Judgment Damages Needed for CGL Coverage
Barry Zalma
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Posted on February 24, 2023 by Barry Zalma
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Hausmann Construction, Inc. (Hausmann) appeals the district court’s grant of summary judgment to Nationwide Mutual Insurance Company (Nationwide) on Hausmann’s breach-of-contract claim. In Hausmann Construction, Inc. v. Nationwide Mutual Insurance Company, f/k/a Allied Property And Casualty Insurance Company, No. 21-1430, Court of Appeals of Iowa (February 22, 2023) resolved the dispute.
FACTS
In 2017, Iowa Western Community College entered into a contract with Hausmann for the construction of a new wellness facility on the college’s campus. The contract provided Hausmann would be responsible for property damage arising during the construction ...
Domestic Abuse Exception to Intentional Act Exclusion
Post 4888
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Brenda Welch owned a home in Lynnwood, and lived there throughout her marriage to David Morgan. The home was subject to a mortgage held by CitiMortgage Inc. During their marriage, Welch and her ex-husband David Morgan had one child together, K.W.
On May 21, 2014, the court finalized their divorce, awarding Morgan the family home and requiring that he “either sell the property or refinance the debts into his sole name within three (3) years of February 25, 2014.” After the divorce, Welch met a new partner and moved in with him. Still, Welch and Morgan shared custody of K.W., and their parenting plan called for joint decision-making.
On November 16, 2014, Welch went to the Lynnwood home at a prearranged time to pick up K.W. from Morgan’s care. But K.W. was not there. ...
Fraud Attempted to Fund a Failing Business
Post 4867
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The insured was a contractor in Honolulu. He made an excellent living cheating his customers. The insured’s most lucrative scheme was an electronic vermin killer. It consisted of a long wire and a transformer. The contractor strung the wire around a house and plugged it in a wall. The device, charged with low voltage from the transformer, allegedly repelled vermin. The insured guaranteed that all roaches, flying insects and rodents could not pass the charge in the wire.
When it didn’t work and a customer called to complain the insured would ignore the complaints.
Since the tropical Hawaiian climate is a prime breeding ground for insects, the insured had no lack of customers. He bought a Ferrari sports car with the profits.
Eventually the attorney general of the State of Hawaii learned of his fraud. ...
Lessors Should be Entitled to Waive Insurer’s Right of Subrogation
Post 4867
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In a subrogation action, Plaintiff Philadelphia Indemnity Insurance Company (Philadelphia), as subrogee of Renaissance Realty Group, Inc. (Renaissance), appealed from the circuit court’s partial grant of defendant Norinaica Gonzalez’s motion to dismiss.
In Philadelphia Indemnity Insurance Company, a/s/o Renaissance Realty Group, Inc. v. Norinaica Gonzalez, 2024 IL App (1st) 230833, No. 1-23-0833, Court of Appeals of Illinois, First District, Sixth Division (August 23, 2024)
BACKGROUND
On September 25, 2019, Renaissance and Gonzalez entered into a written lease agreement (hereinafter “Lease”) for an apartment (“Unit 601”) in a multi-unit building located on the 1500 block of West Belmont Avenue in Chicago.
The Lease contains multiple provisions ...
Go to my Interview on the Art of Adjusting Podcast
Barry Zalma, Esq., CFE
Insurance claims expert, consultant at Barry Zalma, Inc. and author/Publisher at ClaimSchool, Inc.
August 30, 2024
Posted on August 30, 2024 by Barry Zalma
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In this episode, Chantal Roberts and William Auten welcome Barry Zalma, a seasoned insurance industry professional with over 56 years of experience. The trio discusses the changing role of insurance adjusters, their relationship with policyholders, and the current challenges faced by the industry.
Barry shares his journey from a military investigator to a trainee adjuster and recounts significant cases that shaped his career. Barry focuses on the critical importance of effective and fair claims handling for the profitability of insurance companies and the detrimental impact of poor handling practices. The team also grapple insurance fraud, the adversarial nature of the legal system, and the ...
False Swearing & Fraud in Claim Presentation Voids Policy
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NEVER LIE TO YOUR INSURER ABOUT THE EXTENT OF DAMAGE
Post 4833
An insurance coverage dispute that arose from a pipe burst in the historic Pittsfield Building in downtown Chicago. On December 17, 2016, two pipes burst on the tenth floor of the Pittsfield Building, causing water damage to the first ten floors. After the loss event, the Pittsfield Entities filed a claim for the damage with their insurer, The Travelers Indemnity Company (“Travelers”) and could not agree on the extent of damage.
In Pittsfield Development LLC, et al. v. The Travelers Indemnity Company, No. 18CV06576, United States District Court, N.D. Illinois (July 3, 2024) the USDC resolved the action and Travelers’ claim of fraud in the claim presentation discovered during discovery in the plaintiffs’ breach of contract suit.
After initial motion ...
In search of profit, insurers have decimated their professional claims staff. They laid off experienced personnel and replaced them with young, untrained, unprepared people. A virtual clerk replaced the old professional claims handler.
Process and computers replaced hands-on human skill and judgment. Money was saved on the expense side of the business by paying lower salaries. Within three months of firing the experienced claims people gross profit increased. The accountants were happy. The quarterly profits increased. None of the happy people were insurance professionals. None of them understood how a professional claims adjuster saves the insurer by establishing a fair amount of loss, avoiding payment for items not lost or overvalued, and by avoiding losses for which no coverage was provided by the policy.
The promises made by an insurance policy are kept by the professional claims person. Keeping a professional claims staff dedicated to excellence in claims handling is cost-effective over ...
