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.

Eleventh Circuit Allows Retrial of Esformes

Presidential Commutation Doesn’t Stop Retrial On Cases Where Jury was Hung See the full video at https://rumble.com/v26y1nq-eleventh-circuit-allows-retrial-of-esformes.html and at https://youtu.be/vK1jDKcVfVo In United States Of America v. Philip Esformes, Nos. 19-13838, 19-14874, United States Court of Appeals, Eleventh Circuit (January 6, … Continue reading

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Never Breach a Condition Precedent

Protective Safeguard Endorsement is a Condition Precedent for There to be Coverage See the full video at https://rumble.com/v26xnto-never-breach-a-condition-precedent.html  and at https://youtu.be/VIMeCtZQWgA In Mama K’s Diner, LLC v. AMCO Insurance Company, F082800, California Court of Appeals, Fifth District (January 17, 2023) … Continue reading

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No Defense for Economic Damages Alone

No Bodily Injury – No Property Damage – No Coverage See the full video at https://rumble.com/v26smfe-no-defense-for-economic-damages-alone.html  and at https://youtu.be/GQwgp_dywTU In Westfield National Insurance Company; Motorists Mutual Insurance Company v. Quest Pharmaceuticals, Inc., Nos. 21-6026, 21-6043, United States Court of Appeals, … Continue reading

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Imposter not a Customer

Theft by Fraud, Trick or Device Not Covered See the full video at https://rumble.com/v26er44-imposter-not-a-customer.html and at https://youtu.be/zrYJT4mvKVE In Civitas-IT, LLC v. Auto-Owners Insurance Company, No. 359731, Court of Appeals of Michigan (January 12, 2023) dealt with a claim for loss … Continue reading

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Insured Must Occupy Dwelling

Canada Requires Owner Occupant to Occupy Dwelling for Coverage to Apply See the full video at https://rumble.com/v269zk0-insured-must-occupy-dwelling.html  and at https://youtu.be/YkUcGBSONIQ In Dang C. v. Industrielle-Alliance, Assurance Auto et Habitation Inc., 2022 QCCA 1739, the Court of Appeal for the Province … Continue reading

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COVID Does Not Cause Physical Loss or Damage

There Must be an Actual Change in the Appearance, Shape, Color, Or Other Material Aspect Of The Property for Coverage to Apply See the full video at https://rumble.com/v264x2k-covid-does-not-cause-physical-loss-or-damage.html and at https://youtu.be/bRn9YLqynwI Plaintiff MTDB Corporation d/b/a Striker Lanes (MTDB) sued seeking … Continue reading

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No Duty to Defend

NEITHER BATTERY NOR FAILURE TO REMOVE INTOXICATED PATRON IS AN OCCURRENCE See the full video at https://rumble.com/v259ygg-no-duty-to-defend.html and at https://youtu.be/_AprinkacTwhttps://youtu.be/_AprinkacTw In Crum & Forster Specialty Insurance Company v. Spike’s Pub & Grub, d/b/a Vincint Von Hart LLC, and Devin Elliott, … Continue reading

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Zalma’s Insurance Fraud Letter – January 15, 2023

ZIFL – Volume 27, Issue 2 The Source For Insurance Fraud Professionals See the full video at https://rumble.com/v25pfnm-zalmas-insurance-fraud-letter-january-15-2023.html and at https://youtu.be/QP_SqcJJ9QQ This, the second issue of 2023 of Zalma’s Insurance Fraud Letter contains multiple article that will be useful to … Continue reading

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Adjusting Property Claims

An Excellence in Claims Handling Program A Webinar Available only to Subscribers to my Locals Community or my Substack Publications Was Posted Today Please subscribe for only $50 a year or $5.00 a month. To subscribe and be able to … Continue reading

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Late Claim Costs Plaintiff

Death of Defendant Limits Recovery of Damages to Insurance Unless Timely Claim to Estate of Decedent See the full video at https://rumble.com/v253fji-late-claim-costs-plaintiff.html and at https://youtu.be/q2A3kmpOgbk In Maryland, to facilitate the prompt settlement of decedents’ estates, a person must “present” a … Continue reading

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Pollution Exclusions Clear

Intentionally Building Houses on Contaminated Property Excluded See the full video at https://rumble.com/v24x7co-pollution-exclusions-clear.html  and at https://youtu.be/1V79Y3hCZns POLLUTERS FORCED INTO BANKRUPTCY Plaintiffs Victor Rosario, Nilda Maldonado, Jose Flores, and Noemi Flores appealed from three Law Division orders dismissing their second amended … Continue reading

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Farmer’s Poor Records Costs

Crop Insurer Can Recover Over-payments from Farmer See the full video at https://rumble.com/v24njoa-farmers-poor-records-costs.html and at https://www.youtube.com/watch?v=3Vmlym1p8Y4 One of the maxims of farming is the imperative each year to risk the “up-front costs” of sowing in return for the never-guaranteed prospect … Continue reading

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Why Insurance Fraud Succeeds

It is Time For Insurers to be Proactive Against Fraud See the full video at https://rumble.com/v24nici-why-insurance-fraud-succeeds.html and at https://youtu.be/KrAF0lGbwlU There has been much hand wringing and wailing over the malfeasance of the corporate officers and directors of FTX Crypto Exchange, … Continue reading

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Insurer Must Act to Protect its Insured

Insurer Committed Fatal Sin by Sitting Back and Doing Nothing Failure to Conduct a Full and Thorough Investigation to Protect the Insured Caused a Bad Faith Judgment in Favor of one Insurer Against Another See the full video at https://rumble.com/v24lt38-insurer-must-act-to-protect-its-insured.html … Continue reading

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Thieves Compensation

How Laid Off Workers Innocently Become Fraud Perpetrators The story that follows is fiction. It is based, however, on a true situation faced by employers and workers’ compensation insurers in Californian where I live. See the full video at https://rumble.com/v23w6wm-thieves-compensation.html  … Continue reading

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The Covenant of Good Faith

The Tort of Bad Faith See the full video at https://rumble.com/v23vf4m-the-covenant-of-good-faith.html  and at https://youtu.be/l78_6KG5Wsk The implied covenant of good faith and fair dealing is a concept of insurance law at least three centuries old. It first appeared in British jurisprudence … Continue reading

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Employment Exclusion Effective

Worker’s Death Not Covered by E & O Policy See the full video at https://rumble.com/v23v33u-employment-exclusion-effective.html  and at https://youtu.be/siX4bBOz954 To compel coverage under an errors and omissions policy, Roadway Services, Inc. sued its insurer, Travelers Casualty and Surety Company of America … Continue reading

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Renewal is a New Contract

 Claim that $16 Extra Premium on Renewal is Bad Faith Fails See the full video at https://rumble.com/v23l1fa-renewal-is-a-new-contract.html  and at https://youtu.be/SJXom-KCMk0 Peter Gottlieb claimed that the price he agreed to pay Amica Mutual Insurance Company to insure his home was $16 … Continue reading

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Failure to Read Defeats Suit

Payment of Renewal Premium is Acceptance of Policy as Written See the full video at https://rumble.com/v23q13m-failure-to-read-defeats-suit.html and at https://youtu.be/ksGNFu4Y2Oo Ronald Morgan and Cheryl Morgan appealed from the trial court’s grant of summary judgment in favor of Dickelman Insurance Agency, Inc., … Continue reading

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How to Read, Understand, and Interpret an Insurance Policy

New Book for the New Year See the full video at https://rumble.com/v23kne0-how-to-read-understand-and-interpret-an-insurance-policy.html  and at https://youtu.be/Y333NW2wWZY To start off the New Year I published my newest insurance coverage and claims book entitled: A Compact Book on How Judges Read, Understand, Interpret … Continue reading

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Liar, Liar, Pants on Fire

There is More Than One Way to Skin A Fraudster DELAYED RESCISSION FAILS BUT EXCLUSION APPLIES See the full video at https://rumble.com/v23kejy-liar-liar-pants-on-fire.html and at https://youtu.be/WweFL4rJiro Evanston Insurance Company appealed from a bench trial on an insurance-coverage dispute. After determining that … Continue reading

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Zalma’s Insurance Fraud Letter – January 1, 2023

ZIFL January 1, 2023  Volume 27, Issue 1 See the full video at https://rumble.com/v22yi88-zalmas-insurance-fraud-letter-january-1-2023.html  and at  https://youtu.be/MTvEb1uU8pE The Source for the Insurance Fraud Professional Starting the 27th year of publication of Zalma’s Insurance Fraud Letter, ClaimSchool, Inc., Barry Zalma and … Continue reading

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Employee Can’t Sue Employer for Negligence

Proof Of Insurance Endorsement Does not Change Policy Exclusion of Employee See the full video at https://rumble.com/v22m8us-employee-cant-sue-employer-for-negligence.html and at https://youtu.be/76b7s78A0yQ Joshua Ochoa sued his employer, Riata Cattle Company, Inc. (“Riata”) in Texas state court alleging that he suffered bodily injury … Continue reading

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Hero Can’t Convince Court to Change Policy to What he Needs

ATTEMPT TO MAKE A CGL INTO A COURSE OF CONSTRUCTION POLICY FAILS COURT MAY NOT CHANGE AN APPLE INTO AN ORANGE See the full video at https://rumble.com/v22m9wa-hero-cant-convince-court-to-change-policy-to-what-he-needs.html  and at https://youtu.be/Fl8P0PZV9m4 On December 6, 2017, a fire destroyed the residence in … Continue reading

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Why the Insured Should Read the Policy

The Insured is Obligated to Read the Insurance Policy See video at https://rumble.com/v22gp0m-why-the-insured-should-read-the-policy.html  and at https://youtu.be/wL5X6A43ie4 Every person that acquires a policy of insurance, whether designed to protect a dwelling, a commercial property, agriculture, crops from destruction by the actions … Continue reading

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Plaintiff Cannot Create an Ambiguity

No Breach of Contract No Bad Faith See the full video at https://www.youtube.com/watch?v=SsnGqV-KtMg  and at https://rumble.com/v21wr0u-plaintiff-cannot-create-an-ambiguity.html Failure to Read Policy Fatal to Insured’s Claim In Michel Ngakoue v. Safeco Insurance Company Of Indiana, No. 1:22-CV-00363-LY, United States District Court, W.D. … Continue reading

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Insurance Expert Available to Lecture Your Claims Personnel

Do You Need a Speaker on any Insurance Coverage, Claims, Bad Faith or Fraud Issues? ClaimSchool, Inc. Presents Insurance Topics Taught by Barry Zalma Barry Zalma’s Insurance Claims Training When I left my three year enlistment in the U.S. Army … Continue reading

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Dog Bite Excluded

Injury by “Existence” of a Pit Bull Dog Unambiguously Excluded See the full video at https://rumble.com/v21rlaq-dog-bite-excluded.html and at https://www.youtube.com/watch?v=IMRvKQsqXMg In July 2020, a young boy was injured when a dog attacked him in an apartment complex owned by Missy J, … Continue reading

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Workers’ Compensation Benefits Don’t Solve Every Life Problem

Multiple Attempts to Obtain Workers’ Additional Compensation Benefits Fails For Failure to Follow Rules See the full video at https://rumble.com/v21r7im-workers-compensation-benefits-dont-solve-every-life-problem.html and at https://youtu.be/RQqaz3MUqko IT DOES NOT PAY TO ANNOY A COURT OF APPEAL In Marty D. Foust v. Lawrence Brothers, … Continue reading

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Insurer Who Pays Jury Verdict has no Duty to Appeal

He Who Represents Himself Has a Fool for a Client See the full video at https://rumble.com/v21ln00-insurer-who-pays-jury-verdict-has-no-duty-to-appeal.html and at https://youtu.be/lhqb3t2LXck Insurer Punished For Fulfilling Terms of Contract In Fiaze Issa v. Allstate Insurance, 2022 IL App (1st) 210343-U, No. 1-21-0343, Court … Continue reading

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NO LICENSE NO COVERAGE

EXCLUSION FOR LOSSES WHEN DRIVER UNLICENSED IS ENFORCED See the full video at https://rumble.com/v21fllc-no-license-no-coverage.html and at https://youtu.be/CyJ5_TAM8j8 Great West Casualty Company; DTAK, LLC; and Matthew Ehlen (at times collectively referred to as “Great West”) appealed the grant of summary judgment … Continue reading

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Help: My Building is Falling Down

Building Must Actually Fall Down for Collapse to be Covered See the full video at https://rumble.com/v20st5s-help-my-building-is-falling-down.html  and at https://youtu.be/1EN3cXOZVZY Windcrest Owners Association filed a lawsuit against Allstate Insurance after the company declined a claim for property damage to a building … Continue reading

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Assault & Battery Limit Affirmed

Insurer’s $25,000 Assault and Battery Limit Applied to Stabbing on Hotel Property See the full video at https://rumble.com/v20nij8-assault-and-battery-limit-affirmed.html and at https://youtu.be/Yi5zKw2PAtg Great American E & S Insurance Company obtained a trial court judgment that it is only obligated to provide … Continue reading

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Zalma’s Insurance Fraud Letter – December 15, 2022

ZIFL Volume 26 Number 24 Merry Christmas, Happy Hanukah & May The Winter Solstice be Peaceful & Mild See the full video at https://rumble.com/v20n1u8-zalmas-insurance-fraud-letter-december-15-2022.html and at https://youtu.be/TcEBdb9KLMY A Christmas Fable of Fraud ZIFL Publishes This Story At Christmas Time Every … Continue reading

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When Docs Lie to Insurers

To Allege IFPA Fraud Plaintiff Need only Plead the Defendants Knowledge, Falsity, and Materiality of Insurance Claim See the full video at https://rumble.com/v209mtj-when-docs-lie-to-insurers.html  and at https://youtu.be/pKqcquG0OX4 Stephen J. Conte, D.O. (“Dr. Conte”), and various other health care providers (collectively, the … Continue reading

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Criminal Conduct Excluded

Innocent Wife Has No Right to Recover for Criminal Conduct of Husband Causing Damage Public Policy of State Requires Exclusion of Criminal Conduct See the full video at https://rumble.com/v208rka-criminal-conduct-excluded.html and at https://youtu.be/sHulYGajn94 On October 14, 2019-while the Safeway policy was … Continue reading

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Plaintiffs’ Expert Establishes Lack of Coverage

Courts Must Read the Full Policy to Determine Coverage See the full video at https://rumble.com/v1zst3q-plaintiffs-expert-establishes-lack-of-coverage.html and at https://youtu.be/i_x1P_pD4-0 Plaintiffs Joshua and Rachel Dow purchased their home at 1017 Moss Creek Drive in Hurricane, WV in March of 2018.  This property … Continue reading

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How to Defeat Insurance Fraud

An Article for the CPCU Society’s “Insights” Magazine The preponderance of attempted insurance fraud is staggering and costly. But perhaps even more startling, and certainly more avoidable, is the often-muted response to such crime. The Coalition Against Insurance Fraud estimates … Continue reading

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UM & UIM Coverage Are a Single Coverage

No Good Deed Goes Unpunished See the full video at https://rumble.com/v1zf4kb-um-and-uim-coverage-are-a-single-coverage.html and at https://youtu.be/qoGU9mW2UB0 GEICO Advantage Insurance Company and GEICO Choice Insurance Company (collectively “GEICO”) appealed a decision of the Circuit Court of the City of Richmond granting summary judgment … Continue reading

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New York’s Governor is not National or International Body

Chubb Must Pay for Cancellation of Tina Turner Concert Because of Order of State of New York See the full video at https://rumble.com/v1zmlxa-new-yorks-governor-is-not-national-or-international-body.html and at https://youtu.be/vsavVavYZqY Tina Turner Musical LLC v. Chubb Insurance Company of Europe SE, Appeal No. 16804, … Continue reading

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