Zalma on Insurance

Bad Faith in Arkansas Requires Proof of Dishonest, Malicious, or Oppressive Conduct Including Hatred, Ill Will, a Spirit of Revenge Owners Insurance Company moved for summary judgment as to a claim of bad faith. Separately, Owners argued the Court should make a finding that there no evidence to support a punitive damages instruction. In RMS Warehouse 1315, LLC v. Owners Insurance Company, No. 5:22...

Condo Association are Birthplaces of Litigation Plaintiff, Nationwide Mutual Insurance Company (Nationwide), brought a declaratory judgment action against insureds, Beverly Glen Homeowners' Association (Association) and members of the board of directors asking the court to declare that Nationwide had no duty to defend or indemnify defendants against claims made by the Association residents in...

Multi-Unit Construction Exclusion Eliminates Coverage Midvale Indemnity Company (“Midvale”) sued Arevalos Construction Corp. (“Arevalos”), Victor Siguenza Zuniga (“Zuniga”), 625 Halsey LLC (“Halsey”), D&G Construction NY Inc. (“D&G”), and RM Construction and Development Corp. (“RM”) seeking a declaratory judgment relating to a commercial general liability insurance policy Midvale issued to...

Homeowners Policy Requires Insured to Reside at Premises Shanice Currie had a homeowners insurance policy with State Auto Property & Casualty Insurance Company (State Auto). After two fires severely damaged her duplex in Milwaukee, Currie sought payment from State Auto. State Auto denied the request for coverage, claiming that the duplex was not a "residence," and therefore was not c...

Potentially Compromised Embryos not a Direct Physical Loss Modern science allows an embryo to be created outside the body of a woman and later implanted and grown to term. The in vitro fertilization process allows more than one viable embryos to be created and they can be stored for use later in a cryogenic tank. Sherlene and Lawrence Wong (the Wongs) had stored some embryos at a facility that kep...

Anti-Stacking Provision Clear & Unambiguous Plaintiffs, Mark and Karen Kuhn (the Kuhns) sued seeking a declaratory judgment of the available liability insurance covering an accident between a semitruck owned by Jason Farrell and a school bus driven by Mark. In Mark Kuhn and Karen Kuhn v. Owners Insurance Company; et al, No. 4-22-0827, 2023 IL App (4th) 220827, Court of Appeals of Illinois, Fou...

No Coverage Under a False Name Cheryl Tisdale was injured in an automobile collision while she was driving her own vehicle containing passengers while logged into the Uber Technologies ("Uber") application as a paid driver. Tisdale served Farmers Insurance Exchange with the complaint, seeking underinsured motorist ("UM") coverage pursuant to an insurance policy Farmers issued t...

Arbitrator Must Decide No Fault Fraud Claims This case is about the relationship between New Jersey healthcare providers and the insurance companies that pay those providers for treating patients for injuries arising from automobile accidents. In GEICO In v. Caring Pain Management PC a/k/A Careon Pain Management, Jinghui Xie, M.D., First Care Chiropractice Center, L.L.C., and Konstantine Fotiou, D...

ZIFL - Volume 27, Issue 13 - http://zalma.com/blog/wp-content/uploads/2023/06/ZIFL-07-01-2023-1.pdf The Source For Insurance Fraud Professionals From https://zalma.com/blog, this, the Thirteenth issue of the 27th year of publication Zalma’s Insurance Fraud Letter provides multiple articles on how to deal with insurance fraud in the United States. The issue begins with: Fraud in Inception is Ground...

Suing All State Farm Insurers Unconscionable State Farm Mutual Automobile Insurance Company (“State Farm Auto”) and Defendant State Farm General Insurance Company (“State Farm General”) moved the court to dismiss all Plaintiff's claims against the entities. The motion was regarded as unopposed. In Bridget Butler v. State Farm Fire And Casualty Company, State Farm General Insurance Company, And...

Settlement Based on Mutual Mistake Must be Rescinded https://zalma.com/blog

Guilty Pleas Support to Crimes Against Family & Friends Deserves Consecutive Sentences Jon Settlemire ("Settlemire"), appealed the judgment of sentence imposing consecutive sentences only to find an appeals court with no mercy. When the Marion County Grand Jury returned a 45-count indictment charging Settlemire with a variety of felony-level crimes Settlemire entered a plea of not gu...

Fraud in Inception is Ground for Rescission https://zalma.com /blog

Notice-Prejudice Rule Does not Apply to Claims Made and Reported Policy The Kentucky Supreme Court was asked to determine if the claims-made-and-reported management liability policy ("Policy") Allied World Specialty Insurance Company ("Allied World"), issued to Kentucky State University ("KSU") provided coverage because KSU did not comply with the Policy's notice...

Notice-Prejudice Rule Does not Apply to Claims Made and Reported Policy The Kentucky Supreme Court was asked to determine if the claims-made-and-reported management liability policy ("Policy") Allied World Specialty Insurance Company ("Allied World"), issued to Kentucky State University ("KSU") provided coverage because KSU did not comply with the Policy's notice...

Appeal Back to District Court on Coverage Claim by Injured

Mutual Fire Insurance Company (New York Central) is obligated to provide plaintiff with coverage, defense, and indemnification for an August 29, 2021 car accident where he negligently injured his wife. New York Central moved for an order granting summary judgment dismissing plaintiff's complaint and for a declaratory judgment declaring that it is not obligated to provide plaintiff with a defen...

Failure of Proposed Insured Stay Alive Until Policy Delivered Costs Fiance Almost $5 Million On January 27, 2021, Dr. Travis Richardson completed an application for an individual life insurance policy with Pacific Life seeking $4,816,949.00 in coverage. Blevins was Dr. Richardson's fiancé and was listed as the primary beneficiary of the policy. Lamar Breshears was the insurance agent for Pacif...

Fictionalized True Insurance Fraud A Story of Life Insurance Fraud This is a fictionalized True Crime Story of Insurance Fraud to explain why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is intended to  help you to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer...

ZIFL - 6-15-2023 - Volume 27, Issue 12 The Source For Insurance Fraud Professionals This, the Twelfth issue of the 27th year of publication Zalma’s Insurance Fraud Letter provides multiple articles on how to deal with insurance fraud in the United States. The issue begins with: Restitution Order Can’t Be Discharged in Bankruptcy After Frayba Tipton and William Tipton pled guilty to committing insu...

Umbrella Policy Always Excess Over Primary Policy Two insurance companies argued who must indemnify an insured for a settlement involving their mutual insured. Great American Insurance Company paid subject to a reservation and sued the primary insurer, Allied World Assurance Company, alleging that because it was the umbrella insurer it only owed after Allied World as the primary insurer, paid its...

Kona Coffee Must be From the Big Island of Hawaii L&K Coffee claimed its various insurance companies erroneously denied coverage to defend it against a Lanham Act false-advertising lawsuit brought by Hawaiian coffee growers. The district court concluded the applicable insurance policies did not obligate a defense and entered summary judgment in the insurance companies' favor. In L&K Co...

Insurance Fraudster and Killer Wastes the Court's Time With Frivolous Action Pro Se Party Has a Fool for a Client In State Of Delaware v. Ryan Shover, ID No. 1511001640, Superior Court of Delaware (May 15, 2023) the appellate court dealt with proceedings by convicted murderer and insurance fraudster, Ryan Shover who acted as his own attorney. F ACTS Ryan Shover was found guilty of two counts o...

Insured Must Reside at Dwelling for Homeowners Policy Coverage to Apply Plaintiff alleged that, on October 28, 2020, Hurricane Zeta caused significant damage to his property. Plaintiff alleged that Southern conducted an inspection which constituted “satisfactory proof of loss,” but that Southern failed to adjust the claim or provide compensation to Plaintiff following the inspection.  Plaintiff al...

Breach of Contract is not an Occurrence In American Home Assurance Company v. Superior Well Services, Inc., No. 22-1498, United States Court of Appeals, Third Circuit (May 31, 2023) American Home Assurance Co. ("American Home") appealed the District Court's order grant of summary judgment for policy holder Superior Well Services, Inc. ("Superior"). BACKGROUND The Underlying...