Monthly Archives: April 2012

WHO IS FIRST NAMED INSURED?

It is Important to Honor Substance Over Form In the Maryland motor vehicle insurance law, the phrase “first named insured” makes what the Court of Appeals of Maryland calls “a cameo appearance” in Kelly Swartzbaugh, et al. v. Encompass Insurance … Continue reading

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Punish Only Those In Case

Limitations on Punitive Damages When a lawyer asks for punitive damages against an insurer for bad faith conduct he or she will always ask the jury to “teach the insurer a lesson” to stop it from doing the same to … Continue reading

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Eight Corners Rule Strikes Again

Natural or Probable Consequences of an Intentional Act Not an Occurrence On September 27, 2011 I wrote about a holding of the Virginia Court of Appeal at http://zalma.com/blog/?p=1792 where the court concluded that an intentional act cannot be an occurrence. … Continue reading

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Expert Report Not Part of Claims Handling

No Bad Faith When it took more than 20 months to resolve a claim for the theft and burning of a vehicle, Rocky Walker and Kristi Walker (“Walkers”) sued their insurer for bad faith even though the claim was eventually … Continue reading

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ENDORSEMENT SUPERSEDES POLICY WORDING

Pollution Exclusion Endorsement Applies When seeking to insure major risks, like a manufacturing facility, a professional broker will submit a manuscript policy to cover all the risks of loss faced by the insured. Insurers, however, are not obligated to accept … Continue reading

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Red Flags Of Insurance Fraud

Investigating Insurance Fraud Suspicious insurance claims have common attributes that insurers and fraud investigators have collated into lists to be used to determine whether further investigation is required.  Continually growing, these lists are known as the “red flags” or “indicators” … Continue reading

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Just For Fun

Help, My House Is Falling Into The Sea The story that follows is based on fact but is fiction. The names, places and descriptions have been changed to protect the guilty. This story was written for the purpose of providing … Continue reading

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NEVER, EVER, LIE ON AN INSURANCE APPLICATION

A Lawyer Who Steals From His Client Is Not Entitled to Insurance Coverage Insurer Has an Unquestioned Right to Select Whom it Will Insure Zalma on Insurance Makes Top 50 Often forgotten by courts in the United States is the … Continue reading

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NO COVER FOR ACCIDENT IN RENTAL CAR

Permission of Owner Required to Cover Rental Car Sometimes trial courts feel sorry for plaintiffs injured by a totally negligent driver and ignore the provisions of an insurance policy to provide payment to the injured persons. The Louisiana Court of … Continue reading

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FIFTH AMENDMENT DOES NOT APPLY TO INSURANCE CLAIM

Admit Arson-for-Profit to Insurer or Go To Jail Another Weapon Against Insurance Fraud Insurance fraud is a serious problem in the United States estimated to take from $80 billion to $300 billion a year. No one knows for sure how … Continue reading

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How To Take The Profit Out of Insurance Fraud

Zalma’s Insurance Fraud Letter  April 15, 2012 In this, the eighth issue of the 16th year of publication Zalma’s Insurance Fraud Letter (ZIFL), ZIFL reports on: 1.    Barry Zalma submits a proposal for taking the profit out of insurance fraud … Continue reading

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GAMESMANSHIP NOT ALLOWED

Good Faith Requires Professional Claims Handling The California Court of Appeal was asked to resolve a dispute between two insurers concerning the apportionment of the costs to defend and indemnify co-insureds. Axis Surplus Insurance Company and Glencoe Insurance Ltd. provided … Continue reading

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Don’t Lie On An Application For Insurance

Abuse of the Incontestability Clause Life and disability policies usually contain an incontestability clause that prevents an insurer from voiding a contract of insurance after it has been in effect for more than two years. People insured know of the … Continue reading

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Sarah Zalma

My Mother – Sarah Zalma February 28, 1912 – April 9, 2012 On April 9, 2012, my mother, Sarah Zalma, born February 29, 2012 passed away peacefully of natural causes at her home at Palm Court in Culver City, California. … Continue reading

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Tangible Property Must Exist to Be Damaged

ECONOMIC LOSS & PROPERTY DAMAGE The Minnesota Court of Appeal was called upon to resolve a challenge by Farm Bureau Mutual Insurance Company (“Farm Bureau”) to the trial court’s summary judgment in favor of its insured, respondent Earthsoils, Inc. Farm … Continue reading

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The CGL and Trade Dress Infringement

TRADE DRESS INFRINGEMENT The Wisconsin Court of Appeal was called upon to determine if Ross Glove Company was entitled to coverage for defense or indemnity of a suit claiming it had infringed on the trade dress of another in Acuity, A … Continue reading

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WHO’S ON FIRST?

The Selective Tender Rule The Illinois Court of Appeal was asked to resolve a dispute between the Illinois School District Agency (ISDA), a provider of commercial general liability insurance and St. Charles Community Unit School District 303 (District) concerning a … Continue reading

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K.I.S.S.

A Proposal to Defeat Insurance Fraud Insurance Fraud is Endemic Insurers and prosecutors have attempted to be proactive in the fight against insurance fraud by filing cases against medical and legal professionals who commit fraudulent claims. Lawsuits and prosecutions naming … Continue reading

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New York Allows Expert To Testify About Mold Causation

Mold Damages in New York The New York Appellate Division was asked to resolve whether the use of expert witnesses in determining cases claiming damages as a result of exposure to mold. It stated that although previous decisions dismissed a … Continue reading

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Never Deceive A Court

Self Insured Retention Don’t Deceive Court About Terms of Policy The Eighth Circuit Court of Appeal was called upon to resolve an issue of coverage raised by the bankruptcy of an insured who had no ability to pay the self … Continue reading

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NO SURPRISE – RAW SEWAGE IS A POLLUTANT

Human Excrement & Bat Guano Are Pollutants The Colorado Court of Appeal was called upon to determine whether an “absolute pollution” exclusion (APE) applied to a suit for bodily injuries exposed to raw sewage. Plaintiffs, Shadi Figuli, Joshua Figuli, and … Continue reading

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