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?
3 hours ago
Plaintiff Sues Because State Employees Stigmatized Her

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published stigmatizing information, interfered with subsidies and program funding, removed her from a food program, rescinded an expansion grant, and used biased or falsified evidence in licensing proceedings.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was removed from the federal food program (loss approximating $230,496); and her approved $74,000 expansion grant was rescinded due to the unlawful license sanction.

Ms. Grant claims that Defendants also engaged in arbitrary, capricious, and conscience shocking conduct by intentionally misrepresenting compliance status, manipulating licensing and funding mechanisms to punish protected speech, and weaponizing adjudicative proceedings infected by bias and retaliation.

LAW:

The court applied Rule 12(b)(6) plausibility standards, Eleventh Amendment sovereign immunity, exception for prospective relief against appropriate state officials, First Amendment retaliation doctrine, procedural and substantive due process standards, and the Maine Tort Claims Act notice requirements.

DISCUSSION/ANALYSIS:

The court held that DHHS and the employees sued in their official capacities were not proper defendants for damages or broad injunctive relief, and that Grant had not sued an official with authority to implement the requested prospective relief. The court found the First Amendment retaliation claim plausibly pleaded against the individual employees because Grant’s legislative testimony was protected speech and the alleged retaliatory licensing actions followed closely enough to permit an inference of causation at the pleading stage.

The State Defendants note that nowhere in the Complaint does Ms. Grant allege any continuing violations of federal law by the individual State Defendants, nor does she seek to enjoin any of them from violating federal law. As such, the demand for injunctive relief, which is made against DHHS, must be dismissed as violative of the Eleventh Amendment, and the claims against the individual Defendants must also be dismissed because she does not allege any continuing violations.

The due process claims failed because Grant received notice, a hearing, and available appellate procedures, and her allegations did not show conscience-shocking conduct. The state tort claims failed because Grant did not show compliance with the Maine Tort Claims Act’s notice-of-claim requirements.

CONCLUSION:

The motion to dismiss was granted in part and denied in part.

DHHS was dismissed; the official-capacity claims against the individual defendants were dismissed;
the procedural and substantive due process claims were dismissed; and the state-law defamation and tortious-interference claims were dismissed for lack of subject matter jurisdiction. The First Amendment retaliation claim survived against the individual defendants in their personal capacities.

ZALMA OPINION

A licensed childcare provider publicly criticized state agencies. She claimed she was retaliated against by the state agencies she criticized which cost her about $300,000 in subsidies that supported her work. The charges were not made appropriately and most of her complaint was not appropriate and not viable and left her with a claim of retaliation for exercising her First Amendment right and will be allowed to go trial.

(c) 2026 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://gbarryzalma.substack.com/subscribe

Go to X @bzalma;  Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://Cwww.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the InsuranceClaims Library – https://lnkd.in/gwEYk. 

post photo preview
Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
July 22, 2026
The Real Cost of Fraud

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 ...

00:12:33
July 20, 2026
Search Warrant Produces Evidence of Insurance Fraud

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 ...

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

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 ...

00:09:42
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 ...

post photo preview
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.

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...

August 04, 2026
Insurance Fraud is a Violent Crime

Disbarment of Defendant Admissible as Intrinsic Evidence of Fraud Case

Murder of Witness to Staged Auto Accident is Inadmissible in Fraud Case
Posted on August 4, 2026 by Barry Zalma

Post 5416

In United States Of America v. Ryan Harris, et al., Criminal Action No. 24-105, United States District Court, E.D. Louisiana (July 23, 2026) the defendants were charged in connection with an alleged staged-automobile-collision insurance fraud scheme in the New Orleans area and later crimes arising from the murder of cooperating witness Cornelius Garrison.

LAW:

Federal Rule of Evidence 404(b) generally bars other-act evidence offered to prove propensity but allows such evidence for non-character purposes if admissible.

DISCUSSION/ANALYSIS:

The Court held that Alfortish’s disbarment was intrinsic because it explained why he allegedly funneled staged-accident clients to Vanessa Motta rather than litigating the cases himself, thereby illuminating the structure of the mail-and-wire-fraud conspiracy.

...

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