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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August 16, 2022
COVID Claims Continue to Fail

No BI Insurance No Inverse Condemnation
Barry Zalma

Read the full article at https://lnkd.in/gsN5XUg3 and at https://zalma.com/blog plus more than 4300 posts.

Golden Corral Corporation and Golden Corral Franchising Systems, Inc. (hereinafter referred to collectively as “Golden Corral”), appealed the district court’s order granting Illinois Union Insurance Company’s motion for judgment on the pleadings in Golden Corral’s action seeking insurance benefits for business losses Golden Corral incurred during the COVID-19 pandemic.

In Golden Corral Corp.; Golden Corral Franchising Systems Inc. v. Illinois Union Insurance Company, No. 21-2119, United States Court of Appeals, Fourth Circuit (August 11, 2022) the Fourth Circuit affirmed the district court’s order applying Uncork &Create LLC v. Cincinnati Ins. Co., 27 F.4th 926, 933-34 (4th Cir. 2022) that held that an insurance “policy’s coverage for business income loss and other expenses did not apply to plaintiff’s claim for financial losses caused by the COVID-19 pandemic in the absence of any material destruction or material harm to its covered premises and further observing that our holding is consistent with the unanimous decisions by our sister circuits, which have applied various states’ laws to similar insurance claims and policy provisions.

The Fourth Circuit dispensed with oral argument because the facts and legal contentions are adequately presented in the materials before this court and argument would not aid the decisional process.

ZALMA OPINION

It seems plaintiffs and their lawyers refuse to read the opinions of every federal circuit and almost every state trial and appellate court that Covid-19 does not cause direct physical damage to the property of the insured which eliminates the possibility of collecting for business interruption. Some creative lawyers have tried inverse condemnation by the state for closing down businesses as a Fifth Amendment taking.

One court said: “

The Supreme Court of Pennsylvania, however, has found the Governor’s executive orders to be valid uses of police power and not a taking under the exercise of eminent domain power. Friends of Danny DeVito v. Wolf, 227 A.3d 872, 896 (Pa.), cert. denied, ––– U.S. ––––, 141 S. Ct. 239, 208 L. Ed. 2d 17 (2020).” [1600 Walnut Corp. v. Cole Haan Co., 530 F.Supp.3d 555 (E.D. Pa. 2021)]

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, is available at

http://www.zalma.com

and [email protected] and receive videos limited to subscribers of Excellence in Claims Handling at locals.com https://lnkd.in/gfFKUaTf.

Subscribe to Excellence in Claims Handling at https://lnkd.in/gNm9EWKJ.

Write to Mr. Zalma at [email protected];
Follow Mr. Zalma on Twitter at https://twitter.com/bzalma; Go to Rumble.com at https://lnkd.in/gV9QJYH; Go to Barry Zalma on YouTube- https://lnkd.in/g2hGv88; Go to the Insurance Claims Library – https://lnkd.in/gKCTg53

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1 hour ago
Not Nice to Shop the Federal Court to Avoid State Court

Who’s on First? State or Federal Court

Post 5222

Read the full article at https://lnkd.in/gWj97cFs, see the video at https://lnkd.in/gtS6CpUX and at https://lnkd.in/gQEAeyHc,

Conflict Between State & Federal Court Requires Abstention

See the video at https://lnkd.in/gtS6CpUX and at https://lnkd.in/gQEAeyHc,

Conflict Between State & Federal Court Requires Abstention

Hector David Campoverde was injured at a Brooklyn construction site in 2015. Campoverde was an employee of Vazquez Bro Restoration Inc., a subcontractor for C.C.C. Renovation Inc., which was itself a subcontractor for general contractor L&M Builders Group LLC. In Starr Indemnity & Liability Company v. Scottsdale Insurance Company, No. 24-CV-3309 (PKC) (TAM), United States District Court, E.D. New York (September 30, 2025) was asked to determine whether one or more of the involved insurers is obligated to indemnify Campoverde, and in what order Camporverde can receive indemnity, from one or more insurer.

Underlying Incident:

Campoverde sued the ...

00:07:43
November 04, 2025
One Year Suit Limitation Defeats Suit Filed Two Years After Denial of Claim

National Flood Policy Bars Late Filed Suit

Post 5221

Read the full article at https://www.linkedin.com/pulse/one-year-suit-limitation-defeats-filed-two-years-zalma-esq-cfe-olr0c, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

No Excuse for Late Flood Suit After Claim Denial

In Domenico D’ambrosio, Michele D’ambrosio v. American Bankers Insurance Company Of Florida, No. 2:25-cv-155-KCD-NPM, United States District Court, M.D. Florida, Fort Myers Division (October 7, 2025) this is an insurance dispute stemming from Hurricane Ian. Plaintiffs Domenico and Michelle D’Ambrosio submitted a flood claim that Defendant American Bankers Insurance Company of Florida will not pay. To recover the funds allegedly owed, Plaintiffs sued for breach of contract.

Defendant’s moved to dismiss under Fed.R.Civ.P. 12(b)(6). Defendant presses one ...

00:05:49
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November 04, 2025
Zalma’s Insurance Fraud Letter – November 1, 2025

ZIFL – Volume 29, Issue 21

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

Post 5220

Read the full article at https://lnkd.in/gRMJpi4s, see the video at https://lnkd.in/gwGSd6ZA & at https://lnkd.in/gbDiuFJy, and at https://zalma.com/blog plus more than 5200 posts.

See the video at & at https://rumble.com/v711hr0-zalmas-insurance-fraud-letter-november-1-2025.html

See the full 18 page issue of ZIFL at ZIFL-11-01-2025

Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th 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/

Conviction for Health Insurance Fraud Upheld

Physician Conspired with Bonavilla to Effect Health Insurance Fraud

Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on ...

00:10:22
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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