Category Archives: Zalma on Insurance

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

Zalma on Insurance

Free Videos and Blog Postings for the Insurance Professional Videos on YouTube and Zalma on Insurance from Barry Zalma ­­­Over 220 Videos describing important insurance issues from appellate decisions digested and described by Barry Zalma and available to anyone who … Continue reading

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Use of Experts to Resolve Claims

A Video Explaining the Use of Experts to Resolve Claims See the full video at https://rumble.com/vio5xf-use-of-experts-to-resolve-claims.html  and at https://youtu.be/puwHgMHFvA0 When the investigation is complete the adjuster must determine if assistance is needed from liability experts, medical experts, or legal counsel, … Continue reading

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Failure to Issue Summary Judgment Within 90 Days Exonerates Surety Bond

Trial Court’s Lack of Action Made Moot the Issues Raised on Appeal Bankers Insurance Company (the Surety) appealed from trial court orders denying its motion to vacate forfeiture and exonerate bail and denying its subsequent motion to toll time. Because … Continue reading

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Advice of Counsel as a Defense to the Tort of Bad Faith

A Video About the Waiver of the Privilege See the full video at https://rumble.com/vimfzd-advice-of-counsel-as-a-defense-to-the-tort-of-bad-faith.html and at https://youtu.be/o464pGcwcK4 INTENTIONAL WAIVER Insurers frequently turn to outside counsel, or internal claims adjusters who are licensed lawyers, for legal advice regarding their coverage determinations … Continue reading

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Security Officer Must Be an Employee to be An Insured

It is an Issue of Fact that a Security Officer is an Insured of a CGL In Adam O’Shei v. Utica First Insurance Company, 2021 NY Slip Op 03786, 1237 CA 19-02019, Supreme Court Of The State Of New York … Continue reading

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Insurance for Punitive Damages

A Video Explaining Why Insurance for Punitive Damages is Against Public Policy in Most States See the full video at https://rumble.com/viknsj-insurance-for-punitive-damages.html and at https://youtu.be/p2FhazZGFJM Insurers generally argue that they cannot indemnify or insure for punitive damage awards. Insurance carriers typically … Continue reading

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Fairly Debatable Appraisal Award Paid Promptly and in Full Defeats Bad Faith Claim

Insurance Claims Personnel Must Control The Issues To Be Determined By Appraisal And Should Never Leave The Appraisers To Work On A Guess As To What They Were Asked To Determine Appraisal is a means of resolving an amount of … Continue reading

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Zalma’s Insurance Fraud Letter – June 15, 2021

A Video Adapted from ZIFL – 06-15-2021 See the full text of this and the June 1, 2021 issue at https://zalma.com/zalmas-insurance-fraud-letter-2/ See the full video at https://rumble.com/vij029-zalmas-insurance-fraud-letter-june-15-2021.html and at https://youtu.be/gdWNMEgPvgc Quote of the Issue – “Learn from yesterday, live for … Continue reading

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Some Grounds for Finding Bad Faith

A Video Describing Grounds for the Tort of Bad Faith See the full video at https://rumble.com/viecd1-some-grounds-for-finding-bad-faith.html and at https://youtu.be/-8nMKYvZfyY Unexplained Delays in Communication When an insured asks a question of his or her insurer an answer is expected. An insurer … Continue reading

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No Coverage for Injury to a Resident Relative

Residence is Established by Membership to a Group not a Place Markeeta Tennie appealed from a judgment of the trial court granting defendant Louisiana Farm Bureau Mutual Insurance Company’s (Farm Bureau) motion for summary judgment and dismissing her claims against … Continue reading

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Defenses to Intentional Torts

A Video Explaining Various Defenses to Intentional Torts See the full video at https://rumble.com/vicm67-defenses-to-intentional-torts.html?mref=6zof&mrefc=2 and at https://youtu.be/W-fmnrzlnQc Self-Defense and Defense of a Third Party The California Civil Code states: Any necessary force may be used to protect from wrongful injury … Continue reading

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Arson & Fraud by Husband Voids Entire Policy

Wisconsin Supreme Court Concludes that “Innocent Spouse” May Not Recover for Spouse’s Arson and Fraud Ismet Islami asked the Supreme Court to reverse the court of appeals decision affirming grant of summary judgment in favor of Kemper Independence Insurance Company … Continue reading

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Intentional Torts

A Video Explaining Intentional Torts See the full video at https://rumble.com/viatmv-intentional-torts.html and at https://youtu.be/V5x3YCARzKM Negligence, strict liability, absolute liability, and products liability all are “accidental” by definition: the persons being held liable for injury to the plaintiff had no intent … Continue reading

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Issues of Fact Defeat Motions for Summary Judgment

If an Insurer Wants to Defeat Coverage it Should Collect Convincing Evidence Travelers Property Casualty Company (“Travelers”) sued for declaratory relief concerning the defense costs incurred and default judgment obtained against its insured, Bayo Vista Condominium Association (“BVCA”), in a … Continue reading

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Defenses to Accidental Tort Claims

A Video Explaining Defenses to Tort Claims See the full video at https://rumble.com/vi8vj7-defenses-to-accidental-tort-claims.html and at https://youtu.be/HeUZw_Bc0F4 Contributory and Comparative Negligence At one time, a plaintiff who contributed in any amount to his or her own injury recovered nothing. The California … Continue reading

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Evidence Establishing Probability that Insured Set Fire to His Own House Sufficient to Defeat Bad Faith Claim

No Bad Faith if Preponderance of Evidence Exists That Insured Was an Arsonist A fire at the home of Plaintiff Leo Ly caused extensive property damage. Defendant Universal Property and Casualty Insurance Company denied Plaintiff’s claim under his homeowner’s insurance … Continue reading

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Water or Wind Coverage

A Video About Catastrophes and Anti-Concurrent Cause Policy Language See the full video at https://rumble.com/vi6k79-water-or-wind-coverage.html and at https://youtu.be/yjch-OH8iNQ The United States Court of Appeal, Fifth Circuit entered an important decision with regard to water damage and insurance policy coverage for … Continue reading

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Postal Inspector Guilty of Insurance Fraud

After Pleading Guilty Defendant’s  Petition Coram Nobis Fails to Reverse his Conviction Jason Weber pled guilty to a charge of theft of government funds. At the time of the offense, Weber was serving as a postal inspector. The Court sentenced … Continue reading

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An Occurrence Requires Fortuity

A Video Explaining The Need to Prove an Occurrence See the full video at https://rumble.com/vi175t-an-occurrence-requires-fortuity.html and at https://youtu.be/nB8bBGClGYg An “occurrence” is usually defined as accidental loss or damage which results, during the policy period, in bodily injury or property damage. … Continue reading

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Go Directly to Jail – Arson for Profit Fails

Setting a Fire and Presenting a Claim for Items Not Burned is Insurance Fraud & Arson Sherry Lee Lance appealed her convictions for second degree arson, conspiracy to commit second degree arson, and insurance fraud, all stemming from allegations that … Continue reading

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Time to Establish Excellence in Claims Handling

A Proposal to Create a Staff of Claims Professionals See the full video at https://rumble.com/vhzj2z-time-to-establish-excellence-in-claims-handling.html and at https://youtu.be/rYkcNPTQLMY To avoid claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers must maintain a … Continue reading

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Law of the Case Defeats Bad Faith Suit

It Takes a Great Deal of “Chutzpah” to Sue for a Defense After an Appellate Court Declares the Policy Void Yusuf Murad appealed from an order of the Jefferson Circuit Court granting summary judgment in favor of GEICO Indemnity Insurance … Continue reading

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A Video About What is a Moral Hazard?

Recognizing a Moral Hazard in the Underwriting of Insurance See the full video at https://rumble.com/vhxz37-a-video-about-what-is-a-moral-hazard.html?mref=6zof&mrefc=2 and at https://youtu.be/BpVifhr1lXc The moral hazard is the increase in uncertainty caused by personal acts of individuals. These acts may contribute to the probability or … Continue reading

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Homeowners Policy Provides no Coverage for Auto Related Liability Claim

Bad Faith Set Up Fails Because of Genuine Dispute Over Coverage Gregory Woosley, appealed separate summary judgments of the Jefferson Circuit Court. One judgment held that a homeowner’s policy issued by State Auto Property and Casualty Company (“State Auto”) did … Continue reading

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The Rights of an Innocent Co-Insured to Insurance Proceeds When Another Insured Attempted Fraud

A Video Dealing With the So-Called “Innocent” Co-Insured See the full video at https://rumble.com/vhwbrb-the-rights-of-an-innocent-co-insured-to-insurance-proceeds-when-another-ins.html and at https://youtu.be/IEL126xAE2Y When denying a claim for fraud, it is necessary to determine if there are any innocent co-insureds, and if so, whether the innocent … Continue reading

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Declaratory Relief Redundant of Breach of Contract Suit Over Denial of Claim

Breach of Contract Suit Will Resolved Issue of Coverage Some people seem to forget that an insurance policy is nothing more than a contract. When a person sues his or her insurer for refusing to pay a claim a breach … Continue reading

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It is not Fraud When Insurer Pays What it Owed

Jury Verdict Punishing Insurer for Theft by Contractor Hired by Insured Uninforceable MLLCA, Inc. hired a contractor named Frank Walley to repair its gas station after a hail storm. Walley stole several thousand dollars of the insurance proceeds meant for … Continue reading

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Zalma’s Insurance Fraud Letter – June 1, 2021

A Video from ZIFL – June 1, 2021 See the full video at https://rumble.com/vhuwsl-zalmas-insurance-fraud-letter-june-1-2021.html  and at https://youtu.be/mUArAK8OV0w and at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-june-1-2021-barry-zalma-esq-cfe/?trackingId=asLLIAVVxLY8845r5HEvHA%3D%3D Volume 25, Issue 11 – June 1, 2021, A ClaimSchool™ Publication © 2021, Barry Zalma & ClaimSchool, Inc., Go to … Continue reading

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The Elements of Fraud

A Video Explaining Insurance Fraud and How to Defeat It See the full video at https://rumble.com/vhqmn7-the-elements-of-fraud.html?mref=6ozih&mrefc=2 and at https://youtu.be/EZns8mheX6o To prove civil fraud it is the obligation of an insurer to present admissible evidence that establishes the requirements of the … Continue reading

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Notice-Prejudice Rule Does not Exist in Georgia

Lex Loci Contractus Applied by Eleventh Circuit In Mt. Hawley Insurance Company v. East Perimeter Pointe Apartments, Miranda Wilder, Constance Irions, Adrian Johnson, Lexington Insurance Company, Ventron Management, LLC, No. 19-13824, the United States Court Of Appeals For The Eleventh … Continue reading

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Contract of Personal Indemnity & Insurable Interest

A Video Explaining Personal Indemnity and Insurable Interest See the full video at  https://rumble.com/vhp1rz-contract-of-personal-indemnity-and-insurable-interest.html and at https://youtu.be/oEU2g6pbH8c First party property insurance is a contract of personal indemnity. The insurer promises to indemnify the first party, the insured, in the event … Continue reading

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Washington State Immunizes Insurer from Bad Faith Claim if Insured Arrested

Arson Arrest Relied Upon by Insurer is Immunized from Suit by Arsonist In Mary Frances Beck v. Metropolitan Property & Casualty Insurance Company, an insurance company and foreign corporation, Case No. C21-5108 BHS, United States District Court Western District Of … Continue reading

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Casualty Insurance

A Video Explaining Casualty Insurance See the full video at https://rumble.com/vhnb6b-casualty-insurance.html  and at https://youtu.be/163StcCVBLs “Casualty insurance” is defined as an “agreement to indemnify against loss resulting from a broad group of causes such as legal liability, theft, accident, property damage, … Continue reading

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The Law of Unintended Consequences Strikes Again to Help Set Up a Bad Faith Case

Statute to Protect Against Bad Faith Offers Created an Opposite Result In White v. Cheek, A21A0212, Court of Appeals of Georgia (May 21, 2021) a personal injury action arising from an automobile accident involving Stephan Duwayne White and Walter Cheek. … Continue reading

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Just Published – Zalma on Insurance Part 101 – Third Edition

Available from Amazon.com as a Kindle Book, Paperback and Hardcover I have updated, edited to make it easier to read, the Third Edition of first book in my ten part treatise, Zalma on Insurance Claims. Hardcover: Paperback: Kindle book Introduction … Continue reading

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The Unethical Insured

A Video Explaining Ethics and the Covenant of Good Faith & Fair Dealing See the full video at https://rumble.com/vhlk7z-the-unethical-insured.html?mref=6zof&mrefc=2  and at https://youtu.be/1RG7vMKgsCM On rare occasions, an insured will act unethically in his, her or its relations with an insurer. When … Continue reading

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No Bull – Coverage Limited to Described Locations

Certificate of Insurance Provides no Coverage Actual Policy Wording Controls Plaintiffs appealed from the granting of United States Fire Insurance Company’s (USFIC’s) motion for summary judgment refusing to defend or indemnify the insureds to a claim of bodily injury due … Continue reading

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New Free Videos From Barry Zalma, Esq., CFE

Free Insurance Videos Barry Zalma, Esq., CFE has published five days a week videos on insurance claims, insurance claims law, insurance fraud and insurance coverage matters at https://rumble.com/c/c-262921    © 2021 – Barry Zalma Barry Zalma, Esq., CFE, now limits … Continue reading

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Appraisal of a Homeowners Policy Claim

A Video Explaining Appraisal in a Homeowners Claim See the full video at https://rumble.com/vhjmap-appraisal-of-a-homeowners-policy-claim.html and at https://youtu.be/Tll_elfyRAY. Almost all homeowners policies contain an “appraisal” clause similar to that in the Standard Fire Insurance Policy. Appraisal should be used as a … Continue reading

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Insurers do not have Carte Blanche To Take Forever Resolving Their Own Coverage Obligations

Still Adjusting is Not Grounds to Dismiss Lawsuit Three insurers moved to dismiss the suit brought by their insureds because, they say, they are still “adjusting” the claim. In the alternative, they sought a stay of the litigation pending the … Continue reading

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