Category Archives: Zalma on Insurance

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

Insurance Policy Warranties

A Warranty in Insurance is a Special Type of Promise The following was adapted from “Insurance Claims: A Comprehensive Guide” available in two volumes for only $75 (reduced from $196) from ClaimSchool, Inc. at http://www.zalma.com/zalma-books/ Promissory Warranty A promissory warranty … Continue reading

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Professional Insurance Adjusting

How to Make Adjusting a Profession Insurers, in a search for profit, have decimated their professional claims staff. They laid off experienced personnel and replaced them with young, untrained and unprepared people. A virtual clerk replaced the old professional claims … Continue reading

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The Examination Under Oath

The EUO Is a Serious and Important Part of the Insurer’s Investigation The following is an excerpt from my new book available at Amazon.com: “The Insurance Examination Under Oath.” Contrary to the Belief of Lawyers for the Insured, the EUO  … Continue reading

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Zalma’s Insurance Fraud Letter – June 15, 2018

Arson for Profit So Obvious Insured Sentenced to 20 to 40 Months in Prison A successful fraudulent claim will often encourage a new fraudulent claim. Julia Ann Calipo found that twice was not the charm and was convicted by a … Continue reading

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Insurer May Sue Lawyer Hired to Defend Insured for Malpractice

Insurer Must Prove Insured’s Malpractice of Defense Counsel by Clear and Convincing Evidence The relationship between insurers and defense counsel they hire to defend an insured has always been difficult. Since the insurer pays the lawyer’s fees and gives counsel … Continue reading

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Rescission of Insurance

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

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Ethics for the Insurance Professional

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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U. S. Supreme Court Allows Minnesota to Change An Insurance Contract by Statute

Statute Causes Beneficiary Designation to be Voided by Divorce Live insurance contracts contain – as their main purpose – a beneficiary designation advising the insurer who the insured wishes to be paid upon the insured’ death. The designation is an … Continue reading

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California Insurance Claims Regulations

California Fair Claims Settlement Practices Regulations A Guide for 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

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Lawyer Who Represents Himself Has an Idiot for a Client

Incorporeal Damages – Not Damages Lawyers often dislike insurers. Many believe all that is needed to make a small fortune is to sue an insurance company since jurors seem to dislike insurers as much as lawyers do. However, when a … Continue reading

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Cosby Must be Defended for Defamation

Sexual Misconduct Exclusion Ambiguous When an insurer fails to be clear and unambiguous it finds it must defend an insured it never intended to insure. In AIG Property Casualty Company v. William H. Cosby, Jr., Barbara Bowman, Tamara Green, Angela … Continue reading

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Adjusting Property & Liability Claims

Two New Books on How to Adjust Claims From the introduction: The insurance adjuster is not mentioned in a policy of insurance. The obligation to investigate and prove a claim falls on the insured. Standard first party property insurance policies, … Continue reading

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Insurance Fraud New Books

“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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Extrinsic Evidence Disallowed in Dispute Over Duty to Defend

Four Corners Rule Deprives Contractor of Defense In states that apply the four-corners or eight-corners rule the determination of the duty to defend is limited to the allegations of the suit rather than the actual facts that brought about the … Continue reading

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Insurance Law Books Discounted

Four Insurance Texts Price Reduced Two Thirds “Insurance Law” Quick Overview Insurance Law is the most comprehensive, and yet practical, insurance law authority available today. Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness … Continue reading

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Assault & Battery Excluded Regardless of Who Is the Agressor

Assault or Battery Can Never be Fortuitous By definition liability insurance can only indemnify an insured against a contingent or unknown event, an accident, injury that is fortuitous. By definition assault or battery are intentional acts, not accidental, and not … Continue reading

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New Books from Full Court Press:

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

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Failure to Read Policy Expensive

Insurer’s Duty Limited to Provide the Insurance Ordered Insurance is nothing more than a contract between an insured and an insurer. The insured submits an application to the insurer seeking an offer of insurance. When the insurer offers the insurance … Continue reading

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Small Fraud – Big Fraud – Any Fraud Eliminates Coverage

Failure of Insured to Deal Fairly With Insurer Eliminates Coverage New York appellate courts are noted for their concise opinions. In Otsego Mutual Fire Insurance Company v. Sally Dinerman, et al., Tower Insurance Company of New York, et al., 158600/15, … Continue reading

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Liar, Liar, Pants on Fire

False Claim on Proof of Loss Voids Coverage As I have said until I was blue in the face the covenant of good faith and fair dealing applies equally to the insured as it does to the insurer. Failure to … Continue reading

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Arson for Profit So Obvious Insured Sentenced to 20 to 40 Months in Prison

It Takes Skill to Succeed at Arson for Profit A successful fraudulent claim will often encourage a new fraudulent claim. Julia Ann Calipo found that twice was not the charm and was convicted by a jury and sentence to time … Continue reading

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Zalma’s Insurance Fraud Letter – June 1, 2018

My Present Condition I am now four and a half weeks post open heart surgery and taking some time in the office to see how well I am recovering. I was able to walk – albeit slowly – more than … Continue reading

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Borrowed Psycho Swing Injury Not Covered

Insured’s Failure to Fulfill Policy Condition Fatal to Coverage It seems that the insurance contract is the only contract that the parties don’t read. Failure to read and understand an insurance contract can be, and often is, expensive to the … Continue reading

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Cannot Create Coverage by Claiming Ambiguity

No Cover for Diver Who Drowned Liability insurance policies are created with a broad grant of coverage that is then chipped away with limitations and exclusions to cover on the risks of loss that the insured intended to cover. No … Continue reading

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To Prove Exclusion the Injury Must Flow Directly and Immediately from Intentional Act

Release After Payment of Limits Protects Insurers Major losses with insufficient insurance will invariably draw insurance coverage litigation. When insurers paid their limits less than a $200 million train accident loss where twenty-four passengers were killed and scores more were … Continue reading

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Thank You St. Johns

Thank You St. Johns Zalma’s Insurance Fraud Letter The Essential Resource For The Insurance Fraud Professional Since I started ZIFL twenty two years ago all I have discussed is the evil people who are involved in insurance fraud who kill … Continue reading

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Zalma’s Insurance Fraud Letter – May 1, 2018

 Zalma’s Insurance Fraud Letter  May 1, 2018  The Essential Resource For The Insurance Fraud Professional How Much Does Fraud Cost?  In the 2018 Report to the Nation published by the Association of Certified Fraud Examiners an attempt is made to … Continue reading

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Two Books Needed by Every Insurance Adjuster

Being a Professional Adjuster Insurance adjusting is a profession where individual provide service to people who are insured when a contingent or unexpected loss occurs. It requires skill, intelligence, expertise and empathy to do the job properly. The two new … Continue reading

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Imputed Negligence of Auto Owner Dead in Maryland

Innocent Owner Not Deprived of Coverage Because of Negligence of Permissive Driver Maryland still allows contributory negligence as a defense to a tort action thereby depriving recovery for damages incurred by a person contributarily negligent. Most states assess liability on … Continue reading

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How to Avoid & Defeat Insurance Fraud

“Insurance Fraud & Weapons to Defeat Insurance Fraud” In Two Volumes When insurers and governments put on a serious effort to reduce the amount of insurance fraud the number of claims presented to insurers and the pseudo-government-based or funded insurers … Continue reading

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Who’s on First or Which Insurer Owes a Defense and Indemnity

Risk Transfer Device Works for City of New York When insurers dispute over which one owes defense and indemnity to an insured they both insured the result is almost always disappointing. Litigation between insurers should never reach the court of … Continue reading

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Become a Certified Expert in Corporate Property Insurance and a Certified Expert in Corporate Liability Insurance

Certifications to Become an Insurance Professional Now available from Illumeo and Barry Zalma Everyone involved in insurance – either as an insurer or as an insured – requires excellence in claims handling. Businesses need to deal with insurers who have … Continue reading

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The Compact Book on Commercial Property Insurance Policy

How to Obtain, Read, Understand and Make Claims on 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 … Continue reading

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Delivering Anything For Compensation Excluded by Auto Policy

Vehicle While Used to Carry Sandwiches for a Charge Excluded Auto insurance polices provide a great deal of liability insurance for a small premium. It is, usually, a bargain for the purchaser. However, like every insurance policy, the automobile liability … Continue reading

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Five True Crime Insurance Fraud Books

Fiction from an Insurance Lawyer’s Fifty Years Dealing with Insurance Fraud After fifty years acting as a claims adjuster and insurance coverage lawyer I have seen and heard just about every possible way for an insurer to be defrauded. The … Continue reading

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UIM Cover Properly Limited to Designated Vehicles

Ambiguity in State Mandated Policy Wording Should Not Be Held Against Insurer In most states the language of uninsured motorist (UM) and underinsured motorist (UIM) coverages are mandated by state law. Insurers have no choice, they must use the language … Continue reading

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“Random Thoughts on Insurance Volumes I through V

Digests from Barry Zalma’s Blog: “Zalma on Insurance” After more than 50 years acting as a claims person and insurance coverage lawyer I enjoy reading court decisions concerning insurance. The idea of the blog “Zalma on Insurance” is to find … Continue reading

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Subrogation Fails for Failure to State Amount of Damage

Carmack Amendment Requires a Statement of Damage Subrogation is an equitable right provided to an insurer after it indemnifies its insured for a loss covered by the policy of insurance. As a result every subrogating insurer must know how much … Continue reading

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“HEADS I WIN, TAILS YOU LOSE”

How Insurance Fraud Succeeds 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 and … Continue reading

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Fake Psychiatrist Will Get Psychiatric Treatment — in Prison

Unhappy with Sentence Fake Doc Appeals with Fake Arguments Some criminals believe that their crimes do not deserve punishment no matter how egregious their crime. By pretending to be a physician and psychiatrist Scott C. Redman treated people with a … Continue reading

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