Zalma’s Insurance Fraud Letter – September 1, 2018

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 the application for insurance.

In Joseph Smith v. United States Liability Insurance Company, J-A08019-18, No. 1287 EDA 2017, Superior Court Of Pennsylvania (August 15, 2018) an insured intentionally misrepresented material facts when applying for insurance. His suit against his insurer was lost and Joseph Smith was found by the jury to have acquired the policy by fraud. As a result the trial court ordered the policy void from its inception. Smith appealed from the order, entered in the Court of Common Pleas of Philadelphia County.

When a person intentionally presents false material information in an application for insurance to cause an insurer to agree to insure a person it would not otherwise insure, that person commits fraud. No insurance contract can exist if it is acquired as a result of fraud and that is why the trial court and appellate court concluded that the USLI policy was void from its inception.

  The Current Issue Contains the Following

  • False Answers on Application Equals Fraud
  •  Illumeo Continuing Education
  • Barry Zalma Speaks at Your Request
  • Insurance Fraud in the U.K.
  • Wisdom
  • California Created a Medicaid Program Vulnerability by Reporting Placeholders That
    Did Not Represent Actual Expenditures Supported by Documentation
  • Barry Zalma
  • Good News From the Coalition Against Insurance Fraud
  • Zalma’s Flat Rate Opinions
  • Medicare Improperly Paid Hospitals Millions of Dollars for Intensity-Modulated
    Radiation Therapy Planning Services
    Health Insurance Fraud Convictions
  • Other Insurance Fraud Convictions
  • Books from Barry Zalma
  • Books from the American Bar Association
  • Property Investigation Checklists: Uncovering Insurance
    Fraud, 12th Edition
  • Zalma on Insurance Claims

  THE “ZALMA ON INSURANCE” BLOG 

The most recent posts to the daily blog, Zalma on Insurance, are available at http://zalma.com/blog.

Check in every day for a case summary at http://zalma.com/blog:

Zalma’s Insurance 101

I have completed a video blog called Zalma’s Insurance 101 that consist of 1022 three to four minute videos starting with “What is Insurance” and moving forward to insurance fraud investigations explaining the basics of insurance and insurance claims handling in a painless fashion that can be viewed every morning with the first cup of coffee at  Zalma’s Insurance 101.

If you start at Volume 1 at the bottom of the blog’s first page and view one or two videos a day you will have approximately 12 to 24 hours of training a year until you get to the last video.

© 2018 – Barry Zalma

This article, and all of the blog posts on this site, digest and summarize cases published by courts of the various states and the United States.  The court decisions have been modified from the actual language of the court decisions, were condensed for ease of reading, and convey the opinions of the author regarding each case.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant  specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 50 years in the insurance business. He is available at http://www.zalma.com and zalma@zalma.com.

Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.

Books from Full Court Press

Insurance Law Deskbook: Learn the insurance basics that are essential to every civil practitioner. The 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 or 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.

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 Zalma. The California Insurance Law Deskbook is intended to help law students, practitioners, insurance lawyers, professional claims personnel, insured persons, and anyone else involved in insurance. Similar to Barry Zalma’s general Insurance Law Deskbook, this title focuses on the state where the author has long resided and practiced as an expert in California law. The book, published for the first time under Full Court Press, includes the full texts or digests of insurance-related decisions of the U.S. Supreme Court, the U.S. District Courts of Appeal, and California appellate courts, as well as vital explanatory chapters and historical context.

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. Previously, a person suing an insurance company in the United States could only recover contract damages, but when the tort of bad faith was created by the courts contract law was enormously affected, allowing insureds to sue insurers for both contract and tort damages, including punitive damages. Read a thoughtful analysis of how punitive damages apply in the United States to insurance bad faith suits, and why some states allow judges and juries to award punitive damages against insurers in civil litigation.

Mr. Zalma’s books available as Kindle books or paperbacks at Amazon.com can be reached at http://zalma.com/zalma-books/

Mr. Zalma’s reports can be found on Tumbler at https://www.tumblr.com/search/bzalma  on Facebook at https://www.facebook.com/barry.zalma and you can follow him on Twitter at https://twitter.com/bzalma

Legal Disclaimer:

The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.

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About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.
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