Category Archives: Zalma on Insurance

insurance, insurance coverage, insurance claims, insurance bad faith, claims, investigation, fraud.

“Zalma on Insurance Claims”

Ten Volumes on Insurance Claims A Comprehensive Group of Materials on Property & Casualty Insurance Claims Insurance claims professional and expert witness Kevin Quinley said about the following ten volumes: “Zalma’s series of books is a terrific blend of both … Continue reading

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Zalma’s Insurance Fraud Letter – November 15, 2018

The Essential Resource for The Insurance Fraud Professional Zalma’s Insurance Fraud Letter, Volume 22, No. 22    Asbestos Victim Fund Under Investigation When a company is unable to pay liabilities related to asbestos exposure, it may file for Chapter 11 … Continue reading

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New Books from Barry Zalma

Important books dealing with insurance coverage and insurance law by insurance coverage law, insurance claims consultant, insurance claims expert witness that will fulfill every need for access to insurance law and insurance claims law. New Books from Full Court Press … Continue reading

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Crooked Cop Stays in Jail

Police Officer’s Insurance Fraud Conviction A police officer is charged with enforcing the law. There is nothing more wrongful than a police officer who breaks the law. In State Of Tennessee v. Edwin Millan, No. E2017-01053-CCA-R3-CD, Court Of Criminal Appeals … Continue reading

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Fictionalized True Insurance Crime Books

Fictionalized True Insurance Crime Books “HEADS I WIN, TAILS YOU LOSE” 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 … Continue reading

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Insurance Fraud Conviction Helps Establish Lack of Credibility

Prescriptive Easement Established by Fraudulent Testimony of Defendant An New York trial court, after finding that defendant’s credibility was called into question by inconstancies in his testimony and a felony conviction for insurance fraud, discounted the defendant’s testimony and found … Continue reading

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Three Important Insurance Books

The Essence of Insurance Insurance, since the first policy was scratched on a claim tablet eons ago, has always been a business of the utmost good faith. Insurance personnel must act fairly, in good faith and ethically in every interaction … Continue reading

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Corporate Veil Pierced for Lie to Insurer

Lie About Gross Earnings Compel Payment of Additional Premium No one likes to pay insurance premiums. Some, to avoid legitimate premium, will lie on an application about the insured’s gross earnings to reduce the premium paid. The insurer, after a … Continue reading

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Did You Train Your People by September 1 on the Regulations?

Failure to Train Subjects Insurers to Fines The California Court of Appeal recently affirmed the right of the California Department of Insurance to assess serious fines against insurers that fail to fulfill the requirements of the California Fair Claims Settlement … Continue reading

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After Loss it is too Late to Change Policy

Save Premium and Lose Your Business Much to the surprise of individuals and some judges an insurance policy is nothing more than a contract that makes detailed promises to indemnify a person as a result of certain identified perils or … Continue reading

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Two Primers to Create Professional Insurance Adjusters

How to Create a Staff of Competent and Professional Claims Adjusters The training, education, and maintenance of professional insurance adjusters is a rare thing in the modern U.S. insurance market. The lack of education, training and experience of insurance adjusters … Continue reading

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The Stupidity of Covering Others for More than Yourself

You Can’t Make an Insurer Pay for Coverage You Didn’t Buy People injured in auto accidents usually have buyer’s remorse about the insurance they purchased to protect themselves – like Uninsured Motorist/Underinsured Motorist (UM/UIM) coverage. Because the person is injured … Continue reading

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Bad Faith and Fraud – Happy Bedfellows

Time to Rescind the Tort of Bad Faith The tort of bad faith was created to solve a perceived abuse of persons insured by their insurers. The cure, allowing a breach of an insurance contract allow an insured to collect … Continue reading

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Child Molestation can be Fortuitous

Negligent Hiring and Supervision of a Pederast is an Occurrence An evil, intentional act of sexually molesting a minor is never an insured “occurrence” insured by a Commercial General Liability Insurance Policy (CGL). However, when the plaintiff sues the employer … Continue reading

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Construction Defects and Mold Claims

Tools for the First Party Property Claims Person Eventually every first party property insurance claims person will be faced with a claim alleging damages caused by construction defects or infestation by mold or bacteria. The claims require investigative skill and … Continue reading

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Failure to I-Phone Home Costs Insured More than $1.6 Million

Insured Wrongfully Demands More Insurance Coverage than Acquired A first party property insurance policy promises to indemnify the insured for a loss due to a peril insured against at specified locations. Most include endorsements that provide coverage for newly acquired … Continue reading

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Zalma on Insurance Claims

Ten Volumes Comprising A Comprehensive Group of Materials on Property & Casualty Insurance Claims Insurance claims professional and expert witness Kevin Quinley said about the following ten volumes: “Zalma’s series of books is a terrific blend of both the legal … Continue reading

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Appraisers Can’t Determine Amount Without First Determining Cause of Loss

First Party Insurance Appraisers & Causation Insurance appraisals are limited to a determination of the amount of loss. Some courts find that the cause of a loss is prohibited by the language of the appraisal provision of the policy since … Continue reading

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COIL -Commentary on Insurance Law

Everything Needed by the Insurance Claims Professional Over the last 51 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials … Continue reading

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Claiming Injury when not in Vehicle is Fraud

When You do the Crime You Must Pay the Fine Charyse McMillan made a no-fault claim for injuries due to an auto accident even though she was not in the vehicle at the time of the accident. New Jersey found … Continue reading

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Insurance Books Available for Every Insurance Professional

Insurance Books Available for Every Insurance Professional The new publisher, Full Court Press, has published three of my books on insurance coverage available as e-books and for research purposes on the legal research site, Fastcase.com. My books recently taken back … Continue reading

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Zalma’s Insurance Fraud Letter – 11-1-18

Agent Who Kept Premium Owed to Zurich Loses at Ninth Circuit  Zalma’s Insurance Fraud Letter, Volume 22, No. 21    In this, the 21st issue of the 22nd year of the publication of Zalma’s Insurance Fraud Letter (ZIFL) you will … Continue reading

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Fictionalized True Insurance Crime Books

Fictionalized True Insurance Crime Books “HEADS I WIN, TAILS YOU LOSE” 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 … Continue reading

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Fall from Cherry on Top But No Cake

Business Exclusion Clear and Enforceable When a farmer allows individuals access to the farm so they can pick cherries off trees in the orchard and buy the cherries at a lesser price than pre-picked cherries it is doing the business … Continue reading

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Important New Insurance Books – Ethics, EUO, Rescission

Ethics for the Insurance Professional 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 … Continue reading

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Attempt to Save Premium is Costly to Insured

Living in New Jersey but Insured in Florida is Fraud No one like to pay insurance premiums. However, in a state like New Jersey, insuring a vehicle with No Fault insurance is mandatory. Since insurance in Florida is less expensive … Continue reading

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Did You Comply With California Claims Regulations Training?

The state of California requires every person dealing with claims in the state to be trained no later than September 1 each year and submit a sworn statement to insurance company management that they were trained or had read and … Continue reading

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If you do the Crime You Must Do the Time

Guilty of Disability Fraud Insurance criminals today define the Yiddish word “Chutzpah!” Their unmitigated gall to challenge a conviction for fraud is without bound. They appeal and waste the time of courts of appeal. More often than not the attempt … Continue reading

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Basic Adjusting Manuals for New and Experienced Adjusters

Primers for the Insurance Claims Person Claims professionals, whether new to the profession or seriously experienced can profit from the two primers on insurance adjusting where they can either learn for the first time or refresh their knowledge on the … Continue reading

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A Clear and Unambiguous Exclusion Can’t Beat a Great Lawyer

Bar Negligent for not Seeking Arrest of Drunk & Disorderly Customer It is axiomatic among plaintiffs’ personal injury lawyers that the more serious the injury the less the need for legal niceties. In a case of the wrongful death of … Continue reading

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An Exclusion Can Never Create Coverage

A Battery Is Always Intentional and Cannot Be an “Occurrence” Insurance, by definition, only applies to a contingent or unknown event. For a person to obtain defense or indemnity to a claim of bodily injury the injury must be due … Continue reading

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The Problem With Bad Faith & Insurance Fraud

Does the Tort of Bad Faith Help Fraud Perpetrators The tort of bad faith was created by the courts in the 1950’s and allows people mistreated by their insurers to sue for both breach of contract and tort damages including … Continue reading

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Construction Defects, Mold, Bacteria and Insurance

Construction Defects, Mold, Bacteria and Insurance Modern insurance claims professionals now must understand and deal with insurance disputes relating to construction, claims of construction defects, mold and bacterial infestations into structures. Claims for damage to property and bodily injury as … Continue reading

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Contra Preferentum Does Not Apply to a Clear and Unambiguous Policy

No Coverage Before Policy In Effect People who sue insurance companies seem to forget that an insurance policy is a contract – not an entitlement provided by a government. Insurance contracts must be read as a whole document and all … Continue reading

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Zalma on Insurance Claims

Materials Needed by Every Insurance Claims Professional Insurance claims professional and expert witness Kevin Quinley said about the following ten volumes: “Zalma’s series of books is a terrific blend of both the legal underpinnings and the practical implications for the … Continue reading

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Private Limitations of Action Provision Enforced

Ninth Circuit Affirms Summary Judgment Because Suit Was Filed Too Late Every first party property insurance policy contain a special provision that limits the time available for an insured to sue the insurer in the event a claim is rejected. … Continue reading

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Insurance Claims Law

Insurance Claims Law Available now from Barry Zalma, ClaimSchool, and Amazon.com are books and materials essential to the claims professional. COIL provides regular commentary on insurance law to allow the claims professional to remain current on what the courts are … Continue reading

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Agent Who Kept Premium owed to Zurich Loses at Ninth Circuit

Agent Defrauds Insurer by Not Remitting Premium Collected Insurance agents, by contract with insurers they represent, must place all premium collected on behalf of the insurer and place the funds in a separate trust account. Depending on the terms of … Continue reading

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Important Insurance Books from Barry Zalma

New Books from Full Court Press Full Court Press continues to publish expert secondary content. This time it’s a new collection of insurance law treatises from consultant, expert witness, arbitrator, and mediator Barry Zalma. Barry Zalma practiced law in California … Continue reading

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No “Occurrence” in Ohio for Contractor’s or Sub-Contractor’s Defective Work

An “Occurrence” Must Be Fortuitous Ohio, bucking the majority of court opinions, has interpreted the standard Commercial General Liability (CGL) policy to require for coverage to exist that a loss is fortuitous. An “occurrence” to Ohio courts require that the … Continue reading

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