Everything Needed by the Insurance Claims Professional from Barry Zalma
Insurance Fraud – Volume I & Volume II Second Edition
Insurance fraud continually takes more money each year than it did the last from the insurance buying public. No one knows the actual amount with any certainty because most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year. Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored. No one will ever be able to place an exact number on the amount lost to insurance fraud. Everyone who has looked at the issue knows – whether based on their heart, their gut or empirical fact determined from convictions for the crime of insurance fraud – that the number is enormous. When insurers and governments put on a serious effort to reduce the amount of insurance fraud the number of claims presented to insurers and the pseudo-government-based or funded insurers drops logarithmically. The effort to stop insurance fraud against Medicare and Medicaid has increased in recent years.
This book contains appellate decisions regarding insurance fraud from federal and state appellate courts across the country and full text of many insurance fraud statutes. It is available as both a legal research tool and a product to assist insurers, insurance company personnel, independent insurance adjusters, special investigation unit investigators, state fraud investigators and insurance lawyers to become effective persons involved in the attempt to defeat or reduce the effect of insurance fraud.
Volume I of Insurance Fraud includes the following:
- Insurance Fraud is Epidemic.
- Measuring Insurance Fraud
- What is Insurance Fraud?
- Arson for profit.
- Soft Fraud
- Hard Fraud
- Insurance Against the Risk of Loss of Real or Personal Property
- Liability Insurance
- Interpretation of Insurance Contracts
- Ethics & The Insurance Fraud Investigation
- Fraud by Professionals
- First Party Property Fraud
- Health Insurance Fraud
- Insurance Fraud is a Crime
- Fraud Created by Legal Professionals
- Fraud in the Acquisition of Insurance
- Fraud in the Presentation of a Claim
- Investigation of a Claim for Fortuity
- Investigating Fraud
- Arson for Profit Investigation
- Investigation Methods
- Evaluation of Medical Records
Available as a Kindle book; Available as a Hardcover; Available as a Paperback
Volume II of Insurance Fraud provides coverage of the issues not covered by Volume I and, together with Volume I becomes a complete manual for how lawyers and claims people can effectively work to deter or defeat insurance fraud.
INSURANCE FRAUD IS EPIDEMIC
The following are covered in this volume including:
- The Federal Crime of Insurance Fraud
- Insurance Fraud as a State Crime
- Insurance Fraud by Insurers
- California SIU Regulations
- Investigating Insurance Fraud
- The Examination Under Oath
- The Taking of an Examination Under Oath
- The Mutability of Memory
- Rescission
- Insurance Fraud Statutes
- The Tort of Bad Faith and Insurance Fraud
- Sample California Rescission Letters
- Sample Complaint for Declaratory Relief
- Form of Mutual Rescission Agreement
- Fom Declaration of Underwriter in Support of Rescission
- Insurance Fraud Statutes
- Outline of Training for Integral Anti-Fraud Personnel
- Form of EUO Demand Letter
- EUO Testimony admitting fraud.
Available as a Kindle book; Available as a Hardcover; Available as a Paperback
“Construction Defects and Insurance Second Edition”
The Second Edition of all Eight Volumes now Available at Amazon.com
Construction Defects and Insurance Second Edition:
Volume 1: The Structure, The Construction Contract, and Construction Defect Insurance.
Construction defects have grown into one of the most active areas of litigation in the United States.
This Second Edition of a multi-volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.
Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense; both policyholder and insurer), and business owners will benefit greatly from the multiple volumes. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of construction defect law and construction insurance law.
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.
Available as a hard cover, a paperback and as a Kindle Book
Construction Defect and Insurance Volume Two Second Edition”
The Defects and Understanding Construction Defects Insurance and Underwriting
The Treatise, Construction Defects & Insurance addresses a wide range of topics associated with this escalating and expensive problem.
In this the second volume of the series of books he has also provided checklists that walk the reader through an analysis of construction defects, the process of purchasing and later invoking construction defect insurance, and what is necessary to prosecute or defend a construction defect lawsuit. The books also include helpful sample forms to assist in the identification of defects and numerous case studies to illustrate the state of litigation.
Available as a paperback and a Kindle book Available as a hardcover
All of Barry Zalma’s books are available at Zalma’s Insurance Claims Library https://lnkd.in/gKCTg53
Construction Defects and Insurance Volume Three
Second Edition
The Commercial General Liability Policy the Construction Defect Policy; CGL Policy Format and Structure; Exclusions to CGL Insurance
This, the third volume of the eight volume multi-volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.This, the third volume of Construction Defects & Insurance, includes materials concerning:
- Overview
- The Commercial General Liability Policy the Construction Defect Policy
- CGL Policy Format and Structure
- Exclusions to CGL Insurance
- Claims Made Provisions
- Coverage After Project is Completed
- Additional Insured Endorsements
- Failure of Agent or Broker to Obtain Insurance Requested
- Contractor’s Pollution Liability
- Property Insurance
- Construction Related Exclusions
- Deductibles, Self-Insured-Retention & Coinsurance
- Public Insurance Adjusters
- Certificates of Insurance
- Builders Risk Insurance
- Obligations of a Condominium Association
- Surety, Performance and Payment Bond Claims
- Flood Insurance
Construction Defects and Insurance Volume Four Second Edition
Liability Insurance & Construction Defects
This, the second edition of volume four of the eight volume series is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.
This, the fourth volume of Construction Defects & Insurance, includes materials concerning Liability Insurance and covers the following subjects:
- Overview
- What is Involved?
- Liability Insurance
- How To Shop for Insurance
- A Resource for Victims of Fraudulent Insurance Applications
- Duties of the Insured and Insurer
- Other Insurance Clauses
- Subrogation
- Insurance Fraud
- Checklist A – Liability Insurance
- Appendix A Sample Request for Insurance Quotation Form
- Appendix B Commercial General Liability Coverage Form
- Appendix C Claims Made CGL
Construction Defects and Insurance Volume Five Second Edition
The Tort of Bad Faith and Construction Defects
This, the fifth volume, of the eight-volume series is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.
This, the fifth volume of the treatise Construction Defects & Insurance, includes materials concerning the Tort of Bad Faith as it relates to construction defect claims and suits.
In this volume you will see material including:
- Overview
- Bad Faith
- Duties of the Insurer
- Duties of the Insured
- Avoiding Charges of Bad Faith
- Survey of Bad Faith by State
- Defenses to the Tort of Bad Faith
- Required Continuing Education
Construction Defects and Insurance Volume Six Second Edition
Construction defects have grown into one of the most active areas of litigation in the United States.
This, the sixth volume of the eight volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.
Written by nationally-renowned expert, Barry Zalma, Construction Defects & Insurance Volume Six, Second Edition is improved, brought up to date and designed to help property owners, developers, builders, contractors, subcontractors, insurers, lenders, risk managers and lawyers avoid construction litigation, confidently and rapidly resolve claims associated with construction defect issues, or litigate construction defect litigation.
The treatise Construction Defects & Insurance addresses a wide range of topics associated with this escalating and expensive problem. As you read through the various volumes and pages, you will find comprehensive insights into:
- The construction process
- Risks to be managed
- What is required in an application for insurance protecting the insured against the risks of loss anticipated from construction
- How to acquire the correct and complete construction insurance
- How insurers underwrite against construction defect claims
- How insurers decide to insure/not insure
- Confronting losses caused by construction defects
- Litigation or alternative dispute resolution of construction defect claims
Barry Zalma, has more than 50 years’ practical experience in this area. He is a highly sought after consultant and insurance claims handling expert witness nationally.
In this series of books Mr. Zalma has also provided checklists that walk the reader through an analysis of construction defects, the process of purchasing and later invoking construction defect insurance, and what is necessary to prosecute or defend a construction defect lawsuit. The books also include helpful sample forms to assist in the identification of defects and numerous case studies to illustrate the state of litigation.
Thorough, yet practical, this series of books form the ideal guide for any professional who works in or frequently interacts with the construction industry, construction defect insurance or the legal practice.
Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from the multiple volumes. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of construction defect law and construction insurance law.
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.
This, the sixth volume of Construction Defects & Insurance Second Edition, includes materials concerning:
- Construction Defect Suits.
- Overview
- Avoiding Construction Defect Claims
- Using Contracts to Avoid the Cost of Claims & Suits
- The Parties to a Construction Defect Suit
- The Complaint
- Post-Trial Litigation Tactics
- California Modifies the Rights to Indemnity For Residential Construction
- Additional Insured
- Litigation with Design Professionals
- Statutes of Limitation and Repose
- Risk Transfer
- Right to Cure
- AIA Sample Contract
Construction Defects and Insurance Volume 7 Second Edition
Construction defects have grown into one of the most active areas of litigation in the United States.This, the seventh volume, of the multi-volume series is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.
Written by nationally-renowned expert, Barry Zalma, Construction Defects & Insurance is designed to help property owners, developers, builders, contractors, subcontractors, insurers, lenders, risk managers and lawyers avoid construction litigation, confidently and rapidly resolve claims associated with construction defect issues, or litigate construction defect litigation.
Construction Defects & Insurance addresses a wide range of topics associated with this escalating and expensive problem. As you read through the various volumes and pages, you will find comprehensive insights into:
- The construction process
- Risks to be managed
- What is required in an application for insurance protecting the insured against the risks of loss anticipated from construction
- How to acquire the correct and complete construction insurance
- How insurers underwrite against construction defect claims
- How insurers decide to insure/not insure
- Confronting losses caused by construction defects
- Litigation or alternative dispute resolution of construction defect claims
Barry Zalma, has more than 54 years practical experience in this area. He is a highly sought after consultant and insurance claims handling expert witness nationally.
In this series of books, he has also provided checklists that walk the reader through an analysis of construction defects, the process of purchasing and later invoking construction defect insurance, and what is necessary to prosecute or defend a construction defect lawsuit. The books also include helpful sample forms to assist in the identification of defects and numerous case studies to illustrate the state of litigation.
Thorough, yet practical, this series of books form the ideal guide for any professional who works in or frequently interacts with the construction industry, construction defect insurance or the legal practice.
Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from the multiple volumes. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of construction defect law and construction insurance law.
As you read through the various volumes of Construction Defects and Insurance, you will find comprehensive—yet comprehensible—coverage of key topics, including:
- What is a structure?
- How is a structure built?
- The building.
- The construction contract.
- Plans and Specifications
- The Property Inspection.
- The Defects
- Understanding insurance and underwriting.
- Construction Defect Policies.
- Liability Insurance.
- Insurance Bad Faith.
- The Construction Defect Suit.
- Tort Defenses.
- The Trial.
- Evaluation and Settlement.
- Alternative Dispute Resolution.
This, the seventh volume of Construction Defects & Insurance Second Edition, includes materials concerning the tort defenses and the trial of the construction defect suit.
Construction Defects and Insurance Volume 8 Second Edition
Construction defects have grown into one of the most active areas of litigation in the United States.
This, the eighth and last volume, of the multi-volume treatise is the newest addition to Barry Zalma’s insurance claims books that thoroughly explain how to identify construction defects, how to insure, investigate, prosecute, and defend cases that result from construction defect claims.
Written by nationally-renowned insurance claims and insurance coverage expert, Barry Zalma, Construction Defects & Insurance is designed to help property owners, developers, builders, contractors, subcontractors, insurers, lenders, risk managers and lawyers avoid construction litigation, confidently and rapidly resolve claims associated with construction defect issues, or litigate construction defect litigation.
Construction Defects & Insurance addresses a wide range of topics associated with this escalating and expensive problem. As you read through the various volumes and pages, you will find comprehensive insights into t.he construction process.
The Homeowners Insurance Policy Handbook
How To Buy An Appropriate Homeowners Policy And Successfully Make A Claim To The Insurer
Of all insurance acquired in the United States, the most common is the homeowners policy and its sister the tenant’s policy that covers everything a homeowners policy covers but the structure.Homeowners insurance is nothing more than a contract between a person seeking insurance and an insurer who promises to protect the insured against the risks of loss to certain described property or liability to third parties. The insurer can be set up as a stock insurance corporation, a mutual insurance company, an interinsurance exchange or a syndicate of insurers writing through an insurance market place like Lloyd’s, London. The person insured can be an individual, a corporation, a partnership, a limited liability company, a limited liability partnership, a joint venture or any other legal entity.
Available as a Kindle Book here. Available as a paperback here.
It’s Time to Abolish 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, is an example of a positive unintended consequence. INSURANCE AS A NECESSITY Neither the courts nor the governmental agencies seem to be aware that in a modern, capitalistic society, insurance is a necessity. No prudent person would take the risk of starting a business, buying a home, or driving a car without insurance. The risk of losing everything would be too great. By using insurance to spread the risk, taking the risk to start a business, buy a home, or drive a car becomes possible. Insurance has existed since a group of Sumerian farmers, more than 5,000 years ago, scratched an agreement on a clay tablet that if one of their number lost his crop to storms, the others would pay part of their earnings to the one damaged. Over the eons, insurance has become more sophisticated, but the deal is essentially the same. An insurer, whether an individual or a corporate entity, takes contributions (premiums) from many and holds the money to pay those few who lose their property from some calamity, like fire. The agreement, a written contract to pay indemnity to another in case a certain problem, calamity, or damage that is fortuitous, that is that occurs by accident, is called insurance. In a modern industrial society, almost everyone is involved in or with the business of insurance. They insure against the risk of becoming ill, losing a car in an accident, losing business due to fire, becoming disabled, losing their life, losing a home due to flood or earthquake, or being sued for accidentally causing injury to another. The insurers, insureds, or people damaged by those insured are dependent on one another. In a country where human interactions are governed solely by the terms of written contracts, insurance would be a simple means of spreading risk and providing indemnity based on the promises made by the contract of insurance. But, in this the real world, insurance contracts are controlled by statutes enacted to ostensibly protect the consumer of insurance, regulations imposing obligations on the conduct of insurers and the decisions of trial and appellate courts interpreting insurance contracts. A simple insurance contract between two parties might say: “I insure you against the risk of loss of your engagement ring valued at $15,000 by all risks of direct physical loss except wear and tear for a premium paid by you of $15.00.” Anyone who could read would understand that contract. If something happens to damage, destroy or lose the ring the insurer will pay you $15,000.00. However, insurers cannot write such a simple contract because the state requires many terms and conditions that complicate the policy wording and confuse the common person. The states and courts that did so had nothing but good intentions to protect the consumer against the insurer and control the actions of the insurer. The tort of bad faith was created because courts felt that insurers treated their insureds badly and defeated the purpose for which insurance is acquired. It has served its purpose. Fair Claims Settlement Practices laws and regulations are now available to control insurers who do not act in good faith. Insurance fraud statutes and Regulations provide assistance to insurers who have been deceived by those they insure or who are victims of attempted insurance fraud. It is time that all contracts, including insurance contracts, are treated like any other contract, and insureds who believe the insurer breached the contract of insurance can sue to recover the benefits promised by the policy. Available as a paperback here. Available as a Kindle book here.
Insurance Fraud Costs Everyone
Fictionalized True Crime Stories of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.
Fictionalized True Crime Stories of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The stories help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime. This book started as a collection of columns I wrote and published in the magazines “Insurance Journal,” “Insurance Week,” and “The John Cooke Insurance Fraud Report” insurance trade publications serving the insurance community in the United States. Since the last edition I have added more stories that were published in my twice monthly newsletter, Zalma’s Insurance Fraud Letter which is available free to anyone who clicks the links. Available as a Kindle Book and Available as a Paperback from Amazon.com.
California SIU Regulations 2020
The State of California Imposes Control on the Investigation of Insurance Fraud Effective October 1, 2020 – New Regulations to Enforce Statutes Requiring Insurers to Maintain a Special Investigative Unit California SIU Regulations 2020 is designed to assist California insurance claims personnel, claims professionals, independent insurance adjusters, special fraud investigators, private investigators who work for the insurance industry, the management in the industry, the attorneys who serve the industry, and all integral anti-fraud personnel working with California admitted insurers who must comply with the requirements of California SIU Claims Regulations that were rewritten and made operative October 1, 2020. The state of California, by statute, requires all admitted insurers to maintain a Special Investigative Unit (an “SIU”) that complies with the requirements set forth in the Special Investigative Unit Regulations (the “SIU Regulations”) and train all integral anti-fraud personnel to recognize indicators of insurance fraud. It is necessary, therefore, that insurance personnel who are engaged in any way in the presentation, processing, or negotiation of insurance claims in California to be familiar with the SIU Regulations. The state has imposed on all claims personnel duties to deal with insurance fraud if the
insurers are doing business in the state. California licensed insurers are required by California Insurance Code Sections 1875.20-24 and California Code of Regulations, Title 10, Sections 2698.30 -.41 to establish and maintain Special Investigative Units that identify and refer suspected insurance fraud to the California Department of Insurance (CDI) and directly to the local California County District Attorney’s Office for workers’ compensation only. The regulations also require each insurer to submit an SIU Annual Report to CDI which provides important information regarding the insurer’s SIU anti-fraud operations, procedures, and training material. The SIU Compliance Review Program evaluates the accuracy, completeness, and timeliness of the report. The reports are used to conduct a risk assessment to help determine which insurers are selected for SIU compliance review. R The Appendices include outlines to be used by a staff member of the insurance company SIU, its trainers, educators, or lawyers to present a training class for all of the “integral anti-fraud personnel” of the insurers as defined by the SIU Regulations. Insurers must understand that every claims employee must be trained in accordance with the requirements of the SIU Regulations no later than 30 days after the person is hired and annually thereafter. As it is not economically reasonable to train one new employee California SIU Regulations 2020 cam provide the needed training without the additional expense of a training class for one or two persons.California SIU Regulations 2020, and its appendices, will provide the insurer and its staff with the information needed to comply with the SIU Regulations and will provide the training required for what the SIU Regulations describe as an insurer’s “integral anti-fraud personnel.” Available as a Kindle book here. Available as a paperback here.
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
- all insurance claims personnel,
- claims professionals,
- independent insurance adjusters,
- special fraud investigators,
- private investigators who work for the insurance industry,
- the management in the industry,
- the attorneys who serve the industry,
- public insurance adjusters,
- policyholders and
- counsel for policyholders working with insurers doing business in California
For detail about this book and many more by Barry Zalma go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims-library/
“Zalma’s Mold & Fungi Handbook”
Understanding mold, fungi, and bacteria infestations and what to do about them.
This book is the latest addition to Barry Zalma’s series of books and articles that form the most thorough, up-to-date, expert-authored guides available today about damage to structures and injuries to people by mold, fungi, bacteria or viral infections. Zalma’s Mold and Fungi Handbook deals specifically with the issues relating to mold, fungi, and bacterial infestations and provides a detailed examination of the substances, their potential for property damage and bodily injury. Written by nationally-renowned insurance coverage and insurance claims expert, Barry Zalma, a semi-retired insurance coverage attorney, insurance claims consultant, insurance claims expert witness, author, videoblogger and blogger. Zalma’s Mold and Fungi Handbook provides in-depth explanations, analysis, examples, and detailed discussion of: •Mold; •Fungi; •Bacteria; •Mold, fungi and bacteria insurance claims; and •Mold, Fungi, and Bacteria litigation. Thorough, yet practical, this book forms the ideal guide for any property owner, professional who works in or frequently interacts with the repair or remediation of mold, fungi or bacteria infested property. It is also of use to every insurance underwriting, sales or claims professional and any lawyer involved in the construction industry or who is involved in construction defect litigation dealing with mold, fungi or bacterial infestations. Business owners, whether they own or rent property, will benefit greatly from the The Mold and Fungi Handbook. It is the perfect resource for insurance educators, trainers, and students whose role requires an understanding of mold, fungi and bacterial infestations. The author has provided checklists, and information and references to statutes involved with mold, fungi or bacteria. This, Zalma’s Mold & Fungi Handbook was written to help anyone faced with property damage or bodily injury as a result of exposure to mold, fungi or bacterial infestations. It was also written to assist in the presentation of claims to tortfeasors and insurers for the damages to property or persons.
“Getting the Whole Truth: Interviewing Techniques for the Lawyer”
by Barry Zalma, Esq., CFE
Zalma on Insurance Claims – Third Edition
Ten Volumes Comprising A Comprehensive Group of Materials on Property & Casualty Insurance Claims
Insurance claims professional and expert witness Kevin Quinley said about the following ten volumes: “Zalma’s series of books is a terrific blend of both the legal underpinnings and the practical implications for the claim practitioner.” Insurance Maven Bill Willson said: “’Zalma On Insurance Claims’ is a tour de force, an indispensable tool that should be a part of every claims training program in America and in the library of every claims professional for quick and frequent reference. This comprehensive guide belongs in the library of every insurance defense AND policyholder law firm. It should be a part of every claims training program of carriers, independent adjusting firms, and public adjusters. Many of these parts should be part of the training or reference programs for non-claims personnel, from agents to underwriters to risk managers.” This series of books is the latest addition to Barry Zalma’s insurance claims series of books and articles that will form the most thorough, up-to-date, expert-authored insurance claims guide available today. Thorough, yet practical, this series of books form the ideal guide for any professional who works in or frequently interacts with the insurance industry. Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from the ten volume guide. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of insurance law. A Comprehensive Review of insurance, insurance claims, the law of insurance policy interpretations, the practicalities of Property, Casualty and Liability Insurance Claims.
Zalma on Insurance Claims Volume 101 – Third Edition
A Comprehensive Review of insurance, insurance claims, the law of insurance and policy interpretation Paperback– May 26, 20211
This volume covers
- WHAT IS INSURANCE?
- THE HISTORY OF INSURANCE,
- ACQUISITION OF THE POLICY,
- CLAIMS PERSONNEL,
- KINDS OF INSURANCE POLICIES,
- Casualty Insurance
- THE LIABILITY POLICY.
The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide.
Zalma on Insurance Claims Part 102 – Third Edition
Available as a hardcover Available as a Kindle book Available as a paperback
Zalma on Insurance Claims Part 103 Third Edition

This, the third part of a 10-volume treatise on insurance claims is the latest addition to Barry Zalma’s insurance claims series of books and articles is part of the most thorough, up-to-date, expert-authored insurance claims guide available today. Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness and blogger, Zalma on Insurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of:
- Duties Of The Insured And The Insurer
- Duties Of The Public Adjuster
- Excellence In Claims Handling
- Liability Insurance Claims
- No Tort Remedy For Non-Insurance Claims Bad Faith.
- Duties And Liabilities Of Insurance Brokers
- Declaring A Policy Void
- Rescission
- Processing A Claim
- The Public Adjuster
- Common Mistakes And Omissions To Avoid.
- The Proof Of Loss
- California Insurance Code § 2071.
- Letter To Insured From Adjuster.
- Form Letter To Insured Re: Contractor
- Amendment To The California Insurance Code Re: Public Adjusters
- Amendment To The California Insurance Code.
- Form Letter: Advising Of Right To Appraisal
- Form Letter: Reservation Of Rights Letter
The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the services of a competent professional person should be sought. Available as a paperback and Available as a Kindle Book
Zalma on Insurance Claims Part 104 Third Edition
This, the fourth volume in the series of ten books that makes up the treatise, Zalma on Insurance Claims. It is the latest addition to Barry Zalma’s insurance claims series of books and articles that will form the most thorough, up-to-date, expert-authored insurance claims guide available today.
Written by nationally-renowned insurance coverage expert Barry Zalma, a retired from the practice of law insurance coverage attorney, consultant, expert witness and blogger.
As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics, including:
- What is Insurance?
- The History of Insurance
- The covenant of good faith and fair dealing.
- The tort of Bad faith
- Conditions,
- Warranties,
- Exclusions
- Declaring a policy void
- Duties of insured and insurer
- Evaluation and settlement
- Identifying insurance fraud
- Investigation
- Kinds of insurance policies
- Other insurance clauses
- Preparing a case for trial
- Processing a claim
- Responses to fraud
- Subrogation and salvage
- Underwriting and
- Many more property and casualty insurance matters.
Available as a Kindle book; Available as a hardcover; Available as a paperback;
Zalma on Insurance Claims Part 105 Third Edition
Zalma on Insurance Claims Part 105 Third Edition
This is the fifth part of a Treatise on Insurance Claims consisting of a series of ten books, of which this is the latest addition to Barry Zalma’s insurance claims Treatise that will form the most thorough, up-to-date, expert-authored insurance claims guide available today.As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics, including:
- What is Insurance?
- The History of Insurance
- The covenant of good faith and fair dealing.
- The tort of Bad faith
- Conditions,
- Warranties,
- Exclusions
- Declaring a policy void
- Duties of insured and insurer
- Evaluation and settlement
- Identifying insurance fraud
- Investigation
- Kinds of insurance policies
- Other insurance clauses
- Preparing a case for trial
- Processing a claim
- Responses to fraud
- Subrogation and salvage
- Underwriting and
- Many more property and casualty insurance matters.
Table of Contents
Chapter 1 Investigation Of Liability Claims.
Chapter 2 Errors & Omissions & the Claims Made & Reported Policies
Chapter 3 The Notice-Prejudice Rule.
Chapter 4 Types Of Torts.
Chapter 5 The Liability Claim File.
Chapter 6 Duty To Defend.
Chapter 7 Tests For Determining Duty To Defend:
Chapter 8 Scope Of The Duty To Defend.
Chapter 9 Grounds To Reject Coverage For Defense Or Indemnity.
Appendix 1 Form Letter To Expert
Appendix 2 Form Letter To Independent Medical Examiner
Appendix 3 Non Waiver Agreements
Appendix 4 Form Letter: Rescinding Automobile Policy.
Appendix 5 Form Letter: Rescission And Denial Letter
Appendix 6 Form Letter: Advising Of Right To Appraisal
Appendix 7 Form Letter: Reservation Of Rights Letter To Insured.
Appendix 8 Form Letter: Reservation Of Rights Letter B.
Appendix 9 Authorization Forms
Appendix 10 California Actual Cash Value Statute.
Available as a Kindle Book Available as a paperback Available as a hardcover
Zalma on Insurance Claims Part 106 Third Edition
This, the Sixth Part of the Ten Part Treatise, Zalma on Insurance Claims, is the latest addition to Barry Zalma’s insurance claims treatise. It is the sixth part of the most thorough, up-to-date, expert-authored insurance claims guide available today. Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness and blogger, Zalma onInsurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of:
- Property insurance claims
- Third-party liability claims
- Casualty claims
- Insurance Fraud
Thorough, yet practical, this book is the ideal guide for any professional who works in or frequently interacts with the insurance industry. Claims professionals, risk managers, producers, insurance agents, insurance brokers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from this multiple volume guide. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of insurance law. As you read through the various volumes of Zalma onInsurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics, including:
- What is Insurance?
- The History of Insurance
- Bad faith
- Conditions,
- Warranties,
- Exclusions
- Declaring a policy void
- Duties of insured and insurer
- Evaluation and settlement
- Identifying insurance fraud
- Investigation
- Kinds of insurance policies
- Other insurance clauses
- Preparing a case for trial
- Processing a claim
- Responses to fraud
- Subrogation and salvage
- Underwriting
The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide. Available as a Kindle Book or Paperback & Available as a hardcover
Zalma on Insurance Claims Part 107 – Third Edition
This latest addition to Barry Zalma’s ten volume insurance claims treatise and series of books and articles is part of the most thorough, up-to-date, expert-authored insurance claims guides available today. Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness and blogger, Zalma on Insurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of:
- Property insurance claims
- Third-party liability claims
- Casualty claims
- Insurance Coverage
- Insurance Claims Law and
- Insurance Fraud
Thorough, yet practical, this book is the ideal guide for any professional who works in or frequently interacts with the insurance industry. Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from this multiple volume guide. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of insurance law. As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics, including:
- What is Insurance?
- The History of Insurance
- Bad faith
- Conditions,
- Warranties,
- Exclusions
- Declaring a policy void
- Duties of insured and insurer
- Evaluation and settlement
- Identifying insurance fraud
- Investigation
- Kinds of insurance policies
- Other insurance clauses
- Preparing a case for trial
- Processing a claim
- Responses to fraud
- Subrogation and salvage
- Underwriting
The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the services of a competent professional person should be sought. Available as a paperback or Kindle Book Available as a hard cover
Zalma on Insurance Claims Part 108 – Third Edition
- Property insurance claims
- Third-party liability claims
- Casualty claims
- Insurance Fraud
- What is Insurance?
- The History of Insurance
- Bad faith
- Conditions,
- Warranties,
- Exclusions
- Declaring a policy void
- Duties of insured and insurer
- Evaluation and settlement
- Identifying insurance fraud
- Investigation
- Kinds of insurance policies
- Other insurance clauses
- Preparing a case for trial
- Processing a claim
- Responses to fraud
- Subrogation and salvage
- Underwriting
- Preparing a Case for Trial
- Involvement of the Adjuster in Defense of the Insured.
- Conflicts of Interest Between Insured and Insurer
- The Need to Prove the Policy
- Interviewing Techniques
- The Art of the Interview
- Interview General Principles
- The Interviewer
- Preparing for the Interview
- Conducting the Interview
- Control of the Interview
- Dealing with Witness Types
- Interview Approaches that Work
- Dealing with the Nervous Person
- The Use of Bluffs In an Interview
- The mutability of Memory
- The Insurance Examination Under Oath
- Actual Interview 1: Fire Loss Witness
- Interview 2: Earthquake Loss
- Interview 3: Cross examination of Expert on False Memory
- Interview 4 Elizabeth Loftus on False Memory Syndrome
Available as a paperback Available as a Kindle book.
Zalma on Insurance Claims Part 109 Third Edition
This is the latest addition to Barry Zalma’s insurance claims treatise on insurance claims and is the Ninth part of the most thorough, up-to-date, expert-authored insurance claims guide available today.
Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness, Certified Fraud Examiner and blogger. Zalma on Insurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of:
- Property insurance claims
- Third-party liability claims
- Casualty claims
- Insurance Fraud
Thorough, yet practical, this book, and the Treatise of which it is a part, is the ideal guide for any professional who works in or frequently interacts with the insurance industry. Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from this multiple volume guide. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of insurance law.
As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics, including:
- What is Insurance?
- The History of Insurance
- Bad faith
- Conditions,
- Warranties,
- Exclusions
- Declaring a policy void
- Duties of insured and insurer
- Evaluation and settlement
- Identifying insurance fraud
- Investigation
- Kinds of insurance policies
- Other insurance clauses
- Preparing a case for trial
- Processing a claim
- Responses to fraud
- Subrogation and salvage
- Underwriting
The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide.
This, the ninth part of Zalma on Insurance Claims, includes materials concerning:
- Identifying Insurance Fraud
- Professional Conspiracies
- Multiple Types of Insurance Fraud
- How to Join the Fraud Fight
- Case Studies of Successful Fraud Investigations
- Checklist 1 – Types of Insurance Fraud
- Checklist 2 – Red Flags of Fraud – Property Insurance
- Checklist 3 – Red Flags of Fraud – Liability Insurance
- Appendix A – Commonly Used Medical Acronyms and Abbreviations
- Appendix B – Glossary of Medical Terms
Available as a paperback, Kindle book or hardcover
Zalma on Insurance Claims Part 110 Third Edition
This, the latest addition to Barry Zalma’s insurance claims Treatise in a series of ten books that is part of the most thorough, up-to-date, expert-authored insurance claims guide available today.
Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness and blogger, Zalma on Insurance Claims provides in-depth explanations, analysis, examples, and detailed discussion of:
- Property insurance claims
- Third-party liability claims
- Casualty claims
- Insurance Fraud
Thorough, yet practical, this book is the ideal guide for any professional who works in or frequently interacts with the insurance industry. Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from this multiple volume guide. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of insurance law.
As you read through the various volumes of Zalma on Insurance Claims, you will find comprehensive—yet comprehensible—coverage of key topics.
The author has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide.All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the publisher.
May include copyrighted material of Insurance Services Office, Inc., with its permission.
This product may include information which is proprietary to Insurance Services Office, Inc. ISO does not guarantee the accuracy or timeliness of the ISO information provided. ISO shall not be liable for any loss or damage of any kind and howsoever caused resulting from your use of the ISO information.
This, the tenth part of Zalma on Insurance Claims, and includes materials concerning:
- Responses to Fraud
- Grounds For Rescission
- The Denial Letter
- Taking a Fraud Case to Trial
- Evidence Needed to Prove Fraud
- Preparing The Insurance Fraud Case For Trial
- The Fight Against Fraud
- The Legislative Arsenal Against Fraud
- Fraud Control at the State Level
- Is the Fight Against Fraud Being Lost?
- The Fifth Amendment Is No Use To A Fraudster Plaintiff
- Checklist 1—Responses to Fraud
- Checklist 2 – The Fight Against Fraud
- Appendix 1 Insurance Fraud Statutes
- Appendix 2 Rescission For Fraud
- Appendix 3 U.S. v. DeGeorge
- Appendix 4 Form Of An Examination Under Oath Demand
- Appendix 5 EUO Outline
Available as a Kindle book; Available as a Paperback; Available as a hardcover
Mold Claims
This series of books is the latest addition to Barry Zalma’s insurance claims series of books and articles that will form the most thorough, up-to-date, expert-authored insurance claims guide available today. Written by nationally-renowned insurance coverage expert Barry Zalma, a semi-retired insurance coverage attorney, consultant, expert witness and blogger, Mold Claims provides in-depth explanations, analysis, examples, and detailed discussion of:
Thorough, yet practical, this series of books form the ideal guide for any professional who works in or frequently interacts with the insurance industry or is involved in litigation. Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), and business owners will benefit greatly from the mold volumes. It is also the perfect resource for insurance educators, trainers, and students whose role requires an understanding of insurance law as it relates to mold, fungi and bacterial infestations. The autho
r has provided checklists, sample procedures, form letters, tables and information and references to model statutes, state statutes, administrative regulations, and requirements of insurance departments nationwide.
The Compact Book of Adjusting Property Insurance Claims – Third Edition
A Manual for the First Party Property Insurance Adjuster
The insurance adjuster is not mentioned in a policy of insurance. The obligation to investigate and prove a claim falls on the insured. Standard first party property insurance policies, based upon the New York Standard Fire Insurance policy, contain conditions that require the insured to, within sixty days of the loss, submit a sworn proof of loss to prove to the insurer the facts and amount of loss. The policy allows the insurer to then, and only then, respond to the insured’s proof of loss. The insurer can then either accept or reject the proof submitted by the insured. Technically, if the wording of the policy was followed literally the insurer could sit back, do nothing, and wait for the proof. If the insured was late in submitting the proof the insurer could reject the claim. If the insured submits a timely proof of loss the insurer could either accept or reject the proof of loss. If the insurer rejected the proof of loss the insured could either send a new one or give up and gain nothing from the claim. Suit on the policy would be difficult because the policy contract limited the right to sue to times when the proof of loss condition had been met. Insureds and insurers were not happy with that system. It made it too difficult for a lay person to successfully present a claim. The system, as written into the standard fire policy seemed to run counter to the covenant of good faith and fair dealing that had been the basis of the insurance contract for centuries. Most insurers understood that their insureds were mostly incapable of complying with the strict enforcement of the policy conditions. To fulfill the covenant of good faith and fair dealing insurers created the insurance adjuster to fulfill its obligation to deal fairly and in good faith with the insured. The Second edition adds new material from 2018 and 2019, is easier to use and more compact than the original. Available as a Kindle book. Available as a paperback.
The Compact Book on Adjusting Liability Claims, Third Edition
A Handbook for the Liability Claims Adjuster
This Compact Book of Adjusting Liability Claims is designed to provide the new adjuster with a basic grounding in what is needed to become a competent and effective insurance adjuster. It is also available as a refresher for the experienced adjuster. The liability claims adjuster quickly learns that there is little difficulty with a claimant (the person alleging bodily injury or property damage against a person insured) if the claim is paid as demanded. The insured may be unhappy if the claimant’s claim is paid as presented since most do not believe they did anything wrong or fear an increase in premiums charged for subsequent policies. The adjuster must be prepared to salve the insured’s emotions, explain why in the law and the policy it was appropriate to pay the claimant and that the settlement is in the best interest of both the insured and the insurer the adjuster represents. The adjuster knows, and must be prepared to explain to an insured, that if a claim is resisted or denied the claimant will be unhappy, will probably file suit. If not promptly settled the claimant’s lawyers will rake the insured over the coals to prove that the insured is liable for the claimant’s injuries. The litigation will take time, effort, and money to establish the extent of the injuries and who is responsible for the injuries. Failure to settle promptly can cost the insured his or her reputation and will certainly cost the insurer much more than the claim could have been resolved for had it been resolved before the claimant retained a lawyer. Available as a Kindle book Available as a paperback.
The Little Book on Ethics for the American Lawyer
The prac
What is Ethical Behavior?
The concept of ethical behavior refers to well-founded standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues, all of which are essential to the lawyer.
Ethics, for example, refers to those standards that impose the reasonable obligations to refrain from murder, rape, theft, assault, slander, and fraud. Ethical standards also include those that imply virtues of honesty, compassion, and loyalty.
There are rights presumed to exist such as those described in the Declaration of Independence submitted to King George of England in 1776 that held: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of happiness.” The unalienable rights also include the right to life, the right to freedom from injury, and the right to liberty. Such standards are adequate standards of ethics because they are supported by consistent and well-founded reasons.
Ethics, for example, refers to those standards that impose the reasonable obligations to refrain from murder, rape, theft, assault, slander, and fraud. Ethical standards also include those that imply virtues of honesty, compassion, and loyalty.
There are rights presumed to exist such as those described in the Declaration of Independence submitted to King George of England in 1776 that held: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of happiness.” The unalienable rights also include the right to life, the right to freedom from injury, and the right to liberty. Such standards are adequate standards of ethics because they are supported by consistent and well-founded reasons. Ethics also refers to the study and development of one’s standards of conduct.
Feelings, laws, and social norms can deviate from what is ethical. It is necessary, especially to people involved in the practice of law, to constantly examine one’s standards to ensure that they are reasonable and well-founded conduct that ethically treats a client, an adversary, and the court with the utmost good faith.
There is no single answer to the question of what is ethical behavior by a lawyer. Ethical behavior is subjective and fact dependent.
Available as a Kindle book here. Available as a paperback here.Random Thoughts on Insurance
After more than 53 years acting as a claims person and insurance coverage lawyer I enjoy reading court decisions concerning insurance. The idea of this blog is to find new cases that are interesting to me and then write a summary. Some of the cases reviewed will be important. Some may be of first impression. Others will be totally unimportant. All will be interesting. The case digests and articles from 2010 to the present, now in elenven volumes, where I digest 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. Available as a paperback. Available as a Kindle book.
Fictionalized True Insurance Crime Books
Insurance Fraud Costs Everyone
Fictionalized True Crime Stories of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.
Fictionalized True Crime Stories of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The stories help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime. This book started as a collection of columns I wrote and published in the magazines “Insurance Journal,” “Insurance Week,” and “The John Cooke Insurance Fraud Report” insurance trade publications serving the insurance community in the United States. Since the last edition I have added more stories that were published in my twice monthly newsletter, Zalma’s Insurance Fraud Letter which is available free to anyone who clicks the links. The original title was “Heads I Win, Tails You Lose” and was meant to describe insurance fraud as it works in the Unites States. It means that whenever a person succeeds in perpetrating an insurance fraud everyone who buys insurance is the loser. If the fraud succeeds the insurer must charge more premium to cover the expense of defending the fraud and payment of funds to the fraud perpetrator. If the fraud fails the insurer must charge more premium to cover the expense of defending the fraud. Everyone, except the lawyers, lose. As you read the stories I hope they help you understand the effect that insurance fraud has on the perpetrators, the insurers, the people who need insurance, the people who buy insurance, and the people who keep the promises made by insurance policies. Available as a Kindle Book and Available as a Paperback from Amazon.com.
Candy and Abel: Murder for Insurance Money
How a young lawyer and wise old investigator defeated an attempt at life insurance fraud. Available as a Kindle Book. Available as a paperback.
Murder And Insurance Fraud Don’t Mix
My name is Marion Orpheus Montague. My friends, and some enemies, call me “MOM.” It is not a designation of my ability to nurture my clients. I have never been, nor will I ever be, maternal. I accept the play on my initials because it causes adversaries to underestimate me. I am 66-years-old. My grayish blond hair is thin and my full beard is a bit scraggly. My face is round and often tinged with red. My nose is full, my eyes green and my cheeks bulge out to the sides trying to emulate the belly that precedes every other part of my body as I walk. People see me and do not believe that I am a private investigator. Seeing me they often think that I am on leave from my winter work as a Macy’s Santa Claus. I like being underestimated. It makes my job as an investigator easier. See how a fake robbery at a jewelry store led to murder and prison. Available as a Kindle book. Available as a paperback
Murder & Old Lace: Solving Murders Performed for Insurance Money
When the women first met – 20 years ago at a Santa Monica health spa – Magogassasanian appeared taken with Gogolivesky. The women moved Alvarado into an apartment, then started applying for life insurance policies on him. They jointly took out four policies, each as 50% beneficiaries in addition to the individual policies they bought from my client. Gogolivesky also took out three more policies on her own while Magogassasanian only took out a single individual policy on Earnest. The two women pocketed nearly $6,000,000 in insurance benefits on Alvarado alone and $4,000,000 in insurance benefits on Earnest. They also recovered a total of $5,000,000 on the other six old men they killed. Available as a Kindle book. Available as a paperback.
Arson for Terrorism and Profit
How an Insurance Investigator and Insurance Lawyer Defeated a Plot to use a Fire to Fund Terrorism (c) 2020 by Barry Zalma & ClaimSchool, Inc.
There are many excuses for the inability of the criminal justice system to effectively handle arson cases and eventually, almost universally, the prosecutor will find an excuse not to prosecute an arson case regardless of the amount of evidence produced. As a result, with regard to an arson-for-profit scheme, the time, investigative work, and litigation is left to the insurer to refuse to pay a claim based on fraud, pay the investigators and lawyers needed to prosecute a civil fraud defense to a fraudulent claim created with an arson-for-profit scheme. The following story is based upon an attempted arson-for-profit that took up a large portion of my professional career. Although fiction, the story is based on a true crime that involved the efforts of the intended victims – an English insurer and an American insurer – the work of professional fire cause and origin investigators, private investigators, insurance claims handlers, insurance coverage lawyers and insurers who refused to pay tribute to a criminal. After five years of investigation and litigation the defendants established that the arson-for-profit scheme was designed for more than cash but was intended to obtain funds to support a terrorist organization whose purpose was to kill or maim anyone connected to the government of Germany.The names, places, professions, organizations, fire departments, police, prosecutorial agencies and of the individuals involved have been changed to protect the innocent, criminal, and professional. Available as a Paperback Available as a Kindle book
M.O.M. & The Taipei Fraud
How an Experienced Adjuster Defeated a $7 Million Fake Burglary Claim
The problem is that each option the insurers have available have a down side and Feng is represented by a lawyer who has proved highly successful in suing insurers and collecting large compensatory and punitive damage awards. Since the claims exceed $6 million dollars, he can expect, applying the law set out by the U.S. Supreme Court in State Farm Mut. Automobile Ins. Co. v. Campbell and BMW of North America, Inc. v. Gore as much as $60 million in punitive damages. So I need to explain to the insurers that they face an exposure anywhere from their policy limits to ten times the policy limit. They need the courage of their convictions to reject this major claim. Available as a paperback. Available as a Kindle book.
Arson-For-Profit Fire at the Cowboy Bar & Grill
A true crime novel based on the experience of the author, Barry Zalma, who for more than 51 years has acted for insurers who were faced with arson-for-profit, one of the most dangerous insurance fraud schemes. The book explains how an insurance claims adjuster, working with a fire cause and origin expert, a forensic accountant and insurance coverage lawyer, were able to defeat an arson-for-profit scheme and obtain a judgment requiring the perpetrator to take nothing and repay the insurer all of its expenses in defeating the claim. Available as a paperback. Available as a Kindle book.
New Books from Full Court Press
The Insurance Law Deskbook
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 and 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. Paperback, only $95.00 available at https://www.fastcase.com/store/fcp/insurance-law-deskbook-2/
California Insurance Law Deskbook
Zalma on Property and Casualty Insurance
The earnings of almost every civil lawyer in the United States are funded by the insurance industry. Insurance can best be described as the mother’s milk of the law profession. The civil defense lawyer is paid by an insurer for each hour he or she works. The civil plaintiffs’ lawyer is usually paid by taking a percentage of any judgment entered in favor of the plaintiff, which judgment is usually paid by the defendant’s insurer. In almost every situation in which a civil lawyer practices law the funds for that work come, either directly or indirectly, from insurance. Consequently, lawyers must use their wits and energies to avoid or to pursue litigation to the benefit of the client. Both sides understand that an insurer will eventually pay one or both sides in the dispute. Insurance is important to every civil dispute and even some that fall within the criminal courts. Every lawyer retained to prosecute or defend a civil suit should begin the representation with a serious effort to find insurance coverage for the benefit of the client or the defendant the client is suing. Without that knowledge, the lawyer will find he or she is litigating with duct tape firmly self-placed across his or her mouth.
Insurance Law Deskbook
Learn the insurance basics that are essential to every civil practitioner. Available at Fastcase.com bookstore.
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. Available at Fastcase.com bookstore.
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. An annual subscription to secondary content on the Fastcase platform includes new editions and updates published by the author as they are rolled out, so you can rest assured that your research is up to date. Go to fastcase.com for more detail and how to use the material on-line as part of your legal or insurance research or as stand-alone e-books. All available at fastcase.com bookstore.
Books from ClaimSchool, Inc.
Insurance Law
Insurance Law is the most comprehensive, and yet practical, insurance law authority available today. Written by nationally-renowned insurance coverage expert Barry Zalma, an insurance coverage attorney, consultant, expert witness and blogger, Insurance Law introduces the new insurance professional to the fundamental principles of insurance and provides the experienced litigator analyses of today’s leading insurance law decisions nationwide. Insurance Law is the most comprehensive, and yet practical, insurance law authority available today. This book is ideal for any professional who works in or frequently interacts with the insurance industry. Claims professionals, risk managers, producers, underwriters, attorneys (both plaintiff and defense), business owners, and students will benefit greatly from this all-inclusive reference. It is also the perfect resource for educators and trainers whose role requires an understanding of insurance law. In addition to case law, the author has provided countless citations to relevant statutory, regulatory, and judicial sources which are guaranteed to kickstart your research. Price Reduced from $196- Send Check for $75.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.
Mold Claims Coverage Guide
Today, mold claims are common, but they continue to grow in complexity, involving not only property damage but bodily injury as well. Mold-related lawsuits have dramatically increased over the past few years, and the numbers continue to rise. Coverage requirements—and related issues—can be complicated and confusing. This resource will remove the complexity and allow the insurer, insured, property owner or developer and their counsel to deal with mold quickly and effectively and, if possible, avoid unnecessary litigation. Price Reduced – Send Check for $50.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.
Construction Defects Coverage Guide
This insightful and practical two volume resource was envisioned and written by nationally renowned expert Barry Zalma, and it thoroughly explains how to identify construction defects and how to insure, investigate, prosecute, and defend cases that result from construction defect claims. Construction Defects Coverage Guide was designed to help property owners, developers, builders, contractors, subcontractors, insurers, and lenders, as well as their risk managers and lawyers rapidly resolve construction defect claims when they arise and avoid construction litigation. If litigation becomes necessary it will help the prosecution or defense of construction defect suits effectively. Price Reduced from $196 – Send Check for $75.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.
Insurance Claims: A Comprehensive Guide
Insurance contracts and clauses are specific in nature—but the manner in which insurance claims are pursued and resolved can be remarkably different. Mistakes in handling a claim can undermine the outcome—and ultimate value—of the claim itself. Insurance Claims: A Comprehensive Guide is the one resource that enables insurance professionals, producers, underwriters, attorneys, risk managers, and business owners to successfully handle insurance claims from start to finish—employing proven, practical techniques and best practices every step of the way.
Price Reduced from $196 – Send Check for $75.00 to ClaimSchool, Inc., 4441 Sepulveda Blvd., Culver City, Ca 90230 and the book will be mailed to you.
Books from the American Bar Association
The Commercial Property Insurance Policy Deskbook
How to Acquire a Commercial Property Policy and Present and Collect a First-Party Property Insurance Claim
By Barry Zalma
The Commercial Property Insurance Policy Deskbook is a comprehensive resource on acquiring a commercial property policy and presenting and collecting first-party property insurance claims. The book looks at the fundamentals of insurance and a wealth of topics including rules of construction of a policy of commercial property insurance, the commercial first party property insurance policy, different types of property losses, conditions and limitations,specific and blanket coverages, mortgage clauses, the need for a prompt notice of claim, the commercial property claim, adjusting the commercial property loss, the sworn statement in proof of loss, the adjustment of the commercial property loss, subrogation and salvage, and common law bad faith.
The Insurance Fraud Deskbook
Author: Barry Zalma
Sponsor(s): Tort Trial and Insurance Practice Section, Publisher(s): ABA Book Publishing
ISBN: 978-1-62722-676-9 Product Code: 5190506 2014, 638 pages, 7 x 10 This book is written for individuals who are focused on the effort to reduce expensive and pervasive occurrences of insurance fraud. Lawyers who represent insurers, claims personnel, prosecutors and their investigators can all benefit from this exhaustive resource. The Insurance Fraud Deskbook is a valuable resource for those who are engaged in the effort to reduce expensive and pervasive occurrences of insurance fraud. It explains the elements of the crime and the tort to claims personnel, and it provides information for lawyers who represent insurers, so they can adequately advise their clients. Prosecutors and their investigators can use this book to determine what is required to prove the crime and win their case. The full text of decisions from courts of appeal and supreme courts across the country are provided so the reader can understand what happens after the investigation is completed and can apply that information to undertake their own thorough investigations. It allows claims personnel and their lawyers to understand what errors would cause a defeat or a not-guilty verdict. The effort to reduce insurance fraud requires the assistance of both civil and criminal courts. The Insurance Fraud Deskbook can help the prudent fraud investigator, insurance adjuster, insurance attorney, insurance Special Investigation Unit, and insurance company management to attain the information needed to deal with state investigators and prosecutors. Available from the American Bar Association at: http://shop.americanbar.org/eBus/Default.aspx?TabID=251&productId=214624; or orders@americanbar.org, or 800-285-2221.
Diminution in Value Damages
How to Determine the Proper Measure of Damage to Real and Personal Property
ISBN: 978-1-63425-295-8 Product Code: 5190524 2015, 235 pages, 7 x 10, Paperback

Author:Barry Zalma
“Property Insurance Checklists, 13th Edition” Now Available from Thomson Reuters a New Book From Barry Zalma
Read the full article at https://www.linkedin.com/pulse/new-property-insurance-checklists-13th-edition-barry-zalma-esq-cfe and at https://zalma.com/blog plus more than 3700 posts. Property Investigation Checklists: Uncovering Insurance Fraud 13th Edition provides detailed guidance and practical information on the four primary areas of any investigation of suspicious claims:
- Recognizing suspicious claims;
- Proper investigation procedures;
- Analysis of laws concerning fraudulent personal and real property claims; and
- Evaluating and settling claim.
The book also examines recent developments in areas such as arson investigation procedures, bad faith, and extracontractual damages. The appendix includes the NAIC Insurance Information and Privacy Protection Model Act, forms useful to investigators, and the full text of how thorough investigation defeated a fraudulent claim and convicted a lawyer to a long term in prison. Available at https://store.legal.thomsonreuters.com/law-products/Forms/Property-Investigation-Checklists-Uncovering-Insurance-Fraud-13th/p/106702361 and as a THOMSON REUTERS PROVIEW eBOOK EDITION https://store.legal.thomsonreuters.com/law-products/Forms/Property-Investigation-Checklists-Uncovering-Insurance-Fraud-13th/p/106702363
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lost

ZALMA ON INSURANCE: A BLOG
Go to Home Page Write to Barry Zalma Follow Zalma on Twitter at https://twitter.com/bzalma After more than 50 years acting as a claims person and insurance coverage lawyer I enjoy reading court decisions concerning insurance. The idea of this blog is to find new cases that are interesting to me and then write a summary. Some of the cases reviewed will be important. Some may be of first impression. Others will be totally unimportant. All will be interesting. Zalma on Insurance, a Blog is published five days a week.

(c) 2022 Barry Zalma, Inc.
Barry Zalma & ClaimSchool, Inc.
Go to Zalma Books – E-Books and Articles by Barry Zalma at the Insurance Claims Library where ClaimSchool publishes the ZIFL, several books and e-books written by Barry Zalma and sponsors Mr. Zalma’s speaking engagements.
Written by Barry Zalma &
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Read Mr. Zalma’s blog “Zalma on Insurance”
Go to “Zalma’s Insurance 101” Video Training
Go to the Insurance Claims Library; Subscribe to Barry Zalma on Substack.com, Go to Barry Zalma videos at Rumble.com at https://rumble.com/zalma Videos from “Barry Zalma on YouTube; Go to the Insurance Claims Library; Listen to the Podcast: Zalma on Insurance