Monthly Archives: April 2014

Expert Must Explain Conclusions

Conclusory Affidavit Not Evidence An expert witness, providing an affidavit in opposition to a motion for summary judgment, must provide the same type of testimony he or she would provide if called as a witness at trial. Information known to … Continue reading

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Extortion to Get Insurance Commissions

Jail For Influencing Insurance Purchase Public entities buy insurance to protect themselves against various liabilities and property damage. The politicians who run these entities know almost nothing about insurance and insurance pricing. As a result they are at the mercy … Continue reading

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Leaking Corpse Not Named Peril

Explosive Decomposition Not “Explosion” An insured’s next door neighbor died. Time passed before the body was discovered. During that time the decomposed body leaked bodily fluids which infiltrated the walls and the insured’s apartment causing damage. The insurance policy required … Continue reading

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Don’t Let a Viable Defendant Walk Free

A Bird In Had Is Worth More than Four Million in the Bush I have many times in this space cautioned against giving up the ability to sue and collect from a viable defendant with assets to seek damages from … Continue reading

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Posted in Zalma on Insurance | 2 Comments

Employment Practices & Exclusions

No Cover for Employee v. Employee The workplace is often dangerous. Workers and supervisors often disagree. Often such disputes become dangerous and cause serious damages. It has become commonplace for a unhappy employee to sue the employer for real or … Continue reading

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Rape Not Insurable Conduct

Injury Must Be in Course & Scope of Employment Liability insurance protects employers against torts caused by their employees and volunteers acting in the course and scope of their employment or volunteer activities. Some activities, however, can never be within … Continue reading

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“Corrosion” Exclusion is Unambiguous

Court Should Never Engage in Mental Gymnastics to Find Ambiguity For at least the last 50 years, and probably longer, every first party policy of insurance excludes from coverage, wear and tear, rust, and corrosion, probably because they are maintenance … Continue reading

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Don’t Be In a Hurry to Sue

 When Cause of Action Accrues Against Agent Insurance agents and brokers represent, as part of their sales efforts, what they believe to be the coverages being acquired by the client. When the representations made by the sales person is contradicted … Continue reading

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Buyers Remorse

Exclusions Serve an Important Purpose No insurance policy covers every possible risk faced by a person or business. Liability insurance policies are written to cover certain risks faced by a person or entity at a price the person or entity … Continue reading

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Arising Out of Use Required

The Need For a Causal Relationship Uninsured and Underinsured motorist coverage protects against injuries arising out of the use of an automobile. Missouri, in Cindy Walden v. Kenneth Smith and American Family Mutual Insurance Company, Court of Appeals of Missouri … Continue reading

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Catch-22 & Trucking

An “Independent Contractor” Is Not an Employee Insurance of interstate trucking is different than insurance of intrastate trucking because of the requirements of federal law. Sometimes, federal and state law cause confusion over the application of the law and the … Continue reading

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Coverage Counsel Must Protect Privileges

The Attorney Client Privilege & Work Product Protection Plaintiffs’ counsel who bring actions for the tort of bad faith attempt to gain the opinions of coverage counsel and the thought processes of coverage counsel on whose advise an insurer relied … Continue reading

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Limitation on ERISA

ERISA Has No Limitation of Suit Provision Bridget Gordon (“Gordon”) appealed a district court’s summary judgment in favor of Deloitte & Touche, LLP Group Long Term Disability Plan (the “Plan”), which is insured by Metropolitan Life Insurance Company (“MetLife”). The … Continue reading

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Zalma’s Insurance Fraud Letter – April 15, 2014

A Chance to Reduce Medicare Fraud In the eighth issue of its 18th year of publication of Zalma’s Insurance Fraud Letter (ZIFL) Barry Zalma, on April 15, 2014, continues the effort to reduce the effect of insurance fraud around the … Continue reading

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Public Interest Outweighs Private Property Interest

End Of Argument over Insolvency of RRG The Supreme Court of Delaware was faced with challenges to multiple orders issued by the Court of Chancery, the detailed facts of which was discussed here at http://zalma.com/blog/fraud-punished-with-mercy. In Jeffrey B. Cohen, and Jeffrey … Continue reading

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Breach of Condition – Fatal or Not

Kansas Requires Proof Of Substantial Prejudice First party property insurance policies universally contain conditions precedent requiring an insured to submit timely notice of claim and a timely sworn statement in proof of loss. Failure to do so is usually considered … Continue reading

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Suspended License Not a “Disability”

Disability Must Be Real Curtis Cich sued National Life Insurance Company (“National Life”) and Penn Mutual Life Insurance Company (“Penn Mutual”) after both companies denied his claims for disability benefits under insurance policies they had issued to him. The district … Continue reading

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Insured Held to Understand Policy

Cause of Action Accrues When the Insured Could Timely Discover Facts Insurance agents and brokers recommend policy limits but insureds choose the limit of liability. Most policy limits are chosen to limit premium expenditure because most insureds believe they will … Continue reading

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Lawyer Destroys Plaintiff’s Case

Bad Faith is a Two-Way Street Some lawyers and the clients they represent believe insurance companies are evil. They believe that insurance companies only ask questions of people they insure or claimants because they are looking for a way to … Continue reading

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Preemption of State Law Defeats Suit

State Law Preemted by Risk Retention Act The federal Liability Risk Retention Act of 1986, 15 U.S.C. § 3901, et seq. (“the LRRA” or “the Act”), contains sweeping preemption language that sharply limits the authority of states to regulate, directly … Continue reading

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Easy, English, Passover Seder

Passover is Coming The Passover Seder has become complex and difficult for American Jews, many of who have little or no use of the Hebrew language but still wish to fulfill the commandment to explain the Passover to their children … Continue reading

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Interrelated Wrongful Acts

Multiple Breaches of Fiduciary Duty are Interrelated Continental Casualty Company (Continental) appealed from the district court’s grant of summary judgment to Crystal Kilcher, Daniel Kilcher, and Anthony Muellenberg, individually and as trustee of the Troy Muellenberg revocable trust (collectively, Plaintiffs). … Continue reading

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Adjuster – Never Lie to Insured

The Problem with a Demurrer When a party files a demurrer it states that even if everything alleged in the complaint is proved to be true the defense will win. Defendants who succeed in such a pleading will often have … Continue reading

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A Taste of a New E-Book

Mom & The Taipei Fraud The Rescue Plan The Following is Chapter II of my new e-book, “Mom & The Taipei Fraud” where claims investigator Marion Orpheus Montague (aka “MOM”) works to defeat a fraudulent $7 million dollar fraudulent theft … Continue reading

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Insured Friendly Law In Puerto Rico

Defense Required If There is a “Remote” Possibility of Coverage The interpretation of an insurer’s duty to defend varies by jurisdiction. Puerto Rico is a jurisdiction that is exceedingly favorable to insureds and directs its court, when deciding an issue … Continue reading

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Stranger Owned Life Insurance Risky Investment

Lies on Life Application Void Coverage Insurance is a business of utmost good faith requiring both the insured and the insurer to treat each other fairly and in good faith and to do nothing to hurt the right of the … Continue reading

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Not April Fools – The Neverending Story Continues

Zalma’s Insurance Fraud Letter April 1, 2014 Not April Fools – The Neverending Story Continues In the seventh issue of its 18th year of publication of Zalma’s Insurance Fraud Letter (ZIFL) Barry Zalma, on April 1, 2014, continues the effort … Continue reading

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