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Zalma on Insurance
Zalma’s Insurance Fraud Letter – August 15, 2023
Experienced Lawyer Claiming Ignorance of Law Is No Defense. Robert Irving Slater was a practicing worker’s compensation attorney when he entered into an agreement with the owner of USA Photocopy who paid a third party to perform intake interviews with clients of defendant’s practice, saving a significant amount of his lawyer’s own employees time and money. In exchange, defendant used USA Photocopy’s services during all workers’ compensation proceedings on those cases.
Strict Compliance With Warranty Required
Ralph Young owned and lived on a seventy-four-foot motor operated vessel named the SUMMER STAR (“the vessel”). Mr. Young insured the vessel with Yachtinsure Services, Inc. from 2013 through 2019. On August 28, 2019, the vessel ran aground and was destroyed when Hurricane Dorian hit St. Thomas in the United States Virgin Islands, where the vessel was moored. Yachtinsure rejected the abandonment and denied Mr. Young’s claim, based on what it considered his material misrepresentations in his April 2019 policy renewal application.
Refusal to Pay Starts Running of Limitation of Action
Private Limitations of Action Provision of Policy Defeats Late Law Suit. nox Mediterranean Foods, Inc. (Knox) appealed the trial court’s grant of Appellee Amtrust Financial Services (Amtrust)’s motion for traditional summary judgment on Amtrust’s affirmative defense of limitations. In one issue, Knox contends that summary judgment was improper because there was a genuine issue of material fact as to when its claim accrued.
No Fortuity No Coverage
Sexual Abuse of a Child is, by Definition, an Intentional Act. Gustavo Beltran, Alma Beltran, and child A.B. appealed the district court’s pretrial adjudication of their counterclaims against Farmers Insurance Exchange (Farmers). In. A.B., Gustavo Beltran, and Alma Beltran v. Agave Health, Inc.; et. al.; Farmers Insurance Exchange, et al., No. A-1-CA-39620, Court of Appeals of New Mexico (August 1, 2023) the Court of Appeals resolved the dispute by considering whether the acts alleged were fortuitous.
A Lawyer by Any Other Name is Still a Lawyer
NY USDC Eliminates Insurer’s Attorney Client Privilege. I became a lawyer in 1972. Before that I was an insurance adjuster and investigator. Since 1972 I have never been, nor acted as, an adjuster or an investigator. Of course, part of being a lawyer requires some investigation because failing to do so would be a breach of the fiduciary duty of a lawyer to his or her client.
The Spoons Ran Away With Insurance Money
No Right to Insurance Proceeds After Sale of Property. Thomas Spoon and Maria Spoon appealed from the Pulaski County Circuit Court order granting summary judgment in favor of Chester Lee Bolds and Linda Bolds in the Boldses’ civil suit for damages related to insurance proceeds because the Spoons did not own the damaged house at the time of the alleged loss.
Hurricane Warranty Sinks Claim
“The Hello Dolly” Was Not Where the Owner Promised it Would be When it Sunk in Breach of Warranty. Great Lakes Insurance, S.E. insured the Hello Dolly VI, a boat owned by Gray Group Investments, L.L.C. The Hello Dolly sank in Pensacola, Florida, during a hurricane. Gray Group filed a claim under the insurance policy, Great Lakes denied coverage, and Great Lakes then sought a declaratory judgment that it properly did so.
Suit Fails for Failure to Read Policies
Delivery of Policy Starts the Running of the Statute of Limitations. Wooten purchased seven Northwestern Mutual insurance policies. Three are disability income policies. Four are various whole-life policies. Wooten purchased and reviewed the last of the policies in December 2005. He sued claiming he was deceived about what he bought ten years before the suit.
No Defense Because of Six Month Delay
IHC Construction Companies, LLC (“IHC”) and MA Rebar Services, Inc. (“MA Rebar”), appealed a final summary judgment entered in favor of Westfield Insurance Company (“Westfield”) in Westfield’s declaratory judgment action against IHC, MA Rebar, and Wayne McClure. In Westfield Insurance Company v. MA Rebar Services, Inc., IHC Construction Companies, LLC, and Wayne Kelly McClure, No. 1-23-0161, 2023 IL App (1st) 230161-U, Court of Appeals of Illinois, First District, Fourth Division (July 27, 2023) the Court of Appeals resolved the dispute.
Lawyer Paying For Clients Guilty
Experienced Lawyer Claiming Ignorance of Law Is No Defense. Robert Irving Slater was a practicing worker’s compensation attorney when he entered into an agreement with the owner of USA Photocopy who paid a third party to perform intake interviews with clients of defendant’s practice, saving a significant amount of his the lawyer’s own employees time and money. In exchange, defendant used USA Photocopy’s services during all workers’ compensation proceedings on those cases.
NY Applies Policy as Written
Construction and Development Activities Exclusion Unambiguous. In Grenadier Realty Corp., et al. v. RLI Insurance Company, appellant, et al., No. 2020-06795, Index No. 502159/18, 2023 NY Slip Op 03910, Supreme Court of New York, Second Department (July 26, 2023) a New York Supreme Court (trial court) order requiring RLI Insurance Company to defend its insured was appealed by RLI.
No Sprinklers No Coverage
Boulevard RE Holdings, LLC, (Boulevard) sued Mixon Insurance Agency, Inc., (Mixon), alleging breach of contract and negligent procurement of insurance only to find that if the policy had been issued protecting Boulevard there would be no coverage because of a clear and unambiguous exclusion requiring operative fire sprinkler systems.
Is a Covid-19 Lawsuit Frivolous?
Ninth Circuit Is Exhausted by Covid Insurance Claims Suit. Khatchik Hairabedian d/b/a Kris Mobil (“Khatchik”) appealed from the district court’s order granting Defendant Security National Insurance Company’s (“Security”) motion to dismiss this action for insurance coverage in Khatchik Hairabedian, Dba Kris Mobil v. Security National Insurance Company, a Texas Corporation, No. 22-55355, United States Court of Appeals, Ninth Circuit (July 21, 2023) applied its precedent.
Zalma’s Insurance Fraud Letter – July 15, 2023
Zalma’s Insurance Fraud Letter – July 15, 2023. “There Is Always a Well-Known Solution to Every Human Problem — Neat, Plausible, And Wrong.”. t is indisputable that in the 1950’s, 1960’s and 1970’s the insurance industry abused some insureds to avoid paying legitimate claims. Without a factual basis, insureds were accused of arson or other variations on insurance fraud. Indemnity payments were refused on the flimsiest of excuses. People were found to have diseases that only horses could catch. Disability payments were refused because an insured was wheeled in her wheelchair to church one day and, therefore, was not totally house-confined. Insureds were driven into bankruptcy when reasonable demands within policy limits were refused.
No Coverage After Expiration of Policy
The Supreme Court in Allied Premier Insurance v. United Financial Casualty Company, S267746, Supreme Court of California (July 24, 2023) the California Supreme Court logically advised the court of its opinion based on the statute and California precedent.
No Right to Subrogation
Mutual Benefit Insurance Defeats Subrogation Effort. Typically, an insurer that pays a claim to an insured as a result of the negligent acts of a third party an insurer has the right, in the name of its insured, to sue the responsible party in the name of its insured. The right to sue in the name of the insured results from the equitable remedy of subrogation and is effective as long as the insured has not waived the right of its insurer to subrogate.
A Threat of Litigation is not a Claim
There Must be a Claim for Coverage Under a Claims Made Policy. Homeland Insurance Company of New York (Homeland) issued Plaintiff a claims made liability insurance policy covering errors and omissions, effective January 16, 2019 to January 16, 2020. Plaintiff eQHealth AdviseWell, Inc., f/k/a eQHealth Solutions, Inc., a Louisiana corporation that provides health care management services to Medicaid agencies, commercial healthcare payers, third-party administrators, and self-insured employer groups.
Torch Down Roofing Exclusion Unambiguous
Duckworth roofing, while repairing a roof for LGO Properties, caused a fire at the Tulane Building while using hot torches to repair the roof. In Certain Underwriters At Lloyd’s Of London As Subrogee Of L.G.O. Properties, LLC v. Duxworth Roofing And Sheetmetal, Inc., No. 2022-CA-0821, Court of Appeals of Louisiana, Fourth Circuit (July 18, 2023) the defendant sought coverage when the defendant’s insurer denied coverage because of an exclusion called the Torch Down Roofing Exclusion.
Creative Pleading Does not Avoid Punishment for Sloth
Suing for Unfair Competition and an Injunction to Avoid Private Limitation of Action Provision Dismissed. Katherine Rosenberg-Wohl had a homeowners insurance policy with State Farm Fire and Casualty Company (State Farm), providing coverage on her home in San Francisco. The policy has a limitation provision that requires lawsuits to be “started within one year after the date of loss or damage.”
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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