Monthly Archives: October 2013

Lawyer Gets Mercy

Ohio Supreme Court Nice To Wrongdoing Lawyer The right to practice law is usually governed by the state Supreme Court. When lawyers do wrong they can be punished by the bar with private reproval, public reproval, suspension, or disbarment. For … Continue reading

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WC is an Exclusive Remedy

No Duty to Defend Suit by Employee if Workers’ Compensation is Paid Eric F. Melgren, United States District Judge, in Hanover Insurance Co. v. Jones, 12-2196-EFM (D.Kan. 10/28/2013), responded to the request by Plaintiff Hanover Insurance Company (“Hanover”) and Plaintiff … Continue reading

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Declarations Page Controls

Limited Coverage for Employee Dishonesty Sadly, it is not unusual for an employee to embezzle funds from an employer. For that reason most businessowners policies provide limited coverage for losses incurred as a result of the dishonesty of an employee. … Continue reading

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Exclusive Remedy Remains Exclusive

Extrinsic Evidence Determines Duty to Defend This appeal required a New Jersey Appellate court to determine the scope of an insurer’s duty to defend an insured under Indiana law. In Ware Industries, Inc. v. Wausau Underwriters Insurance Co., A-3522-11T1 (N.J.Super.App.Div. … Continue reading

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Zalma Fraud Webinar on Monday

Insurance Fraud and Weapons to Fight Fraud A webinar presented by Barry Zalma, Esq., CFE on Monday, October 28, 2013 at 10:00 AM PDT to 11:00 AM PDT.  This webinar highlights the multi-billion dollar crime that bleeds the insurance industry … Continue reading

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Residence Premises is Not a Home

Metes & Bounds Define Residence Premises In September 2000, Norman and Glenna Schuchman purchased homeowner’s insurance from State Auto Property and Casualty Insurance Company (“State Auto”) to insure a residence in Junction City, Illinois. Almost ten years later, a fire … Continue reading

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Waiver of Subrogation Limited

Subrogation Only Waived for the “Work“ Almost every construction project contains a waiver of subrogation, preventing the property insurer from seeking indemnity from the contractor for its negligence. In such contracts both parties agree to limit themselves to the recovery … Continue reading

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Fortuity

Insurance Should Only Indemnify Damage Caused by Fortuitous Acts Contrary to statements made by politicians, insurance is not a right. Insurance is not a means of curing social ills. Insurance is not a means of curing environmental problems. Insurance is … Continue reading

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Don’t Sweat the Small Fraud

Don’t Sweat the Small Fraud The story that follows is based on fact. The names, places and descriptions have been changed to protect the guilty. This story was written for the purpose of providing insurers, those in the insurance business, … Continue reading

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Willful & Wanton Conduct

Malicious Conduct That Causes Damage is Vandalism The United States Court of Appeals for the Second Circuit asked the highest court in New York two questions relating to a property insurance policy covering acts of “vandalism.” (1)     For purposes … Continue reading

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Non-Renewal Requires Request For Coverage

No Cancellation Still No Coverage Workers’ Compensation insurance policies are often issued for a fixed term. When the term expires the policy expires unless renewed. Insurance companies are not required to renew a policy when the insured fails to ask … Continue reading

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Pay a Million for Nothing

Sufficient Notice of Premium Due Cash Surrender Value Life Insurance On Old Person Not a Bargain Conseco Life Insurance Company’s predecessor issued a flexible premium life insurance policy to Johnston & Johnston on the life of Mary Ann D. Johnston … Continue reading

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Two Years Late – No Coverage

Another Short & Sweet Decision From New York Insurance policies that insure against liability to third parties require prompt notice to the insurer to avoid fraud and allow the insurer to mount a prompt and effective defense. In Property & … Continue reading

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Criminal Avoids Restitution

The Law of Unintended Consequences Strikes Again The United States Congress in an attempt to protect the honest and innocent consumers enacted the Consumer Credit Protection Act (the “Act”), 15 U.S.C. § 1673(a). Congress had no intent to protect criminals … Continue reading

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A Work of Art Is Not Consumed

Exceptions to Exclusion Don’t Always Grant Coverage Lawyers are creative people. They can find an ambiguity in an insurance policy on the the thinnest of rhetorical threads. A creative lawyer litigates to courts of appeal even when its creative interpretation … Continue reading

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Stupid is as Stupid Does

Policy Must Say What Insurer Meant In what the First Circuit Court of Appeal found to be an oxymoron: an interesting insurance coverage question, it was called to resolve the claims of an insurer that an exclusion eliminates its duty … Continue reading

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Failure of Maneuver To Claim Bad Faith

Is There Bad Faith Refusal to Settle? When a serious injury is incurred with a defendant who has inadequate insurance coverage to compensate the injured party, counsel for the party will often use counsel’s wits and energies to lead the … Continue reading

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Insurance Fraud Webinar

Insurance Fraud and Weapons to Fight Fraud A webinar presented by Barry Zalma, Esq., CFE on Monday, October 28, 2013 at 10:00 AM PDT to 11:00 AM PDT This webinar highlights the multi-billion dollar crime that bleeds the insurance industry … Continue reading

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UIM Knowingly Rejected

Is It Best to Use Form Mandated by Statute? Underinsured motorist insurance (UIM) coverage is usually optional. In some states, like West Virginia, a statute requires automobile insurers to offer UIM coverage to its insureds. The state regulator created specific … Continue reading

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Equitable Subrogation

Excess Insurer Entitled to Prove Right to Equitable Subrogation From Primary The Missouri Court of Appeal, for the first time, was called upon to resolve a dispute between an excess insurer who sought to recover from a primary insurer the … Continue reading

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Life Insurance Fraud Fails

Reinstatement of Life Policy Like New Policy States, in an attempt to protect life insurance beneficiaries, make it impossible to contest the viability of a life insurance policy, even if obtained by fraud, unless the coverage is contested within two … Continue reading

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Polluter Must Pay

Pollution Exclusion Applies It is axiomatic that insurance companies have the right to limit coverage in any manner they desire, so long as the limitations do not conflict with statutory provisions or public policy. People who are sued have a … Continue reading

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Rescission Attempt Fails

You Can Lie to an Insurer in Illinois and Still Keep Coverage When a person, directly or through a broker, lie in an application for insurance it usually results in voidance of the insurance policy either by the equitable remedy … Continue reading

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No Damage to Vexatious Litigant

There Must Be Damages for Coverage Liability insurance policies are designed to protect those insured against claims seeking damages from the insured. Some suits, however, seek equitable remedies and no damages. In such a case, where damages are neither alleged … Continue reading

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ZIFL — October 1, 2013

34 Years In Business Continuing with the nineteenth issue of the 17th year of publication of Zalma’s Insurance Fraud Letter (ZIFL), Barry Zalma, in the October 1, 2013 issue, thanks you all for his 34 Years in business as Barry … Continue reading

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