Monthly Archives: June 2011

The Need for Simple Declarative Sentences

CGL Exclusion for Injuries to Children Ambiguous in Florida The most difficult task faced by an underwriter, and those representing underwriters, is to write insurance policy provisions in clear and unambiguous language. It has become even more difficult when the … Continue reading

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“CSL” Standing Alone Is Ambiguous

Key Terms Must Be Defined A major automobile accident between a bus carrying developmentally disabled people and a driver on the wrong side of the road resulted in multiple deaths and major injuries to those not killed. The responsible driver … Continue reading

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More on Bananas

Fraud From Foreign Courts Imported to US The United States court system is fair to all who seek redress even if they are not citizens of the United States. People from across the world have been allowed to sue multi-national … Continue reading

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The Problem of Mutual Benefit Insurance

When a person leases a portion of a structure with multiple tenants it is usual for the landlord to promise to buy property insurance to protect the entire structure and make, as part of the rent charged, the tenant pay … Continue reading

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Sloth Defeats UIM Claim

Counsel: Never Ignore Statute of Limitations In Connecticut there is a three year limitation period for any uninsured or underinsured motorist claim. When a person, or counsel, allows the limitation period to run before making a claim cannot, no matter … Continue reading

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Easy to Create Ostensible Agency in Canada

An Insurance Broker Is Not an Insurer Insurance brokers, people who transact insurance with, but not on behalf of, an insurer. Insurance brokers often confuse their duties and obligations. Similarly, those who are insured, confuse their insurance broker with their … Continue reading

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Cutting Into Moradi-Shalal

There is a Private Right of Action Against California Insurers who Violate California Insurance Code Section 758.5 In Moradi-Shalal v. Fireman’s Fund Insurance Companies (1988) 46 Cal.3d 287 (Moradi-Shalal) the California Supreme Court reversed its decision in Royal Globe Ins. … Continue reading

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No Right to Speculative Injury

Fear Of Future Illness Is Not Damage in Wisconsin Every person who resides on planet earth are at some time exposed to toxic chemicals, toxic substances, molds, viruses, bacteria and poisons. Human beings as they grow develop immunities to disease … Continue reading

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Just for Fun

The Case of the Art Flambé When a person decides to perpetrate an insurance fraud, he pushes the pause button on his morality. His plan to commit the fraud will then become so flamboyant and creative that even the most … Continue reading

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No Excuse For Not Reading Policy

You Cheated Me Because You Knew I Would Not Read Policy Marshal Howard admitted that he did not read the application for insurance he signed, the quotation for the insurance, the binder nor the policy that was issued. He thought … Continue reading

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Expert Testimony

I testify as an expert witness on insurance coverage and insurance claims handling in state and federal courts across the country based on over forty years as an insurance claims person and insurance coverage lawyer and insurance author. It is … Continue reading

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Fraud Investigation is Dangerous

Zalma’s Insurance Fraud Letter — June 15, 2011 Continuing with the twelfth issue of the 15th Year of publication of Zalma’s Insurance Fraud Letter (ZIFL) Barry Zalma reports on June 15, 2011 about the murder of two unarmed fraud investigators … Continue reading

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“Millions for Defense and not a Dime for Tribute.”

Attempted Fraud Fails Insurers Must Never Pay a Fraud When I was a young adjuster the motto of the insurance industry was “Millions for Defense and not a Dime for Tribute.” Fraud was known but not a large problem. Police … Continue reading

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Flag Day & Army Birthday

Happy Birthday to the U.S. Army and fly the flag at least today, flag day.

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A Property Loss Can Have Only One Efficient Proximate Cause

Some Insurers are Unwilling to Take Certain High Risks Insurance is a risk-spreading business. The greater the risk the more it must be spread to make profit in insurance possible. When the risk of loss is high and there are … Continue reading

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The Need for Substantial Compliance With Policy Condition

Prompt Reporting of Loss It is always best for plaintiffs to immediately make claim to the person responsible when injured. It is equally important that the defendant, if insured, immediately notify the insurer who might owe a duty to defend … Continue reading

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Courts May Not Change Clear and Unambiguous Language of a Policy

The Trouble With Underinsured Motorist Insurance When someone is seriously injured courts will often work hard to find a way to indemnify the innocent injured party. If an insurer can be made to pay a claim it should not owe … Continue reading

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The Employee Exclusion

Creativity Fails When Policy Wording is Clear and Unambiguous In Texas workers’ compensation insurance is not mandatory. Employees injured on the job with an employer who does not have workers’ compensation insurance can be sued by the injured employee for … Continue reading

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Barry Zalma as Expert

I did not post yesterday because I was honored to be called as an expert on behalf of Coast National Insurance Company in a suit pending in San Bernardino, California. I testified on direct and cross examination.  The jury should … Continue reading

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The Insured Must Produce Tax Returns If The First Party Insurer Demands Production

Tax Returns are Privileged — But Every first party property policy contains a provision requiring an insured to produce all relevant documents required to be produced by the Insurer and to appear for examination under oath [California Insurance Code § … Continue reading

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Interesting New Uninsured Motorist Cases

Rejection of Uninsured Motorist Uninsured and underinsured motorist coverage is required by the State of Louisiana unless rejected in a form acceptable to its Department of Insurance and the court. It is incumbent on the insurer that accepts a rejection … Continue reading

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Gary A. Hernandez — RIP

California Insurance Commissioner Jones Issued a Statement on the Passing of Gary A. Hernandez Although my contact with Mr. Hernandez was minimal I remember him as a good man who really understood insurance and the need for insurance in a … Continue reading

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Insurance Fraud Continues Unabated

The June 1, 2011 Issue of Zalma’s Insurance Fraud Letter Now Available Continuing with the eleventh issue of the 15th Year of publication of Zalma’s Insurance Fraud Letter (ZIFL) Barry Zalma reports on June 1, 2011 on a sentence of … Continue reading

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