Zalma’s Insurance Fraud Letter – August 1, 2019

Zalma’s Insurance Fraud Letter  


 Insurance Fraud by Insurers

Zalma’s Insurance Fraud Letter, Volume 23, No. 15    

  Some of the articles you can read in this issue of ZIFL follow: 

Insurance Fraud by Insurers

Insurance Fraud is an Equal Opportunity Crime

Insurance fraud is not limited to fraud by insureds against their insurers. Much to the shame of the insurance industry, the reverse also happens.

If you do the Crime – do the Time

An Insurance Criminal’s Conviction Appealed on Many Inept Grounds

 A massive workers’ compensation insurance fraud conducted by physicians and chiropractors resulted in the conviction of Dolphus D. Pierce II only to have him file appeals on multiple useless grounds that resulted in an extremely long decision from the Court of Appeal finding none of the grounds worthy of consideration.


It seems bad enough to commit the crime of insurance fraud and make excessive profits from the criminal conduct. Insurance criminals are simply not willing to accept the fact that they were caught and need to do the time required by the trial judge. Because they have available the funds they illegally obtained they can afford lawyers to bring the type of appeal here that resulted in more than 50 paragraphs of analysis that established the jury was right, the defendant was guilty and must pay the restitution ordered or spend the entire sentence in jail.

Notice to All California Insurance Fraud Investigators

From the California Department of Insurance a proposed Change in the SIU Regulations



July 19, 2019 REG-2018-00023


The Commissioner will hold a public hearing to provide all interested persons an opportunity to present statements or arguments, orally or in writing, concerning the proposed regulation as follows:

    Date: September 5, 2019
Time: 10:00 a.m. If it is necessary for the hearing to exceed two hours, there will likely be a one-hour break from 12:00 noon to 1:00 p.m.
Location: California Department of Insurance
300 Capitol Mall, 13th Floor, Room 13025
Sacramento, California

Arson for Profit Fails in New York

She did the Crime & Must Do the Time

Arson for profit is an evil version of insurance fraud since people can be injured or killed in the fire. In a case where a person who, but for the heroic efforts of fire fighters, escaped a painful death in an arson fire set by the defendant, still resulted in an appeal from the person convicted of the crimes of arson and insurance fraud  that was shut down with alacrity by the Appellate Division of the New York Supreme (trial) Court.


It is the utmost variation on “Chutzpah” (unmitigated gall) to try to claim your lawyer was inadequate because you were convicted even though he did a yeoman effort that failed because of the existence of unimpeachable evidence that the defendant was seen to leave the building just as the fire broke out, that she took her passport with her and her son, and that the fire was started by the use of an accelerant  poured down the basement stairs and almost resulted in the death of the tenant. She should and will spend the next 25 years in state prison.

Health Insurance Fraud Convictions

Justice Department Obtains $1.4 Billion from Reckitt Benckiser Group

Largest Recovery in a Case Concerning an Opioid Drug in United States History

Other Insurance Fraud Convictions

Guilty of Arson for Profit

Christopher Hedgecock, 35, of Douglas, Georgia was sentenced to 30 years in prison with 20 to serve and ordered to pay $10,000.00 in restitution for scheming with an employee to start a fire at his business on August 5th, 2014.

The Current Issue Contains the Following:

  • Insurance Fraud by Insurers
  • If you do the Crime – do the Time
  • Notice to All California Insurance Fraud Investigators
  • Good News from the Coalition Against Insurance Fraud
  • Arson for Profit Fails in New York
  • Health Insurance Fraud Convictions
  • New Model Fraud Act
  • Other Insurance Fraud Convictions
  • Excellence in Claims Handling Courses From 
  • “Zalma on Property and Casualty Insurance”, “Insurance Law Deskbook”, “California Insurance Law Deskbook”, and “Insurance Bad Faith and Punitive Damages Deskbook”
  • Learn Everything You and Your People Need to Know About Insurance at reduced prices now only $95.00.


Zalma on Insurance 

The Zalma on Insurance blog has posted over 2650 digests of insurance appellate decisions and other important insurance materials and articles published five days or more a week and are available at

I have completed a video blog called Zalma’s Insurance 101 that consists of 1022 three to four minute videos starting with “What is Insurance” and moving forward to insurance fraud investigations explaining the basics of insurance and insurance claims handling in a painless fashion that can be viewed every morning with the first cup of coffee at  Zalma’s Insurance 101.

If you start at Volume 1 at the bottom of the blog’s first page and view one or two videos a day you will have approximately 12 to 24 hours of training a year until you get to the last video.

For detail go to,, and

About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.
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