Insurance Claims Library

Everything Needed by the Insurance Claims Professional from Barry Zalma

Over the last 55 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 to make it for insurers and their claims staff to become insurance claims professionals.

The Compact Book of Adjusting Property Claims – Fourth Edition

A Primer for the First Party Property Adjuster

The insurance adjuster is seldom, if ever, mentioned in a policy of insurance. The strict wording of the first party property policy sets the obligation to investigate and prove a claim on the insured.

Standard first party property insurance policies, based upon the more than a century old New York Standard Fire Insurance policy, contain conditions that require the insured to, within sixty days of the loss, submit a sworn proof of loss to prove to the insurer the facts and amount of loss.

In general, failure to file the proof within the time limited by the policy is fatal to an action upon it (White v. Home Mutual Ins. Co., 128 Cal. 131, 60 P. 666 (1900); Beasley v. Pacific Indem. Co., 200 Cal.App.2d 207, 19 Cal.Rptr. 299 (Cal. App. 1962).
The California Supreme Court in 1900, when it decided White v. Home Mutual concluded that the requirement of proof of loss by the insured within the 60-day limit provided by the standard form of policy is a condition precedent to the right of the insured to maintain suit.

Available as a hardcover here. Available as a Kindle Book here.  Available as a paperback here

The Defeat of a Fake $10 Million Jewelry Robbery Insurance Claim

Barry Zalma, Esq., CFE, a Certified Fraud Examiner and a retired insurance coverage lawyer and active insurance claims, insurance coverage and insurance fraud expert has just published a fictionalized novella about how a thorough investigation defeated an attempted $10 million insurance fraud when a jeweler attempted to defraud the Underwriters at Lloyd’s, London by creating a false $10 million inventory with the assistance of a less than honorable accountant and public adjuster.

His attempted fraud was unexpectedly subject to the investigation of Morpheus Othello McCloskey (called only by his friends by his initials “MOM”) and insurance coverage lawyer Samuel B. Hazan who, at the instructions of the Lloyd’s Underwriters, conducted a thorough and effective good faith investigation of the policy and the claim and defeated the attempted fraud.

A jeweler attempted to defraud the Underwriters at Lloyd’s, London by creating a false $10 million inventory with the assistance of a less than honorable accountant and public adjuster. His attempted fraud was unexpectedly subject to the investigation of Morpheus Othello McCloskey (called only by his friends by his initials “MOM”) and insurance coverage lawyer Samuel B. Hazan who, at the instructions of the Lloyd’s Underwriters, conducted a thorough and effective good faith investigation of the policy and the claim and defeated the attempted fraud.

Available as a Kindle Book here. Available as a paperback here.

A Compact Book on How Judges Read, Understand, Interpret and Rule on Insurance Policy Issues

Every Person Who is Insured Needs to Understand How Judges interpret Insurance Policies.

The book provides those who are insured, insurance claims people, insurance claims executives, underwriters, insurance agents, insurance brokers, insurance coverage lawyers and policyholders lawyers an ability to understand how they should emulate the courts when interpreting an insurance policy to avoid taking untenable positions with regard to claims.

Understanding the Terms and Conditions of an Insurance Policy

The challenge faced by every person insured when making a claim is to determine what was insured and what was not insured. Similarly, every insurance claim professional when faced with the need to resolve a claim presented by an insured is required to determine if the insurance policy, by its wording, provides coverage to indemnify the insured or does not. To do so the insured and the insurance claim professional must read, understand, and interpret the policy and apply the wording of the policy to the facts determined by the claims investigation.

To present or investigate a claim fairly both those insured and those representing the insurer must understand what insurance is and its history of indemnifying those who incur losses as a result of a fortuitous event.

An insurance policy is a contract. It is a written agreement between the person named as insured and the insurer. Each party to the insurance contract make promises to each other. The insured, for example, promises to pay the premium charged and in the event of a claim cooperate in the investigation of the insurer and will do nothing to deprive the insurer of the benefits of the policy. The insurer, on the other hand, promises to thoroughly investigate each claim presented by the insured fairly and in good faith and to do nothing that will prevent the other to obtain the benefits of the contract.

The book is available at Amazon.com as a hardcover here; a paperback here; and as a Kindle Book here.

The Compact Book on Ethics

How Ethical Doctrines from the Beginning of the Written Word to the Present Resulted in the Incorporation of the Covenant of Good Faith

Every Person Involved in the Business of Insurance Must Act Ethically in the Business of Insurance

Insurance is, by definition, a business of the utmost good faith. This means that both parties to the contract of insurance must act fairly and in good faith to each other and do nothing that will deprive the other of the benefits the contract of insurance promised.

Without the covenant of good faith and fair dealing, and ethical people who work in the insurance industry applying and fulfilling the covenant, effective insurance to spread the risk of loss to a large community of insurance professionals, is impossible. One cannot act fairly and in good faith without being a person with a well-formed ethical compass.

The book is available as a Kindle book, a Paperback or a Hardcover

“How to Acquire, Understand, and Make a Successful Claim on a Commercial Property Insurance Policy: Information Needed for Individuals and Insurance Pros to Deal With Commercial Property Insurance”

Available as a Kindle book here, paperback here and as a hardcover here

Commericial Property Insurance is a necessity for any person or entity owning a piece of commercial property whether it is small or large, whether it is an office building or a warehouse or a factory.

A property owner – unless exceptionally wealthy – cannot afford the risk of losing that property, what it earns from tenants paying rent or from the product produced at the property.

Commercial property insurance is a specialized form of insurance designed to to protect the owner or lessee of the property from loss due to perils like fire, lightning, windstorm, hail, earthquake, flood, tornado or other risks of loss.

Most commercial property insurance policies are written on a “direct risk of physical loss” or “all risk of physical loss” basis subject to exclusions that are directly related to to the risks faced by the property or some standard exclusions.

This book explains the coverages provided by a commercial property insurance policy, how to acquire a policy of commercial property insurance, what the policy of commercial property insurance insures, how to present a claim, and how to successfully present a claim and collect the funds needed to repair or replace the structure and indemnify the insured against the losses incurred because of the interruption of the business of the insured.

The Tort of Bad Faith

Read the full article at https://www.linkedin.com/pulse/new-book-from-barry-zalma-tort-bad-faith-barry-zalma-esq-cfe and at https://zalma.com/blog plus more than 4300 posts.

What Every Insurance Professional, Every Insurance Coverage Lawyer, Every Plaintiffs Bad Faith Lawyer, and Every Insurance Claims Person Must know About the Tort of Bad Faith 

A Book Needed by Every Insurance Claims Professional

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 in a case decided by Lord Mansfield sitting in the House of Lords as the highest court in Britain. In Carter v. Boehm. 3Burrow, 1905, Lord Mansfield explained that insurance is a contract upon speculation; the special facts upon which the contingent chance is to be computed, lie, most commonly, in the knowledge of the insured only. The underwriter trusts to his representation, and proceeds upon confidence that he does not keep back any circumstance in his knowledge, to mislead the underwriter into a belief that the circumstance does not exist, and to induce him to estimate the risk as if it did not exist.The keeping back such circumstance is a fraud, and therefore the policy is void.

Lord Mansfield stated the rule still followed to this day: “Good faith forbids either party by concealing what he privately knows, to draw the other into a bargain, from his ignorance of that fact, and his believing the contrary.

The implied covenant explains that no party to a contract of insurance should do anything to deprive the other of the benefits of the contract.”

Available as a Hardcover   Available as a paperback  Available as a Kindle Book

The Equitable Remedy of Rescission of Insurance

An Effective Tool to detect, deter and defeat insurance Fraud Hardcover – June 17, 2022

The Equitable Remedy of Rescission

Rescission is an equitable remedy first created in the ecclesiastical courts of Elizabethan England.When the United States was conceived in 1776 the founders were concerned with protecting their rights under British common law.

Common Law is a form of law developed by judges through tribunals and decisions of courts rather than executive branch action and legislative statutes.Following the common law tradition, legal principles were referred to courts of equity to “mitigate the rigor” of the common law.The new United States of America adopted British common law as the law once the U.S. Constitution was adopted in 1789. British common law was only modified by the limitations placed on the central government by the Constitution.The viability and ability to enforce contracts was recognized as essential to commerce. Courts of law, following the British Common Law, were charged with enforcing legitimate contracts and rendering money judgments against the party who breached the contract.It became clear, however, that some contract disputes cannot be resolved with a money judgment. Rather, it needed the assistance of the courts of equity whose judges, in the Elizabethan era were presided over by priests who were believed to be better able to render fair judgments.

A court of equity is a court which can apply equitable remedies to disputes. These courts operate within the legal system, but rather than focusing on the application of law, they look at cases and determine outcomes based on fairness. They can be found in many regions of the world. In modern usage in the United States trial courts are empowered to handle both legal and equitable remedies.
A court of equity can hand down a judgment which includes an equitable remedy such as an injunction, as opposed to simple monetary damages.The judge in a court of equity can weigh many different sides to a case and explore different perspectives to arrive at a judgment.

Available as: A Kindle book A Paperback or a hardcover .

Insurance Fraudsters Deserve No Quarter

A Book That Explains How to Defeat or Deter Insurance Fraud

What every insurer should know about how it can be proactive in the efforts against insurance fraud by refusing to pay every fraudulent claim.

How Giving No Quarter Works

Many years ago a client I represented was offended that an insured tried to defraud him and the people who were names in the syndicate he represented at Lloyd’s, London. I walked the Underwriter through the debris of the house that was burned, showed him some of the remains of the allegedly highly valuable fine arts, and then explained how he was deceived into issuing the policy. I was the attorney for Lloyd’s underwriters for the fine arts and Imperial Casualty for the homeowners policy. Once it became clear to the Underwriter I was given the following instruction:

Available as a paperback here.  Available as a hardcover here. Available as a Kindle Book here.

The Examination Under Oath to Resolve Insurance Claims

The Most Effective Tool Available to Insurers to Defeat Attempts at Insurance Fraud & to Resolve Questionable Claims

The insurance Examination Under Oath (“EUO”) is a condition precedent to indemnity under a first party property insurance policy that allows an insurer to compel an insured to submit to questioning from a representative of the insurer under oath. It is a formal type of interview authorized by an insurance contract. The EUO is taken under the authority provided by the agreement of the insured when he, she or it acquires a policy of insurance, to submit to the requirement of the insurer that the insured appear and give sworn. Failure to appear and testify is considered a breach of a material condition that can cause the insured to lose the right to indemnity.

The EUO is conducted before a notary and a certified shorthand reporter. The reporter is present to give the oath to the person interviewed and record the entire conversation and prepare a transcript, in question and answer format, to be read, reviewed, corrected and signed by the witness under penalty of perjury or by an oath taken before a notary or judge.

The EUO is a tool sparingly used by insurers in the United States. A professional insurer will only require an insured to submit to an EUO when a thorough claims investigation raises questions:

  1. about the application of the coverage to the facts of the loss,

  2. the potentiality that a fraud is being attempted, or

  3. to assist the insured in the obligation to prove to the insurer the cause and amount of loss.

Although seldom used the EUO is an important tool needed by insurers when there is a question of coverage, destruction of evidence needed to prove a compensable loss or the amount of loss or evidence indicating the potential that a fraud is being attempted.

Available as a Kindle book Available as a paperback. Available as a hardcover.

Insurance Fraud – Volume I & Volume II Second Edition

Insurance Fraud Volume I Second Edition: How Lawyers & Claims People Defeat Insurance FraudInsurance 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 attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year. Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored. No one will ever be able to place an exact number on the amount lost to insurance fraud. Everyone who has looked at the issue knows – whether based on their heart, their gut or empirical fact determined from convictions for the crime of insurance fraud – that the number is enormous. 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 drops logarithmically. The effort to stop insurance fraud against Medicare and Medicaid has increased in recent years. Insurance Fraud Volume II Second Edition: A Manual for How Lawyers & Claims People Can Defeat Insurance FraudThis book contains appellate decisions regarding insurance fraud from federal and state appellate courts across the country and full text of many insurance fraud statutes. It is available as both a legal research tool and a product to assist insurers, insurance company personnel, independent insurance adjusters, special investigation unit investigators, state fraud investigators and insurance lawyers to become effective persons involved in the attempt to defeat or reduce the effect of insurance fraud.

Available as a Kindle book; Available as a Hardcover;  Available as a Paperback 

Volume II of Insurance Fraud provides coverage of the issues not covered by Volume I and, together with Volume I becomes a complete manual for how lawyers and claims people can effectively work to deter or defeat insurance fraud.
INSURANCE FRAUD IS EPIDEMIC

Available as a Kindle bookAvailable as a HardcoverAvailable as a Paperback

California SIU Regulations 2020

The State of California Imposes Control on the Investigation of Insurance Fraud Effective October 1, 2020 – New Regulations to Enforce Statutes Requiring Insurers to Maintain a Special Investigative Unit California SIU Regulations 2020 is designed to assist California insurance claims personnel, claims professionals, independent insurance adjusters, special fraud investigators, private investigators who work for the insurance industry, the management in the industry, the attorneys who serve the industry, and all integral anti-fraud personnel working with California admitted insurers who must comply with the requirements of California SIU Claims Regulations that were rewritten and made operative October 1, 2020. 

California SIU Regulations 2020 cam provide the needed training without the additional expense of a training class for one or two persons.California SIU Regulations 2020, and its appendices, will provide the insurer and its staff with the information needed to comply with the SIU Regulations and will provide the training required for what the SIU Regulations describe as an insurer’s “integral anti-fraud personnel.” Available as a Kindle book here.  Available as a paperback here.

“Construction Defects and Insurance Second Edition”

The Second Edition of all Eight Volumes now Available at Amazon.com

Construction Defects and Insurance Second Edition:

Construction Defects and Insurance Volume One Second Edition: The Structure, The Construction Contract, and Construction Defect Insurance. by [Barry Zalma]Volume 1: The Structure, The Construction Contract, and Construction Defect Insurance.

Construction defects have grown into one of the most active areas of litigation in the United States.

This Second Edition of a multi-volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense; both policyholder and insurer), and business owners will benefit greatly from the multiple volumes. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of construction defect law and construction insurance law.

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.

Available as a hard cover, a paperback and as a Kindle Book

Construction Defect and Insurance Volume Two Second Edition”

The Defects and Understanding Construction Defects Insurance and Underwriting

Available as a paperback  and a Kindle book  Available as a hardcover

Construction Defect and Insurance Volume Three Second Edition”

The Commercial General Liability Policy the Construction Defect Policy; CGL Policy Format and Structure; Exclusions to CGL Insurance

This, the third volume of the eight volume multi-volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

Construction Defects and Insurance Volume Four Second Edition

Liability Insurance & Construction Defects

This, the second edition of volume four of the eight volume series is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

Construction Defects and Insurance Volume Five Second Edition

The Tort of Bad Faith and Construction DefectsConstruction Defects and Insurance Volume Five Second Edition: The Tort of Bad Faith and Construction Defects by [Barry Zalma]

This, the fifth volume, of the eight-volume series is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

 

Construction Defects and Insurance Volume Six Second Edition

Construction Defects and Insurance Volume Six Second Edition: Construction Defect Claims and Suits by [Barry Zalma]Construction defects have grown into one of the most active areas of litigation in the United States.

This, the sixth volume of the eight volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

The treatise Construction Defects & Insurance addresses a wide range of topics associated with this escalating and expensive problem.

Construction Defects and Insurance Volume 7 Second Edition

Construction defects have grown into one of the most active areas of litigation in the United States.
Construction Defects and Insurance Volume Seven Second Edition: Tort Defences and the Trial of a Construction Defect Case by [Barry Zalma]This, the seventh volume, of the multi-volume series is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

This, the seventh volume of Construction Defects & Insurance Second Edition, includes materials concerning the tort defenses and the trial of the construction defect suit.

Construction Defects and Insurance Volume 8 Second Edition

Construction defects have grown into one of the most active areas of litigation in the United States.

This, the eighth and last volume, of the multi-volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.

Construction Defects & Insurance addresses a wide range of topics associated with this escalating and expensive problem. As you read through the various volumes and pages, you will find comprehensive insights into t.he construction process.

The Homeowners Insurance Policy Handbook

How To Buy An Appropriate Homeowners Policy And Successfully Make A Claim To The Insurer

Of all insurance acquired in the United States, the most common is the homeowners policy and its sister the tenant’s policy that covers everything a homeowners policy covers but the structure.Homeowners insurance is nothing more than a contract between a person seeking insurance and an insurer who promises to protect the insured against the risks of loss to certain described property or liability to third parties. The insurer can be set up as a stock insurance corporation, a mutual insurance company, an interinsurance exchange or a syndicate of insurers writing through an insurance market place like Lloyd’s, London. The person insured can be an individual, a corporation, a partnership, a limited liability company, a limited liability partnership, a joint venture or any other legal entity.

Available as a Kindle Book here.   Available as a paperback here.

It’s Time to Abolish The Tort of Bad Faith

The concept of unintended consequences is one of the building blocks of economics. Adam Smith’s “invisible hand,” the most famous metaphor in social science, is an example of a positive unintended consequence.

INSURANCE AS A NECESSITY

Neither the courts nor the governmental agencies seem to be aware that in a modern, capitalistic society, insurance is a necessity. No prudent person would take the risk of starting a business, buying a home, or driving a car without insurance. The risk of losing everything would be too great. By using insurance to spread the risk, taking the risk to start a business, buy a home, or drive a car becomes possible. Insurance has existed since a group of Sumerian farmers, more than 5,000 years ago, scratched an agreement on a clay tablet that if one of their number lost his crop to storms, the others would pay part of their earnings to the one damaged. Over the eons, insurance has become more sophisticated, but the deal is essentially the same. An insurer, whether an individual or a corporate entity, takes contributions (premiums) from many and holds the money to pay those few who lose their property from some calamity, like fire. The agreement, a written contract to pay indemnity to another in case a certain problem, calamity, or damage that is fortuitous, that is that occurs by accident, is called insurance. In a modern industrial society, almost everyone is involved in or with the business of insurance.

Fair Claims Settlement Practices laws and regulations are now available to control insurers who do not act in good faith. Insurance fraud statutes and Regulations provide assistance to insurers who have been deceived by those they insure or who are victims of attempted insurance fraud. It is time that all contracts, including insurance contracts, are treated like any other contract, and insureds who believe the insurer breached the contract of insurance can sue to recover the benefits promised by the policy. Available as a paperback here.  Available as a Kindle book here.

California Fair Claims Settlement Practices Regulations 2022 Now Available

Minimum Standards for Adjusting Claims in California

Every Claims Person in California Must Read, Understand, or be Trained About the California Fair Claims Settlement Practices Regulations by September 1 of Each Year

This book was designed to assist insurance personnel who do business in the state of California.

All insurers doing business in California must comply with the requirements of the Regulations or face the ire of, and attempts at financial punishment from, the CDOI. That punishment was found to be questionable and limited because of one courageous insurer who fought the CDOI and succeeded before an administrative law judge who limited the right to punish. That success, as far as I have been able to determine, has not been emulated.

Everyone in the business of insurance whether as an insurance adjuster, insurance claims management, public insurance adjuster, policyholder, defense lawyer, insurance coverage lawyer, and policyholder’s lawyer needs to understand the Regulations.

Available as a Kindle Book.  Available as a Paper Back

 
 

Zalma on Insurance Claims –  Third Edition

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 underpinnings and the practical implications for the claim practitioner.” Insurance Maven Bill Willson said: “’Zalma On Insurance Claims’ is a tour de force, an indispensable tool that should be a part of every claims training program in America and in the library of every claims professional for quick and frequent reference. This comprehensive guide belongs in the library of every insurance defense AND policyholder law firm. It should be a part of every claims training program of carriers, independent adjusting firms, and public adjusters. Many of these parts should be part of the training or reference programs for non-claims personnel, from agents to underwriters to risk managers.”

This series of 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. Thorough, yet practical, this series of books form the ideal guide for any professional who works in or frequently interacts with the insurance industry.

Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from the ten volume guide. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of insurance law. A Comprehensive Review of insurance, insurance claims, the law of insurance policy interpretations, the practicalities of Property, Casualty and Liability Insurance Claims.

Zalma on Insurance Claims Volume 101 – Third Edition

A Comprehensive Review of insurance, insurance claims, the law of insurance and policy interpretation Paperback– May 26, 20211

This volume covers

  1. WHAT IS INSURANCE?
  2. THE HISTORY OF INSURANCE,
  3. ACQUISITION OF THE POLICY,
  4. CLAIMS PERSONNEL,
  5. KINDS OF INSURANCE POLICIES,
  6. Casualty Insurance
  7. THE LIABILITY POLICY.

The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide.

Zalma on Insurance Claims Part 102 – Third Edition

Available as a hardcover Available as a Kindle book  Available as a paperback

Zalma on Insurance Claims Part 103 Third Edition

This, the third part of a 10-volume treatise on insurance claims is the latest addition to Barry Zalma’s insurance claims series of books and articles is part of the most thorough, up-to-date, expert-authored insurance claims guide available today. Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness and blogger, Zalma on Insurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of:

  • Duties Of The Insured And The Insurer
  • Duties Of The Public Adjuster
  • Excellence In Claims Handling
  • Liability Insurance Claims
  • No Tort Remedy For Non-Insurance Claims Bad Faith.
  • Duties And Liabilities Of Insurance Brokers
  • Declaring A Policy Void
  • Rescission
  • Processing A Claim
  • The Public Adjuster
  • Common Mistakes And Omissions To Avoid.
  • The Proof Of Loss
  • California Insurance Code § 2071.
  •  Letter To Insured From Adjuster.
  • Form Letter To Insured Re: Contractor
  • Amendment To The California Insurance Code Re: Public Adjusters
  • Amendment To The California Insurance Code.
  • Form Letter: Advising Of Right To Appraisal
  •  Form Letter: Reservation Of Rights Letter

The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the services of a competent professional person should be sought. Available as a paperback  and Available as a Kindle Book

Zalma on Insurance Claims Part 104 Third Edition

Zalma on Insurance Claims Part 104 Third Edition: A Comprehensive Review of the Law and Practicalities of Property, Casualty and Liability Insurance Claims by [Barry Zalma]This, the fourth volume in the series of ten books that makes up the treatise, Zalma on Insurance Claims. It 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.

As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topicsperback;

Zalma on Insurance Claims Part 105 Third Edition

Zalma on Insurance Claims Part 105 Third Edition
This is the fifth part of a Treatise on Insurance Claims consisting of a series of ten books, of which this is the latest addition to Barry Zalma’s insurance claims Treatise that will form the most thorough, up-to-date, expert-authored insurance claims guide available today.

As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics

Available as a Kindle Book Available as a paperback Available as a hardcover

Zalma on Insurance Claims Part 106 Third Edition

Zalma on Insurance Claims Part 106 Third Edition: Part Six of a Ten Part Treatise on Everything Related to Property and Casualty Insurance Claims by [Barry Zalma]This, the Sixth Part of the Ten Part Treatise, Zalma on Insurance Claims, is the latest addition to Barry Zalma’s insurance claims treatise. It is the sixth part of the most thorough, up-to-date, expert-authored insurance claims guide available today.  Zalma on Insurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of Property insurance claims, Third-party liability claims, Casualty claims, and Insurance Fraud.

The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide.

Available as a Kindle Book or Paperback & Available as a hardcover

Zalma on Insurance Claims Part 107 – Third Edition

This latest addition to Barry Zalma’s ten volume insurance claims treatise and series of books and articles is part of the most thorough, up-to-date, expert-authored insurance claims guides available today.  Zalma on Insurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of Property insurance claims, Third-party liability claims, Casualty claims, Insurance Coverage, Insurance Claims Law and Insurance Fraud.

Available as a paperback or Kindle Book Available as a hard cover

Zalma on Insurance Claims Part 108 – Third Edition

This latest addition to Barry Zalma’s insurance claims series of books and articles is part of the most thorough, up-to-Zalma on Insurance Claims Part 108 Third Edition: A Comprehensive Review of the law and Practicalities of Property, Casualty and Liability Insurance Claims by [Barry Zalma]date, expert-authored insurance claims guide available today, the ten part treatise, Zalma on Insurance Claims.The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide including in this volume: Preparing a Case for Trial, Involvement of the Adjuster in Defense of the Insured.

Available as a paperback  Available as a Kindle book.

Zalma on Insurance Claims Part 109 Third Edition

The Ninth part of the most thorough, up-to-date, expert-authored insurance claims guide available today.Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness, Certified Fraud Examiner and blogger. Available as a paperback, Kindle book or hardcover

Zalma on Insurance Claims Part 110 Third Edition

This, final part of  Barry Zalma’s insurance claims Treatise in a series of ten books that is part of the most thorough, up-to-date, expert-authored insurance claims guide available today.

As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics.

Available as a Kindle bookAvailable as a Paperback; Available as a hardcover

“Zalma’s Mold & Fungi Handbook”

Understanding mold, fungi, and bacteria infestations and what to do about them.

Zalma's Mold & Fungi Handbook: Understanding mold, fungi, and bacteria infestations and what to do about them. by [Barry Zalma]This book is the latest addition to Barry Zalma’s series of books and articles that form the most thorough, up-to-date, expert-authored guides available today about damage to structures and injuries to people by mold, fungi, bacteria or viral infections.

The Mold and Fungi Handbook is the perfect resource for insurance educators, trainers, and students whose role requires an understanding of mold, fungi and bacterial infestations. The author has provided checklists, and information and references to statutes involved with mold, fungi or bacteria. Kindle Edition & Paperback Edition

 

Mold Claims

This series of 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.Mold Claims Volume One: Understanding insurance claims and litigation concerning mold, fungi, and bacteria infestations. Written by nationally-renowned Mold Claims Volume Two: Understanding insurance claims and litigation concerning mold, fungi, and bacteria infestations.insurance coverage expert Barry Zalma, a semi-retired insurance coverage attorney, consultant, expert witness and blogger, Mold Claims provides in-depth explanations, analysis, examples, and detailed discussion of:

Mold, Fungi; Bacteria; Mold; fungi;  Bacteria claims; and Mold, Fungi, Bacteria litigation.

The Compact Book on Adjusting Liability Claims, Third Edition

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 and effective insurance adjuster. It is also available as a refresher for the experienced adjuster.

The liability claims adjuster quickly learns that there is little difficulty with a claimant (the person alleging bodily injury or property damage against a person insured) if the claim is paid as demanded. . Available as a Kindle book Available as a paperback.

The Little Book on Ethics for the American Lawyer

The practice of law demands more than knowledge of statutory and case law. It requires more than technical proficiency in the nuts and bolts of legal practice. A lawyer is an officer of the legal system whose conduct should conform to the requirements of the law, both in professional service to clients and in the lawyer’s business and personal affairs. The practice of law requires that every lawyer treat each client, each adversary, and the court ethically and in good faith. The practice of law is different from other professions because it requires that the lawyer act for his or her client, not him or herself, only if the actions for the client are ethical and in good faith.

There is no single answer to the question of what is ethical behavior by a lawyer. Ethical behavior is subjective and fact dependent.

Available as a Kindle book here. Available as a paperback here.


Fictionalized True Insurance Crime Books

Insurance Fraud Costs Everyone

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.

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 How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime. This book started as a collection of columns I wrote and 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. Since the last edition I have added more stories that were published in my twice monthly newsletter, Zalma’s Insurance Fraud Letter which is available free to anyone who clicks the links. The original title was “Heads I Win, Tails You Lose” and was meant to describe insurance fraud as it works in the Unites States. It means that whenever a person succeeds in perpetrating an insurance fraud everyone who buys insurance is the loser. If the fraud succeeds the insurer must charge more premium to cover the expense of defending the fraud and payment of funds to the fraud perpetrator. If the fraud fails the insurer must charge more premium to cover the expense of defending the fraud. Everyone, except the lawyers, lose. As you read the stories I hope they help you understand the effect that insurance fraud has on the perpetrators, the insurers, the people who need insurance, the people who buy insurance, and the people who keep the promises made by insurance policies. Available as a Kindle Book and Available as a Paperback from Amazon.com.

Candy and Abel: Murder for Insurance MoneyProduct Details

How a young lawyer and wise old investigator defeated an attempt at life insurance fraud. Available as a Kindle Book. Available as a paperback.

Murder And Insurance Fraud Don’t Mix

My name is Marion Orpheus Montague. My friends, and some enemies, call me “MOM.” It is not a designation of my ability to nurture my clients. I have never been, nor will I Product Detailsever be, maternal. I accept the play on my initials because it causes adversaries to underestimate me. I am 66-years-old. My grayish blond hair is thin and my full beard is a bit scraggly. My face is round and often tinged with red. My nose is full, my eyes green and my cheeks bulge out to the sides trying to emulate the belly that precedes every other part of my body as I walk. People see me and do not believe that I am a private investigator. Seeing me they often think that I am on leave from my winter work as a Macy’s Santa Claus. I like being underestimated. It makes my job as an investigator easier. See how a fake robbery at a jewelry store led to murder and prison. Available as a Kindle book. Available as a paperback

Murder & Old Lace: Solving Murders Performed for Insurance Money

Product Details When the women first met – 20 years ago at a Santa Monica health spa – Magogassasanian appeared taken with Gogolivesky. The women moved Alvarado into an apartment, then started applying for life insurance policies on him. They jointly took out four policies, each as 50% beneficiaries in addition to the individual policies they bought from my client. Gogolivesky also took out three more policies on her own while Magogassasanian only took out a single individual policy on Earnest. The two women pocketed nearly $6,000,000 in insurance benefits on Alvarado alone and $4,000,000 in insurance benefits on Earnest. They also recovered a total of $5,000,000 on the other six old men they killed. Available as a Kindle book. Available as a paperback.

Arson for Terrorism and Profit

Arson for Terrorism and Profit: How an Insurance Investigator and Insurance Lawyer Defeated a Plot to use a Fire to Fund Terrorism by [Zalma, Barry]How an Insurance Investigator and Insurance Lawyer Defeated a Plot to use a Fire to Fund Terrorism (c) 2020 by Barry Zalma & ClaimSchool, Inc.

There are many excuses for the inability of the criminal justice system to effectively handle arson cases and eventually, almost universally, the prosecutor will find an excuse not to prosecute an arson case regardless of the amount of evidence produced. As a result, with regard to an arson-for-profit scheme, the time, investigative work, and litigation is left to the insurer to refuse to pay a claim based on fraud, pay the investigators and lawyers needed to prosecute a civil fraud defense to a fraudulent claim created with an arson-for-profit scheme. The following story is based upon an attempted arson-for-profit that took up a large portion of my professional career. Although fiction, the story is based on a true crime that involved the efforts of the intended victims – an English insurer and an American insurer – the work of professional fire cause and origin investigators, private investigators, insurance claims handlers, insurance coverage lawyers and insurers who refused to pay tribute to a criminal. After five years of investigation and litigation the defendants established that the arson-for-profit scheme was designed for more than cash but was intended to obtain funds to support a terrorist organization whose purpose was to kill or maim anyone connected to the government of Germany.The names, places, professions, organizations, fire departments, police, prosecutorial agencies and of the individuals involved have been changed to protect the innocent, criminal, and professional. Available as a Paperback Available as a Kindle book

M.O.M. & The Taipei Fraud

How an Experienced Adjuster Defeated a $7 Million Fake Burglary Claim

The problem is that each option the insurers have available have a down side and Feng is represented by a lawyer who has proved highly successful in suing insurers and collecting large compensatory and punitive damage awards. Since the claims exceed $6 million dollars, he can expect, applying the law set out by the U.S. Supreme Court in State Farm Mut. Automobile Ins. Co. v. Campbell and BMW of North America, Inc. v. Gore as much as $60 million in punitive damages. So I need to explain to the insurers that they face an exposure anywhere from their policy limits to ten times the policy limit. They need the courage of their convictions to reject this major claim. Available as a paperback. Available as a Kindle book.

Arson-For-Profit Fire at the Cowboy Bar & Grill

A true crime novel based on the experience of the author, Barry Zalma, who for more than 51 years has acted for insurers who were faced with arson-for-profit, one of the most dangerous insurance fraud schemes. The book explains how an insurance claims adjuster, working with a fire cause and origin expert, a forensic accountant and insurance coverage lawyer, were able to defeat an arson-for-profit scheme and obtain a judgment requiring the perpetrator to take nothing and repay the insurer all of its expenses in defeating the claim. Available as a paperback. Available as a Kindle book.


New Books from Full Court Press

The Insurance Law Deskbook

9781949884296The Insurance Law Deskbook is intended to help law students, practitioners, insurance lawyers, professional claims personnel, insured persons, and anyone else involved in insurance. The book, published for the first time under Full Court Press, includes the full texts and digests of insurance-related decisions of the U.S. Supreme Court, the U.S. District Courts of Appeal, state appellate courts, and foreign courts that have molded the American insurance law, as well as vital explanatory chapters, historical context, form letters, and more. Paperback, only $95.00 available at https://www.fastcase.com/store/fcp/insurance-law-deskbook-2/

California Insurance Law Deskbook

9781949884289

 
ISBN: 978-1-949884-28-9 (Print) 978-1-949884-30-2(Ebook)
Format: Digital(Epub,Mobi,PDF), Print
California has long led the way when it comes to insurance jurisprudence in the United States, and few know more about California insurance law than Barry Zalma. Available at https://www.fastcase.com/store/fcp/california-insurance-law-deskbook/ a paperback for only $95.00.

Zalma on Property and Casualty Insurance

The earnings of almost every civil lawyer in the United States are funded by the insurance industry. Insurance can best be described as the mother’s milk of the law profession. The civil defense lawyer is paid by an insurer for each hour he or she works. The civil plaintiffs’ lawyer is usually paid by taking a percentage of any judgment entered in favor of the plaintiff, which judgment is usually paid by the defendant’s insurer. In almost every situation in which a civil lawyer practices law the funds for that work come, either directly or indirectly, from insurance. Consequently, lawyers must use their wits and energies to avoid or to pursue litigation to the benefit of the client. Both sides understand that an insurer will eventually pay one or both sides in the dispute. Insurance is important to every civil dispute and even some that fall within the criminal courts. Every lawyer retained to prosecute or defend a civil suit should begin the representation with a serious effort to find insurance coverage for the benefit of the client or the defendant the client is suing. Without that knowledge, the lawyer will find he or she is litigating with duct tape firmly self-placed across his or her mouth.

Insurance Law DeskbookZalma

Learn the insurance basics that are essential to every civil practitioner. Available at Fastcase.com bookstore.

California Insurance Law Deskbook

California has long led the way when it comes to insurance jurisprudence in the United States, and few know more about California insurance law than Barry Cal LawZalma.  Available at Fastcase.com bookstore.

Insurance Bad Faith and Punitive Damages Deskbook

Understand the relationship between insurance, the tort of bad faith, and why punitive damages are awarded to punish insurers. An annual subscription to secondary content on the Fastcase BadFaithplatform includes new editions and updates published by the author as they are rolled out, so you can rest assured that your research is up to date. Go to fastcase.com for more detail and how to use the material on-line as part of your legal or insurance research or as stand-alone e-books. All available at fastcase.com bookstore.

Books from the American Bar Association

“Getting the Whole Truth: Interviewing Techniques for the Lawyer”

by Barry Zalma, Esq., CFE

Learn techniques that can help you interact with others and effectively gather the facts you need.

The purpose of an interview is to uncover the truth; the method of uncovering the truth is the art of the interview. Obtaining sufficient relevant information is imperative in everything a lawyer does to protect the interests of the client, yet interviewing techniques are not emphasized in law school training. Getting the Whole Truth teaches lawyers–from novices meeting their first clients to experienced trial lawyers–effective methods of obtaining information by human interaction. No matter from whom you are seeking information or what your reason for desiring it, these techniques can help you meet and interact with others and effectively gather the facts you need.

$59 NON-MEMBERS, $44 MEMBERS

The Commercial Property Insurance Policy Deskbook

How to Acquire a Commercial Property Policy and Present and Collect a First-Party Property Insurance Claim

By Barry Zalma

The Commercial Property Insurance Policy Deskbook is a comprehensive resource on acquiring a commercial property policy and presenting and collecting first-party property insurance claims. The book looks at the fundamentals of insurance and a wealth of topics including rules of construction of a policy of commercial property insurance, the commercial first party property insurance policy, different types of property losses, conditions and limitations,specific and blanket coverages, mortgage clauses, the need for a prompt notice of claim, the commercial property claim, adjusting the commercial property loss, the sworn statement in proof of loss, the adjustment of the commercial property loss, subrogation and salvage, and common law bad faith.

Also included are five appendixes of forms, letters, and other documents.
Available from the American Bar Association at: http://shop.americanbar.org/eBus/Default.aspx?TabID=251&productId=214624; or  orders@americanbar.org, or 800-285-2221.

The Insurance Fraud Deskbook

Author: Barry Zalma

Sponsor(s):  Tort Trial and Insurance Practice Section, Publisher(s):   ABA Book Publishing

ISBN: 978-1-62722-676-9 Product Code: 5190506 2014, 638 pages, 7 x 10 Product DetailsThis book is written for individuals who are focused on the effort to reduce expensive and pervasive occurrences of insurance fraud. Lawyers who represent insurers, claims personnel, prosecutors and their investigators can all benefit from this exhaustive resource. The Insurance Fraud Deskbook is a valuable resource for those who are engaged in the effort to reduce expensive and pervasive occurrences of insurance fraud. It explains the elements of the crime and the tort to claims personnel, and it provides information for lawyers who represent insurers, so they can adequately advise their clients. Prosecutors and their investigators can use this book to determine what is required to prove the crime and win their case. The full text of decisions from courts of appeal and supreme courts across the country are provided so the reader can understand what happens after the investigation is completed and can apply that information to undertake their own thorough investigations. It allows claims personnel and their lawyers to understand what errors would cause a defeat or a not-guilty verdict. The effort to reduce insurance fraud requires the assistance of both civil and criminal courts. The Insurance Fraud Deskbook can help the prudent fraud investigator, insurance adjuster, insurance attorney, insurance Special Investigation Unit, and insurance company management to attain the information needed to deal with state investigators and prosecutors. Available from the American Bar Association at: http://shop.americanbar.org/eBus/Default.aspx?TabID=251&productId=214624; or  orders@americanbar.org, or 800-285-2221.

Diminution in Value Damages

How to Determine the Proper Measure of Damage to Real and Personal Property

ISBN: 978-1-63425-295-8 Product Code: 5190524 2015, 235 pages, 7 x 10, Paperback

This book was written to provide sufficient information to those who became interested in the issue since the Georgia Supreme Court decided State Farm Mutual Automobile Insurance Co. v. Mabry, 274 Ga. 498, 556 S.E.2d 114 (Ga. 11/28/2001) and includes cases dealing with the use of diminution in value as a method of determining the amount of loss incurred by a plaintiff seeking indemnity for damage to real or personal property. Because confusion has reigned across the United States concerning the proper measure of damages for property damage to property that has been repaired, Diminution In Value Damages assists the reader in answering the questions concerning the proper measure of damage in each of the fifty United States and federal United States jurisdictions This edition has been totally rewritten and expanded, providing the most extensive and detailed coverage of the issue and a thorough explanation of how to apply diminution in value damages to losses to property.


Author:Barry Zalma

“Property Insurance Checklists, 13th Edition” Now Available from Thomson Reuters a New Book From Barry Zalma

Read the full article at https://www.linkedin.com/pulse/new-property-insurance-checklists-13th-edition-barry-zalma-esq-cfe and at https://zalma.com/blog plus more than 3700 posts. Property Investigation Checklists: Uncovering Insurance Fraud 13th Edition provides detailed guidance and practical information on the four primary areas of any investigation of suspicious claims:

  • Recognizing suspicious claims;
  • Proper investigation procedures;
  • Analysis of laws concerning fraudulent personal and real property claims; and
  • Evaluating and settling claim.

The book also examines recent developments in areas such as arson investigation procedures, bad faith, and extracontractual damages. The appendix includes the NAIC Insurance Information and Privacy Protection Model Act, forms useful to investigators, and the full text of how thorough investigation defeated a fraudulent claim and convicted a lawyer to a long term in prison. Available at https://store.legal.thomsonreuters.com/law-products/Forms/Property-Investigation-Checklists-Uncovering-Insurance-Fraud-13th/p/106702361 and as a THOMSON REUTERS PROVIEW eBOOK EDITION https://store.legal.thomsonreuters.com/law-products/Forms/Property-Investigation-Checklists-Uncovering-Insurance-Fraud-13th/p/106702363


“The Passover Seder For Americans”

For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lost the ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah. Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and wonder how did all these wonderful things come into being. Jews believe the force we call G_d created the entire universe and everything in it. Jews feel G_d is all seeing and knowing and although we can’t see Him, He is everywhere and in everyone.We understand that when G_d began to create the world there was nothing and that time, as we know it, had no meaning. G_d created all. Because of the creation we are able to track time and celebrate Passover every year at the same time. We do so based on the lunar calendar used by our ancestors not the Julian calendar modern people use. As a result, Passover se We feel G_d gave people a conscience hoping it would help us decide right from wrong, to do our best to make good choices, to try to help others, not hurt others and to try to make right the wrongs we have done to others. The rituals that make up the Jewish holidays help remind us how thankful we are for how much we have accomplished with G_d ’s help and how grateful we are to G_d for everything we have and everything we are. Thea and Barry Zalma have created this English only Seder that works for our family and will allow you and your families to tell the story of the Exodus painlessly and with the joy and celebration it deserves so that no member of our family forgets what G_d did for us when He took us out of slavery in Egypt and led us to a promised land. Available as a Kindle Book  Available as a Paperback