Author Archives: Barry Zalma

Third Party Insurance Only Protects Damage to Other than the Insured See the full video at https://rumble.com/v27z52z-liability-insurance-only-protects-other-than-the-insured.html and at https://youtu.be/rlkxxfG4QOE Finger Oil &Gas, Inc. (“Finger Oil”), the insured, and Mid-Continent Casualty Company (“Mid-Continent”) disputed coverage and the magistrate judge granted … Continue reading →

GOOD CAUSE FOR IME ESTABLISHED THE INDEPENDENT MEDICAL EXAMINATION AS A TOOL TO DEFEAT FRAUD See the full video at https://rumble.com/v27v4zs-ime-required.html  and at https://youtu.be/FFt40r53O7Q In Costa Rwagasore v. Grange Property & Casualty Insurance Co., No. 2022-CA-0413-MR, Court of Appeals of … Continue reading →

ZIFL – Volume 27, Issue 3 See the full issue here. See the full video at https://rumble.com/v27r4rk-zalmas-insurance-fraud-letter-february-1-2023.html  and at https://youtu.be/2gDf1Se5wzw The Source for Every Insurance Fraud Professional In this, the third issue of the 27th year of publication ZIFL provides … Continue reading →

Fairly Entered Plea Agreement Sustained See the full video at https://rumble.com/v27qb7d-go-directly-to-jail.html and at https://youtu.be/G1YGsf7HGOE In United States Of America v. Joshua Louis Rupp, No. 22-1240, United States Court of Appeals, Sixth Circuit (January 24, 2023) a case involving a fraud … Continue reading →

Insurance Fraud by Killing Children & Attempted Killing of Wife Affirmed See the full video at https://rumble.com/v27cnui-212-years-in-prison-for-fraud.html  and at https://youtu.be/NClM00oU-GI In United States Of America v. Ali F. Elmezayen, AKA Ali F. Elmeza Yen, AKA Ali Fathelelah Elmezayen, AKA Ali … Continue reading →

The Devil’s in Details This is one of many fictionalized True Crime Stories of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The stories help to Understand … Continue reading →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

 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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →