Zalma on Insurance
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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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November 18, 2021
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Seeking the Same Remedy Against the Same Parties in a Different Jurisdiction is Improper

Read the full article at https://www.linkedin.com/pulse/anti-suit-injunction-must-carefully-drafted-barry-zalma-esq-cfe and https://zalma.com/blog plus more than 3950 posts.

In St. Paul Fire And Marine Insurance Company v. Amerisourcebergen Drug Corporation, and Bellco Drug Corporation v. ACE American Insurance Company and ACE Property And Casualty Insurance Company, No. 21-0036, Supreme Court of Appeals of West Virginia (November 15, 2021) insurers sought to reverse an order of a West Virginia Trial court enjoining them from pursuing a suit in California.

An anti-suit injunction is an order barring parties to an action in this state from instituting or prosecuting substantially similar litigation in another state. Whether the foreign state action is substantially similar involves assessing (1) the similarity of the parties; (2) the similarity of the issues; and (3) the capacity of the action in this state to dispose of the foreign state action. An anti-suit injunction is appropriate when equity compels the circuit court:

1. to address a threat to the court’s jurisdiction;

2. to prevent the evasion of an important public policy;

3. to prevent a multiplicity of suits that result in delay, inconvenience, expense, inconsistency, or will be a “race to judgment”; or

4. to protect a party from vexatious, inequitable or harassing litigation.

Over the last two decades, the United States has experienced an epidemic of overdose deaths involving prescription and illicit opioid medications. Governments, businesses and individuals have sued the pharmaceutical distributors that sold prescription opioid medicines and “seek to recover billions in governmental and economic costs allegedly incurred in providing a wide array of public services in response to the influx of opioids into their communities.

The injunction is directed, not to the court, but to the litigant parties, and in no manner denies the jurisdiction of the legal tribunal.

ZALMA OPINION

Insurance disputes over a multiplicity of lawsuits against an insured in multiple jurisdictions raises serious problems for the courts where the suits are brought. West Virginia’s courts spent a great deal of time and trouble to resolve the suits before it and obviously became concerned when a party tried to go to another forum to receive a “better” result against the same parties. The injunction was proper but it needs to be more carefully drafted to be fair to the parties.

© 2021 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders.

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Videos
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11 hours ago
Adjuster May Not be Sued to Defeat Federal Jurisdiction

One Year Private Limitation of Action Provision Enforceable

Post 5233

See the video at and at and at https://zalma.com/blog.

Barn Roof Collapse Suit Attempts to Avoid Federal Court Fails Because of Fraudulent Joinder

In Funaro v. State Farm Fire & Casualty Co., United States District Court for the Western District of Pennsylvania, Civil Action No. 25-04, Judge: W. Scott Hardy (W.D. Pa. Nov. 19, 2025) the District Court was faced with motions by Plaintiff Funaro including the following:

1 Motion to Remand.
2 State Farm’s Partial Motion to Dismiss.
3 Statutory bad faith (42 Pa. C.S. § 8371) against State Farm alone

KEY FACTS

On January 10, 2021 a large barn roof in Honesdale, PA collapsed under weight of snow. The barn incurred structural damage, contents damage (including $90,000 to 100,000 in a custom French stove).

Plaintiffs were insured under a State Farm policy (using a standard ...

00:08:35
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November 21, 2025
Party Seeking Discovery is Entitled to “Anything Relevant to Party’s Claim or Defense

Discovery Attempt by Alleged Fraudulent Health Care Provider Fails

Post 5232

Read the full article at https://www.linkedin.com/pulse/party-seeking-discovery-entitled-anything-relevant-zalma-esq-cfe-ce7kc, see the video at https://rumble.com/v7204g8-discovery-is-entitled-to-anything-relevant-to-partys-claim-or-defense.html and at https://youtu.be/Nuet_er3qXU, and https://zalma.com/blog plus more than 5200 posts.

Upcoding and Health Care Fraud

In UnitedHealthcare Services, Inc., et al. v. Team Health Holdings, Inc., et al., No. 3:21-cv-00364-DCLC-DCP, United States District Court for the Eastern District of Tennessee, District Judge Clifton L. Corker (November 18, 2025) This is a discovery ruling, not a final merits decision.

The Disputes

This is a fraud/RICO lawsuit brought by UnitedHealthcare (and affiliates, collectively “United”) aganst TeamHealth (a large physician staffing company focused on emergency medicine). The companies have a history of mutual litigation over billing practices, including prior suits where TeamHealth accused ...

00:09:59
November 21, 2025
Party Seeking Discovery is Entitled to “Anything Relevant to Party’s Claim or Defense

Discovery Attempt by Alleged Fraudulent Health Care Provider Fails

Post 5232

Read the full article at https://www.linkedin.com/pulse/party-seeking-discovery-entitled-anything-relevant-zalma-esq-cfe-ce7kc, see the video at https://rumble.com/v7204g8-discovery-is-entitled-to-anything-relevant-to-partys-claim-or-defense.html and at https://youtu.be/Nuet_er3qXU, and https://zalma.com/blog plus more than 5200 posts.

Upcoding and Health Care Fraud

In UnitedHealthcare Services, Inc., et al. v. Team Health Holdings, Inc., et al., No. 3:21-cv-00364-DCLC-DCP, United States District Court for the Eastern District of Tennessee, District Judge Clifton L. Corker (November 18, 2025) This is a discovery ruling, not a final merits decision.

The Disputes

This is a fraud/RICO lawsuit brought by UnitedHealthcare (and affiliates, collectively “United”) aganst TeamHealth (a large physician staffing company focused on emergency medicine). The companies have a history of mutual litigation over billing practices, including prior suits where TeamHealth accused ...

00:09:59
October 31, 2025
The Zalma Philosophy of Claims Handling – Part 9

The Professional Claims Handler
Post 5219

Posted on October 31, 2025 by Barry Zalma

An Insurance claims professionals should be a person who:

Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.

How to Create Claims Professionals

To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...

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October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail

Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.

My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
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