Zalma on Insurance
Education • Business
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.
Interested? Want to learn more about the community?
March 02, 2022
Who’s on First? Employer’s Insurer While Driving Home

Trucker Driving to his Home Where Truck is Garaged is Still Working for Employer

Read the full article at https://www.linkedin.com/pulse/whos-first-employers-insurer-while-driving-home-zalma-esq-cfe and at https://zalma.com/blog plus more than 4100 posts.

Posted on March 2, 2022 by Barry Zalma
INSURERS SHOULD AVOID LITIGATING OVER WHO INSURES WHAT

It should be axiomatic that insurers who both insure the same person should resolve coverage disputes rather than litigate. When two insurers disputed which was required to defend and indemnify an insured they brought about a necessary appeal when they could have, and should have, resolved the dispute directly or with the assistance of Alternative Dispute Resolution

like mediation.

Acuity, A Mutual Insurance Company (“Acuity”) preferred to litigate and, after losing, appealed the decision of the Butler County Court of Common Pleas granting summary judgment to Great American Assurance Company (“GAAC”). In Great American Assurance Company v. Acuity, A Mutual Insurance Company, et al., 2022-Ohio-501, No. CA2021-08-097, Court of Appeals of Ohio, Twelfth District, Butler (February 22, 2022) the Court of Appeals resolved the dispute between insurers.
FACTS

This case arose from a vehicular accident between a 2000 Volvo tractor owned by Herb Winsted (“the Truck”) and another motor vehicle. At the time of the accident, Winsted was an independent contractor for Wm. Hafer Drayage Co. (“Hafer”), which is an intermodal trucking company that hauls containers via company drivers and independent contractors.

Pursuant to his independent contractor agreement with Hafer, Winsted provided transportation related services to Hafer and used the Truck to move containers to and from different warehouses. Winsted began exclusively hauling loads for Hafer in 2019, and at the time of the accident, the Truck displayed Hafer’s name and “DOT” number on its door.
Winsted’s Insurance Coverage

Pursuant to Winsted’s independent contractor agreement with Hafer, the Truck was covered by Hafer’s “public liability [and] property damage * insurance coverage[.]” At the time of the accident, Hafer was insured with Acuity via a Commercial Auto and Commercial Excess Liability Policy (“the Acuity Policy”). Pursuant to the Acuity Policy, Acuity agreed to injuries caused by an accident and resulting from the ownership, maintenance or use of a covered auto. The parties do not dispute that the Acuity Policy includes the Truck in its schedule of covered autos.

Winsted also obtained a Non-Trucking Liability and Physical Damage Policy from GAAC for the Truck while it was not being operated on behalf of Hafer (“the GAAC Policy”). Obtaining such a policy was a requirement of Winsted’s independent contractor agreement with Hafer. Pursuant to the GAAC Policy, GAAC agreed to provide liability coverage for the Truck as described by Part (II)(A) of the policy.
Winsted’s Business for Hafer and the Day of the Accident

While working with Hafer, Winsted received his job assignments from Hafer’s dispatcher. After completing his final assignment of the day, Winsted would either proceed to the Hafer shipping yard (“the shipping yard”), or go directly to his home. Winsted typically began and ended his workday with the Truck at his home.

On October 4, 2019, the date of the accident, Winsted informed dispatch that he had completed a delivery, but still had a chassis. At that point, dispatch instructed Winsted to return to the shipping yard to return the chassis. The location of Winsted’s final delivery was approximately two or three miles from the Hafer shipping yard. Upon arriving at the shipping yard, Winsted returned the chassis and submitted his weekly paperwork to the dispatcher. On his way home, Winsted stopped at Ollie’s Bargain Outlet (“Ollie’s”), where his wife was working at the time, and purchased blue jeans. After leaving Ollie’s, Winsted continued his customary route home, stopping for fuel at a Marathon gas station on the way. The accident occurred after Winsted left the Marathon gas station, around 5:00 p.m., and on Winsted’s typical route home from the shipping yard.

After purchasing fuel, Winsted continued on Hamilton Cleves Road, as he would have on a typical drive home. Approximately five to seven minutes from Winsted’s home, at the intersection of Cincinnati Brookville Road and Brown Farm Drive, Winsted collided with another vehicle, allegedly causing harm to the vehicle’s minor passengers. Thus, despite the brief departures and returns to his normal route, Winsted’s drive home from the shipping yard was the same route he would have typically taken at the end of a workday.
The Declaratory Action and Summary Judgment Decision

After the accident, GAAC filed a complaint for declaratory judgment in the trial court. Relevant here, GAAC requested the trial court to enter a judgment against Acuity declaring that, based on the language in the Trucking or Business Use Exclusion in the GAAC Policy did not provide coverage for injury arising out of the October 2019 accident.

The trial court granted GAAC’s motion for summary judgment and denied Acuity’s motion. In so doing, the trial court held that “based upon the undisputed facts, * the GAAC Policy does not provide coverage based upon the application of the GAAC Policy’s Trucking or Business Use Exclusion.”
The Appeal

The words and phrases contained in an insurance policy must be given their plain and ordinary meaning unless there is something in the contract that would indicate a contrary intention. It is well established that contracts of insurance are to be strictly construed against the insurer, especially when an exclusionary clause is at issue.

The parties do not dispute that the Truck is a covered auto as defined by the GAAC Policy, that the Truck was regularly garaged at Winsted’s home, or that the shipping yard is a facility of Hafer, a lessee. The primary issue on appeal is whether Winsted was “in the business of [Hafer],” as that term is defined in the Trucking or Business Use Exclusion, at the time of the accident.

The Court of Appeal concluded that when a driver is operating a vehicle in the business of a motor carrier on a customary route, short personal detours do not take the driver out of the business of the motor carrier and that Winsted was operating the Truck “in the business of Hafer at the time of the accident.” This is because Winsted had completed his short personal detours and returned to his customary route home before the accident occurred. Consequently, because Winsted was traveling from a Hafer facility to the place where the Truck was regularly garaged at the time of the accident, the GAAC Policy excludes any coverage for damage or liability.

Lastly, while the court agreed with Acuity that Winsted did not travel directly from the Hafer facility to his home, it disagreed that such a fact precludes application of the GAAC Policy’s Trucking or Business Use Exclusion. Winsted’s brief personal detours did not negate that Winsted was traveling from the facility of the lessee to a location where the Truck was regularly garaged, nor did they alter his status of being in the business of Hafer at the time of the accident. On this basis, reasonable minds could only conclude that the GAAC Policy does not provide coverage in this instance.

Thus, in light of the plain and unambiguous language in the policy GAAC has demonstrated that there are no genuine issues of material fact and that it is entitled to judgment as a matter of law.

Because the Trucking or Business Use Exclusion conclusively resolves this dispute. Finding no error in the trial court’s decision granting summary judgment in favor of GAAC.
ZALMA OPINION

The Court of Appeal, as the parties were required to do, read both insurance policies and applied the terms and conditions of the policies as written. Since Winsted garaged the Volvo Tractor at his home and started and ended his work for Hafer at that home, the Court of Appeal, affirming the trial court, concluded that since the accident happened before he got home he was in the course and scope of his work and the Acuity policy applied to the accident and the GAAC policy, that excluded business uses, did not. A decision that could easily have been reached if the two insurer’s adjusters met and reviewed the facts rather than turning the dispute over to lawyers.

© 2022 – 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.

He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business.

Subscribe to “Zalma on Insurance” at https://zalmaoninsurance.locals.com/subscribe and “Excellence in Claims Handling” at https://barryzalma.substack.com/welcome.

You can contact Mr. Zalma at https://www.zalma.com, https://www.claimschool.com, [email protected] and [email protected] . Mr. Zalma is the first recipient of the first annual Claims Magazine/ACE Legend Award.

You may find interesting the podcast “Zalma On Insurance” at https://anchor.fm/barry-zalma; you can follow Mr. Zalma on Twitter at; you should see Barry Zalma’s videos on https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg/featured; or videos on https://rumble.com/zalma. Go to the Insurance Claims Library – https://zalma.com/blog/insurance-claims–library/ The last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud-letter-2/

Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
September 18, 2026
Expert May Only Testify to What Experience Supports

Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.

Posted on September 18, 2026 by Barry Zalma

See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html

In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.

The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.

Law

The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution

Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

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

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

00:05:14
October 19, 2026
Plaintiff’s Reading of the Policy is Plaintiff’s Reasonable Allegations Posted on October 19, 2026 by Barry Zalma CLASS ACTION THAT STATES A SIMPLE CLEAR AND PLAUSIBLE CAUSE OF ACTION SURVIVES Post 4868 In Sheila Marino v. Farmers New World Life Insura

Plaintiff’s Reading of the Policy is Plaintiff’s Reasonable Allegations

Posted on October 19, 2026 by Barry Zalma

Post 4868

CLASS ACTION THAT STATES A SIMPLE CLEAR AND PLAUSIBLE CAUSE OF ACTION SURVIVES

In Sheila Marino v. Farmers New World Life Insurance Company, No. 2:25-cv-02200-JNW, United States District Court, W.D. Washington, Seattle (October 13, 2026) defendant Farmers New World Life Insurance Company’s (“FNWL”) moved to dismiss Plaintiff Sheila Marino’s putative class action involving flexible universal life insurance.

Marino filed a putative class action in King County Superior Court alleging: (1) breach of contract, (2) breach of the implied covenant of good faith and fair dealing, and (3) violation of the Washington Consumer Protection Act (CPA).

She pleaded two theories: an “overcharge” theory and an “underpayment of interest” theory asked the Court to take judicial notice of historical Federal Funds Effective Rates.

THE LAW

Pleading Standard.

To survive a Rule 12(b)(6) motion, a ...

post photo preview
October 22, 2026
John Madden and The US Patent and Trademark Office

Blockchain Fraud Detection Loses Protection

Posted on October 22, 2026 by Barry Zalma

John Earl Madden (April 10, 1936 – December 28, 2021) was an American Professional Football Coach and Sports Commentator in the National Football League Seeking Patent & Trademark Protection

BLOCKCHAIN FRAUD

Mr. Madden was more than football. He was working to establish a program called “Fraud Protection Systems, Methods, and Computer Programs for Blockchain Financial Transactions.”

In Ex parte John Madden, Appeal 2026-001497, Application 18/495,506, Technology Center 3600, United States Patent and Trademark Office, Patent Trial and Appeal Board (October 14, 2026)

The Examiner rejected claims several numbered claims under 35 U.S.C. § 101 as directed to an abstract idea without significantly more.

THE LAW

Section 101 makes patentable any new and useful process, machine, manufacture, or composition of matter.Laws of nature, natural phenomena, and abstract ideas are implicitly excluded.

THE PATENT TRIAL AND ...

post photo preview
October 21, 2026
Supervisory Officials are not Individually Liable

Sovereign Immunity Defeats Suit Against Police Officers

Post 4866

Posted on October 21, 2026 by Barry Zalma

In Chad Lightfoot, et al. v. Progressive Direct Insurance Company, et al., Civil Action No. 26-434, United States District Court, E.D. Louisiana (October 9, 2026) Chad Lightfoot was involved in an Orleans Parish automobile accident in 2011 and filed claims with several insurers, including Progressive.

After a related civil dispute, Progressive counsel allegedly submitted a false affidavit stating that Lightfoot had fraudulently received a $50,000 payment. A New Orleans police detective relied on the affidavit to obtain an arrest warrant, and Louisiana State Police Lieutenant Alan Arcana allegedly reported that Lightfoot had received the payment. Lightfoot was arrested in 2015 and charged with theft, insurance fraud, and perjury.

Plaintiffs alleged that no record of the payment existed and that the criminal charges were dismissed on October 15, 2024.

Lightfoot and Geralyn Hawkins filed suit in October 2025 and ...

post photo preview
See More
Available on mobile and TV devices
google store google store app store app store
google store google store app tv store app tv store amazon store amazon store roku store roku store
Powered by Locals