Monthly Archives: May 2016

Beating a Person Unconscious Is an Intentional Act

No Coverage for Bar Room Attack I have, until I was blue in the face, reminded my readers that liability insurance only applies to fortuitous events – there must be an accident, an occurrence, an injury without intent to cause … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Beating a Person Unconscious Is an Intentional Act

Corrosion Determined as a Matter of Law

Insurance Policies are Creatures of Contract Insurance contracts must be interpreted like any other contract. When there is a dispute between an insurer and insured on the meaning of a term or condition in the insurance policy the court must … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Corrosion Determined as a Matter of Law

Intentional & Wrongful Eviction Not Covered

  A“Wrongful Eviction” May or May Not Be Intentional Liability insurance policies, under the personal injury cover, agrees to insure against certain offenses including the offense of wrongful eviction. In State Farm Fire and Cas. Co. v. Otten, Not Reported … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Intentional & Wrongful Eviction Not Covered

Marine Insurance Requires Insured to Exercise Uberrimae Fidei

Insured May Not Hide Material Information From a Marine Insurer Marine insurance is, because of the risks taken, applies the doctrine of  uberrimae fidei (utmost good faith) strictly. In Fireman’s Fund Ins. Co. v. Great American Ins. Co. of New … Continue reading

Share
Posted in Zalma on Insurance | 1 Comment

Intentional Acts Can’t Be Insured

No Fortuity – No Coverage Insurance, by definition, insures only against contingent or unknown events. To obtain coverage for defense or indemnity an insured only needs to establish that the suit against the insured was fortuitous – accidental – unintentional … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Intentional Acts Can’t Be Insured

Bad Faith “Set Up” Fails

No Duty to Defend Breach of Contract Insurance covers many risks of loss but not all. Essentially, a liability insurance policy, insures the insured against risks of loss due to the negligence of the insured that causes property damage or … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Bad Faith “Set Up” Fails

A House is Also a Home

Where You Reside Is A Question of Fact Resident relatives are usually covered by insurance policies in the name of a parent or other relative. What is a residence, however, is a question fraught with danger and an insurer denies … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on A House is Also a Home

Written Notice to State Required to Sue State

Strict Compliance With Statute Required to Sue State Since states and state agencies are protected by sovereign immunity most states have enacted statutes to allow certain people injured by the state to sue the state if the injured person complies … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Written Notice to State Required to Sue State

An Insurer Who Pays a Claim Negligently May Obtain Restitution

Don’t Look a Gift Horse in the Mouth The failure of life insurance companies to check the Social Security Administration death records to determine if anyone is owed benefits on a life insurance policy has caused serious and expensive administrative … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on An Insurer Who Pays a Claim Negligently May Obtain Restitution

Requirements for Bad Faith in Alabama

Tort of Bad Faith Different from Wanton and Negligent Conduct When a claim is not paid as the insured desires a suit will be invariably filed against the insurer seeking both contract and tort damages. When an insurer is sued … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Requirements for Bad Faith in Alabama

Negligent Entrustment of Auto Requires Ownership

Sell a Car & Eliminate Responsibility for its Operation When a person is injured or killed in an automobile accident where the owner and operator of the vehicle causing the accident is uninsured the injured parties try everything possible to … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Negligent Entrustment of Auto Requires Ownership

Health Insurance & the U.S. Supreme Court

Why Government Should Not Require Insurance Insurance is a contract a contract whereby one undertakes to indemnify another against loss, damage, or liability arising from a contingent or unknown event. The Patient Protection and Affordable Care Act (ACA) changes the … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Health Insurance & the U.S. Supreme Court

Zalma’s Insurance Fraud Letter – May 15, 2016

N.Y. Speaker Guilty Zalma’s Insurance Fraud Letter May 15, 2016, Volume 20, No. 10   In this, the tenth issue of the 20th year of publication of Zalma’s Insurance Fraud Letter (ZIFL), Barry Zalma, on May 15, 2016 continues the … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Zalma’s Insurance Fraud Letter – May 15, 2016

Affordable Care Act Not Affordable

Constitution Requires Congress to Appropriate Funds Before It Can Be Spent Insurance should be based on a contract between the insurer and the person seeking insurance. The so-called Affordable Care Act (ACA) requires insurers to write government mandated insurance and … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Affordable Care Act Not Affordable

Subrogation Right Sacrosanct

Anti-Subrogation Rule Misapplied The equitable right of subrogation is a profit center available to, and often ignored by, many insurers. When a right of subrogation is available to allow an insurer to obtain its payments for defense and indemnity of … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Subrogation Right Sacrosanct

London Market Tradition Must Change

London Market System of Communication Waives Attorney Client Privilege Insurance brokers, by definition, are people who transact insurance with but not on behalf of the insurer. As such the broker’s duty is to the person insured and not to the … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on London Market Tradition Must Change

Conduct Criminal in Nature Excluded

Alford Plead Is Guilty Plea Insurance companies write policies to explain to the insured the risks they are willing to take and those they are not willing to take. When the policy excludes coverage for a serious loss court are … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Conduct Criminal in Nature Excluded

Lie to Life Insurer Deprive Beneficiaries of Benefits

Fraud Claim Requires Intent to Deceive An insurance company is entitled to determine for itself what risks it will accept, and therefore to know all  the facts relative to the applicant’s physical condition. It has the unquestioned right to select … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Lie to Life Insurer Deprive Beneficiaries of Benefits

VERTICAL EXHAUSTION AND ALL SUMS ALLOCATION

Who’s on First? When an insured carries multiple layers of insurance started with a primary policy and then several layers of excess insurance designed to pay only after the layers of insurance below have been exhausted. Insurers have the unquestioned … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on VERTICAL EXHAUSTION AND ALL SUMS ALLOCATION

Proof of Mailing Required

When Insured Fails to Appear for EUO THE NEED TO PROVE THE EUO WAS PROPERLY DEMANDED The appearance at an examination under oath (EUO) is a condition precedent to obtaining the benefits of an insurance policy. When the insured claims, … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Proof of Mailing Required

Workers’ Compensation is an Exclusive Remedy

Temporary Staffing Employee is Employee of Two Entities The reason for workers’ compensation insurance is to allow no-fault coverage to employees injured on the job. By eliminating the need to prove fault the employee loses the right to sue the … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Workers’ Compensation is an Exclusive Remedy

Estoppel is a Rare and Limited Tool

No Right to Create Coverage by Estoppel When a Bentley (a $500,000 automobile)  is damaged in an accident while being operated by a stranger to the policy the material damage coverage may not apply. When a dispute arose about the … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Estoppel is a Rare and Limited Tool

Blaming Agent for Insured’s Mistake Fails

Report Your Loss Promptly – Or Else Every liability insurance policy has a reporting provision that requires the insured to promptly report any known loss to its insurer. Failure to report a loss promptly, depending on the jurisdiction, can be … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Blaming Agent for Insured’s Mistake Fails

Zalma’s Insurance Fraud Letter – May 1, 2016

  CONFABULATION!     Zalma’s Insurance Fraud Letter May 1, 2016, Volume 20, No. 9     Click here to receive the current issue In this, the ninth issue of the 20th year of publication of Zalma’s Insurance Fraud Letter (ZIFL), … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Zalma’s Insurance Fraud Letter – May 1, 2016