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October 30, 2023
Withholding Coverage for Criminal Acts Disincentivizes Criminal Conduct

Crime Does Not Allow Insurer to Pay

Barry Zalma
Oct 30, 2023

Read the full article at https://lnkd.in/gdiSZbpG and see the full video at https://lnkd.in/g2BNUV84 and at https://lnkd.in/ghcKCect and at https://zalma.com/blog plus more than 4650 posts.

Safeway Insurance Company sought supervisory writs from the judgment of the lower court which denied its motion for summary judgment. In Damien Harris v. Safeway Insurance Company Of Louisiana And Justin Rossette, No. CW 23-165, Court of Appeals of Louisiana, Third Circuit (October 25, 2023) the Louisiana Court of Appeals resolved an insurance coverage dispute over a criminal acts exclusion.

FACTS

After a motor vehicle accident which occurred on April 10, 2019 in Abbeville, Louisiana. Plaintiff, Damien Harris, a passenger in a 2009 Toyota Camry being driven by Defendant, Justin Rossette, collided with a pickup truck while the Toyota was running from the polices. The Camry was covered by an automobile insurance policy issued by Safeway.

Officers from the Abbeville Police Department were in pursuit of Rossette with sirens and lights on the police cars were activated and the facts establish this was a high-speed pursuit. Rossette ignored a stop sign at the intersection and collided with the vehicle being driven by Aaron T. Durke. Rossette was arrested for aggravated flight from an officer and possession of narcotics at the scene of the accident.

Plaintiff sustained multiple injuries. Safeway denied coverage based on a policy exclusion clause included in their standard contracts for criminal acts.

Following the denial of coverage, Plaintiff filed suit against Safeway and Rossette for damages arising from the motor vehicle accident. Plaintiff and Safeway filed cross motions for summary judgment on the coverage issues. Both motions were denied.

ANALYSIS

Safeway argued that at the time of the collision, Rossette was engaged in and/or committing several criminal acts. Safeway noted that before the collision occurred, Rossette had been chased by numerous police cars for several blocks through parts of Abbeville. Safeway also noted that Rossette disregarded several stop signs, was speeding excessively, and the specific cause of the collision was Rossette ignoring another stop sign at the intersection. Therefore, Safeway argued Rossette was in the commission of a crime under La.R.S. 14:108.1.

Plaintiff countered that Rossette was not engaging in a criminal act in the moments right before the collision.

Although coverage exclusions generally do not comport with the policy of granting protection for injured persons, the exclusions in the Safeway policy served a separate public policy interest of prohibiting persons from insuring themselves against their own intentional or criminal acts. Withholding insurance coverage for intentional or criminal acts helps to disincentivize such conduct, which in turn serves the purpose of eliminating reckless and irresponsible drivers from the highways.

Whether Rossette was contemplating discontinuing the flight from police as the trial court implied, the facts are clear that the accident occurred immediately after he again ran through a stop sign and collided with Mr. Durke. There was no question of fact that Rossette ran into Mr. Durke’s vehicle while intentionally fleeing from a police officer, which is a crime.

The Safeway policy in this case clearly provides that damages arising out of the use of an automobile “while being operated or used in the preparation to commit a crime, commission of a crime, and/or flight from a crime, other than a traffic violation,” are excluded from coverage.

Safeway’s writ application was , therefore, granted and summary judgment in favor of Safeway was ordered.

ZALMA OPINION

Liability Insurance, by definition, provides coverage for fortuitous or accidental events. Running from the police in a high speed chase while blowing through stop signs and colliding with an innocent driver is a criminal act in Louisiana. That the driver had a subjective intent to avoid the accident was convicted of multiple crimes that resulted in the injuries that were the subject of Mr. Harris’s injuries. There was no fortuity and the acts of Mr. Rossette were criminal and excluded.

(c) 2023 Barry Zalma & ClaimSchool, Inc.

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00:07:51
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May 01, 2026
Zalma’s Insurance Fraud Letter – May 1, 2026

Happy Law Day

ZIFL – Volume 30, Issue 9 – May 1, 2026

Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-may-1-2026-barry-zalma-esq-cfe-2tywc, see the video at at and at https://zalma.com/blog plus more than 5300 posts.

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

ZIFL – Volume 30, Issue 9 – May 1, 2026

Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year and is written by Barry Zalma.

DOJ Creates National Fraud Enforcement Division

Will the Feds Take on Insurance Fraud? Possibly as Part of a National Anti-Fraud Effort

On April 7, 2026, the Acting Attorney General, Todd Blanche, issued a memorandum establishing the Department of Justice National Fraud Enforcement Division (NFED). The memo describes an ambitious, but perhaps redundant, vision for this ...

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April 30, 2026
The Efficient Proximate Cause Doctrine Saves a Claim

When Abalone Died As a Result of Multiple Causes The Efficient Proximate Cause Requires Payment

Post number 5345

Read the full article at https://www.linkedin.com/pulse/efficient-proximate-cause-doctrine-saves-claim-barry-zalma-esq-cfe-yndlc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

In American Abalone Farms, LLC v. Star Insurance Company et al., H052643, California Court of Appeals, Sixth District (April 27, 2026) the Court of Appeals dealt with an insurance coverage issue that required application of the efficient proximate cause doctrine.

FACTS

American Abalone Farms, LLC ("American Abalone" ) operates an aquaculture farm in Santa Cruz County, California, raising abalone in tanks. In August 2020, the CZU Lightning Complex Fires led to a prolonged power outage and road closures near the farm. As a result, the farm’s water pumps failed, causing the death of most of the ...

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April 29, 2026
Breach of a Specific Condition Precedent Is a Complete Defense

Breach of a Specific Condition Precedent Is a Complete Defense

See the video at and at and at https://zalma.com/blog plus more than 5300 posts.

In United Services Automobile Association and State Farm Mutual Automobile Insurance Company v. Anthony Wenzell, 2026 CO 25 (Colo. Apr. 27, 2026) Anthony Wenzell was rear-ended in a car accident. He had a significant prior 2014 accident that required back surgery.

Wenzell claimed underinsured-motorist (UIM) benefits under three policies: (1) the tortfeasor’s liability policy, (2) his own primary UIM policy with State Farm, and (3) an excess UIM policy issued by USAA (under his brother’s policy, which contained an “other insurance” clause making USAA’s coverage excess over any collectible insurance).

After receiving the claims, both USAA and State Farm repeatedly requested that Wenzell execute comprehensive medical-release authorizations so they could obtain his full medical records and ...

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12 hours ago

It is Fraud to Make the Same Claim Twice

Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.

Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages

Post number 5347

No One is Entitled to be Paid for the Same Loss Twice

In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.

BACKGROUND

In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.

PROCEDURAL HISTORY

State Farm filed motion for summary...

post photo preview
12 hours ago

It is Fraud to Make the Same Claim Twice

Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.

Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages

Post number 5347

No One is Entitled to be Paid for the Same Loss Twice

In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.

BACKGROUND

In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.

PROCEDURAL HISTORY

State Farm filed motion for summary...

post photo preview
April 30, 2026
Investigation of First Party Property Claims

What Must be Done after Notice of a Claim is Received by the Insurer

Read the full article at https://lnkd.in/gzvvdkMZ and at https://zalma.com/blog.

Below you will read from this post until you reach the the end of this blog post as the free part of an Excellence in Claims Handling post. To read the full article and receive all articles for members of Excellence in Claims Handling you should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the subscription link below.

A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...

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