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Zalma on Insurance
Bloods Gang Member Guilty of RICO to Defraud Insurers
Insurance Fraud is a Violent Crime and is Everywhere. Jatiek Smith (also known as “Tiek”) a member of the Bloods Gang was charged with one count of racketeering conspiracy, in violation of 18 U.S.C. § 1962(d), and one count of extortion conspiracy, in violation of 18 U.S.C. § 1951, arising out of allegations that Smith and his co-conspirators engaged in a pattern of extortionate conduct to dominate the fire restoration industry. Smith’s case was tried in a ten-day bench trial between November 27, 2023 and December 11, 2023.
Zalma’s Insurance Fraud Letter – February 15, 2024
Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication. After pleading guilty, Armando Valdes appealed his 60-month sentence for health care fraud. This is ZIFL’s twenty fourth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana.
Agent’s Statement Binds Insurer
The California Court of Appeals dealt with a claim by Wynzell Lynn, Jr. in a breach of insurance contract case against defendants AAA Life Insurance Company and its agent, Craigory Webb. Plaintiff appealed from a final judgment of dismissal that was entered after the trial court struck certain causes of action in plaintiff’s operative complaint and sustained the defendants’ demurrer as to other causes of action, without leave to amend.
No Duty to Defend No Possible Duty to Indemnify
Zox LLC (“Zox”) appealed the district court’s grant of summary judgment in favor of West American Insurance Company. Zox contended the district court erred because the Zox Brothers sought damages for three potentially covered claims: (1) malicious prosecution; (2) disparagement; and (3) use of an “advertising idea.”
Arson & Restitution
Read the full article at https://lnkd.in/gzzUfUGN and see the full video at https://lat https://zalma.com/blog plus more than 4700 posts. A fire at a residential property destroyed several structures and made nearly all of the owner’s personal property unsalvageable. M.W. pleaded guilty to first degree reckless burning for his role in starting the fire. The trial court ordered M.W. to pay over $1 million in restitution.
Ambiguous Exclusion Unenforceable
Unrepaid, Unrecoverable, or Outstanding Credit Exclusion Unenforceable. Read at https://zalma.com/blog plus more than 4700 posts. Huntington National Bank (“Huntington”) sued AIG Specialty Insurance Company and National Union Fire Insurance Company of Pittsburgh, Pennsylvania (together, “AIG”) alleging breach of contract and bad faith stemming from AIG’s denial of insurance coverage for Huntington’s settlement of a bankruptcy fraudulent transfer proceeding brought by the trustee of a bankrupt company. In granting summary judgment for AIG, the district court held that:
Serious Injury Does Not Change Policy Wording
UIM Policy Reduced Limit Reduced by Amount Paid by Other Insurers. In an interpleader action involving the insurance coverage for survivors of a tragic auto accident De Smet Insurance Company of South Dakota (De Smet) proposed distribution of the available insurance funds that had been paid into the Court.
Serious Injury Does Not Change Policy Wording
UIM Policy Reduced Limit Reduced by Amount Paid by Other Insurers. In an interpleader action involving the insurance coverage for survivors of a tragic auto accident. De Smet Insurance Company of South Dakota (De Smet) proposed distribution of the available insurance funds that had been paid into the Court.
A Incomplete Aircraft is Still an Aircraft
Injured by an Aircraft Fuselage Arose Out of Ownership of Aircraft. A woman was severely injured while moving an inoperable airplane. She now seeks to recover from her husband’s homeowner’s insurance policy. The insurance policy excludes injuries “arising out of” the ownership, maintenance, use, loading or unloading of an aircraft. The policy further defines “aircraft” as “any conveyance used or designed for flight.”
Zalma’s Insurance Fraud Letter February 1, 2024
Read the full article at https://lnkd.in/gbvHmgGf; read the full issue in pdf at https://lnkd.in/giC2Kg4f; video at https://lnkd.in/gM-C-yif and at https://lnkd.in/gNPgmgqm, and go to https://zalma.com/blog plus more than 4700 posts.
Punitive Damages
For more than fifty six years working in and about the insurance industry I For more than fifty six years working in and about the insurance industry I have personally seen the fear in the faces of corporate executives faced with a suit claiming wrongful conduct and punitive damages. Even those who knew that they had acted properly and fairly and that the allegations of the suit were totally spurious, the fear and trembling engendered by a suit seeking punitive damages is patent.
First Party Property Losses
What is Required of a Claims Department After a Claim is Presented When Faced With Loss Report. See the full video at https://lnkd.in/gGnZtzDc and at https://lnkd.in/grSNtjpv the full article at https://lnkd.in/g35ZtdSj and see the full video at https://lnkd.in/gGnZtzDc and at https://lnkd.in/gBd4WX7q and at https://zalma.com/blog plus more than 4700 posts.
Zalma's Insurance Fraud Letter - January 15, 2024
ZIFL - 01-15-2024. Zalma’s Insurance Fraud Letter (ZIFL) continues its 28th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/
No Coverage for Benefits no Right to Bad Faith Damages
CONCURRENT CAUSE REQUIRES SEGREGATION OF COVERED FROM NON COVERED LOSSES. Landmark Partners, Inc. (Landmark) sued Western World Insurance (Insurance) after it denied Landmark’s claim under an insurance policy. Landmark asserted claims for breach of contract, statutory violations, breach of common-law duties, and attorney’s fees and statutory interest. Relying in part on the testimony of Landmark’s own expert, Insurance moved for summary judgment on the ground that the concurrent causation doctrine defeated Landmark’s contractual claim, which in turn defeated Landmark’s other claims. The trial court granted summary judgment for Insurance, and Landmark appealed.
Violation of Statute Allows Suit for Negligent Failure to Resolve Insurance Claim
Oregon Allows Emotional Distress Damages for Poor Claims Handling. Read the full article at https://lnkd.in/gf-3aVtj, see the full video at https://lnkd.in/gX2anXGg and at https://lnkd.in/gsAjjJSR and at https://zalma.com/blog plus more than 4700 posts.
GEICO takes a Bite Out of Fraud
No Fault Insurance is a Formula For Insurance Fraud. Read the full article at https://lnkd.in/gxEUCQmH and see the full video at https://lnkd.in/geDuWn2h and at https://lnkd.in/g3v4PECM and at https://zalma.com/blog plus more than 4700 posts.
No Right to Indemnity After Policy Limit Exhausted
Insurer has no Obligation to Pay More than an Aggregate Limit of Liability. Read the full article at https://lnkd.in/gxQEHguD and see the full video at https://lnkd.in/gD59xWr6 and at https://lnkd.in/ge4fgKEu and at https://zalma.com/blog plus more than 4700 posts.
Zalma on Insurance
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Barry Zalma, Esq., CFE is a retired insurance coverage lawyer who blogs daily with digests of insurance cases and writes books and articles on insurance claims, insurance law, and insurance fraud.
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