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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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November 10, 2025
Convicted Insurance Fraud Sentence Stands

When You Do the Crime You Must Do the Time

Post 5224

Read the full article at https://lnkd.in/ghNVD-f9, see the video at https://lnkd.in/gPCxMn5T and at https://lnkd.in/ga6ZVGDz, and at https://zalma.com/blog plus more than 5200 posts.

When a Person is Convicted of a Crime The Hardship Inflicted on His Family is the Result of His Actions Alone

In United States v. Tarek Abou-Khatwa, CRIMINAL No. 18-cr-67 (TSC), United States District Court, District of Columbia (October 24, 2025) after Defendant Tarek Abou-Khatwa was convicted in November 2019 on 22 counts related to a sophisticated health insurance fraud scheme as head of an insurance-brokerage firm, initially Tarek was sentenced to 70 months in prison.

Home Confinement:

After less than 16 months in prison, Tarek was placed on home confinement under the CARES Act. He was later remanded to prison for violating the conditions of his home confinement order.

Motion for Sentence Reduction:

Tarek filed for sentence reduction under 18 U.S.C. § 3582(c)(2) based on Amendment 821 to the Sentencing Guidelines, which provides a two-point offense-level reduction for certain zero-point offenders.

Legal Analysis – Eligibility for Sentence Reduction

Both parties agreed Abou-Khatwa was eligible for a reduction under Amendment 821, which applies retroactively and would lower his guideline range from 70–87 months to 57–71 months. The court is required to consider the nature and (1) the nature and circumstances of the offense, (2) the history and characteristics of the defendant; (3) the need for the sentence imposed; (4) the kinds of sentences available; (5) the sentencing range established; (6) any Sentencing Commission policy statements; (7) the need to avoid sentencing disparities among defendants; and (8) the need to provide restitution. [18 U.S.C. § 3553(a).] The court noted that the 8 factors counsel strongly against a sentence reduction.

The court found the crimes were serious, motivated by greed, and involved a calculated scheme resulting in large losses to both a major insurer and small business clients. Defendant’s conduct during home confinement — his failure to disclose financial information, persistent complaints about restrictions, and lack of full accountability — counted against any reduction in his sentence.

The court acknowledged Abou-Khatwa’s low risk of recidivism and hardships faced by his family. The court also noted that these factors were already considered at sentencing and did not outweigh the seriousness of the offense. However, the court concluded that Abou-Khatwa’s crimes were serious and motivated by greed.

Despite making “a handsome living” and “enjoy[ing] a life of great privilege,” Defendant engaged in a years-long, calculated scheme to line his pockets with millions of fraudulently obtained dollars.

CONCLUSION

Although eligible for a sentence reduction, the court found it unwarranted given the facts and law. The court ordered the original sentence to stand.

It is important to note that hardships for defendants and their families are common in criminal cases. The existence of hardships on Tarek and his family they were not particularly compelling in Tarek’s case because the hardships do not outweigh the seriousness of the Defendant’s crimes and his inappropriate conduct while on home confinement.

ZALMA OPINION

The USDC for the District of Columbia recognized the seriousness of health insurance fraud that made Abou-Khatwa tons of money hurting individuals and insurers for his handsome living that allowed him to enjoy a life of great privilege. He was caught, tried and convicted and showed contempt for the system by abusing home confinement. He will, therefore, serve his entire sentence in prison and is responsible for the hardships incurred by his family not the prosecutors or the court.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:07:11
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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.

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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

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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.

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00:08:22
July 17, 2026
The Great Jewel Theft

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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.

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00:09:42
11 hours ago

Guilty of Misprison of a Felony Admitted by Owner of Insurers

Posted on August 12, 2026 by Barry Zalma

Second Trial of Coram Nobis Relief Fails

Post 5422

Coram Nobis is an Extraordinary Remedy

In United States Of America v. David Judd Disiere, Criminal Action No. 99-151-SDD-SDJ, United States District Court, M.D. Louisiana (August 10, 2026 David Judd Disiere was convicted in 2000 after pleading guilty to misprision of a felony under 18 U.S.C. § 4 in connection with allegations involving a scheme to influence the resolution of an investigation into insurance companies he owned.

He was sentenced to probation and a fine, did not directly appeal, and completed probation in 2003. After an earlier unsuccessful postconviction challenge, Disiere filed a second petition for writ of error coram nobis in 2024, claiming his plea was coerced by prosecutors’ threats relating to an employee allegation, that those threats were concealed from the court, that his counsel was ineffective, and that the factual basis did...

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August 11, 2026
Plaintiff Sues Because State Employees Stigmatized Her

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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 ...

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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 ...

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