The Quality of Insurance Fraud Perpetrators is Declining
Post 5162
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Insured Admits Fake Theft and Shows Allegedly Stolen Item to Insurance Investigator
Christie Paolino an investigator for Westfield Insurance Company testified that appellant Matthew McGrath reported the theft of his vehicle and equipment to Westfield, including the VIN for the GMC truck. Paolino met with McGrath at his residence in Cleveland. She asked if they could move to a quieter spot such as the backyard. As they walked up the driveway towards the backyard, Paolino noticed “two snowplows sitting in the driveway” and recognized one as the snowplow “that he had reported stolen.” She asked appellant “if that was, in fact, the snowplow,” and he admitting to the falsity of his claim he responded that it was.
In STATE OF OHIO v. MATTHEW MCGRATH, 2025-Ohio-2600, No. 114758, Court of Appeals of Ohio, Eighth District, Cuyahoga (July 24, 2025) affirmed the trial court verdict finding him guilty at trial.
THE TRIAL
McGrath waived his right to a jury trial, opting instead for a bench trial held on August 26 and 27, 2024. The state presented five witnesses. The evidence showed that on June 21, 2023, McGrath reported his truck, plow, salt spreader, and crack filler stolen to the University Heights Police, an interaction documented on body camera. McGrath was found guilty at trial of falsification, attempted grand theft, and insurance fraud. On January 13, 2025, he was sentenced to the minimal one year of community-control sanctions.
The appellate court found no merit to his appeal and affirmed the trial court’s decision.
ANALYSIS
An appellate court views the evidence in a light most favorable to the prosecution to determine whether any rational trier of fact could have found the essential elements of the crime proven beyond a reasonable doubt. Appellate courts are not to assess whether the State’s evidence is to be believed, but whether, if believed, was the evidence against a defendant sufficient to support a conviction. In essence, sufficiency is a test of adequacy. Whether the evidence is legally sufficient to sustain a verdict is a question of law.
The Court of Appeals concluded that the state’s evidence was sufficient to support the trial court’s verdicts because the evidence was sufficient to prove that McGrath knowingly made false statements and that his purpose was to commit or facilitate a theft offense, and that he was thereby attempting, by deception, to knowingly deprive his insurer of a sum exceeding $7,500.
The evidence was sufficient to establish that appellant’s statements reporting the theft of his vehicle were false and that appellant knew it.
To warrant reversal from a bench trial under a manifest weight of the evidence claim, the Court of Appeals must review the entire record, weigh the evidence and all reasonable inferences, consider the credibility of witnesses and determine whether in resolving conflicts in evidence, the trial court clearly lost its way and created such a manifest miscarriage of justice that the judgment must be reversed, and a new trial ordered.
Here, the State introduced substantial evidence to establish, beyond a reasonable doubt, that appellant committed the offenses of falsification and attempted grand theft. He initiated a claim with Westfield Insurance for the lost property. The testimony and the State’s exhibits established that appellant’s report was false and that he made the deceptive report in a thwarted effort to collect insurance proceeds from Westfield. The judgment was affirmed.
ZALMA OPINION
It seems people believe that insurance fraud is so easy that anyone can do it and profit from the fraud with ease. Mr. McGrath was a believer but was so stupid as to invite an investigator from his insurance company into his back yard where the allegedly stolen property was parked and admitted it was the same item that was the subject of his claim, admitting to the fraud. With such damning evidence McGrath, who received a light sentence and no jail time, had the unmitigated gall to appeal the verdict and waste the time of the Court of Appeals affirming the trial court’s verdict.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Policy Limits Demand Accepted Settles Claim
Post 5434
Posted on August 26, 2026 by Barry Zalma
See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute
In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange, The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.
FACTUAL BACKGROUND
Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.
Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...
Policy Limits Demand Accepted Settles Claim
Post 5434
Posted on August 26, 2026 by Barry Zalma
See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute
In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange, The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.
FACTUAL BACKGROUND
Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.
Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...
The Largest Residential Burglary of All Time
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 ...
Insurance Requires Fortuity to be an Insured Risk
Post 5485
Posted on September 8, 2026 by Barry Zalma
In Industrial Park Center, LLC, doing business as Mainspring Capital Group v. Great Northern Insurance Company, a foreign insurer, No. CV-25-0330-CQ, Supreme Court of Arizona (September 1, 2026).
The United States Court of Appeals for the Ninth Circuit certified the following question to this Court:
"Is damage to property a “fortuitous” loss when, based on the insured’s knowledge at the time the insurance policy issued, it was reasonably foreseeable that such damage was almost certain to occur if certain preventative measures were not taken?"
FACTUAL BACKGROUND
Mainspring owned commercial property leased to Star Fisheries for decades. Star Fisheries’ use of water and salt allegedly caused structural damage over time. In 2010, Mainspring learned of damage and made some repairs but did not implement all recommended preventive measures. In 2021–2022, additional similar structural damage was discovered, and ...
Qui Tam Relators are not officers of the United States
Posted on September 4, 2026 by Barry Zalma
Attempt to use Constitution to Stop a Qui Tam False Claims Act Case
Post 5486
FCA’s Qui Tam Provisions do not Violate the Appointments Clause.
In United States Of America, Clarissa Zafirov, ex rel; Dr. v. Florida Medical Associates, LLC, d.b.a. Vipcare, Physician Partners, LLC, Anion Technologies, LLC, Freedom Health, Inc., Optimum Healthcare, Inc., Physician Partners Specialty Services, LLC, et al., No. 24-13581, United States Court of Appeals, Eleventh Circuit (September 1, 2026).
The False Claims Act (“FCA”) allows the Attorney General to bring civil suits against perpetrators of fraud against the government. This case involves another portion of the FCA-the qui tam provisions-which allow people, called relators, who have knowledge about fraud against the government to pursue a case against the perpetrator of the fraud.
Dr. Clarissa Zafirov filed a qui tam action under the False Claims Act on behalf of...
Posted on September 3, 2026 by Barry Zalma
You Only Get One Chance to Sue
Post 5484
In David Cromp v. Johnny Harkrider, Monique Harkrider, and their Marital Community, dba Able Plumbing Plus, No. 61678-5-II, Court of Appeals of Washington, Division 2 (August 25, 2026) David Cromp hired Able Plumbing Plus in 2018 to install plumbing, including two toilets, at his residence. In 2019, both toilets allegedly leaked, causing damage. Insurance claims were submitted through Able’s contractor policy, but the insurer eventually denied the claims.
Cromp sued Able in 2022 for breach of contract based on the allegedly defective toilet installation. During that case, Cromp attempted to add claims related to Able’s conduct during the insurance claim process, including fraud, bad faith, tortious conduct, and bond-related claims, but the superior court denied leave to amend. The 2022 breach-of-contract claim was later dismissed with prejudice on summary judgment as time-barred.
On the same day the 2022 case was dismissed, Cromp filed a ...
