ZIFL – Volume 30, Issue 6
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post number 5304
Posted on March 16, 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:
There is no Statutory Right to Defraud an Insurer
Fraudsters Attempt to Use Statute to Force Payment Fails
In Connecticut General Life Insurance Co. et al. v. East Coast Advanced Plastic Surgery, LLC, No. 25 Civ. 1686 (PAE), United States District Court, S.D. New York (February 24, 2026) a dispute between Connecticut General Life Insurance Company and its subsidiary Cigna Health and Life Insurance Company (collectively, “Cigna”) and East Coast Advanced Plastic Surgery, LLC (“ECAPS”), a New Jersey-based medical practice specializing in post-mastectomy breast reconstruction.
Read the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
Fraud and Artificial Intelligence
According to Gallagher Bassett’s 2026 Carrier Report, 64% of North American carriers report increased claims complexity over the past year. Medical inflation remains the most frequently cited driver of rising costs, with 56% of respondents identifying it as the top contributor. Longer recovery durations, extended wage replacement periods and a growing number of psychological injury claims are adding pressure to adjusters already managing heavier caseloads.
Gallagher Bassett’s findings were drawn from a global survey of carrier executives, underwriting leaders and claims professionals, with data and market analysis across North America, Europe, Asia‑Pacific and the U.K. Insights include quantitative survey responses and qualitative input from leaders responsible for claims, risk and operational strategy.
Read the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
Allianz Reveals Case Of Broker Abusing Position As Over 34,000 Fraud Cases Identified In 2025
From the Insurance Times, A Copywritten Article you read at Link :
https://www.insurancetimes.co.uk/news/allianz-reveals-case-of-broker-abusing-position-as-over-34000-fraud-cases-identified-in-2025/1457999.article?utm_id=34468&adredir=1
Introduction :
“Fraudsters are continually changing their tactics and we need to match their efforts with greater speed and agility than ever before,’ says director of fraud”
Read the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
Press Release from the California Department of Insurance
Owners Of One Of The Largest Towing Businesses In Southern California Arrested In Nearly 6 Million Dollar Fraud Scheme
LOS ANGELES, — Brothers and tow company owners, Mark Hassan, 46, of Corona Del Mar, and Ahmed Hassan, 35 of Walnut, were arrested today on multiple counts of felony insurance fraud after allegedly underreporting employee payroll and paying portions of employees’ wages in cash to defraud workers’ compensation insurance companies out of nearly 6 million dollars of insurance premiums.
Read the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
Health Insurance Fraud Convictions
Long Island Medical Doctor Sentenced to 7 Years in Prison for Operating Oxycodone Pill Mill Out of her Great Neck Office
Dr. Roya Jafari-Hassad was sentenced by United States District Judge Gary R. Brown to 7 years’ imprisonment for prescribing oxycodone pills without a legitimate medical purpose and fraudulently billing insurance providers for procedures which were never performed. In addition to the term of imprisonment, Judge Brown imposed a fine of $150,000 and ordered Jafari-Hassad to pay restitution in the amount of $152,765.
Read about 31 convictions and the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
Other Than Health Insurance Fraud Cases
Tragic death uncovers alleged insurance fraud by Oxnard licensed agent
Fake Coverage Left Recreational Soccer Leagues And School District Exposed
Gonzalo Lorona, 58, a licensed insurance agent of Oxnard, California has been charged with 37 felony counts, including insurance fraud and grand theft, after a California Department of Insurance investigation found he allegedly stole client premium payments and issued fraudulent insurance certificates leaving organizations uninsured and at financial risk.
Read the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
How Not to Commit Arson
This is 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, one of many, is designed to help insurance people 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.
Most people do not understand how hard it is to set fire to a house that will destroy the entire dwelling and its contents. Most residences simply do not have sufficient combustibles in the right place to allow for a sustained fire. Many homes, especially the more modern ones, have fail-safe devices everywhere that make accidental fires a thing of the past.
Adapted from my book Insurance Fraud Costs Everyone Available as a Kindle Book and Available as a Paperback from Amazon.com.
Read the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
WHAT IS NEEDED TO DETER INSURANCE FRAUD?
Insurers must train their staff to recognize the elements of both the crime of insurance fraud and the elements of the civil tort of insurance fraud. If well trained, insurance personnel collecting information about a potential insurance fraud, will know the type and quality of information that either a prosecutor or a civil defense lawyer will need to prove fraud was attempted.
Read the full 21 page article at http://zalma.com/blog/wp-content/uploads/2026/03/ZIFL-03-15-2026.pdf
Barry Zalma
Barry Zalma, Inc., 4441 Sepulveda Boulevard, CULVER CITY CA 90230-4847, 310-390-4455.
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 practiced law for more than 44 years as an insurance coverage and claims handling lawyer and more than 58 years in the insurance business. He is available at http://www.zalma.com and [email protected]. Go to Zalma’s Insurance Fraud Letter at https://zalma.com/zalmas-insurance-fraud-letter-2/,
Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome.
Arsonist Tried To Represent Himself, Failed, and Sought Habeas Relief
Post number 5357
Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.
Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed
In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.
FACTS
Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...
Foolish to Repeatedly Disobey Court Orders
All That Remains For Trial Is Plaintiff’s Damages On Each Of These Claims And Establishing Proximate Causation Of Those Damages.
Post number 5348
See the full video at and at and at https://zalma.com/blog plus 5300 posts.
In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).
FACTUAL BACKGROUND
This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...
The Right to Negotiate with Insurer is Not an Assignment of Claims
Post number 5347
Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.
Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer
In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.
FACTUAL BACKGROUND
In ...
Qui Tam Case Without Evidence to Prove Fraud Fails
Post number 5369
Read the full article at https://www.linkedin.com/pulse/qui-tam-insurer-contended-defrauded-barry-zalma-esq-cfe-pgfgc and at https://zalma.com/blog plus more than 5550 posts.
In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended parties in an automobile collision case involving a McLaren and a tour van. After that case settled for $25,000, the firm filed a qui tam action under California’s Insurance Frauds Prevention Act (IFPA) against Silver Bird Auto Leasing, LLC, X-Law Group, PC, and Filippo Marchino. The firm alleged three fraudulent acts in the underlying litigation:
1. the complaint falsely stated the McLaren was making a “legal turn,”
2. respondents produced a fraudulent repair bill/estimate, and
3. respondents failed to disclose Marchino’s GEICO insurance and its payment for repairs....
Full Faith and Credit Act Controlled
Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.
Posted on June 9, 2026 by Barry Zalma
Post number 5368
Posted on June 9, 2026 by Barry Zalma
In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.
After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...
Full Faith and Credit Act Controlled
Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.
Posted on June 9, 2026 by Barry Zalma
Post number 5368
Posted on June 9, 2026 by Barry Zalma
In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.
After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...
