Category Archives: Zalma on Insurance

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

Zalma’s Insurance Fraud Letter – July 1, 2022

ZIFL Volume 26 Number 13 ZIFL-07-01-2022. See the video explaining what is in the July 1, 2022 issue at https://rumble.com/v1al2t7-zalmas-insurance-fraud-letter-july-1-2022.html?mref=6zof&mrefc=3  and at https://youtu.be/-8orMv2GuSU In the July 1, 2022 issue of Zalma’s Insurance Fraud Letter you will be able to read … Continue reading

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An Umbrella Policy’s UM Cover is not Auto Insurance

Umbrella Insurance is Only Obligated After Underlying Insurance is Exhausted See the full video at https://rumble.com/v1ag99d-an-umbrella-policys-um-cover-is-not-auto-insurance.html?mref=6zof&mrefc=2  and at https://youtu.be/gCXGTPD1_os Anthony DeSmet appealed from the summary judgment granted to  Scottsdale Insurance Company on his claim alleging that Scottsdale had acted in … Continue reading

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Do You Need a Claims Staff Ready to Provide Excellence in Claims Handling?

A Sample of What Will Be Available to Subscribers zalmaoninsurance.locals.com If you, or your staff of insurance claims people, need to understand insurance, insurance law, and how to professionally handle first or third party insurance claims, sign them up for … Continue reading

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An Assignment of Claim Against Insurer After Insured Signed a Release is Worthless

Insured’s Release of Insurer Defeats Claim of Third Party When a CT Scanner was destroyed as a result of two fires at the storage facility claims were presented and suits filed against the warehouse, Blocker Storage. Blocker was insured by … Continue reading

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The Problem With Blindly Changing Insurers

Coverage Gap Created by Inept Changes in Insurers and Policy Wording Often insureds will change insurers to save premium or obtain promised additional coverages. However, switching insurance providers can be tricky and dangerous to the insured. The separate insurance policies-drafted … Continue reading

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The Insured is Presumed to Know What His Policy Insures

Undisclosed Intent Does Not Change the Wording of a Policy Insurance policies are contracts that are interpreted by their plain meaning. An insured is bound by the terms and conditions of the insurance policy. In Progressive Mountain Insurance Company v. … Continue reading

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Intentional Act Exclusion Defeats Claim for Defense & Indemnity

Customer Complaint Coverage Doesn’t Apply to Claim of Consumer Fraud Plaintiff, Owners Insurance Co. (insurer), appealed from the judgment of the circuit court of Du Page County ruling that an intentional-acts exclusion in an insurance policy did not exclude coverage … Continue reading

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Chutzpah: Murder for Insurance Money Life Sentences Affirmed

Killers Try Again to Reduce Sentence & Fail Again INSURANCE FRAUD IS A VIOLENT CRIME When convicted of murder in the first degree and conspiracy to commit murder for life insurance money, the defendants require a great deal of chutzpah … Continue reading

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A Policy Rescinded Never Existed

Monies Paid on a Claim Before Rescission Ordered Must be Returned to the Insurer Liberty Mutual Personal Insurance Company (“Liberty Mutual”) moves for summary judgment on its counterclaim for unjust enrichment and return of funds paid on a policy that … Continue reading

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Insurance Videos to Help Provide Excellence in Claims Handling: Only on Locals.com

Zalma on Insurance & Excellence in Claims Handling Videos Explaining the Excellence in Claims Handling Video Program for Subscribers to Locals.com. Starting on July 1, 2022 the Excellence in Claims handling videos will only be available to subscribers at Locals.com … Continue reading

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The Equitable Remedy of Rescission of Insurance:

An Effective Tool to Detect, Deter and Defeat Insurance Fraud On Today, the Summer Solstice, The Equitable Remedy is Now Available at Amazon.com from Barry Zalma & the Insurance Claims Library Rescission is an equitable remedy first created in the … Continue reading

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Lawyer Admits to Insurance Fraud & Theft from Clients

Convicted of Fraud & Theft Enough for Disbarment On September 7, 2021, the Office of Disciplinary Counsel (ODC) requested this Court place Respondent Richard Alexander Murdaugh on interim suspension based upon information indicating Respondent had stolen funds from the law … Continue reading

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Failure to Ask for Defense Eliminates Coverage Until Insured Asks

No Right to Pre-Tender Defense Costs HDI Global Insurance Company (“HDI”) sought an order eliminating its obligation to pay pre-tender defense costs of its insured.  HDI was sued by plaintiffs, Nucor Steel Louisiana, LLC (“Nucor”) and Dynamic Environmental Services, LLC … Continue reading

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Bad Faith Set-Up Suit Fails

Insured Who Refuses to Allow Insurer to Defend or Indemnify Has No Right Against Insurer It Takes Knowledge & Skill to Set-Up an Insurer for Bad Faith and an Excess Judgment When the district court determined that an insurer’s duty … Continue reading

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Accused of Fraud Failed to Promptly File Dispositive Motion

Provider to PIP Insured not a Party to Contract Plaintiffs Hartford Accident and Indemnity Company, Property & Casualty Ins. Company of Hartford, Trumbull Insurance Company, and Twin City Fire Insurance Company (together, “Hartford”) claim that Defendant Greater Lakes Ambulatory Surgical … Continue reading

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Zalma’s Insurance Fraud Letter – June 15, 2022

ZIFL Volume 26 Issue 12 Zalma’s Insurance Fraud Letter Contains articles on the following subjects in great detail at ZIFL-06-15-2022. The following are some of the articles available with the full 20 pages available at the link. Insurance Fraud & … Continue reading

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Explaining Reasonable Conduct of Insurer

How Courts Deal With Defenses to the Tort of Bad Faith I will not be posting for a week after this but you have available more than 4250 posts and more than 400 videos at rumble.com/zalma. See the full video … Continue reading

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Reporting on an Accusation of Insurance Fraud Results in Defamation Suit

Fair Report Privilege Protects Reports of Insurance Fraud I will not be posting for a week after this but you have available more than 4250 posts and more than 400 videos at rumble.com/zalma. Fox Television Stations, LLC (Fox), William Melugin, … Continue reading

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The Effect of the Tort of Bad Faith on the USA

Living with the Tort of Bad Faith Hurts Both Parties See the full video at https://rumble.com/v17jc3v-the-effect-of-the-tort-of-bad-faith-on-the-usa.html and at https://youtu.be/I-YF0EeL5CU It is indisputable that in the 1950’s, 1960’s and 1970’s the insurance industry abused some insureds to avoid paying legitimate claims. … Continue reading

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A Reefer Trailer is a Vehicle

A Trailer Is Used To Transport, Which Is How Vehicles Are Commonly Defined And Understood and It Is Registered As A Vehicle Kiolbassa Provision Company (“Kiolbassa”) operates a smoked meat business out of San Antonio, Texas, where it keeps its … Continue reading

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Fairly Debatable or Genuine Dispute Defenses to Bad Faith

Defenses to the Tort of Bad Faith See the full video at https://rumble.com/v177ocj-fairly-debatable-or-genuine-dispute-defenses-to-bad-faith.html and at https://youtu.be/1gW3RoO2g4I A bad faith claim should be dismissed on summary judgment if there was a genuine dispute on a reasonable factual dispute or an unsettled … Continue reading

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Denial of Liability is not a Denial of Insurance Coverage

No UM/UIM Coverage if Responsible Party is Insured Why Did the Obvious Go to an Appeal? Juan Brambila appealed an order granting summary judgment in favor of Great West Casualty Company (“Great West”) in Great West’s action for a declaratory … Continue reading

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The Law of Unintended Consequences and The Tort of Bad Faith

Insurance Contract Law See the full video at https://rumble.com/v173p1n-the-law-of-unintended-consequences-and-the-tort-of-bad-faith.html and at https://youtu.be/jRikx108Q3I In a typical contract, one party has a duty to perform (construct a building, deliver goods, convey real estate, pay indemnity) and the other party has a duty … Continue reading

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Unambiguous Contract Must Be Interpreted as Written

Two Insurers Protected the Insured and Resolved the Coverage Dispute Later When two insurers dispute which is obligated to defend and indemnify the insured in a bodily injury suit, they both paid half of the settlement and agreed to resolve … Continue reading

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Bad Faith & Damages

Bad Faith & Damages & The Tort of Bad Faith See the full video at https://rumble.com/v16z3tv-bad-faith-and-damages.html and at https://youtu.be/m3EPAbrNK88 In 1958 the California Supreme Court, with the best of intentions, changed centuries of contract law in Comunale v. Traders & … Continue reading

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Pennsylvania Requires Court to Announce a Convicted Defendant’s Recidivism Risk Reduction Incentive

Convicted of Insurance Fraud Still Entitled to a Legal Sentence Claire A. Risoldi, in a second try appealed from the Judgment of Sentence, entered after remand for resentencing on the restitution portion of her sentence. Risoldi challenged the legality of … Continue reading

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Damages for Breach of an Insurance Policy

Damages for Breach of Contract See the full video at https://youtu.be/e7FSHw-IY0M   and at https://rumble.com/v16ul9c-damages-for-breach-of-an-insurance-policy.html Generally, the purpose of an award of damages for breach of contract is to compensate the injured party and provide the benefits promised by the … Continue reading

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An Occurrence Can Include The Unintended Physical Damage Caused By Intentional Development Activity

Pollution Exclusion is Effective and Does not Make Policy Illusory In Employers Mutual Casualty Company v. Tiger Creek Development, Inc., David Erickson, and Cherry Pease, No. 4:21-CV-65 (CDL), United States District Court, M.D. Georgia, Columbus Division (May 25, 2022) the … Continue reading

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Zalma’s Insurance Fraud Letter – June 1, 2022

ZIFL Volume 26, Number 11 See the full video at https://rumble.com/v16pykr-zalmas-insurance-fraud-letter-june-1-2022.html and at https://youtu.be/JmYBmTXE2IU The full issue in Adobe .pdf format is available here. The following are summaries of some of the articles that can be found in the current … Continue reading

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INSURANCE AS A NECESSITY

HOW THE LAW OF UNINTENDED CONSEQUENCES COSTS THE INSURANCE INDUSTRY See the full video at https://rumble.com/v16br9v-insurance-as-a-necessity.html  and at https://youtu.be/xBvYxc_ooTU Neither the courts nor the governmental agencies seem to be aware that in a modern, capitalistic society, insurance is a necessity. … Continue reading

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ERISA Preempts State Law

Analysis of Claim for Services Requires Review of ERISA Plan Brainbuilders LLC appealed an order dismissing plaintiff’s complaint against defendants IBEW Local Union 456 Welfare Fund (the Plan), Trustees of the IBEW Local Union 456 Welfare Fund (Trustees or Plan … Continue reading

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The Law of Unintended Consequences & Insurance

The Business Of Insurance Is Subject To The Law Of Unintended Consequences As If It Were On Steroids See the full video at  https://rumble.com/v167qyt-the-law-of-unintended-consequences-and-insurance.html and at https://youtu.be/EAbMnWUw2a8 The law of unintended consequences is not statutory. No state or federal government … Continue reading

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No Good Deed Goes Unpunished: Insurance Coverage Cannot be Created by Estoppel

 An Insurer Mistakenly Providing Benefits Does not Bind Insurer After it Discovers Error Dymond Ottey sued Maya Assurance Company for a judgment declaring that the defendant is obligated to provide insurance coverage. Ottey appealed from an order of the Supreme … Continue reading

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True Crime of Insurance Fraud Video Number 81

Professional Insurance Adjusting See the full video at https://rumble.com/v166mcn-true-crime-of-insurance-fraud-video-number-81.html and at https://youtu.be/4f4oeo8oCXk At the turn of the century, insurers, in a search for profit, decimated their professional claims staff. They laid off experienced personnel and replaced them with young, untrained … Continue reading

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Health Insurance Fraud Convict Appeals Again

Go Directly to Jail, Do not Pass Go Again Douglas Moss, a convicted health insurance fraud perpetrator on his way to federal prison sought an in banc review of his trial and unsuccessful appeal that I reported on at https://zalma.com/blog/go-to-jail-go-directly-to-jail-do-not-pass-go/ … Continue reading

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True Crime of Insurance Fraud Video Number 80

What a Great Country! See the full video at https://rumble.com/v15xwbx-true-crime-of-insurance-fraud-video-number-80.html  and at https://youtu.be/NIE7BGGSJUE Wo Ping Chen was trained as a physician in Hong Kong. Until Hong Kong was returned by the United Kingdom to the Peoples Republic of China, he … Continue reading

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Estoppel Cannot Create Insurance Coverage

Lack of Bodily Injury, Personal Injury or Occurrence Bars Coverage Cambridge Mutual Fire Insurance Company (Cambridge) sued seeking a declaratory judgment that it did not owe Defendants Terry Gaca and Janet Waymen (collectively, “Defendants”) a duty to defend an underlying … Continue reading

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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 newly updated and rewritten book was designed … Continue reading

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True Crime of Insurance Fraud Video Number 79

The Sweet Little Old Lady & Fraud Insurance Fraud is an Equal Opportunity Crime See the full video at https://rumble.com/v15t91d-true-crime-of-insurance-fraud-video-number-79.html and at https://youtu.be/pPCiqZAFWo8 The Insured was 82 years old and bored. She was born shortly after the turn of the … Continue reading

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Lawyer Appointed by Insurer had a Duty of Zealous Representation

DEFENSE LAWYER HIRED BY INSURER DOES NOT BIND INSURER Comegys, an independent insurance agency, had an independent contractor relationship with Safeco, a liability insurer-in short, Comegys marketed Safeco insurance policies to the public. Comegys was allegedly negligent in procuring automobile … Continue reading

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