THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Posted on June 15, 2026 by Barry Zalma
ZIFL – Volume 30, Issue 12
June 15, 2026
Post number 5372
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:
Go to Jail, Do Not Pass Go
Arsonist Who Tried to Defraud Insurer Failed to Avoid Jail
Arson is a Violent and Dangerous Crime Deserving Serious Punishment
The People of the State of New York v. Zef Gjurashaj, 2026 NY Slip Op 03320, No. 2023-03675, Ind. No. 70463/21, Supreme Court of New York, Second Department (May 27, 2026) the defendant owned a restaurant that was destroyed by fire on September 6, 2017. Prosecutors alleged that he and a codefendant conspired to intentionally set the fire in order to obtain financial benefit.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Conspiring to Burn a Vehicle for Insurance Money is a Crime
Police Chief’s Guilty Verdict Affirmed
Cumulative Evidence Sufficient to Prove Fraud
In United States of America v. Christopher Filline, No. 25-50049, United States Court of Appeals, Fifth Circuit (June 1, 2026) Christopher Filline, the police chief of Castroville, Texas, reported that his wife’s Lincoln Navigator had been stolen.
In truth, the vehicle had actually been burned on a remote road two days earlier.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Qui Tam Insurer Contended it was not Defrauded
Qui Tam Case Without Evidence to Prove Fraud Fails
To Prove Insurance Fraud the Qui Tam Plaintiff Must Allege and Prove Fraud
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.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Insurer Sued Defendants for Submitting Thousands of Fraudulent Claims
Attempt at Intervention Fails
GEICO Should be Commended and Emulated for its Action Against Fraud Perpetrators
In Government Employees Insurance Co., et. al. v. Tarakchyan D.C., et al., Civil No. 24-cv-6952 (ZNQ)(JTQ), United States District Court, D. New Jersey (May 29, 2026) GEICO sued medical-provider defendants for allegedly submitting thousands of fraudulent insurance charges for unnecessary treatment.
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Health Insurance Fraud Convictions
Case Update- Former Brookline Doctor Convicted of Health Care Fraud and Money Launderng
A former Brookline Massachusetts physician was convicted following a 10-day jury trial in federal court in Boston of health care fraud, money laundering, tax evasion and conspiring to defraud the Internal Revenue Service (IRS). Dr. Pankaj Merchia of Brookline, Massachusetts and Boca Raton, Florida was convicted on January 27, 2026 of one count of health care fraud, three counts of money laundering, two counts of tax evasion and one count of conspiracy to defraud the IRS.
Read the full article plus dozens of convictions and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.pdf
Other Than Health Insurance Fraud Cases
Lawrence Man Sentenced to Probation for Phony Hit While Parked Claim
A Lawrence, Massachusetts man was placed on pretrial probation for one year on charges of motor vehicle insurance fraud and attempt to commit a crime. He was ordered to pay $756 in restitution. The Lawrence man reported to Mapfre Insurance Company that on December 10, 2021, his 2014 Subaru Forester was hit while parked causing damage to the driver side and bottom of the doors.
Physician’s Malpractice Insurance not Available When License Revoked
Applicant for Insurance is Obligated to Advise Insurer in Material Changes After Application Was Signed
Doctor Criminally Charged and License Suspended After Application Signed had Policy Rescinded for Failure to Advise Insurer of Change
Read the full article and the full June 15, 2026 Issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/06/ZIFL-06-15-2026.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.
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 ...
Chutzpah is not Enough
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
Magistrate Issues a Search Warrant if there is a Fair Probability that Contraband or Evidence of a Crime will be Found in a Particular Place.
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.
LAW:
The ...
Fraud Shouldn’t Pay
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.
One month after the policy was ...
Day Care Owner Loses Subsidies Because She Criticized State
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 ...
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 ...
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.
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 facts been disclosed. To establish materiality as a matter of law, the insurer must submit documentation of its underwriting practices, such as manuals, guidelines, bulletins, or rules addressing similar risks.
DISCUSSION/ANALYSIS:
As a result, the...
