Author Archives: Barry Zalma

When is a lie on an Application Potentially Truthful? Insurance contracts are based upon an application – a request for an offer of insurance – from the potential insured. The facts stated in the application must be absolutely true and … Continue reading →

Insurance Fraud Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number because most attempts at insurance fraud succeed. We can only make educated guesses about the … Continue reading →

Short, Simple and Direct Decision from the USDC When an insurer believes it has no coverage for a loss presented it may seek relief from a United States District Court and ask for a decision interpreting the policy. In Commerce … Continue reading →

First Party Property Insurance Insures Against the Risk of Loss of Property Insurance policies are contracts between an insurer and an insured that are designed to provide indemnity from the insurer to the insured. The language of insurance contracts are … Continue reading →

Texas Finds a Chink in the Eight Corners Rule The eight-corners rule of insurance contract interpretation about duty to defend directs Texas courts to determine a liability insurer’s duty to defend its insured based on: the pleadings against the insured … Continue reading →

Reinsurance Attaches only after Reinsured Expends Underlying Limit Where the losses in question did not exceed the limits stated for bodily injury in the Schedules, the reinsurer, Fireman’s Fund, claimed it had no obligation under the reinsurance contracts to pay … Continue reading →

The Supreme Court of the U.S. Found a Lie at EUO was Fraud Even if the Insured Did not Intend to Defraud the Insurer A false answer as to any matter of fact material to the inquiry, would be fraudulent. … Continue reading →

Sexual Assault Is Not An “Occurrence” Because The Consequent Harm Is Always Intended By The Insured A state court action asserted nine causes against various defendants including Lewis Croft, all based on Croft’s sexual abuse of his granddaughters from 1994 … Continue reading →

Insurers Can Void a Policy if the Insured Lies About a Material Fact See the full Video Here In almost every policy of insurance, there is a clause declaring the policy void if the insured misrepresents or conceals material facts … Continue reading →

Everything Needed by the Insurance Claims Professional from Barry Zalma Over the last 52 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 … Continue reading →

ZALMA’S INSURANCE FRAUD LETTER – May 1, 2020 Read the full text of the May 1, 2020 ZIFL at https://lnkd.in/g9wwKHd I’m Not a Carjacker – I was Only Helping an Insurance Fraud Positing one of the most ridiculous defenses and ground … Continue reading →

Video Explaining Convictions for Health Insurance Fraud ADAPTED FROM ZALMA’S INSURANCE FRAUD LETTER Volume 24, Issue 9 – May 1, 2020, Subscribe to e-mail Version of ZIFL, it’s Free!  Read last two issues of ZIFL here. Go to the Barry Zalma, … Continue reading →

Estate of Murderer Gets Defense for Injuries to Visitor who Arrived During Murder Suicide Attempt When Mr. Carley interrupted McCuctcheon’s murder of his ex-wife he was assaulted and shot in the face by McCutcheon. Carley alleged the shooting was negligent … Continue reading →

Insurance Claims Library Insurance Claims Regulations and Insurance Ethics Over the last 52 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 … Continue reading →

How to be a Professional Claims Handler See the full video at https://youtu.be/1nVg3ZqtDpA To avoid claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers must maintain a claims staff dedicated to excellence … Continue reading →

Failure to Pay Premium Causes Life Insurance Policy to Expire A key condition of every insurance policy is the payment of premium when due. When the insured of a life insurance policy failed to pay the premium his policy lapsed … Continue reading →

Property and Liability Insurance Claims Adjusting Over the last 52 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 … Continue reading →

Marine Insurers Invented The Warranty In An Insurance Policy The video is available at Zalma on Insurance on YouTube at https://youtu.be/Vjb1PKEs3K8 Marine insurers invented the warranty in an insurance policy. So, it is fitting that a boat was involved in … Continue reading →

Appraisal Inappropriate When Coverage Issues Must Be Resolved Plaintiff Kathy Cox sued Defendant State Farm Fire and Casualty Company (“State Farm”) for breach of contract, appraisal, and statutory interest. Plaintiff alleges Defendant failed to pay her the full value of … Continue reading →

Bad Faith & Insurance Fraud The Law of Unintended Consequences and 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, … Continue reading →

Insurance Conditions Precedent Video available at https://youtu.be/I1ByB3cE34E.  When used in contract law, the word condition refers to an event, the occurrence or non-concurrence of which alters the previously existing relations of the parties by creating or extinguishing a legal duty. … Continue reading →

No Viable Excuse for Convicted Green Card Holder not to be Deported After a conviction for insurance fraud, among other things, Omar Osman Mohamed (“Mohamed”) brought a petition for a writ of error coram nobis to the USDC in New … Continue reading →

Everything Needed by the Insurance Claims Professional from Barry Zalma Over the last 52 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 … Continue reading →

Private Limitation of Action Provision is Enforceable The video is available at https://youtu.be/RvFP2j0Jpp4 Frankie and Michael Cabral sued for breach of contract, insurance bad faith, conversion, and negligence after defendant Public Storage disposed of personal belongings that plaintiffs had placed … Continue reading →

No Action Available Against Surplus Line Broker for Breach of Contract or Bad Faith After her house burned to the ground and her insurer rescinded the policy Suzan E. Taylor sued the insurer and the surplus line broker who obtained … Continue reading →

Zalma on Insurance Podcast Now Available Available at PocketCasts: https://pca.st/ujampbxm; RadioPublic: https://radiopublic.com/zalma-on-insurance-Wel2lZ; Google Podcasts app. You’ll be able to find it at this link, and Breaker: https://www.breaker.audio/zalma-on-insurance Surplus Line Broker Not an Insurer After her house burned to the ground … Continue reading →

Zalma on Insurance Claims Second Edition Ten Volumes Comprising A Comprehensive Group of Materials on Property & Casualty Insurance Claims Over the last 52 years Barry Zalma has dedicated his life to insurance, insurance claims and the need to defeat … Continue reading →

The Tale of the Incompetent Arsonist A video from Barry Zalma available at https://youtu.be/ebGEkaL3euc Most people do not understand how hard it is to set fire to a house that destroys the entire dwelling and its contents. Most residences simply … Continue reading →

Forced Placed Insurance and Direct Insurance Both Validly Insured the Same Risk When a lender was listed as a mortgagee on a policy and, because it mistakenly believed that policy had been cancelled, protected its interest by initiated forced placed … Continue reading →

Books for the Insurance Claims Professional Read about the following and other insurance books by Barry Zalma at the Insurance Claims Library at https://zalma.com/blog/insurance-claims-library/ The Insurance Examination Under Oath Second Edition A Tool Available to Insurers to Thoroughly Investigate Claims … Continue reading →

Don’t Take “The Fifth” When Your Insurer Asks For An Examination Under Oath If an insured refuses to appear for an examination under oath because he or she might incriminate him or her self, may find the Fifth Amendment doesn’t … Continue reading →

Thievery by Controller Effectively Excluded by E & O Policy Errors and Omissions insurance is designed to protect an insured against liability due to errors and omissions by the insured. It does not, however, cover every potential error or omission … Continue reading →

The History of Insurance I have started a new podcast called Zalma on Insurance. It is presently available at  https://anchor.fm/barry-zalma Please subscribe if you are interested.

A Video Explanation of the Basic Homeowners Policy The video explaining the homeowners policy is now available at https://youtu.be/ua9mKf1QJHM The Homeowners 3 – Special Form A type of Homeowners 3 – Special Form for the American Association of Insurance Services, … Continue reading →

No Duty to Defend or Indemnify After Cancellation When a bar loses its liquor license and fails to pay the premium on its insurance policy there should be little doubt that the insurer will cancel the policy for non-payment of … Continue reading →

Construction Defect Negotiation Negotiation is an art that is impossible to teach. It is not the same as haggling at a bazaar over the value of a brass pot. It is an art by which one person convinces another that … Continue reading →

Robber Failed in Attempt to Turn Victim into Insurance Fraudster Criminals are, by definition, unreliable and dishonest. In an attempt to obtain a new trial a convicted armed robber tried to convince the Wisconsin Court of Appeal that the victim … Continue reading →

No Duty to Defend if no Bodily Injury, Property Damage or Personal Injury Alleged When a plaintiff asks as their own attorneys they tend to have stupid clients and inadequate people pretending to act as a lawyer. Pro se plaintiffs … Continue reading →

Insurer Entitled to Damages for Fraud From Broker Insurance brokers and agents often find themselves in trouble because of the rescission statutes. In Century Surety Co. v. Crosby Insurance, Inc., 124 Cal.App.4th 116, 21 Cal.Rptr.3d 115 (Cal.App. Dist.4 11/17/2004) an … Continue reading →

What is an Insurable Interest? Every first party policy of insurance requires that the insured have an insurable interest in the property that is the subject of the policy of insurance. See the video at https://youtu.be/6Vz0O6S0kGY When multiple interests in … Continue reading →