Monthly Archives: April 2017

Fraud Investigation & Punitive Damages

Tort Damages for Failed Fraud Investigation Insurance fraud investigations by Special Investigation Unit (SIU) have saved the insurance industry millions of dollars that would have been paid to fraud perpetrators without the SIU investigation. Even though states require the existence … Continue reading

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Insured Must Prove Whether Insurance Conditions Were Satisfied

Even a Stopped Watch Is Correct Twice a Day The often reversed Ninth Circuit Court of Appeal gets things right once in a while. In this brief and clear opinion the Ninth Circuit granted an insurer declaratory relief because the … Continue reading

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Travelers Avoids $36 Million Verdict

“Arising Out Of” Not Ambiguous In Pennsylvania Decades of litigation over the effects of pervasive asbestos use have yielded a financial burden borne across an array of industries. A historical manufacturer of asbestos-containing products and its insurer disputed the rightful … Continue reading

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Assault & Battery Exclusion Unambiguous

 An Insurance Company May Limit Coverage in any Manner Alcoholic beverages tend to have an effect on the ability of those who consume it to lose their ability to control their tempers. People who work in bars to protect the … Continue reading

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Insurance is an Important Part of Every Commercial Lease

Two Cases Confirm the Importance of Insurance I admire New York appellate courts because they write opinions that are truly brief, concise, and state the law without fluff or attempts to look wise when a simple paragraph will do. The … Continue reading

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When Joint Venture Is Insured Joint Venturer is Insured

To Prove Bad Faith Plaintiff Must Prove Malice, Oppression, Wilfulness or Reckless Indifference Insurers, like every business, will often err, be lazy, or just fail to treat their insured properly. When that happens the insured will invariably sue or cross-claim … Continue reading

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Zalma’s Insurance Fraud Letter – April 15, 2017

Zalma’s Insurance Fraud Letter The Essential Resource For The Insurance Fraud Professional    Zalma’s Insurance Fraud Letter, Volume 21, No. 8 Every Insurance Adjuster Must Be Trained About Fraud In the last 49 years that I have been in the business … Continue reading

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Broker Responsible to Assure Policy Provides Coverage Ordered

Broker May Not Rely on Representation of Underwriter About Coverage Provided It is axiomatic that an insurance broker is responsible to obtain the coverage required by the insured. As an insurance professional the broker is required to read the policy … Continue reading

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Washington State Turns TPA Into a Virtual Insurer

Washington State Court Finds TPA Subject to Bad Faith Law I has been axiomatic across the country that only an insurer may be liable for the tort of bad faith. For example, in 1973 Gruenberg v. Aetna Ins. Co. (1973) … Continue reading

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Happy Passover

Passover 2017 – In English Passover is a time when every Jewish father and mother tell their children the story of the Exodus of the Jews from slavery in Egypt. It is a story that Jewish people have told every … Continue reading

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Fraudulent Claim Voids Coverage

When Insured Admits Tax and Bankruptcy Fraud They Should Be Prosecuted Making false reports to the IRS and to Bankruptcy Courts about the value of a business or its property to avoid taxes and paying legitimate debts seems to be … Continue reading

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Punished for Not Reading Policy

Broker Can Be Negligent For Failing To Acquire Insurance Requested Insurance brokers transact insurance with but not on behalf of insurers. They act as the agent of the insured to acquire the insurance required by their client. By so doing … Continue reading

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Justice Gorsuch and Insurance

Two Insurance Cases Written by the New Supreme Court Justice Today, Justice Neil Gorsuch will be appointed to the U.S. Supreme Court. Since I and my readers are interested in insurance matters I thought it might be useful to see … Continue reading

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Police Officer Immune as a Result of Dog’s Bite

Immunity Exists for Policy Officer Unless The State Has Insurance A state government in Arkansas, and its employees, are immune from suit unless and only up to the amount of available insurance. In Jason Harris v. Norman Beth, Supreme Court … Continue reading

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Zalma At The Atlantic Claim Executive Association Spring Conference

Resources to Defeat Insurance Fraud Yesterday I was honored to speak before the Atlantic Claim Executive Association Spring Conference at the Hammock Beach Resort in Palm Coast, Florida.  The slide show is at the link below. ACA-INSURANCE FRAUD & WEAPONS … Continue reading

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