Monthly Archives: February 2016

Multiple Crashes Still One Accident

Sole, Uninterrupted Proximate Cause Of Accident Determines Coverage Limit Automobile insurance policy limits are usually based on a per accident basis. When an automobile accident involves multiple collisions disputes arise as to the limits. The insurer will try to limit … Continue reading

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Policy Properly Rescinded for Misrepresentation of Material Facts

Insured Required to Read and Affirm Application Even If Filled out by Agent Insurance is a business of utmost good faith. The covenant requires that neither party do anything that would harm the right of the other to the benefits … Continue reading

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Litigation Privilege Defeats Claim of the Lawyer Committed Fraud

Attempt to Take the Profit Out of Insurance Fraud Fails Insurance fraud is rampant in California and the rest of the United States. Insurers, finding no help from prosecutors, have become proactive in the fight against insurance fraud and have … Continue reading

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Claim Made Before Policy Not Covered

Interrelated Acts & Claims Insurance companies who write claims made policies are only required to pay to defend or indemnify an insured when the claim is made during the operative dates of the policy. The date the claim is made … Continue reading

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Special Relationship Needed to Hold Insurance Agent For Negligence

Trier of Fact Must Establish Existence of Special Relationship An insurance agent, typically, need only provide the insurance ordered by the customer unless there is a special relationship between the client and the insurance agent. The determination of the existence … Continue reading

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When Insured Commits Fraud or False Swearing It Should Not be Confused with Appraisal

Appraisal Required If Dispute Over Amount of Loss Exists A proof of loss is a sworn document. It establishes the claim made by the insured to the insurer. If falsely sworn the policy may be declared void and all claims … Continue reading

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Insurance Is Going to Pot in Colorado

A Crop of Pot is a Crop Even If Planted in Pots Marijuana is a legal crop in Colorado and the product is legally insurable. However, as the marijuana farmer learned, no insurance policy covers everything and an insurer is … Continue reading

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Jury Selection Comments Not Evidence

 Mention of Insurance Not Always Prejudicial People involved in tort suits seeking damages from a defendant are prohibited from mentioning the existence of insurance to protect the defendant from damages that might not be granted if the jury thought he … Continue reading

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Deductible Applies to Each Occurrence

Wrongful Strip Search a Single Occurrence Per Arrestee Liability insurance policy deductibles are odd things because the insured is only required to pay them after a claim is resolved while a self-insured-retention (SIR) which requires the insured to expend the … Continue reading

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No Coverage No Bad Faith

Fifth Circuit Applies Policy as Written Modern liability insurance policies insure against all causes that might result in a court concluding that the insured is legally liable to a third person for bodily injury or property damage. However, often to … Continue reading

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Actual Conflict Required for Independent Counsel

Reservation of Rights Does Not Always Require Independent Counsel Third party liability policies authorize insurers to control the defense of a suit against the insured and appoint counsel of the insurer’s choice. As a result of many court decisions if … Continue reading

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Zalma’s Insurance Fraud Letter, February 15, 2016

No Honor among Insurance Criminals Volume 20, No 4 In this, the third issue of the 20th year of publication of Zalma’s Insurance Fraud Letter (ZIFL), Barry Zalma, on January 15, 2016 continues the effort to reduce the effect of … Continue reading

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Agents May Compete in California

To Sue for Intentional Interference With Economic Advantage You Must Prove an Independently Wrongful Act In California insurance agents and brokers aggressively compete for business. In 1998, by legislative action, repealed a law prohibiting “unlawful rebates” in connection with the … Continue reading

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Claims File Sacrosanct Until Coverage Established

Fishing For Bad Faith Evidence Not Allowed in Florida Some people believe it is best to obtain an agreed upon judgment against a person who has limited insurance and then take an assignment of the defendant’s rights against his insurer … Continue reading

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Innocent or Intentional Misrepresentation Requires Rescission

The Equitable Remedy of Rescission Sometimes courts think insurance is a government entitlement rather than a contract between two parties. In H.J. Heinz Company v. Starr Surplus Lines Insurance Company, Slip Copy, United States District Court, W.D. Pennsylvania 2016 WL … Continue reading

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Umbrella Excess over Municipal Risk Pool

Umbrella Provides a Unique and Special Coverage It is a rare and useful occurrence when an appellate court applies the clear and unambiguous language of an insurance policy. When an insured buys an umbrella policy the insured knows that it … Continue reading

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No Honor Among Insurance Criminals

Lying to the FBI About Insurance Fraud is Fatal Because it is a $300 billion a year business many amateurs believe it is easy to defraud an insurance company as long as they have the unmitigated gall to deny all … Continue reading

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Speculative Class Action Fails

Claim of Future Injury Not Basis For Declaratory Relief When the Supreme Court of the state of Georgia decided State Farm Mutual Automobile Insurance Co. v. Mabry, 274 Ga. 498, 556 S.E.2d 114 (Ga. 11/28/2001) it opened the door to … Continue reading

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Exclusion Clear & Unambiguous Applies

Unless the Legislature Specifically Prohibits Action It is Not Against Public Policy Insurance policies, if written in clear and unambiguous language, are enforceable. The United States District Court for the Eastern District of Arkansas in a simple, brief and unambiguous … Continue reading

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Agent’s Duty Limited

Expanded Duty of Agent Withdrawn by Iowa Supreme Court Although insurance professionals recommend against it most people shop for insurance based upon premium not coverages available. As a result, when a loss occurs that is not covered by the apparently … Continue reading

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Claim File Sacrosanct Until Right to Benefits Established

No Right to Claim File In Florida Until Coverage Established Insurers create claims files for many different reasons including, but not limited to, management of claims handling, preparation for litigation as work product, and analysis of insurance coverages available to … Continue reading

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Zalma’s Insurance Fraud Letter – February 1, 2016

  Zalma’s Insurance Fraud Letter February 1, 2016, Volume 20, No. 3   Welcome to the February 1, 2016 Issue of ZIFL Click here to receive the current issue In this, the second issue of the 20th year of publication of … Continue reading

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