Zalma on Insurance

Videos Explaining the Excellence in Claims Handling Video Program for Subscribers to Locals.com. Starting on July 1, 2022 the Excellence in Claims handling videos will only be available to subscribers at Locals.com although the blog posts will be available to all, at no cost, at my blog, Locals.com. If you wish to subscribe for only $5 a month go to locals.com at https://zalmaoninsurance.locals.co...

Zalma on Insurance & Excellence in Claims Handling   A Video Explaining the Excellence in Claims Handling Video Program for  Subscribers to Locals.com.  Starting on July 1, 2022 the Excellence in Claims handling videos will  only be available to subscribers at Locals.com although the blog posts  will be available to all, at no cost, at my blog, Locals.com.   If yo...

How Courts Deal With Defenses to the Tort of Bad Faith  https://zalma.com/blog When the Court found that an insureds claim was debatable, the bad-faith  claim must fail. Bad-faith claims were insufficient as a matter of law  where the status of Kentucky law on the issue was "fairly debatable."  [Willowbrook Invs., LLC v. Md. Cas. Co., 325 F.Supp.3d 813 (W.D. Ky.  2018) &nb...

Defenses to the Tort of Bad Faith   https://zalma.com/blog A bad faith claim should be dismissed on summary judgment if there was a  genuine dispute on a reasonable factual dispute or an unsettled area of  insurance law. In determining if a dispute is genuine, the court does  not decide which party is “right” as to the disputed matter, but only  that a reasonable and legit...

In a typical contract, one party has a duty to perform (construct a  building, deliver goods, convey real estate, pay indemnity) and the  other party has a duty to pay money or perform a task.  Breach by the  performer may take the form of nonperformance, defective performance, or  delay in performance. The primary purpose of damages for breach of a  contract is to pr...

HOW THE LAW OF UNINTENDED CONSEQUENCES COSTS THE INSURANCE INDUSTRY   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 usi...

The Business Of Insurance Is Subject To The Law Of Unintended  Consequences As If It Were On Steroids   The law of unintended consequences is not statutory. No state or federal  government has enacted it into law. No executive has signed the law. It  is, rather, a law of the nature of people. It is an adage or idiomatic  warning that an intervention in a complex system alw...

Zalma’s Insurance Fraud Letter   A ClaimSchool™ Publication © 2022, Barry Zalma & ClaimSchool, Inc.,  Go to my blog & Videos at: Zalma on Insurance, and at https://zalma.com/blog       The full issue in Adobe .pdf format is available here.  The following are summaries of some of the articles that can be found in  the current issue. Allianz Subsi...

Insurance is a business.  https://zalma.com/blog Professional Insurance Adjusting At the turn of the century, insurers, in a search for profit, decimated  their professional claims staff. They laid off experienced personnel and  replaced them with young, untrained and unprepared people.  A virtual clerk replaced the old professional claims handler. Process  and computers r...

What a Great Country!   Wo Ping Chen was trained as a physician in Hong Kong. Until Hong Kong  was returned by the United Kingdom to the Peoples Republic of China, he  was the best known Orthopedist in the Crown Colony. Fearing problems  with the new government he emigrated to Vancouver, British Columbia,  Canada as a citizen of the commonwealth.   He worked as an emp...

The Sweet Little Old Lady & Fraud  https://zalma.com/blog Insurance Fraud is an Equal Opportunity Crime   The Insured was 82 years old and bored. She was born shortly after the  turn of the century to a wealthy family of Connecticut merchants. She  had been a debutante. She lived most of her life in luxury. Now, at 82,  she was a widow living alone.  She had a sma...

Am I In Trouble? Bankruptcy Fraud Defeats Legitimate Insurance Claim  https://zalma.com/blog Insurance fraud, like any other profession, improves with practice. The  beginner, unaware of the tools available to an insurer, makes a stupid  error that will destroy him or her.  Abraham MacPherson was an insurance fraud novice. He had succeeded, with  ease, in defrauding his ba...

Don’t Need Your Stinkin’ License!  Yuri Gasparov was 19 years old when he entered the United States from  the old Soviet Republic of Georgia. Although still a teenager he was  strong of will and body. In the old Soviet Georgia he had made his mark  as a thief, extortionist and enforcer. Yuri was 13 years old when he  first killed a man who refused to pay half his earnings...

Someone Stole My Rolls Royce  Investing in California real estate in the 1980’s was fun. Whatever you  bought you could sell for more. The doctrine: “there is always a greater  fool than I,” worked.   Li Chen Hua immigrated to California from Hong Kong in 1981. He did it  legally, winning a lottery for a Green Card. He came to the U.S. with  his savings (converted fro...

https://zalma.com/blog Nobody’s Been Hurt Dr. Scrooge was eighty-five-years old. He lived with his daughter and  son-in-law in a remodeled tract home outside of Portland, Oregon.  The doctor’s daughter had insisted that he move into her house, even  though he owned one of his own, after his last heart attack. She was  afraid that her father, now a widower, would succumb to his...

Levon Sogomonian v. Imperial & Lloyd's  https://zalma.com/blog Since I began writing these stories in 1990 I have changed the names of  the parties to protect the guilty. This is an exception.  In 1981, Levon Sogomonian, a person who claimed to be a refugee from  Soviet Armenia purchased a homeowners policy from Imperial Casualty.  Simultaneously he purchased a Persona...

Rita was five months’ pregnant.  Her entire family greeted her condition  as an opportunity to make sufficient money for a happy Christmas in  sunny Hawaii.  For four generations Rita’s family has lived luxuriously on insurance  claims.  Their last names changed more often than their underwear.  Wherever they go, they carry a small plastic valve of soapy liquid a...

The Golden Taxi   https://zalma.com/blog  Mischa came to Houston in 1990 directly from the old Soviet Union. His  dream was to be a cowboy. He became a cab driver.  Mischa picked up the English language quickly and memorized the  convoluted streets of Houston. Within a year of his arrival, he could  find with ease any hotel, restaurant or bar in the overgrown small to...

How a Thorough Fraud Investigation Dealt With False Charges of Fraud   https://zalma.com/blog. Being a good neighbor is hard work. Sometimes it’s impossible. Marsha  was not a good neighbor. She would “borrow” things from her neighbors  and never return them. Most of her small kitchen appliances arrived  because of such loans. Marsha had an extensive collection of CDs and &nbsp...

The Flying Carpet   Omar T. Tentmaker had immigrated from Iran shortly before the fall of  the Shah. Persian money was difficult to take out of the country. Omar  purchased an entire inventory of Persian rugs and shipped them, with the  rest of his household goods, to the United States. On arrival he rented  a small shop in Beverly Hills, California and began selling the r...

Policy Obtained by Fraud Requires Insured to Reimburse Insurer for  Defense and Indemnity   https://zalma.com/blog See the full video at  and at  Diverting from stories where I was personally involved this story comes  from the U.S. Tenth Circuit Court of Appeal.  An insurer asserted claims against its insured for fraud and unjust  enrichment. The Tenth Circuit w...

Lucy and the Tsar   Lucy served as second officer on a 747 operated by Trans-Oceanic  Airlines. Twice a week she flew from Dallas to Leningrad; with brief  layovers in New York and Brussels. She had been a second officer for  five years.  Lucy was looking forward to promotion to first officer. She  would be the second woman to command a 747 for Trans-Oceanic.  He...

Fraud by Divine Right They were All-American girls.  https://zalma.com/blog Muffy and Buffy met each other as  cheerleaders in high school. They were best friends. They did everything  together. The two young women shared everything from clothes to  boyfriends.  When they graduated from high school, both started to work as trainee  tellers at the Fresno Friendly Loan...

Profits Are Where You Make Them On his 50th birthday Louie  concluded he was a failure. For thirty years he sold insurance to the  public. For a $40 commission Louie would often spend hours explaining a  tenants’ homeowners policy to a client. The next year, because another  broker promised to save the client $5 in premiums, they did not renew  and he received no commissio...

Fraud Isn’t Fun Anymore   Not everyone who commits insurance fraud is a hardened criminal. Not all  perpetrators of insurance fraud do so to profit. Some, like the person  who is the subject of this story, do it for fun.  Insurance investigators have an unearned reputation for brilliance in  investigation. Movies and television paint insurance investigators as  tough,...