Monthly Archives: February 2017

Prima Facie Evidence of Insurance Needed

Insurer Must Prove Adverse Vehicle is Insured to Avoid UM Arbitration I often praise the New York Appellate Courts for their ability to resolve a dispute in concise, clear and brief opinions. Fiduciary Ins. Co. of America v. Greenidge, Supreme … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Prima Facie Evidence of Insurance Needed

Six Years Successfully Stealing from Medicare

Convicted after Stealing Almost $20 Million From Medicare One of the greatest thefts of all time is that by health care providers against Medicare and Medicaid. For six years defendant Michael J. Galatis stole from the U.S. Government with impunity. … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Six Years Successfully Stealing from Medicare

Utah Eliminates Tort Defense by Statute

Statute Requires Insurer to Pay for Injuries Incurred Without Fault of Driver For a person to be responsible for injuries resulting from the operation of an automobile the persons injured must prove that the driver had a duty to operate … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Utah Eliminates Tort Defense by Statute

To Find Actual Cash Value Labor as well as Components Must be Depreciated

No Component of a Property Exists Without the Labor to Make It The definition of the term “Actual Cash Value” (ACV) has been difficult for insurers over the last few decades. States and insurers define it differently. Some insurers, attempting … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on To Find Actual Cash Value Labor as well as Components Must be Depreciated

No Premium No Policy

Insurer Cancels Policy for Non Payment of Premium Many people across the U.S. use debit cards, credit cards and access to checking account to pay ongoing debts automatically. For such a system to work the checking account must have sufficient … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on No Premium No Policy

Failure to Prove Lack of Insurance Fatal to UM Claim

Incompetent Trial Evidence Loses UM Coverage When an insured sues its Uninsured/Underinsured (UM) Motorist insurer the insured need only prove that the motorist who damaged the insured in an auto accident it need only prove that the person responsible for … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Failure to Prove Lack of Insurance Fatal to UM Claim

No Proof of Loss No Flood Coverage

Flood Insurance Conditions Must Be Strictly Construed Catastrophes cause as many legal problems as they cause damage to property. Super Storm Sandy is a catastrophe that seems to prove the proposition. People who acquire a flood insurance policy based upon, … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on No Proof of Loss No Flood Coverage

When a Policy Is Not Illusory

A Crane On a Skyscraper Is an Excluded Tool No insurance policy covers every eventuality that can damage property. All insurance policies contain exclusions advising the insured of those certain risks of loss the insurer is unwilling to accept. People … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on When a Policy Is Not Illusory

Contempt Sanctions Not Insurable Damages

Lawyers Held In Contempt Cannot Receive Defense or Indemnity From E&O Insurer Lawyers acting badly can cause problems for others. When a group of lawyers violated a court order and caused a company to be sued who would never have … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Contempt Sanctions Not Insurable Damages

Zalma’s Insurance Fraud Letter — February 15, 2017

Lie on Health Insurance Application Is Criminal   Zalma’s Insurance Fraud Letter, Volume 21, No. 3 Zalma’s Insurance Fraud Letter, Volume 21, No. 4 Every Insurance Adjuster Must Be Trained About Fraud In the last 49 years that I have … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Zalma’s Insurance Fraud Letter — February 15, 2017

Claim of Estoppel Does Not Create Coverage

Coverage by Estoppel Requires Evidence of Prejudice Emulating their brother jurists in New York the District Court of Appeal of Florida wrote a succinct, brief and easy to understand an insurance coverage dispute. In Progressive Express Insurance Company v. Anzualda … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Claim of Estoppel Does Not Create Coverage

Sovereign Immunity Statute Causes Coverage Issue

Governmental Insurers and Insured’s Litigate Because of Failure to Deal With State Statutes A Florida county bought an excess insurance policy from Star Insurance Company with a self insured retention of $350,000 at the same time a state statute waived … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Sovereign Immunity Statute Causes Coverage Issue

Breach of Lease Forfeits Right to Sue Lessor

Lessee Who Does Not Buy Required Liability Insurance for Lessor Loses Commercial leases, as a matter of course, require the lessee to obtain liability insurance in favor of the lessor. The insurance condition is usually a condition precedent and failure … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Breach of Lease Forfeits Right to Sue Lessor

Emotional Decision of Jury Overturned

Two Juries Give Verdict to Church and Ignores Law Juries are made of humans who wish to provide justice. On a rare occasion a jury will ignore the law to help a plaintiff they feel is more righteous than the … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Emotional Decision of Jury Overturned

Excellence in Claims Handling

It is Time For Insurers to Require Excellence from Their Claims Staff In search of profit, insurers have decimated their professional claims staff. They laid off experienced personnel and replaced them with young, untrained, unprepared people. A virtual clerk replaced … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Excellence in Claims Handling

Failure to Conduct Real Investigation Supports Bad Faith Judgment

Hiring Counsel Not Investigation In the last few decades insurance companies, recognizing that their failure to train their new claims staff, failure to keep experienced claims staff, and failure to require a staff that can provide excellence in claims handling, … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Failure to Conduct Real Investigation Supports Bad Faith Judgment

Pollution Exclusion Unambiguous

After Insurer Proves Exclusion Applies Burden Shifts to Insured to Prove Otherwise Pollution exclusions have been rewritten over the last few decades until courts now agree that the absolute pollution exclusion is not ambiguous. In Hiland Partners GP Holdings, LLC … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Pollution Exclusion Unambiguous

New Jersey Eliminates Stink Over Assignments of Claims

Non-Assignment Clauses Only Prevent Assignment of Policy Not a Perfected Loss and Claim Every third party liability insurance policy contains an anti-assignment condition that prevents an insured from assigning the policy to a third party without the permission of the … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on New Jersey Eliminates Stink Over Assignments of Claims

Judge Gorsuch on Insurance

Entire Policy Must Be Read – Not Just Selected Parts Since Tenth Circuit Judge Gorsuch has been submitted to the U.S. Senate to be confirmed to sit on the U.S. Supreme Court I thought it would be interesting to review … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Judge Gorsuch on Insurance

Zalma’s Insurance Fraud Letter – February 1, 2017

Lie on Health Insurance Application Is Criminal   Zalma’s Insurance Fraud Letter, Volume 21, No. 3 Every Insurance Adjuster Must Be Trained About Fraud In the last 49 years that I have been in the business of insurance I have … Continue reading

Share
Posted in Zalma on Insurance | Comments Off on Zalma’s Insurance Fraud Letter – February 1, 2017