Category Archives: Zalma on Insurance

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

How to Avoid Insurance Fraud

Tools to Investigate and Defeat Insurance Fraud Insurers faced with a potential insurance fraud have available tools to defeat the attempted insurance fraud. One of the most effective tools is the examination under oath where the insured is required to … Continue reading

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Late Report of Loss Fatal to Claim to Excess Insurer

No Sufficient Excuse for Late Report Every third party liability insurance policy contains a requirement that the insured report a loss, suit, or potential loss promptly as a condition precedent to suit. New York courts take that condition seriously and … Continue reading

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Zalma on Insurance Blog in Feedspot Blog Top 50 Insurance Law Blogs

My name is Anuj Agarwal. I’m Founder of Feedspot. I would like to personally congratulate you as your blog  Zalma on Insurance has been selected by our panelist as one of the Top 50 Insurance Law Blogs on the web. https://blog.feedspot.com/insurance_law_blogs/   I personally … Continue reading

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Ethics and Rescission

Insurance is, and has always been, a business of the utmost good faith requiring ethical conduct by insurers when dealing with their customers: the insureds. To do so requires an understanding of ethics and how ethical behavior controls the business. … Continue reading

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Abbe Bikila’s Name is an Advertising Idea

Potential for Coverage Requires Insurer to Defend The key to the duty to defend is an analysis whether the plaintiff seeks damages from a cause that could potentially be covered by the policy. There is no need to plead an … Continue reading

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California Claims Regulations Require Training Completed September 1, 2018

Have your people complied with the requirements of the California Fair Claims Settlement Practices Regulations and the California SIU Regulations? Every claims person dealing with claims in California are required to be trained annually concerning the Regulations or file a … Continue reading

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If Your Have no Rights You Have Nothing to Assign

Policy Expires If Premium Not Paid One month auto policies are issued to people who are high risks or who cannot afford a longer term. It allows them to comply with the statutes that require insurance to register an auto … Continue reading

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The Compact Books of Adjusting Claims

Do you have new claims adjusters working for you? Do you have old insurance adjusters working for you who have forgotten or refused to learn the basics? Do your claims professionals fail to keep the promises made by the policies … Continue reading

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Lie on Application & Lose Coverage

Taking an Assignment from Tortfeasor to Sue Insurer Not Always Profitable Mark A. Link and Susan Link (collectively referred to as “the Links”) appeal the Allen County Common Pleas Court’s ruling granting summary judgment in favor of Wayne Insurance Group … Continue reading

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“Insurance Fraud & Weapons to Defeat Insurance Fraud”

“Insurance Fraud & Weapons to Defeat 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 … Continue reading

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Zalma’s Insurance Fraud Letter – September 15, 2018

Ethics & the Insurance Fraud Investigation  Zalma’s Insurance Fraud Letter, Volume 22, No. 18     Uberrimae Fidei – Utmost Good Faith Insurance adjusters and fraud investigators, like everyone else, can become frustrated. Every adjuster and fraud investigator have had “gut … Continue reading

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New Books from Full Court Press

New Books by Barry Zalma From Full Court Press Do you or your staff need access to easy to read, comprehensive, yet understandable information about insurance law and the litigation of bad faith suits seeking punitive damages? If you do, … Continue reading

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Not Reading a Policy is Fatal to a Fire Claim

Foreclosure Voids Insurance Policy In the last 51 years I have asked hundreds of insureds directly and under oath whether they read and understood their insurance policy. Most respond with nervous laughter. Only two, in 51 years, claimed to have … Continue reading

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Zalma on Insurance Claims

Zalma on Insurance Claims Do you want to know what is needed to be an insurance claims professional? Do you want to  train your employees to be an insurance claims professional? Do you need to prove that your claims people … Continue reading

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No Coverage For Criminal Acts by Insured

Criminally Tampering With Evidence is Not Malicious Prosecution Police officers are expected to be honest and present true and accurate evidence. Presenting false evidence to a court to support a criminal prosecution is a criminal act. No insurer intends to, … Continue reading

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Construction Defect

Construction Defects and Insurance Are you faced with a construction defect claim? Do you insure contractors, builders, sub-contractors, architects, engineers or anyone facing a claim or suit for construction defects? Do you understand insurance of construction defects? Do you understand … Continue reading

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Accident – the name of the Insurance – Needed to Obtain ADD Benefits

Insurer Reasonably Concluded that Death from Natural Causes not an Accident Life is a terminal disease from which all humans suffer. We all die eventually. Accidental Death and Dismemberment insurance (AD&D) only responds when the death or dismemberment is due … Continue reading

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Tort of Bad Faith Must Be Eliminated

Time to Rescind the Tort of Bad Faith The tort of bad faith was created by courts in the 1950’s to solve a problem of abuse by a few insurers. It has become a devise to enrich plaintiffs’ lawyers and … Continue reading

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No Coverage — No Bad Faith

Failure to Plead Plausible Claims Defeats Lawsuit It is the obligation of every lawyer representing a plaintiff to plead plausible claims for relief or find the suit dismissed summarily. In Eileen Coonce v. CSAA Fire & Casualty Insurance Company, and … Continue reading

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New Insurance Claims Books

The Making of an Insurance Claims Professional It is the insurance claims person – the adjuster – who meets with the person insured and works to keep the promises made by the insurance policy. The adjuster cannot, however, help the … Continue reading

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Who’s on First for Negligent Hiring?

Personal Auto Policy Limited to Acts of Owner/Operator Auto liability insurance policies promise to defend the insured. When more than one policy provides coverage the question of who owes a defense and indemnity to whom is often complex with multiple … Continue reading

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Who’s on First? The Insured Must Allocate

Double Recovery Not Allowed When a contractor is faced with a massive judgment that must be satisfied it looks first to its subcontractors who agreed to defend or indemnify the insured. If inadequate to pay the full judgment the contractor … Continue reading

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Have You Complied with California Claims Regulations?

Training Required to be Completed by September 1, 2018 Every insurer that does business in the state of California was required to train all of their integral claims personnel about the California Fair Claims Settlement Regulations and the California SIU … Continue reading

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Lawyer: Never Lie to Your Insurer

More Than Two Million Judgment Against Client for Neglect to Protect Client Should Have Been Reported Insurance is a contract where the parties are compelled, by an unwritten covenant of good faith and fair dealing, to do nothing to deprive … Continue reading

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Mortgagee’s Right to Insurance Proceeds Primary

Regardless of Acts of Insured Mortgagee Gets Insurance Proceeds When two or more people make claim to the proceeds of an insurance claim that the insurer admits it owes the prudent insurer interpleads the funds into court and allows the … Continue reading

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The Unattended Auto Exclusion in Jewelers Block Policies

An Exclusion That Is Interpreted Differently The purpose of the unattended auto exclusions is twofold: to curb what is called “moral hazard” and to limit coverage in high-risk settings even when there is no moral hazard. Moral hazard refers to … Continue reading

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Claims Personnel Keep the Promises Made by the Insurance Policy

Insurance Policies Make Promises to Insureds The essence of every insurance policy is the promises made by the insurer to the insured to indemnify the insured against losses causing damage to the insured by a contingent or unknown event. How … Continue reading

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Information to Develop Professional Claims Personnel

“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

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Zalma’s Insurance Fraud Letter – September 1, 2018

False Answers on Application Equals Fraud  Zalma’s Insurance Fraud Letter, Volume 22, No. 17 It’s Not Nice to Lie to Your Insurer The covenant of good faith and fair dealing applies equally to the insured as it does the insurer. … Continue reading

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Time to Rescind the Tort of Bad Faith

Time to Rescind the Tort of Bad Faith Insurance and the Law of Unintended Consequences Paperback  by Barry Zalma (Author)   See all formats and editions Paperback Kindle Book Insurance is, and always will be, a business of the utmost … Continue reading

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No Harm, No Foul when Agent Issues False Certificate

Insurance Agent’s Duty Limited to Insured Plaintiff PWB Development leases its Oklahoma City property to Kampco Foods. The property sustained a March 2015 fire that caused Kampco’s rent to abate during nine months of repairs. Plaintiff alleges that before the … Continue reading

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Insurance Fraud

“Insurance Fraud & Weapons to Defeat 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 … Continue reading

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World Trade Center Recovered Total Loss From the Insurers

Is This the Last Insurance Decision Re September 11, 2001? The terrorist attack on the World Trade Center on September 11, 2001 gave rise to much litigation concerning insurance and tort damages. The plaintiffs, the holders of the leases of … Continue reading

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Insurance Books by Barry Zalma

Time to Rescind the Tort of Bad Faith Insurance and the Law of Unintended Consequences Paperback  by Barry Zalma (Author) Paperback Kindle Book Insurance is, and always will be, a business of the utmost good faith. All parties to the … Continue reading

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Abusing Ex-Wife is Not a Physician’s Service

Obtaining Ex-Wife’s Medical Records to Harass Not a Professional Service Divorce causes people to act in ways they would never act in normal interaction between a man and a woman. People in a divorce give up common morality and become … Continue reading

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Tenants Criminal Acts Damaging Property Eliminates Coverage

Criminal Act Exclusion Enforced Landlords must be careful who they allow to rent their property. K.V.G. Properties rented real property to criminals who created a marijuana growing facility in the property and, as part of the work to grow the … Continue reading

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NEW BOOKS

Zalma on Insurance Claims This series of ten books is the latest addition to Barry Zalma’s insurance claims series of books and articles that will form the most thorough, up-to-date, expert-authored insurance claims guide available today. Written by nationally-renowned insurance … Continue reading

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False Answers on Application Equals Fraud

It’s Not Nice to Lie to Your Insurer The covenant of good faith and fair dealing applies equally to the insured as it does the insurer. When applying for insurance the covenant requires absolute honesty in the representations made in … Continue reading

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Time to Rescind the Tort of Bad Faith

Insurance and the Law of Unintended Consequences Insurance is, and always will be, a business of the utmost good faith. All parties to the insurance contract agree, in good faith and fair dealing, to do nothing to deprive the other … Continue reading

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Residence Premises Requires Resident

No Cover if Dwelling is not the Insured’s Residence Dwelling policies require that the dwelling is the insured’s residence premises. It can’t be a commercial use or vacant and unoccupied. The risk of loss an insurer is asked to take … Continue reading

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