Monthly Archives: October 2017

Do the Crime – Do the Time – And Pay Restitution

Insurance Available to Victim of Crime Should Not Be Used to Avoid Restitution When a crime victim suffers bodily injury or property damage it the duty of the trial court to order restitution be paid by the convicted criminals to … Continue reading

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Are Insureds More Equal Than Insurers?

Montana’s Insurance Exception to the American Rule Re Attorneys’ Fees The “American Rule” requires both parties to a tort action to pay their own attorneys. There is no right for a litigant to collect attorneys fees from the defendant. However, … Continue reading

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Punitive Damages and Taxes

The IRS Takes the Joy Out of a Punitive Damages Award   The stated purpose of punitive damages is to punish a wrongdoer civilly to deter the wrongdoer and others from acting wrongfully. Insurance Bad Faith litigants dream of large … Continue reading

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Request for a Quote Is Not Insurance

The Most Believable Witness Carries Day When a person asks an insurance agent or broker to obtain insurance he is merely asking the agent to obtain an offer of insurance from an insurer. No insurance exists until the insurer makes … Continue reading

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Failure to Disclose Driver Can Be Expensive to Trucker

Unreported Driver Coverage Limited to State Minimum Motor Truck Liability Insurance is controlled by both state and federal law. Insurers, to protect themselves from excessive liability desire to vet every driver operating a large vehicle by requiring the insured to … Continue reading

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Don’t Plead Guilty If You Don’t Mean It

Crooked Chiro Pleads Guilty to Insurance Fraud and Then Tries to Take it Back After Chiropractor John Fortuna admitted that he and his co-defendants knowingly and willfully executed a scheme to defraud the insurers’ health care benefit programs, he pleaded … Continue reading

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Intentional Manslaughter Not Fortuitous

No Coverage for Intentional Killing Insurance, by definition a contract whereby one undertakes to indemnify another against loss, damage, or liability arising from a contingent or unknown event. Therefore, no one can buy insurance against his or her intentional acts. … Continue reading

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Duty to Defend Is Not Absolute

Do Not Refuse to Accept an Offer of Defense Without Reservation Unless You Have Evidence of Conflict It is axiomatic that the duty to defend is broad and that a liability insurer must defend its insured if there is a … Continue reading

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Don’t Change Your Mind After Accident

Waiver of Stacking UM/UIM Cover Upheld Insurance is a contract. An insured saves money by agreeing to limit the coverage available because the insured does not believe it would be needed. Only after an accident does an insured reconsider the … Continue reading

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Workers’ Compensation Policy Does Not Cover Defense of Third Parties

No Cover for Liability Assumed by Contract Workers’ Compensation is required by statute to provide coverage to employees who are injured in the course of employment without a need to prove liability, negligence or any other tort. Workers’ Compensation policies … Continue reading

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When is an Appraiser Disinterested?

What is “Competent and Disinterested”? California Insurance Code, at § 2071 provides a method by which an insured and insurer may quickly, and informally, resolve disputes concerning the amount of loss. Although called “appraisal” it is really a contractual arbitration … Continue reading

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No Good Deed Goes Unpunished

Pay the Premium or Lose Coverage States across the U.S. have passed statutes regulating the cancellation of insurance policies. The statutes impose strict notice to the insured and how cancellation for failure to pay premium can be cured. In Anthony … Continue reading

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Insurance Claims In a Catastrophe

Insurance Claims In a Catastrophe If your house was damaged or destroyed by a wildfire, accidental fire, windstorm, flood, hurricane or earthquake, as a result of state declared catastrophes and you had a fire, homeowners, flood insurance, tenant’s homeowners or … Continue reading

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Convicted Insurance Fraud Perpetrator Sues Insurer for Reporting Him

“Chutzpah” by Fraud Perpetrator Fails “Chutzpah” is a Yiddish term meaning unmitigated gall. The best definition I have heard is when a man is convicted of murdering his parents and pleads for mercy because he is an orphan. In David … Continue reading

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Zalma’s Insurance Fraud Letter – October 15, 2017

Zalma’s Insurance Fraud Letter The Essential Resource For The Insurance Fraud Professional Barry Zalma, Inc.  October 15, 2017   Any Medical Provider Convicted of Fraud in California Will Be Suspended The liens of a physician, practitioner or provider and the … Continue reading

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Trademark Infringement Claim Places Insured at Land’s End

Advertising Injury Coverage & Exclusion Clarified Trademark infringement lawsuits are often complex and difficult for insurers to deal with. Some provide coverage without dispute while others rely on exclusions written to limit the coverages provided. Since insurance coverage grants are … Continue reading

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Oklahoma Statute Deprives UM/UIM Insurer of the Equitable Remedy of Subrogation

Oklahoma Statute Takes Away Insurer’s Right of Subrogation Against UM/UIM Insurer Subrogation is an equitable remedy that allows an insurer who pays a claim to an insured due to the actions of a tortfeasor to sue the tortfeasor as if … Continue reading

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I’m Dead – Really I Am!

Life Insurance Fraud Fails Nigeria seems to be the birthplace of different types of fraud. Everyone in the U.S. has received a letter, e-mail or fax offering millions from some Nigerian prince or government official if only the recipient gives … Continue reading

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Incorrect Statement of Values Allows Rescission

Innocent Material Misrepresentation Sufficient to Allow Rescission Insurance, as I have said over and over again, is a business of the utmost good faith that requires both parties to do nothing that will deprive the other of the benefits of … Continue reading

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The Duty to Select Type and Amount of Insurance Belongs to the Insured

Insurance Agent Only Required to Provide Insurance Ordered Unless they take on a fiduciary obligation an insurance agent or broker is only required to provide the insurance it was asked to acquire. The agent or broker need not – unless … Continue reading

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No Occurrence – No Fortuity – No Coverage for Defense or Indemnity

Lack of the Potential for a Covered Claim Defeats Bad Faith Suit The ability to allege and prove a right to a defense under a liability insurance policy is usually fairly simple. All that is required of the insured is … Continue reading

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Restoration of Ill Gotten Gains Not Insurable – Fraud Doesn’t Pay

Neither an Intentional Nor a Criminal Act is Fortuitous From the first insurance coverage issued on a clay tablet in ancient Sumeria every insurance claim required a fortuitous loss – one that is either contingent or unknown at the time … Continue reading

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Who Pays Black Lung Victim When His Employer and Its Insurer are Insolvent?

Guaranty Fund Is More Responsible than the Federal Black Lung Trust Fund Island Fork Construction v. Jimmy Bowling; Director, Office Of Workers’ Compensation Programs, No. 16-4319, United States Court Of Appeals For The Sixth Circuit (September 29, 2017) Jimmy Bowling … Continue reading

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Why Pennsylvania Made it Easier to Prove Insurer Bad Faith

No Need to Prove Ill-Will or Self-Interest to Prove Bad Faith Since its creation as a tort in the 1950’s and 1960’s the tort of bad faith required proof the the insurer will do nothing which will injure the right … Continue reading

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Zalma’s Insurance Fraud Letter – October 1, 2017

Zalma’s Insurance Fraud Letter The Essential Resource For The Insurance Fraud Professional October 1, 1979 – 2017 Another Anniversary   Thirty eight years ago today I left the world of the employed and became an entrepreneur by opening my own … Continue reading

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