Monthly Archives: November 2015

Fortuity

The Unwritten Exclusion Before insurance or insurance fraud can be fully understood it is essential to understand that, as the Restatement of Contracts, Section 291, states insurance is: “A fortuitous event . . . is an event which so far … Continue reading

Posted in Zalma on Insurance | Comments Off on Fortuity

Crooked Doc Gets Nothing From Insurer

Refusal to Answer Relevant Question at EUO Defeats Claim In no-fault states a physician, treating a person injured in an auto accident, obtains an assignment of the no-fault benefits, and steps into the shoes of the injured person. The physician … Continue reading

Posted in Zalma on Insurance | Comments Off on Crooked Doc Gets Nothing From Insurer

Never Volunteer To Pay More Than Your Policy Limit

Primary Insurer May Not Obtain Contribution from Excess for Voluntary Payment Insurance companies make payments based upon the terms and conditions of the contract of insurance. Every liability insurance contract has a limit of liability amount stated on its declarations … Continue reading

Posted in Zalma on Insurance | Comments Off on Never Volunteer To Pay More Than Your Policy Limit

Potential for Coverage Requires Defense

Poor Underwriting Defeats Attempt to Defeat Defense Duty Insurance companies have the right to choose who they wish to insurance and to rely upon he who will be insured for sufficient information to make a well-reasoned decision whether to insure … Continue reading

Posted in Zalma on Insurance | Comments Off on Potential for Coverage Requires Defense

No Right to Bad Faith Claim Against NFIA

NFIA Preempts State Law Most people, probably because of the name given to the National Flood Insurance Program (NFIP), believe it is insurance. It is not. Insurance is a risk taking and risk spreading device that agrees to indemnify an … Continue reading

Posted in Zalma on Insurance | Comments Off on No Right to Bad Faith Claim Against NFIA

What I am Thankful For

 I am Thankful that I am an American MY FAMILY HISTORY About 100 years ago my grandparents escaped the Ottoman Empire where people who did not follow Islam were subject to automatic execution if found on the street, and brought … Continue reading

Posted in Zalma on Insurance | Comments Off on What I am Thankful For

Always Best to Defend Close Cases

Duty To Defend Is Extremely Broad Insurance companies have difficulty with class actions because they are often vague in asserting property damage, bodily injury or personal injury. Most class actions seek damages because of wrongful actions by a manufacturer who … Continue reading

Posted in Zalma on Insurance | Comments Off on Always Best to Defend Close Cases

Unambiguous Exclusion Always Applies

Another Attempt to Rewrite a Policy After a Loss Insurers, working hard to make precise and understandable insurance policy language while still using “Sesame Street” English, write policy exclusions in language that a 4th grader or a judge can understand. … Continue reading

Posted in Zalma on Insurance | Comments Off on Unambiguous Exclusion Always Applies

Insurer Has the Right to Limit Coverage

No Coverage for an Insured v. Insured Exclusion An insurance company is entitled to determine for itself what risks it will accept. It has the unquestioned right to select those whom it will insure and to rely upon him who … Continue reading

Posted in Zalma on Insurance | Comments Off on Insurer Has the Right to Limit Coverage

Murder Does Not Pay

Murder Conviction Defeats Claim on Life Insurance Policy The U.S. District Court for the Northern District of Alabama was faced with an unusual claim made by a person with unmitigated gall – a murderer seeking the benefits of the life … Continue reading

Posted in Zalma on Insurance | Comments Off on Murder Does Not Pay

Claims Made & Reported Condition Defeats Late Claim

“Notice Prejudice Rule” Does Not Apply to Claims Made & Reported Policies Claims made and reported policies require that a claim be both made and reported to the insurer during the policy period. Insureds who know of a claim against … Continue reading

Posted in Zalma on Insurance | Comments Off on Claims Made & Reported Condition Defeats Late Claim

No Excuse For Refusing to Respond to Motion for Summary Judgment

Bad Faith Charges Don’t Eliminate The Burden of Proof Because most people dislike insurance companies and believe just filing suit against an insurer seeking bad faith damages is enough to win major damages. Those people are wrong. Every plaintiff, even … Continue reading

Posted in Zalma on Insurance | Comments Off on No Excuse For Refusing to Respond to Motion for Summary Judgment

Failure to Maintain Insurance a Crime In Arkansas

Homicide is Not Always Criminal – Lack of Insurance Is Many states, like Arkansas, require that everyone who operates a motor vehicle must carry insurance and, if he or she is involved in an accident, can be criminally responsible and … Continue reading

Posted in Zalma on Insurance | Comments Off on Failure to Maintain Insurance a Crime In Arkansas

CGL Provides No Cover For Building House on Someone Else’s Land

Insured’s Work On Property Was Clearly Excluded No insurance policy provides coverage for every possible risk of loss. When an insured builder built a house that encroached on the property of another, it sought coverage for the damages of the … Continue reading

Posted in Zalma on Insurance | Comments Off on CGL Provides No Cover For Building House on Someone Else’s Land

30 Year Failure of Notice Bars Coverage

Ignorance Can Be Cured But When it Was Not Insured Lost $8 million When a client is sued the first question every defense lawyer should ask of the client is: “what insurance do you have that could possibly provide coverage … Continue reading

Posted in Zalma on Insurance | Comments Off on 30 Year Failure of Notice Bars Coverage

Zalma’s Insurance Fraud Letter – November 15, 2015

Zalma’s Insurance Fraud Letter November 15, 2015 Volume 19, No. 22 Welcome to the November 15, 2015 Issue of ZIFL In this, the twenty second issue of the 19th year of publication of Zalma’s Insurance Fraud Letter (ZIFL), Barry Zalma, … Continue reading

Posted in Zalma on Insurance | Comments Off on Zalma’s Insurance Fraud Letter – November 15, 2015

Filed Rate Doctrine Defeats Class Action

Forced Placed Insurers Face Higher Risks of Loss No one, neither the lender nor the borrower, like forced placed policies because they only protect the lender and are invariably expensive because of the increased risk faced by the lender dealing … Continue reading

Posted in Zalma on Insurance | Comments Off on Filed Rate Doctrine Defeats Class Action

It’s The Insured’s Fault

The Duty of an Insurance Producer is Limited in Illinois In the news today it appears clear that no one is willing to take responsibility for his or her own acts. If something goes wrong, if someone loses money, if … Continue reading

Posted in Zalma on Insurance | Comments Off on It’s The Insured’s Fault

Coverage for Consequential Property Losses

Claim for Coverage for Consequential Property Losses California Code of Regulations, Section 2695.9. Additional Standards Applicable to Fire and Extended Coverage Type Policies with Replacement Cost Coverage provides: ” Section 2695.9. Additional Standards Applicable to First Party Residential and Commercial … Continue reading

Posted in Zalma on Insurance | Comments Off on Coverage for Consequential Property Losses

Connecticut Explains Meaning of “Arising Out Of”

Loss Arising Out Of Business Excluded No matter how egregious the fact situation; no matter how badly a claimant was injured; no matter who is claiming what, when there is an exclusion for a loss arising out of a business … Continue reading

Posted in Zalma on Insurance | Comments Off on Connecticut Explains Meaning of “Arising Out Of”

Medical Liens – A Way to Avoid The Limits of Howell v. Hamilton

Does a Medical Lien Have Any Relationship to The Value of the Medical Services? Some physicians and health care providers are willing to provide services on a lien where they agree to be paid only after the injured person recovers … Continue reading

Posted in Zalma on Insurance | Comments Off on Medical Liens – A Way to Avoid The Limits of Howell v. Hamilton

Accident Must “Arise out of” the Use of Auto

Nexus to Injury Required Automobile insurance is, by definition, limited to actions or events causing bodily injury or property damage arising out of or as a result of the operation, use, loading or unloading of a vehicle. It is not … Continue reading

Posted in Zalma on Insurance | Comments Off on Accident Must “Arise out of” the Use of Auto

Insurance 101 – Volume 35 – Liability Insurance

Liability Insurance Liability insurance is a promise made by an insurer to pay for all or part of a loss of money that results from a specified type of accident. The promise is in the form of a written, legal … Continue reading

Posted in Zalma on Insurance | Comments Off on Insurance 101 – Volume 35 – Liability Insurance

Precise Use Of Language in Policy Controls

Second Circuit Applies Policy Language as Written What should be obvious to anyone reading Zalma on Insurance is that insurance is nothing more than a contract. When a dispute arises the court is required to look to the words of … Continue reading

Posted in Zalma on Insurance | Comments Off on Precise Use Of Language in Policy Controls

Mailing Sufficient to Establish Cancellation

Failure to Get Photo of Vehicle Required Cancellation In New Jersey state law requires that a new policy of auto material damage insurance cannot be in force if the vehicle is not photographed.  After plaintiff damaged his automobile by  driving … Continue reading

Posted in Zalma on Insurance | Comments Off on Mailing Sufficient to Establish Cancellation

What Is Needed to Prove Rescission in New York

Court Explains Proof Required to Rescind Policy The District Court for the Western District of Pennsylvania was faced with a major lawsuit between a large and sophisticated corporation and an experienced and powerful insurer over whether a misrepresentation – whether … Continue reading

Posted in Zalma on Insurance | Comments Off on What Is Needed to Prove Rescission in New York

First Party “All Risk” Policies Can be Stacked

Ambiguity Costs Insurer More Than $25 Million Insurance companies and their lawyers work very hard to write insurance policies that are clear and unambiguous. It is a difficult task since courts interpret policies based upon a set of facts that … Continue reading

Posted in Zalma on Insurance | Comments Off on First Party “All Risk” Policies Can be Stacked

Insurer Can’t Exclude Cover for No-Fault Limits

Insurers Dispute Who Needs to Defend and Indemnify the Insured Insurance companies have the right to include any language in an insurance policy that the person insured is willing to accept unless the language included violates the local law. In … Continue reading

Posted in Zalma on Insurance | Comments Off on Insurer Can’t Exclude Cover for No-Fault Limits

It’s Not Nice To Lie to Your Insurance Company

A Lie About a 15-Year-Old Living in the House Voids Coverage Insurance,  as I have said often, is a business of the utmost good faith and neither party should do anything to deprive the other of the benefit of the … Continue reading

Posted in Zalma on Insurance | Comments Off on It’s Not Nice To Lie to Your Insurance Company

Zalma’s Insurance Fraud Letter – 11-1-2015

Insurance Fraud & Weapons to Defeat Fraud Zalma’s Insurance Fraud Letter November 1, 2015 Volume 19, No. 21 Welcome to the November 1, 2015 Click Here and Download ZIFL-11-01-2015 In this, the twenty first issue of the 19th year of … Continue reading

Posted in Zalma on Insurance | Comments Off on Zalma’s Insurance Fraud Letter – 11-1-2015