Mountain View
Zalma on Insurance
No Coverage to Run Down Your Wife
For Want of $78 a Wife’s Injuries Go Uncompensated. Plaintiff Eric Levy sought a declaration that defendant New York Central 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 defense or indemnification for the motor vehicle accident that is alleged to have occurred on August 29, 2021, as no Supplemental Spousal Liability coverage exists for this claim.
Judicial Restraint
Appeal Back to District Court on Coverage Claim by Injured. Jacob E. Godlove, Sr., and Kayla Kelley, on behalf of themselves and the Estate of Jacob Godlove, Jr., (collectively, Appellants), appealed to the District Court’s order denying their motion to intervene in an insurance-coverage dispute. In County Hall Insurance Company, Inc. v. Mountain View Transportation, LLC; John R. Humes, Jacob E. Godlove; Kayla Kelley; Estate Of Jacob Godlove, Jr., No. 22-2397, United States Court of Appeals, Third Circuit (June 16, 2023) the Third Circuit deal with changed circumstances.
Bee Gees Were Right: Staying Alive is Important
Failure of Proposed Insured Stay Alive Until Policy Delivered Costs Fiance Almost $5 Million. In Pacific Life Insurance Company v. Katie Blevins, No. 3:21-CV-00143 JM, United States District Court, E.D. Arkansas, Northern Division (June 15, 2023} the USDC resolved the claim of the beneficiary.
Zalma’s Insurance Fraud Letter – June 15, 2023
ZIFL – 6-15-2023 – Volume 27, Issue 12. 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:
Life Insurance Can Be Hazardous to Your Health
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 and More Profitable for the Perpetrators than any Other Crime.
Primary Insurer On First
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 limits. The district court agreed, granting summary judgment in Great American’s favor.
Policy Enforced as Written
NO COVERAGE FOR INSURED WHO DOES NOT RESIDE IN DWELLING. The plaintiffs appealed the dismissal of their suit against Farmers Automobile Insurance Association (Farmers). The plaintiffs were insured by Farmers for a St. Joseph residence that the plaintiff Judy had inherited from her deceased brother. The plaintiffs filed a claim with the company following a fire that destroyed the residence. Farmers denied the claim as the plaintiffs were not occupying the property at the time of the fire and were therefore not covered under the terms of the policy.
No Damages for Litigating While Black
Losing a Lawsuit is not Evidence of Discrimination. David Webb, proceeding pro se, appealed an order dismissing his complaint. Webb was involved in a car accident. He sued a law firm, firm employees, insurance companies, and other entities related to his legal representation, insurance coverage, and the sale of his vehicle after the accident. The District Court dismissed the complaint on the grounds that Webb’s claimed losses were either frivolous or he failed to state a claim upon which relief may be granted.
No Cover for Faulty Workmanship
BACKGROUND - The Underlying State Law Claim. U.S. Energy contracted with Superior for hydraulic fracking services to extract natural gas from wells owned by U.S. Energy. In November 2007, Superior notified its insurance provider, American Home, about the potential claim for damage to wells. In February 2008, American Home agreed to provide Superior with defense counsel, but it also sent Superior a letter reserving its right to contest insurance coverage.
Stay in Jail
Insurance Fraudster and Killer Wastes the Court’s Time With Frivolous Action. 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.
Second Attempt at Same Argument Fails
Insured Must Reside at Dwelling for Homeowners Policy Coverage to Apply. DOING THE SAME THING TWICE AND EXPECTING A DIFFERENT RESULT IS THE DEFINITION OF INSANITY. 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 alleged that he was forced to hire his own experts, and repair estimates. He was not paid and sued.
Restitution Order Can’t Be Discharged in Bankruptcy
California’s Dumbest Criminals Must Pay Restitution. After Frayba Tipton and William Tipton pled guilty to committing insurance fraud, after claiming the loss of the priceless “Starry Night” by Vincent Van Gogh, they were ordered to pay victim restitution to Nationwide Insurance Company of America (Nationwide). Nationwide obtained a civil judgment an award of over $1,200,000 in civil litigation against the Tipton’s only to have the judgment discharged in bankruptcy. Nationwide then petitioned the trial court to convert the criminal restitution orders to civil judgments against both defendants. The trial court granted Nationwide’s petition and entered civil judgments against the defendants.
Tinkle Steals as an Authorized Representative
Westlake Chemical Corporation (Westlake) tendered claims to Berkley Regional Insurance Company (Berkley) and Zurich American Insurance Company (Zurich) seeking coverage for $16,000,000 in losses resulting from the payment of fraudulent invoices for shipping bags used to export Westlake’s products. After a dispute arose among the parties regarding coverage for the tendered claims, Westlake sued the insurers for breach of contract, violations of the Texas Insurance Code, and declaratory relief. The trial court granted summary judgment in favor of the insurers and the decision was appealed.
No Claim – No Coverage
In Brown Goldstein Levy LLP; Joshua Treem v. Federal Insurance Company, No. 22-1023, United States Court of Appeals, Fourth Circuit (May 18, 2023) the law firm of Brown Goldstein Levy LLP (“BGL”) and one of its partners, Joshua Treem, (collectively, “Appellants”) sued their insurer, Federal Insurance Company (“Appellee”), when it refused to provide coverage for costs Appellants incurred after the Government investigated Treem, executed a search warrant at BGL’s office, and notified Treem that his representation of certain clients may present a conflict of interest. The district court dismissed Appellants’ complaint, holding that there was no “Claim,” as that term is defined in the insurance policy, and alternatively that any costs Appellants incurred were excluded from the policy’s definition of “loss.”
The Law of Unintended Consequences
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 always creates unanticipated and often undesirable outcomes.
Fraud Investigation
The heart of any successful investigation of suspected insurance fraud is the insured’s statement. Its importance cannot be over emphasized, and it should be recorded electronically and then transcribed. The transcribed statement should then be sent to the insured to read, correct and sign.
Zalma on Insurance
305+
Posts
607K+
Views
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.
It’s essential to note our commitment to transparency:
Our Terms of Use acknowledge that our services may not always be error-free, and our Community Standards emphasize our discretion in enforcing policies. As a platform hosting over 100,000 pieces of content published daily, we cannot pre-vet content, but we strive to foster a dynamic environment for free expression and robust discourse through safety guardrails of human and AI moderation.