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.

Murder Pays

LIFE INSURANCE FRAUD FOR FUN & PROFIT This following is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is … Continue reading

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No Coverage for Benefits no Right to Bad Faith Damages

CONCURRENT CAUSE REQUIRES SEGREGATION OF COVERED FROM NON COVERED LOSSES Post 4707 See the full video at https://rumble.com/v4614d9-no-coverage-for-benefits-no-right-to-bad-faith-damages.html and at https://youtu.be/_1OWgl_l3P8 Landmark Partners, Inc. (Landmark) sued Western World Insurance (Insurance) after it denied Landmark’s claim under an insurance policy. Landmark … Continue reading

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Oregon Allows Emotional Distress Damages for Poor Claims Handling

Violation of Statute Allows Suit for Negligent Failure to Resolve Insurance Claim Post 4706 See the full video at https://rumble.com/v45wcqx-oregon-allows-emotional-distress-damages-for-poor-claims-handling.html  and at https://youtu.be/WW9Ij4oK0rQ Christine Moody, individually, and in her capacity as the Personal Representative of the Estate of Steven “Troy” … Continue reading

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Equity Requires Fairness

Equitable Indemnity Only Available to One Without Fault Post 4705 See the full video at https://rumble.com/v45tgrx-equitable-indemnity-only-available-to-one-without-fault.html and at https://youtu.be/Pm94OcqWFoU In Martha M. Fountain and Curtis Fountain v. Fred’s, Inc. and Wildevco, LLC v. Tippins-Polk Construction, Inc. and Rhoad’s Excavating Services, … Continue reading

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Coinsurance

An Important Condition of Every Commercial Property Insurer (c) 2024 Barry Zalma https://barryzalma.substack.com/publish/post/%%checkout_url%% An Important Condition of Commercial Property Insurance Policies Coinsurance is often misunderstood in first party property insurance. It is a clause that causes frequent dissatisfaction with insureds … Continue reading

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GEICO takes a Bite Out of Fraud

No Fault Insurance is a Formula For Insurance Fraud Post 4703 See the full video at https://rumble.com/v454eso-geico-takes-a-bite-out-of-fraud.html and at https://youtu.be/ZDK0rlrlnPQ GEICO, as a pro-active victim of insurance fraud, sued Jean-Pierre Barakat, M.D., et al, alleging that Defendants defrauded GEICO in … Continue reading

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No Right to Indemnity After Policy Limit Exhausted

Insurer has no Obligation to Pay More than an Aggregate Limit of Liability Post 4702 See the full video at  https://rumble.com/v44waj2-no-right-to-indemnity-after-policy-limit-exhausted.html and at https://youtu.be/Pl-tuUjAG28 Denis Mucha sustained injuries after he was assaulted by employees at defendant MDF 92 River Street, … Continue reading

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Failure to Reside at Dwelling Eliminates Coverage

FOR COVERAGE TO EXIST ON A HOMEOWNERS POLICY THE INSURED MUST RESIDE AT THE RESIDENCE Post 4700 See the full video at https://rumble.com/v44dtzi-failure-to-reside-at-dwelling-eliminates-coverage.html  and at https://youtu.be/lvFALpBzRoQ The USDC was asked to grant dueling motions for summary judgment: (1) Motion for Summary … Continue reading

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Zalma’s Insurance Fraud Letter – January 2, 2024

See the full video at Zalma’s Insurance Fraud Letter and https://youtu.be/TH_iv5WQuN4 Subscribe here: Zalma’s Insurance Fraud Letter (ZIFL) continues its 25th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times … Continue reading

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Clear Policy Exclusion Defeats Claim

Policy only Applies to Risks Taken by Insurer Post 4699 See the full video at https://rumble.com/v43u8ht-clear-policy-exclusion-defeats-claim.html   and at https://youtu.be/4aByIN1KBJo Plaintiffs in multiple consolidated actions appealed the Judgment granting the Motion for Summary Judgment in favor of defendant, The Burlington Insurance … Continue reading

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Lie to Your Insurer and You Will Lose

Coverage Limited to What the Insured Pays For at Inception See the full video at https://rumble.com/v43mpmb-lie-to-your-insurer-and-you-will-lose.html  and at https://youtu.be/9SPvYRsVfoc Post 4698 The Eleventh Circuit Court of Appeals was asked to resolve whether two residential homes destroyed by a fire while … Continue reading

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Go to Jail, Do Not Pass Go

Fraudster Must Serve Time and Lose His Residence to Pay Restitution Post 4698 See the full video at https://rumble.com/v43fprn-go-to-jail-do-not-pass-go.html and at https://youtu.be/Dvn85TdW320 Armando Valdes appealed his 60-month sentence for health care fraud after he pleaded guilty. Valdes’s conviction and sentence … Continue reading

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Fictionalized True Crime

The Largest Residential Burglary of All Time See the full video at https://rumble.com/v43auvt-fictionalized-true-crime.html  and at https://youtu.be/xJ0jwx70HsQ This is a Fictionalized True Crime Stories of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails … Continue reading

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Named Beneficiary Must be Paid Death Benefit

Where There is a Will – There are Relatives Post 4695 See the full video at https://rumble.com/v42jwx3-named-beneficiary-must-be-paid-death-benefit.html  and at https://youtu.be/hjG5sMnXY1s Della Lopez, Fred Lopez, Shella Gill, and Paul Imrie (collectively “Plaintiffs”) appealed from the trial court’s Order, arguing the trial … Continue reading

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Insurance Fraud as a State Crime

States Make Insurance Fraud a Crime See the full video at https://rumble.com/v42cao0-insurance-fraud-as-a-state-crime.html  and at https://youtu.be/jDi62dEpuiA Post 4694 In Hawaii, a person was convicted of fraud in State v. Whitaker, 175 P.3d 136, 117 Hawai’i 26 (Haw.App. 12/31/2007). As a result … Continue reading

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Waiver of Right to Appeal Effective

 Insurance Agent Defrauded Clients by Taking Premium Money and Keeping it for Personal Expenses See the full video at https://rumble.com/v426ins-waiver-of-right-to-appeal-effective.html and at https://youtu.be/vBixIaZUyBE When a criminal defendant’s valid guilty plea includes a waiver of the right to appeal, the Fourth … Continue reading

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A Christmas Fable of Fraud

The Christmas Gift of Insurance Fraud The story that follows is fiction based, in part, on a true case worked on by me. Any similarity to real people is unintentional. It is meant only to educate fraud professionals about how … Continue reading

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Subrogation Must be Fair

Insurer May Never Subrogate Against its own Insured Post 4691 See the full video at https://rumble.com/v41fqbk-subrogation-must-be-fair.html  and at  https://youtu.be/YXe2JxSJ2XM Zurich American Insurance et al sued their coinsurers – Appellant Certain Underwriters at Lloyd’s, London Subscribing to Policy Number B12630308616 (Lloyd’s) … Continue reading

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Zalma’s Insurance Fraud Letter – December 15, 2023

ZIFL – Volume 27 – Issue 24 Merry Christmas,   Happy Hanukah, and May the Winter Solstice be Peaceful & Mild Post 4690 ZIFL-12-15-2023 See the full video at https://rumble.com/v419744-zalmas-insurance-fraud-letter-december-15-2023.html  and at https://youtu.be/ByPCyXI_BlY The Resource for the Insurance Claims and … Continue reading

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Insurance Litigation Never Easy

When Appraisers Fail to Agree on Umpire Court Must Appoint One See the full video at https://rumble.com/v4124us-insurance-litigation-never-easy.html  and at https://youtu.be/B51ilfy6dLk Post 4689 When a claim for damages due to a hurricane was disputed the parties demanded appraisal and appointed their … Continue reading

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Activities of Lawyer in the Capacity of an Officer of Another Business Excluded

No Defense for Lawyer/Business Owner Post 4788 See the full video at https://rumble.com/v40vw8n-activities-of-lawyer-in-the-capacity-of-an-officer-of-another-business-excl.html  and at https://youtu.be/2WSSwJjP4bA Associated Industries Insurance Company (AIIC) sued Howard Kleinhendler and his former law firm, Wachtel Missry LLP, seeking a declaration that it need not provide … Continue reading

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No Right to Insurance Proceeds After Foreclosure

Foreclosure Changes Insurable Interest from Borrower to Lender Post 4787 See the full video at https://rumble.com/v40quhb-no-right-to-insurance-proceeds-after-foreclosure.html and at https://youtu.be/iNSo-kpWp7A In this contested residential mortgage foreclosure, defendants Mitchell and Deanna Minchello appealed from the entry of summary judgment. Defendants contended that … Continue reading

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When Parties Agree to Appraisal Court has no Choice but to Agree

Appraisal Required to Resolve Extent of Loss Post 4786 See the full video at  https://rumble.com/v409y5z-when-parties-agree-to-appraisal-court-has-no-choice-but-to-agree.html and at https://youtu.be/oOGc-09xpWs In an insurance dispute stemming from Hurricane Ian The parties agreed that their case should go to appraisal to determine the extent … Continue reading

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Drunk Driving into a Pole Not a Covered Loss

No Coverage for Loss After Policy Cancelled Post 4685 See the full video at https://rumble.com/v3zwzo8-drunk-driving-into-a-pole-not-a-covered-loss.html and at https://youtu.be/M8dwl_aHU70 In an action for declaratory judgment to determine whether the plaintiffs had a duty to defend and indemnify the defendants under certain … Continue reading

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Mold Suit Must Be Defended

Equally Fair Interpretation Favors Insured Post 4685 See the full video at https://rumble.com/v3zqebh-mold-suit-must-be-defended.html and at https://youtu.be/DarYdfMbWns WCPP Risk Purchasing Group, Inc. (“WCPP”) asserted coverage claims under a Commercial General Liability Policy (“Policy”) issued by Defendant, Lexington Insurance Company, on behalf … Continue reading

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Tardy Claim Allows Judgment for Defendant

Claim Against State Must be Filed in Accord with Statute See the full video at https://rumble.com/v3zlm4i-tardy-claim-allows-judgment-for-defendant.html and at https://youtu.be/DrXR1c0v4tM In Angela Erika Cantu v. California Department Of Transportation et al., F084601, California Court of Appeals (November 30, 2023) Angela Cantu … Continue reading

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Never Assume You Are Insured

Contractor Needs Permission of Insurer to be Protected by an Owner-Controlled Insurance Program Post 4682 See the full video at https://rumble.com/v3zjnd8-never-assume-you-are-insured.html and at https://youtu.be/cp5PjEBh2_w Team Industrial Services, Inc. (Team) found it had incurred a $222 million judgment against it in … Continue reading

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Chutzpah: Criminal Seeks Disability Because his Crime was Discovered and Prosecuted

Claim of Disability Because of Stress of Arrest & Conviction Fails Post 4681 See the full video at https://rumble.com/v3z1w38-chutzpah-criminal-seeks-disability-because-his-crime-was-discovered-and-pro.html and at https://youtu.be/90NDhUDIa18 Jason Brand (“Brand”) appealed from the judgment of the district court entered on September 30, 2021, challenging the … Continue reading

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Zalma’s Insurance Fraud Letter – January 1, 2024

ZIFL – Volume 28 Issue 1 See the full video at  and https://rumble.com/v4429q3-zalmas-insurance-fraud-letter-january-1-2024.html  at https://youtu.be/TH_iv5WQuN4 The Resource for the Insurance Claims and Insurance Fraud Professionals This, the first issue of the 28th Year of ZIFL includes articles and reports relating … Continue reading

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Too Stupid to Succeed at Fraud

Why an Amateur’s Attempt at Fraud Failed Post 4679 See the full video at https://rumble.com/v3ylwbq-too-stupid-to-succeed-at-fraud.html and at https://youtu.be/-AfnWKClZ-E This is a fictionalized true crime story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” … Continue reading

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It is Expensive to Lie to Your Insurer

Fraud in Inception Allows Insurer to Rescind Post 4678 See the full video at https://rumble.com/v3yd183-it-is-expensive-to-lie-to-your-insurer.html  and at https://youtu.be/oLMR9KIIEp4 Lamin Fatty appealed the trial court’s order granting summary disposition to Farm Bureau on the basis of finding Fatty’s fraud was grounds … Continue reading

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Unambiguous Policy Terms Must Be Applied

Coverage Excluded Cannot be Changed to Coverage Provided See the full video at https://rumble.com/v3y6ehn-unambiguous-policy-terms-must-be-applied.html  and at https://youtu.be/3RbjqMeW_pE An insurance coverage dispute that involved a commercial insurance policy (“the Policy”) that plaintiff, Winfire Management, LLC (“Winfire”) held with defendant, Massachusetts Bay … Continue reading

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The Perfect Gift for Your Insurance Company & Insurance Claims Clients

Most Insurers Have Rules Prohibiting their Employees to Get Gifts See the full video at https://rumble.com/v3xfec0-the-perfect-gift-for-your-insurance-company-and-insurance-claims-clients.html  and at https://youtu.be/7qPdaA01t3A When I was a young lawyer I tried to give gifts to the claims personnel who referred cases to me and … Continue reading

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Insurance Does Not Cover a Sure Thing

Underwriting Against a Certain Loss and Claim is Appropriate See the full video at https://rumble.com/v3xloeq-insurance-does-not-cover-a-sure-thing.html and at https://youtu.be/NRguA8OLZCs The underwriting of an insurance policy requires evaluation of risks of loss faced by the proposed insured. When a proposed insured advises … Continue reading

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You Win Some & You Lose Some

USDC Should Have Considered the Intentional Act Statute See the full video at https://rumble.com/v3xfyah-you-win-some-and-you-lose-some.html  and at https://youtu.be/AKrFx1KdgwM California State Grange (“Grange”) brought this action as a judgment creditor of non-party Chico Community Guilds (“Guilds”) seeking to recover from Guilds’ insurer … Continue reading

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No Sprinklers – No Coverage

Breach of Condition Precedent Defeats Policy See the full video at https://rumble.com/v3x2s1f-no-sprinklers-no-coverage.html  and at https://youtu.be/IfcxiDYTx_4 Blog Post 4673 Plaintiff appealed the trial court’s order granting summary disposition in favor of defendant. In 23771 Blackstone, LLC v. Conifer Insurance Company, No. … Continue reading

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I AM THANKFUL

My Family and I are Thankful to Share This Thanksgiving with You See the full video at https://rumble.com/v3x8se6-i-am-thankful.html  and at https://youtu.be/WZV5IWPH4lM My family and I have much to be thankful for this year, not the least of which are the … Continue reading

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“Personal Injury” Coverage Exclusion Eliminates Coverage

Speculation About Extraneous Facts Does Not Trigger Duty to Defend Blog Post 4672 See the full video at https://rumble.com/v3x1wsl-personal-injury-coverage-exclusion-eliminates-coverage.html and  at https://youtu.be/XfyWqrSsU3U AutoDistributors, Inc. and Steven Schneider (collectively “AutoDistributors”) appealed the district court’s order granting judgment on the pleadings in … Continue reading

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No Good Deed Goes Unpunished

After Paying the Insured More than $637,000 he Sues for More See the full video at https://rumble.com/v3wvpyx-no-good-deed-goes-unpunished.html and at https://youtu.be/l_s97-gbFEQ Vahagun Safarian appealed from the judgment entered after the trial court granted the summary judgment motion filed by Fire Insurance … Continue reading

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Why Insurance Fraud Is Costing You & Your Neighbors

Honest People Pay to Fund the Criminal Conduct of Insurance Fraudsters INSURANCE FRAUD IS EPIDEMIC Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number. No one … Continue reading

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