Author Archives: Barry Zalma

An Important Tool to Defeat Fraud The Standard Fire Insurance policy, statutorily mandated for two centuries, contains a condition that requires an insured to appear for and testify at examination under oath before anyone appointed by the insurer. The U.S. … Continue reading →

Insured Must Cooperate in Insurer’s Investigation of Claim The covenant of good faith and fair dealing goes in both directions. Neither party to the contract of insurance may do anything to deprive the other of the benefits of the contract … Continue reading →

How to Be an Effective Insurance Professional Since insurance is a business of utmost good faith it is necessary for every insurance professional to understand the ethical compass that must be followed to deal fairly and in good faith with … Continue reading →

Appeal to Remove Guilty Plea Ridiculous Arson is the most dangerous and vicious of insurance crimes. Firefighters, residents, neighbors, passers by, pets and other animals often die as a result of an arson for profit. “Chutzpah” as readers of this … Continue reading →

Training Required Every September The state of California regulates the insurance industry with a vengeance. Every year everyone involved in claims must be trained on the application of the California Fair Claims Settlement Practices Regulations and the California SIU Regulations. … Continue reading →

Sex With Patient Not a Legitimate Psychotherapeutic Treatment A practicing psychologist, Richard Scott Lenhart, engaged in sexual behavior with two of his patients under the guise that the sexual contact was legitimate psychotherapeutic treatment which he then routinely billed insurance … Continue reading →

All Adjusters Need Knowledge of Insurance and Claims Handling Are you a claims person? Do you employ claims people? Do they all know the basics necessary to thoroughly and in good faith investigate and resolve an insurance claim? Do they … Continue reading →

Equitable Subrogation Requires Subrogee to Stand in the Shoes of the Insured In Preferred Professional Insurance Company v. The Doctors Company, 2018 COA 49, Court of Appeals No. 17CA0405, Colorado Court of Appeals (April 5, 2018), because the insured would … Continue reading →

A Brief Opinion Must Be Honored Landlords engage in risk transfer by requiring a tenant to insure the property leaving the responsibility for damages to the structure or bodily injury occurring to people on the premises. Because they don’t trust … Continue reading →

Insurance Fraud A Manual for Insurance Claims Professionals, Insurance Fraud Investigators and Insurance Coverage Lawyers Insurance fraud continually takes more money each year than it did the last from the insurance buying public. No one knows the actual amount with … Continue reading →

The Essential Resource For The Insurance Fraud Professional    April 15, 2018 Ethics & the Insurance Fraud Investigation     In 1973 an insurance adjuster, frustrated by his failure to prove that a bar owner had destroyed his bar by arson … Continue reading →

The Means to Effectively Acquire a Commercial Property Policy and Present and Collect a First Party Property Insurance Claim   Insurance is a contract that requires an offer to provide insurance to a person or entity, acceptance of the offer … Continue reading →

Win Some – Lose Some Insurance contracts need to be written in clear and unambiguous language that can be understood by anyone with a Fourth Grad education. Preparing an insurance contract is often difficult and by not being absolutely clear … Continue reading →

Insurance Crime Stories from an Insurance Fraud Expert Insurance fraud is a major crime taking as much as $300 billion every year from the insurance public. Understanding insurance fraud is important to the public and the people involved in the … Continue reading →

Nexus With Vehicle and Injury Required Uninsured motorist (UM) coverage and Personal Insurance Protection (PIP) coverage is designed to protect an insured person against the risk of injury by an uninsured person. If an uninsured operator of an automobile causes … Continue reading →

 Digests from Barry Zalma’s Blog: Zalma on Insurance Volume V: Digests from Barry Zalma’s Blog: ‘Zalma on Insurance’” Since 2010 I have been writing a blog post at least five days a week. After more than 50 years acting as … Continue reading →

Certificate of Insurance Has Legal Efficacy Although issued by insurance agents with alacrity, Certificates of Insurance (COA) are important documents relied upon by those who receive them to provide comfort that the person they are dealing with is appropriately insured. … Continue reading →

Fictionalized Real Insurance Crime Stories A collection of columns originally published in the magazines “Insurance Journal,” “Insurance Week,” and “The John Cooke Insurance Fraud Report” insurance trade publications serving the insurance community in the United States that have been updated … Continue reading →

Statute Makes Individual Adjuster Liable for Tort of Bad Faith The state of Washington, in an attempt to protect consumers, has acted in a way to drive insurers and their employed adjusters out of the state. This case makes it … Continue reading →

“The Insurance Examination Under Oath” The insurance Examination Under Oath (“EUO”) is a formal type of interview authorized by an insurance contract. It is taken under the authority provided by a condition of the insurance contract that compels the insured … Continue reading →

No Cover Available from Excess and Umbrella Policies Insurers use a self-insured-retention (SIR) to avoid the expense of dealing with small claims and avoid the expense of defending or indemnifying an insured until the SIR or underlying insurance is exhausted. … Continue reading →

Rescission of Insurance Rescission is an equitable remedy as ancient as the common law of Britain. When the United States was conceived in 1776 the founders were concerned with protecting their rights under British common law. They adopted it as … Continue reading →

Creative Criminal Gets 57 Months in Prison If criminals would put in the effort and skill they use to defraud insurers they would own a multi-million dollar business. Rather, they get short term profits and then find themselves is an … Continue reading →

Methods for Insurers and their Personnel to Act with the Utmost Good Faith Ethics is a process of systematically applying, using, defending and recommending concepts of right and wrong behavior. Ethical behavior is required of both parties to a contract … Continue reading →

Auto Must Be Identified on Policy to Provide Coverage Classic automobiles often require a specialty insurer to insure the risks of loss to the classic automobile or caused by the operator of a classic auto. For that reason the basic … Continue reading →

California Fair Claims Settlement Practices Regulations A Guide to Insureds, Public Insurance Adjusters, and Lawyers to Properly Investigate and Adjust Insurance Claims This book was designed to assist insurance personnel who do business in the state of California. It will … Continue reading →

There is no Right to Beat Your Girlfriend and Get Defense from your Insurer People are known to do stupid things. Insurance is designed to protect the insured against his or her negligence or stupid conduct. People who drink alcohol … Continue reading →

“The Compact Book on Adjusting Liability Claims: A Handbook for the Liability Claims Adjuster” This Compact Book of Adjusting Liability Claims is designed to provide the new adjuster with a basic grounding in what is needed to become a competent … Continue reading →

Appellate Court May Not Rewrite Insurance Policy Construction contracts are risk transfer devices. They often require each subcontractor to name the general contractor and the owner as an additional insured. The requirement can include multiple additional insured. Insurance policies, even … Continue reading →

Zalma’s Insurance Fraud Letter  April 1, 2018  The Essential Resource For The Insurance Fraud Professional   Murder for Life Insurance Some criminal have no sense of honor or justice. Emma J. Raine was involved in the violent death of one or … Continue reading →

The Means to Effectively Acquire a Commercial Property Policy The Means to Effectively Acquire a Commercial Property Policy and Present and Collect a First Party Property Insurance Claim Paperback – March 22, 2018 Insurance is a contract that requires an … Continue reading →

Is it Fair to Require an Insurer to Pay for Periods for which it Received no Premium? Some events causing pollution damage can occur over many decades, even more than a century. Existence of coverage for risks of loss by … Continue reading →

 Insurance Fraud In Two Volumes Insurance fraud continually takes more money each year than it did the last from the insurance buying public. No one knows the actual amount with any certainty because most attempts at insurance fraud succeed. Estimates … Continue reading →

Fourth Circuit Stops Asbestos Bleeding After Aggregate Limit is Exhausted Asbestos litigation has destroyed multiple businesses who dealt with the product. Insurers of those entities have spent billions of dollars defending and indemnifying those insureds who dealt with asbestos. Some … Continue reading →

Insured May Not Lie to Avoid Summary Judgment No one likes to have an insurance claim denied even if the insurer has a a good reason for denying the claim. In litigation, as in every aspect of insurance, both parties … Continue reading →

Passover Seder for Americans: An All English – Easy to Perform – Passover Seder Paperback As my wife and I grew older and became seasoned citizens, it fell upon us to carry on the Passover tradition for our family. We … Continue reading →

Failure to Testify at EUO Breaches Material Condition The following is adapted from my new book, “The Insurance Examination Under Oath” now available on Amazon.com Available as a Kindle book and Available as a paperback. Brizuela v. Calfarm In Brizuela v. … Continue reading →

Rescission of Insurance Rescission is an equitable remedy as ancient as the common law of Britain. When the United States was conceived in 1776 the founders were concerned with protecting their rights under British common law. They adopted it as … Continue reading →

Pollution Exclusion Is Conspicuous, Plain and Clear Insurance lawsuits abound like then ten plagues Moses imposed on Egypt. Insurers spend hundreds of hours and millions of dollars to write their policies in a way that they only take on the … Continue reading →

The Means to Effectively Acquire a Commercial Property Policy and Present and Collect a First Party Property Insurance Claim Paperback – March 22, 2018 Insurance is a contract that requires an offer to provide insurance to a person or entity, … Continue reading →