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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December 10, 2021
To Obtain UM Coverage One Must be a Resident Relative

Adult Child Not a Resident Relative if she Moves Out of Family Home

Read the full article at https://www.linkedin.com/pulse/obtain-um-coverage-one-must-resident-relative-barry-zalma-esq-cfe and at https://zalma.com/blog plus more than 4000 posts.

Kawaljit Bhatia challenged the district court’s grant of respondent insurer’s summary-judgment motion on an uninsured motorist claim. Bhatia argued that there is a genuine fact issue as to whether his daughter was a resident relative under his insurance policy when she was killed in a fall from a motorcycle. In Kawaljit S. Bhatia v. Owners Insurance Company, Court of Appeals of Minnesota (December 6, 2021).

FACTS

In 2016, 21-year-old Ena Bhatia fell off a moving motorcycle that her boyfriend was driving. She died at the scene.

Alleging that the motorcycle was an uninsured vehicle, Bhatia sought UM benefits from his auto insurer.

The policy defines “relative” as “a person who resides with you and who is related to you by blood, marriage or adoption.”

Owners denied Bhatia’s claim because Ena was not a resident relative of her father. Bhatia sued.

Bhatia argued that the district court erred in determining that the undisputed record evidence established that Ena did not reside with him and was therefore not a “relative” under his insurance policy.

ANALYSIS

A party claiming insurance coverage bears the preliminary burden of proof to show a prima facie case of coverage. Once the party claiming coverage meets this burden, the party the burden of proof then shifts to the insurer to prove facts establishing avoidance of liability under the insurance policy as an affirmative defense. Whether the insured has demonstrated a prima facie case of coverage depends on the language of the insurance policy at issue.

Although Ena maintained her childhood bedroom in Bhatia’s Burnsville home, had a key to the home, and would occasionally spend the night, she did not reside there. The undisputed evidence is that Ena resided in the St. Paul apartment.

The evidence left the Court of Appeal no doubt that Bhatia loved his daughter and that he remained close and connected with her until she passed away.

ZALMA OPINION

The Minnesota Court of Appeal read the policy and found that for coverage to apply Ena needed to reside in her father’s home where his auto policy was situated. She did not. She lived in an apartment with her boyfriend whose motorcycle she fell off causing her death. She was moving to another apartment that her father did not owe. To find coverage under the father’s policy the court would have needed to rewrite the policy and change the wording to cover close relatives regardless of where they lived. The court did not have the power to change the policy language and refused to do so even though the judges would have liked to have helped the bereaved father. Insurance is not an eleemosynary society it is a contractual relationship.

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August 27, 2026
Offer Made and Accepted Creates Enforceable Contract

Policy Limits Demand Accepted Settles Claim

Post 5434

Posted on August 26, 2026 by Barry Zalma

See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute

In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange,  The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.

FACTUAL BACKGROUND

Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.

Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...

00:08:28
August 26, 2026
Offer Made and Accepted Creates Enforceable Contract

Policy Limits Demand Accepted Settles Claim

Post 5434

Posted on August 26, 2026 by Barry Zalma

See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute

In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange,  The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.

FACTUAL BACKGROUND

Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.

Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...

00:08:28
July 22, 2026
The Real Cost of Fraud

The Largest Residential Burglary of All Time
Post 5407

Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma

See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help 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.

After ...

00:12:33
21 hours ago
Failure to Plead a Facially Plausible Claim Requires Dismissal

Referral of Claims to its SIU Is Not Bad Faith

Post 5487

Posted on September 10, 2026 by Barry Zalma

In WIZ Collision, LLC, on behalf of itself and as assignee of Jawara Small, Chester Street LLC, and Aziz Brooks v. GEICO Corporation, No. 25-cv-4201 (KAM)(JAM), United States District Court, E.D. New York (August 28, 2026) Wiz Collision, a New York City auto-body shop, regularly repaired vehicles and submitted insurance claims for customers. It alleged that GEICO repeatedly approved claims and repairs, then referred certain claims to its Special Investigations Unit, stopped issuing payments, and delayed resolution despite ultimately finding no fraud.

Wiz Collision sued on its own behalf and as purported assignee of three customers, asserting contract, good-faith, consumer-protection, and injunctive claims. GEICO removed the case and moved to dismiss under Rule 12(b)(6).
LAW

Under Rule 12(b)(6), a complaint must plead facts supporting a facially plausible claim. Article III standing requires a concrete injury, ...

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21 hours ago
Sentence Set by Extent of Crime

Crime Requires 121-151 Months of Imprisonment

Post 5486

Posted on September 9, 2026 by Barry Zalma

Mr. Baiyewu Is Liable For The Loss Resulting From Acts Directly Attributable To Him And For The Loss Resulting From The Reasonably Foreseeable Acts Of Others Taken In Furtherance of the Criminal Activity

In United States Of America v. Oluwasegun Baiyewu, CRIMINAL No. 21-395 (RAM), United States District Court, D. Puerto Rico (August 26, 2026) the court dealt with a case after on October 20, 2021, a grand jury in the District of Puerto Rico returned a single-count Indictment charging Mr. Baiyewu with conspiracy to commit money laundering, in violation of 18 U.S.C. § 1956(h). About a year and a half later, on March 31, 2023, a grand jury returned a single-count Superseding Indictment charging Mr. Baiyewu and four co-defendants with conspiracy to commit money laundering, in violation of 18 U.S.C.

CONVICTION

Baiyewu was convicted by a jury of conspiracy to commit money laundering under 18 U.S.C. § 1956(h). The charged conspiracy, ...

September 09, 2026
Sentence Set by Extent of Crime

Crime Requires 121-151 Months of Imprisonment

Post 5486

Posted on September 9, 2026 by Barry Zalma

Mr. Baiyewu Is Liable For The Loss Resulting From Acts Directly Attributable To Him And For The Loss Resulting From The Reasonably Foreseeable Acts Of Others Taken In Furtherance of the Criminal Activity

In United States Of America v. Oluwasegun Baiyewu, CRIMINAL No. 21-395 (RAM), United States District Court, D. Puerto Rico (August 26, 2026) the court dealt with a case after on October 20, 2021, a grand jury in the District of Puerto Rico returned a single-count Indictment charging Mr. Baiyewu with conspiracy to commit money laundering, in violation of 18 U.S.C. § 1956(h). About a year and a half later, on March 31, 2023, a grand jury returned a single-count Superseding Indictment charging Mr. Baiyewu and four co-defendants with conspiracy to commit money laundering, in violation of 18 U.S.C.

CONVICTION

Baiyewu was convicted by a jury of conspiracy to commit money laundering under 18 U.S.C. § 1956(h). The charged conspiracy, ...

post photo preview
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