026
IVF is not Excluded Sexual Conduct

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 ...

00:07:58
April 02, 2026
Zalma’s Insurance Fraud Letter – April 1, 2026

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...

April 01, 2026
Zalma’s Insurance Fraud Letter – April 1, 2026

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...

March 31, 2026
Insurance Fraud Costs Everyone

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 ...

post photo preview
See More
Available on mobile and TV devices
google store google store app store app store
google store google store app tv store app tv store amazon store amazon store roku store roku store
Powered by Locals