Category Archives: Zalma on Insurance

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

Liar, Liar, Pants on Fire

Insurance Fraud Required to Survive The following is a fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. Post 4739 See the full … Continue reading

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Insurance Fraud is a Violent Crime

A Murderer Guilty of Killing for Insurance Money Must Serve the Full Sentence 60 Year Sentence Post 4738 See the full video at  https://rumble.com/v4ecyr5-insurance-fraud-is-a-violent-crime.html and at https://youtu.be/Bimzmn7IVb8 CHUTZPAH: DEFENDANT KILLS GIRLFRIEND AND TRIES TO COLLECT LIFE INSURANCE Ronald Epps, a … Continue reading

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Bloods Gang Member Guilty of RICO to Defraud Insurers

Gangs Took Over Fire Reconstruction Industry in New York See the full video at https://rumble.com/v4dsnef-bloods-gang-member-guilty-of-rico-to-defraud-insurers.html  and at https://youtu.be/APS-gKatDpE Post 4736 Insurance Fraud is a Violent Crime and is Everywhere Jatiek Smith (also known as “Tiek”) a member of the Bloods … Continue reading

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Why to Never Take an Assignment of Claim Against Insurer

Burning Limits Policy Defeats Attempt to Collect $60,000,000 Verdict Post 4735 See the full video at https://rumble.com/v4dkqr9-why-to-never-take-an-assignment-of-claim-against-insurer.html and at https://youtu.be/nIsplGAO1LM Unless There is Coverage or Evidence of Bad Faith Assignment Useless FACTUAL BACKGROUND In Kevin Julmist, et al v. Prime … Continue reading

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Zalma’s Insurance Fraud Letter – February 15, 2024

ZIFL Volume 28, Issue 4 Post 4735 See the full video at  https://rumble.com/v4de1di-zalmas-insurance-fraud-letter-february-15-2024.html  and at https://youtu.be/APCrcm2M9xw The Source for the Insurance Fraud Professional Subscribe here: Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved … Continue reading

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Insurance Fraud Attempt Defeated

The Hawaiian The following is a fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. Post 4734 See the full video at  https://rumble.com/v4d6bkh-insurance-fraud-attempt-defeated.html … Continue reading

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Agent’s Statement Binds Insurer

It is not Bad Faith Only to Deny a Claim Post 4734 See the full video at https://rumble.com/v4cz4cc-agents-statement-binds-insurer.html  and at https://youtu.be/FLwTo0vAjDE The California Court of Appeals dealt with a claim by Wynzell Lynn, Jr. in a breach of insurance contract … Continue reading

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No Duty to Defend No Possible Duty to Indemnify

Legal Conclusions are Not Allegations of Fact See the full video at https://rumble.com/v4ct78x-no-duty-to-defend-no-possible-duty-to-indemnify.html  and at https://youtu.be/Gkc6TQmMVZc Post 4734 Zox LLC (“Zox”) appealed the district court’s grant of summary judgment in favor of West American Insurance Company. The district court held … Continue reading

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Arson and Restitution

Convicted Arsonist Must Pay Restitution Post 4731 See the full video at https://rumble.com/v4bz7jx-httpsyoutu.besu9qwq568du.html  and at https://youtu.be/su9qwq568dU A fire at a residential property destroyed several structures and made nearly all of the owner’s personal property unsalvageable. M.W. pleaded guilty to first … Continue reading

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Ambiguous Exclusion Unenforceable

Unrepaid, Unrecoverable, or Outstanding Credit Exclusion Unenforceable Post 4731 See the full video at https://rumble.com/v4bywi9-ambiguous-exclusion-unenforceable.html  and at https://youtu.be/H26hZ10akmE Huntington National Bank (“Huntington”) sued AIG Specialty Insurance Company and National Union Fire Insurance Company of Pittsburgh, Pennsylvania (together, “AIG”) alleging breach … Continue reading

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Do the Crime, Serve the Time

Chutzpah: After Pleading Guilty Fraudster Tried to Reduce his Sentence by an Appeal See the full video at https://rumble.com/v4bkm60-do-the-crime-serve-the-time.html  and at https://youtu.be/hrfjwKNeGrI Post 4730 After pleading guilty, Armando Valdes appealed his 60-month sentence for health care fraud, in violation of … Continue reading

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Serious Injury Does Not Change Policy Wording

UIM Policy Reduced Limit Reduced by Amount Paid by Other Insurers Post 4729 See the full video at  https://rumble.com/v4bjaof-serious-injury-does-not-change-policy-wording.html and at https://youtu.be/j1fh2FIpfdo In an interpleader action involving the insurance coverage for survivors of a tragic auto accident De Smet Insurance … Continue reading

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Appraisal Pointless if Coverage Not Provided

If Policy Says Building Coverage is “Not Provided” There Can be no Claim Post 4728 See the full video at https://www.youtube.com/watch?v=8AXdDrS5NfU at https://rumble.com/v4axay6-appraisal-pointless-if-coverage-not-provided.html Plaintiff Kota Me Patates LLC (“KMP”) filed a motion to compel appraisal to abate an insurance coverage … Continue reading

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A Incomplete Aircraft is Still an Aircraft

Injured by an Aircraft Fuselage Arose Out of Ownership of Aircraft See the full video at https://rumble.com/v4aq632-a-incomplete-aircraft-is-still-an-aircraft.html  and at https://youtu.be/DRTMwAsXbcU Post 4727 A woman was severely injured while moving an inoperable airplane. She now seeks to recover from her husband’s … Continue reading

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Zalma’s Insurance Fraud Letter February 1, 2024

ZIFL Volume 28 Issue 3 Post 4726 See the full video at https://rumble.com/v4aircl-zalmas-insurance-fraud-letter-february-1-2024.html   and at https://youtu.be/cOhwnmCvuxY Subscribe here: Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. … Continue reading

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Punitive Damages

How to Put Fear of Insolvency Into a Defendant Post 4725 See the full video at https://rumble.com/v4aaf7k-punitive-damages.html  and at https://youtu.be/QeGvDvfn_p8 For more than fifty six years working in and about the insurance industry I have personally seen the fear in … Continue reading

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Liability Insurance & the Need for Fortuity

Liability Insurance & the Need for Fortuity Post 4724 See the full video at https://rumble.com/v4a2ie8-liability-insurance-and-the-need-for-fortuity.html  and at https://youtu.be/7P2LjIWo5F8 Liability insurance requires that the loss or damage that needs defense or indemnity from an insurer, must be contingent or unknown at … Continue reading

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Property Investigation Checklists – 14th Edition

Uncovering Insurance Fraud Available here See the full video at https://rumble.com/v49o2po-property-investigation-checklists-14th-edition.html  and at https://youtu.be/xWvhvIQxvDs Publisher: Clark Boardman Callaghan, Copyright: 2024 Property Investigation Checklists: Uncovering Insurance Fraud, 14th Edition provides detailed guidance and practical information on the four primary areas of any … Continue reading

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First Party Property Losses

What is Required of a Claims Department After a Claim is Presented When Faced With Loss Report Post 4722 See the full video at https://rumble.com/v49w8g3-first-party-property-losses.html  and at https://youtu.be/fckgq5VNoAc Every claim begins with receipt of the Notice Of Loss A Notice … Continue reading

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FAKE APPLICATIONS COSTS AGENT HIS LICENSE

Fraudulently Submitting Fake Application Violates Licensing Statutes Post 4721 See the full video at https://rumble.com/v497zy3-fake-applications-costs-agent-his-license.html  and at https://youtu.be/F8r9EGSoNHk Paul B. Kumar appealed a final agency decision of Commissioner of the Department of Banking and Insurance (Commissioner or Department) revoking his insurance … Continue reading

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Infestation of Vultures Excluded

Reasonable Basis for Denying Coverage Defeats Bad Faith Claim Post 4720 See the full video at https://rumble.com/v490ax5-infestation-of-vultures-excluded.html?mref=22lbp&mrefc=2  and at https://youtu.be/FhwvgPTiQn8 Mitchellville Plaza Bar LP (“Mitchellville”) appealed the district court’s granting summary judgment to Hanover American Insurance Company on Mitchellville’s breach … Continue reading

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False Statement on Application Requires Rescission

Never Sign an Application Without Reading It Post 4719 See the full video at https://rumble.com/v48s8di-false-statement-on-application-requires-rescission.html and at https://youtu.be/Cl_4fSIj1vQ Betty Baldwin appealed from a summary judgment in favor of Kentucky National Insurance Agency (KNIC) and Holton, Melugin, and Haverstock Insurance Agency, … Continue reading

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Court May Not Rewrite Policy

Insured Must Fulfill Policy Conditions Post 4718 See the full video at https://rumble.com/v48ken9-court-may-not-rewrite-policy.html and at https://youtu.be/FgAtPWARwPA Pharmacia Corporation appealed the District Court’s order granting summary judgment declaring that one of its excess insurers, Twin City Fire Insurance Company, did not … Continue reading

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Who’s on First – Defense and/or Indemnity

Insurer v. Insurer Disputes Should be Resolved by Mediation Rather Than Litigation Post 4717 See the full video at https://rumble.com/v4801wq-whos-on-first-defense-andor-indemnity.html  and at https://youtu.be/_BTsDxR5J4Y In an insurance coverage dispute that arose out of the tragic death of an employee on a … Continue reading

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TOO FUNNY NOT TO PASS ON!!

How Do Court Reporters Keep Straight Faces? The following comments are from a book called Disorder in the Courts and are things people actually said in court, word for word, taken down and published by court reporters that had been … Continue reading

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Diminution of Value Excluded

Public Policy Argument Fails for Lack of Evidence of Statute or Judicial Statement Post 4716 See the full video at https://rumble.com/v47rz2q-httpsyoutu.besrufrkzia90.html and at https://youtu.be/SRufrkZIa90 Following a car accident, Kenan Watkins (“Watkins”) filed a diminished value claim with his insurer, Allstate … Continue reading

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You Only Get What You Pay For

To Obtain Coverage Insured Must Pay a Premium See the full video at https://rumble.com/v47r513-you-only-get-what-you-pay-for.html  and at https://youtu.be/nNZN6sg8Tbw Erie Insurance Exchange (Erie Insurance) claims that the trial court erred in granting partial summary judgment in favor of Icon, d/b/a Allure on … Continue reading

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The Baseball Card Scam

Insurance Fraud Costs Everyone Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story that follows are designed to help everyone Understand … Continue reading

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Zalma’s Insurance Fraud Letter – January 15, 2024

ZIFL Volume 28, Issue 2 See the full video here https://rumble.com/v475g46-zalmas-insurance-fraud-letter-january-15-2024.html and here https://youtu.be/xs4PPJ3NPDg Subscribe here: Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is … Continue reading

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Loss of Inventory by Bankruptcy

Bankruptcy of Storage Facility Created a Compensable Loss Post 4711 See the full video at https://rumble.com/v46nn1r-loss-of-inventory-by-bankruptcy.html and at https://youtu.be/i3novf2CLZA Plaintiffs insurers sought a declaration that there is no coverage for the insurance claim made under the policy for the loss … Continue reading

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Join My Substack So You Can Get the Full Articles

  Subscribe to my Substack, Excellence in Claims Hnadling, here. Exclusions Relating to Proof of Loss An exclusion is a provision of an insurance policy referring to hazards, perils, circumstances, or property not covered by the policy. Exclusions are usually … Continue reading

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ALLSTATE TAKES A BITE OUT OF CRIME

Another Proactive Insurer Works to Take the Profit Out of Insurance Fraud Post 4709 See the full video at https://rumble.com/v46fyt8-allstate-takes-a-bite-out-of-crime.html and at https://youtu.be/AMcxMaSN2mg In Allstate Insurance Company, Allstate Indemnity Company, Allstate Fire & Casualty Insurance Company, and Allstate Property & … Continue reading

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Murder Pays

LIFE INSURANCE FRAUD FOR FUN & PROFIT This following is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is … Continue reading

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No Coverage for Benefits no Right to Bad Faith Damages

CONCURRENT CAUSE REQUIRES SEGREGATION OF COVERED FROM NON COVERED LOSSES Post 4707 See the full video at https://rumble.com/v4614d9-no-coverage-for-benefits-no-right-to-bad-faith-damages.html and at https://youtu.be/_1OWgl_l3P8 Landmark Partners, Inc. (Landmark) sued Western World Insurance (Insurance) after it denied Landmark’s claim under an insurance policy. Landmark … Continue reading

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Oregon Allows Emotional Distress Damages for Poor Claims Handling

Violation of Statute Allows Suit for Negligent Failure to Resolve Insurance Claim Post 4706 See the full video at https://rumble.com/v45wcqx-oregon-allows-emotional-distress-damages-for-poor-claims-handling.html  and at https://youtu.be/WW9Ij4oK0rQ Christine Moody, individually, and in her capacity as the Personal Representative of the Estate of Steven “Troy” … Continue reading

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Equity Requires Fairness

Equitable Indemnity Only Available to One Without Fault Post 4705 See the full video at https://rumble.com/v45tgrx-equitable-indemnity-only-available-to-one-without-fault.html and at https://youtu.be/Pm94OcqWFoU In Martha M. Fountain and Curtis Fountain v. Fred’s, Inc. and Wildevco, LLC v. Tippins-Polk Construction, Inc. and Rhoad’s Excavating Services, … Continue reading

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Coinsurance

An Important Condition of Every Commercial Property Insurer (c) 2024 Barry Zalma https://barryzalma.substack.com/publish/post/%%checkout_url%% An Important Condition of Commercial Property Insurance Policies Coinsurance is often misunderstood in first party property insurance. It is a clause that causes frequent dissatisfaction with insureds … Continue reading

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GEICO takes a Bite Out of Fraud

No Fault Insurance is a Formula For Insurance Fraud Post 4703 See the full video at https://rumble.com/v454eso-geico-takes-a-bite-out-of-fraud.html and at https://youtu.be/ZDK0rlrlnPQ GEICO, as a pro-active victim of insurance fraud, sued Jean-Pierre Barakat, M.D., et al, alleging that Defendants defrauded GEICO in … Continue reading

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No Right to Indemnity After Policy Limit Exhausted

Insurer has no Obligation to Pay More than an Aggregate Limit of Liability Post 4702 See the full video at  https://rumble.com/v44waj2-no-right-to-indemnity-after-policy-limit-exhausted.html and at https://youtu.be/Pl-tuUjAG28 Denis Mucha sustained injuries after he was assaulted by employees at defendant MDF 92 River Street, … Continue reading

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Failure to Reside at Dwelling Eliminates Coverage

FOR COVERAGE TO EXIST ON A HOMEOWNERS POLICY THE INSURED MUST RESIDE AT THE RESIDENCE Post 4700 See the full video at https://rumble.com/v44dtzi-failure-to-reside-at-dwelling-eliminates-coverage.html  and at https://youtu.be/lvFALpBzRoQ The USDC was asked to grant dueling motions for summary judgment: (1) Motion for Summary … Continue reading

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