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Zalma on Insurance
Liability Insurer Has Sole Right to Settle Suits Against Insured
Insurer’s Reports to Insurance Support Organization is Privileged. Allstate Northbrook Indemnity Company (“Allstate”) moved for Judgment on the Pleadings. Plaintiff Zhiwei Chen (“Plaintiff”) opposed and Allstate filed a Reply. After considering the moving, opposing, and reply papers, and the arguments therein, in Zhiwei Chen v. Allstate Northbrook Indemnity Company, No. CV 24-5239-JFW(Ex), United States District Court, C.D. California (October 2, 2024) and the court resolved the motion.
Conviction Affirmed
CONFRONTATION CLAUSE OF THE CONSTITUTION NOT VIOLATED BY ADMISSION OF MEDICAL RECORDS OF VICTIM. Read the full article at https://lnkd.in/ghgkJy-K, see the full video at https://lnkd.in/gSzVWPcy and at https://lnkd.in/ga96PU9E and at https://zalma.com/blog plus more than 4900 posts.
Court System Abused by In Forma Pauperis Plaintiff
Refusing to Pay Policy Limits to Plaintiff not Fraud. Plaintiff Sonia C. Roberson, in pro se, was granted leave to proceed in forma pauperis (“IFP”) without paying filing fees. Her first attempt was dismissed by the court and the defendants were required to pay filing fees and attorneys fees to respond a second time.
Zalma’s Insurance Fraud Letter – October 1, 2024
ZIFL – 10/1/2024 -Volume 28, Issue 19. Forty five years ago today I left the world of the employed and became an entrepreneur by opening my own law firm. The law practice was incorporated shortly thereafter as Barry Zalma, Inc. When I opened for business on October 1, 1979, I had no clients and no certainty that I would have any in the future. I had borrowed money from the bank to carry me through the first six months and was concerned about my ability to pay the loan with my third child about to be born. At 8:10 a.m. on October 1, 1979, Alan Warboys, called from London and provided me with my first case as an independent lawyer to represent Certain Underwriters at Lloyd’s, London. He, and the Lloyd’s Underwriters he represented, showed faith in me as a lawyer and insurance expert. Alan is now, and will forever be, my first client and a good friend.
Failure to Pay a Premium Results in Cancellation
No Coverage After Failure to Pay Premium Before Ten Days Notice to Cure Cancellation. In this first-party automobile negligence action, defendant, USA Underwriters (USAU), appealed the trial court’s order denying its motion for summary disposition even though policy had been cancelled six months before accident.
When Insurance Agent Controlled Action of Broker No Action Against Broker
No Right to Sue Broker Who Does Not Have Special Relationship With Insured. Plaintiff Green Technology Lighting Corporation (“Green Tech”) appealed the order of the District Court for the District of Idaho granting summary judgment in favor of Defendant Crouse and Associates Insurance Services of Northern California (“Crouse”).
Genuine Dispute Requires Reversal of Summary Judgment
Property Damage Invokes Insurer’s Duty to Indemnify. The Fifth Circuit was asked to determine if “property damage” existed that would invoke an insurer’s obligation to indemnify under a common Commercial General Liability insurance policy had occurred. The district court determined there was no property damage under the policy, and the insurer therefore had no duty to indemnify the insured for an adverse state arbitration award.
Policy Conditions Remain when Named Insured Added
Adding Named Insured Does Not Change Policy's Refusal of UM Coverage. Progressive Select Insurance Company appealed the summary final judgment rendered in favor of its insured, Cindy Dunkel in her declaratory judgment action concerning whether she was entitled to uninsured motorist coverage.
Unlicensed Contractor Cannot Enforce Contract
Lack of Workers’ Compensation Insurance Voids Contractor’s License. As a condition precedent to the issuance of a contractor’s license, continued maintenance, or reinstatement of a contractor’s license, California law requires applicants and licensees to have on file at all times a current and valid certificate of workers’ compensation insurance.
For Want of a Union Mortgage Clause Lender Gets Nothing
Loss Payable Clause Limits Recovery Only if Insured Can Recover. Following a fire that damaged a malt beverage store owned by A Maxon Company, LLC (AMC), Acuity Insurance Company asked the Supreme Court of South Dakota to determine a question of coverage under the terms of an insurance policy, which listed Greg and Tammy Weatherspoon as additional loss payees. At trial, the circuit court granted Acuity’s motion for judgment as a matter of law with respect to the Weatherspoons’ counterclaim based upon the court’s determination that the terms of the insurance policy prevented the Weatherspoons from recovering damages unless AMC successfully asserted a claim for coverage.
Suit Must be Prosecuted Diligently
Insured Can’t Sit on a Lawsuit to Punish the Defendant. Almost every litigating lawyer has tried to get an appellate court to grant a writ of mandate to overturn an error or abuse by a trial court. Successful writs of mandate are as rare as a snowstorm in the Sahara.
Actual Notice of Cancellation Effective
Cashing Refund Check is Evidence of Receipt of Notice of Cancellation. The Supreme Court of North Carolina considered whether Nationwide effectively canceled plaintiffs’ fire insurance policy before their house burned down. Almost two months before that tragic fire, Nationwide mailed plaintiffs a letter explaining when and why it was terminating their coverage. The cancellation date came and went. Afterwards, Nationwide sent plaintiffs a check listing their policy number and refunding the excess premium.
No Coverage to Repair or Replace Construction Defects
Construction Defects, Standing Alone, Do Not Constitute Property Damage. The Appeals Court of Massachusetts was asked to decide whether the costs of repairing or removing construction defects constitute "damages because of . . . 'property damage'" within the meaning of a commercial general liability policy.
Victims of Bankrupt Insured Collect Nothing
Keeping Clients Funds Without Right Excluded Professional Service. Profit, Remuneration, or Advantage When Insured Not Legally Entitled Excluded. In USCC Services, LLC, et al., The Pep Boys - Manny, Moe & Jack v. Young America, LLC, Endurance Risk Solutions Assurance Co., No. A23-1982, Court of Appeals of Minnesota (August 5, 2024) resolved an insurance dispute.
Zalma’s Insurance Fraud Letter August 15, 2024
“It Is Better To Be A Mouse In A Cat’s Mouth Than A Man In A Lawyer’s Hands.” – Spanish Proverb. 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/ This issue contains the following articles about insurance:
CEO Used Money From Company & Its Insurers to Defend Criminal Conduct
Conviction of Wire Fraud Requires Defendant to Repay Funds Advanced by Employer and Insurers. Defendant Dr. W. Scott Harkonen was the Chief Executive Officer of InterMune, Inc. (“InterMune” or the “Company”). Following the issuance of a misleading press release in 2002, Dr. Harkonen became a criminal defendant. To fund his sophisticated and well-resourced defense, Dr. Harkonen requested and accepted very sizeable advancements from the Company that funded the advancements via several director and officer (“D&O”) insurance policies and from its own coffers. The advanced sums were subject to repayment if the litigation was found to be non-indemnifiable. A federal jury subsequently convicted Dr. Harkonen of felony wire fraud in 2009. Dr. Harkonen then embarked on nearly a decade of unsuccessful appeals to overturn that conviction.
Defendant Turned Down Plea & Went To Trial
Thomas Sher was convicted of health care fraud and conspiracy to commit the same. The District Court sentenced him to ninety-six months' imprisonment. Sher appealed his sentence, arguing that the court erred in its loss calculation and in its application of a sophisticated means enhancement.
Fraud Doesn't Pay but Keeps Trying
Fraud Perpetrators Fail in Attempt to Get Around Settlement. "Operation Back Cracker" (a joint state and federal criminal investigation) exposed a ring of Minnesota healthcare providers (mostly chiropractors) who were recruiting car accident victims and fraudulently billing auto insurers for their treatment. In related civil settlements, several providers agreed not to bill some of the insurance companies for any treatment provided to their insureds.
Zalma’s Insurance Fraud Letter – August 1, 2024
Read the full issue of ZIFL and the full article here https://lnkd.in/gaFvcuTg. 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.
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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