Author Archives: Barry Zalma

About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.

Good Faith & Fair Dealing Require Ethical Behavior from Insurer and Policyholder

“Ethics for the Insurance Professional” and “Rescission of Insurance” To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library of insurance … Continue reading

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No Damages – No Case

Genuine Dispute Defeats Bad Faith Case Magma Design Automation, Inc. appealed the district court’s grant of summary judgment for National Union Fire Insurance, Co. on Magma’s claims for breach of contract and breach of the covenant of good faith and … Continue reading

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Zalma’s Insurance Fraud Letter – August 15, 2019

Zalma’s Insurance Fraud Letter     An Excerpt from Zalma on Insurance ClaimsIdentifying Insurance Fraud – Introduction  Zalma’s Insurance Fraud Letter, Volume 23, No. 16 Some of the articles you can read in this issue of ZIFL follow:      An … Continue reading

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Fraudulent Joinder Does Not Defeat Removal to Federal Court

Bad Faith Suit Can’t Be Joined with Injury Suit in Federal Court Bad faith law suits deal with the actions of an insurer to prevent a person to receive the benefits of an insurance policy and is distinct from claims … Continue reading

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How to Deal with Claims of Bad Faith and Fraud

“The Law of Unintended Consequences and the Tort of Bad Faith;” “California Fair Claims Settlement Practices Regulations;” and “California SIU Regulations” To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, … Continue reading

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Seventh Circuit Requires Insurer to Match Damage Replacements

Insurer Must Pay to Replace Damaged & Undamaged Part of Building to Make Insured Whole First party property insurance is intended to provide sufficient funds to make an insured whole – that is enough to put the property back like … Continue reading

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Manuals for the First Party Property & Third Party Liability Adjuster

“The Compact Book on Adjusting Liability Claims, Second Edition” and “The Compact Book of Adjusting Property Insurance Claims – Second Edition” To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, … Continue reading

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No Fault Available Coverage is Important to Injured Client

Lawyer Commits Malpractice When He Fails to Advise Client of Insurance Coverage A bodily injury plaintiff who needed surgery asked his lawyer several times to determine if the No-Fault (PIP) coverage would pay for needed spinal surgery resulting from an … Continue reading

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Insurance Books to Help Defeat Insurance Fraud

“The Insurance Examination Under Oath” and “Insurance Fraud & Weapons to Defeat Insurance Fraud” To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has … Continue reading

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Failure to Submit Proof of Loss Within Two Years of Accident Bars Claim

Ignore Requests from Insurer & Lose State Farm Mutual Automobile Insurance Company (State Farm), sued Maricela Leon seeking declaratory judgment that there was no uninsured motorist (UM) coverage available to Leon. The circuit court entered a judgment in favor of … Continue reading

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Insurance Books for Everyone

“Construction Defects and Insurance” and “The Law of Unintended Consequences and the Tort of Bad Faith” To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims … Continue reading

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A Major Fraud Scheme is Important to the State

When the State of California is Plaintiff Case Cannot be Removed to Federal Court When a defendant in a qui tam – whistle blower – suit brought for violation of the California Insurance Frauds Prevention Act (IFPA) moved the case … Continue reading

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Books Needed by Everyone Interested in Insurance

The Homeowners Policy and Mold Claims To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library of insurance claims books and … Continue reading

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No Such Thing as Post Claim Underwriting in Illinois

No Coverage for Loss Before Inception of Policy Insurance, by definition, only applies to fortuitous losses. If a loss had already occurred before the insurance was acquired it cannot be fortuitous to the insurer. For that reason many liability policies … Continue reading

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Ten Volumes Comprising A Comprehensive Group of Materials on Property & Casualty Insurance Claims

Zalma on Insurance Claims To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library of insurance claims books and internet based … Continue reading

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Ohio Requires Actual Rather than Minor Deviation from Permission

Is Coverage for a Permissive User Lost if the User Exceeds the Permission? Most liability insurance policies allow an insured to give permission to another to use a vehicle or boat and be insured as a permissive user. That coverage … Continue reading

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Daubert’s Requirement Peer Review, Publication, Potential Error Rate, Etc Do Not Apply to Non-technical Expert Testimony

Attorney Expert May Present Limited Opinions Insurance claims handling experts opine about the custom and practice of insurance claims handlers and whether the insurer involved in litigation has failed to act fairly and in accordance with the custom and practice … Continue reading

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The People who Keep the Promises Made by an Insurance Policy

Insurance Claims Personnel The Claims Adjuster The claims adjuster is the contact between the insured and the insurer. He or she can be an employee of the insurer or an independent contractor retained by the insurer to investigate and adjust … Continue reading

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Underwriting for the Claims Professional

The Nature of Underwriting Before the insurance claims adjuster begins a claims investigation he or she must understand the nature of underwriting because it is how an insurance policy comes into existence. Underwriting is defined as the process of accepting … Continue reading

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Zalma’s Insurance Fraud Letter – August 1, 2019

Zalma’s Insurance Fraud Letter      Insurance Fraud by Insurers Zalma’s Insurance Fraud Letter, Volume 23, No. 15       Some of the articles you can read in this issue of ZIFL follow:  Insurance Fraud by Insurers Insurance Fraud is … Continue reading

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E-Books from Full Court Press and Fastcase.com

Learn Everything You and Your People Need to Know About Insurance To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library … Continue reading

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Equitable Contribution Is to Spread the Ultimate Liability in a Fair Proportion among the Jointly Liable Obligors

Contribution Between Insurers is an Equitable Decision When more than one insurer is obligated to defend and indemnify an insured after an incident causing bodily injury to a third person, the sharing is usually an easy allocation of pro rata … Continue reading

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Insurance Fraud for Fun & Profit

Fictionalized True Insurance Crime Books Insurers must bring a new crop of graduates into the insurance profession. Since most insurer based insurance training departments have been eliminated there is a need for other means to train a new generation of … Continue reading

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Failure to Timely Report “Claim” Avoids Duty to Defend

Claims Made Policy Requires Timely Notice Liability insurers prefer claims made policies to limit their exposure. The person or entity insured must, under such policies, report a claim as long as it is made during the policy period or an … Continue reading

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Avoid Bad Faith – Educate & Train Your Claims Personnel

The Insurance Examination Under Oath, Rescission of Insurance, and Ethics for the Insurance Professional To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has … Continue reading

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Attempt to Avoid Multi-Million Dollar Obligation Fails

Exclusions Must be Written Carefully to be Effective When an insurer writes an excess policy that follows the form of the first layer of coverage it is important that they understand how to interpret the language stated in the primary … Continue reading

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California Fair Claims Settlement and California SIU Regulations

California Law Requires Every Claims Person to Certify Knowledge of Fair Claims Settlement Practices Regulations and SIU Regulations by September 1 California law requires that every claims person be trained or certify under oath that they have been trained or … Continue reading

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Imminent Collapse not Collapse & Not a Covered Cause of Loss

Insured Must Prove that Facts of Loss Fall Withing Grants of Coverage People who buy insurance do not usually understand that it is the obligation of an insured to prove to the insurer that there is a loss and that … Continue reading

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How to Adjust Propety & Liability Claims

The Compact Books on Adjusting Property and Liability Claims To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library of insurance … Continue reading

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Arson for Profit Fails in New York

She did the Crime & Must Do the Time Arson for profit is an evil version of insurance fraud since people can be injured or killed in the fire. In a case where a person who, but for the heroic … Continue reading

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The Total Resource for Anyone Involved with Insurance Claims

Understand Insurance and Insurance Claims Mold Claims, The Law of Unintended Consequences and the Tort of Bad Faith, and Insurance Fraud & Weapons to Defeat Insurance Fraud To assist the insurance industry in its efforts to avoid the tort of … Continue reading

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When you can’t Trust Your Lawyer Don’t Admit a Crime

Lawyer who Disclosed Confidential Information to Collect an Excessive Fee Suspended Indefinitely Like a priest or doctor a lawyer must, under all circumstances, maintain the confidences learned from the client. When a lawyer threatens to disclose confidential information that might … Continue reading

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Find a Way to Understand Insurance

The Total Resource for Anyone Involved with Insurance Claims To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library of insurance … Continue reading

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It is not Unfair to Refuse to Defend Someone Not an Insured

No Coverage if you are not an Insured It should be obvious that an insurer has no obligation to defend or indemnify a person who is not named an insured or who is not an insured by definition. Similarly it … Continue reading

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How to Become an Insurance Claims Professional

The Total Resource for Anyone Involved with Insurance Claims To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library of insurance … Continue reading

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When an Additional Insured is not Entitled to Defense or Indemnity

Additional Insured only Covered for Liability Resulting from the Acts of the Named Insured Owners and General Contractors almost always require that the subcontractor make the owner and General Contractor an additional insured on its policy. Additional insured provisions come … Continue reading

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Does Your Claims Staff Need Education & Training?

Here are Resources to Create Insurance Claims Professionals To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created a library of insurance claims … Continue reading

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Sore Loser Contumaciously Runs Away From Court and Sanctions

When Plaintiff Lost the Coverage Issue it Abandoned its Suit When a party files a lawsuit it is obligated to pursue that suit effectively or advise the court that it wishes to dismiss the suit because it is not viable. … Continue reading

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Create a Team of Insurance Claims Professionals

Ethics, The Examination Under Oath, Random Thoughts on Insurance,  and Rescission of Insurance To assist the insurance industry in its efforts to avoid the tort of bad faith Barry Zalma, Esq., CFE, an insurance coverage and claims consultant, has created … Continue reading

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If you do the Crime — do the Time

A Insurance Criminal’s Conviction Appealed on Many Inept Grounds A massive workers’ compensation insurance fraud conducted by physicians and chiropractors resulted in the conviction of Dolphus D. Pierce II only to have him file appeals on multiple useless grounds that … Continue reading

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