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December 22, 2023
Where There is a Will – There are Relatives

Named Beneficiary Must be Paid Death Benefit

Barry Zalma
Dec 22, 2023

Read the full article at https://lnkd.in/g7V-HV_v and see the full video at https://lnkd.in/g25Q8_3C and at https://lnkd.in/gt_VGTb6 and at https://zalma.com/blog plus more than 4690 posts.

Della Lopez, Fred Lopez, Shella Gill, and Paul Imrie (collectively “Plaintiffs”) appealed from the trial court’s Order, arguing the trial court erred by granting summary judgment in favor of The Prudential Insurance Company of America (“Prudential”) and abused its discretion by denying Plaintiffs’ Motion to Compel.

In Della Lopez, Fred Lopez, Shella Gill and Paul Imrie v. The Prudential Insurance Company Of America, No. COA23-427, Court of Appeals of North Carolina (December 19, 2023) the Court of Appeals resolved the dispute of relatives of a decedent’s fight over life insurance benefits.

FACTUAL BACKGROUND

Following her husband’s death, Sherry elected to purchase a Policy from Prudential and continued to make the premium payments. To effectuate purchase of the Policy, Sherry completed and signed an Optional Group Universal Life Enrollment Form (the “Beneficiary Designation”) on 25 April 2007, naming her half-sister, Diana Imrie (“Diana”), as her sole beneficiary and Diana’s children as contingent beneficiaries.

After her husband’s death in 2007, Sherry moved in with Diana and her then-husband Paul Imrie (“Paul”) in North Carolina. Diana and Paul divorced in December 2014, and Sherry continued to live with Diana in North Carolina until March 2016.

Sherry believed Diana took the money because Diana was a joint signatory on the account and had access to the funds. Following this discovery, Sherry wanted to cancel the Policy with Prudential because she could no longer make the monthly payments, and “Diana was the sole beneficiary.”

The Prudential representative advised Della she would send a “Cancel Coverage Form” via email. Della did not complete and return this form. Without the return of this form, the cancellation of the Policy did not go into effect.

In 2016, Sherry attempted to commit suicide by overdosing on her heart medication. On 22 March 2016, Sherry died due to complications from her suicide attempt.

On 10 May 2016, Diana emailed Prudential with a copy of the Beneficiary Designation form Sherry had signed in April 2007. After Prudential received the Beneficiary Designation from Diana Prudential was asked to verify whether the Beneficiary Designation should be accepted by Prudential. Prudential paid Diana $54,000, the full amount of the Policy.

On 5 May 2017, after Paul and Della emailed Prudential alleging Diana was aware the Policy had been canceled and therefore fraudulently claimed she was the beneficiary of the purportedly canceled Policy. As a result of Paul and Della’s multiple emails and the transcription of the cancelation call, the matter was referred to Prudential’s Corporate Investigations Division (“CID”).

CID Investigator Peter Friscia (“Friscia”) was assigned to investigate any alleged fraud regarding the payment of the Policy to Diana and the cancelation call made by Della. Following interviews with Della, Paul, and Diana, Friscia concluded there was no evidence to substantiate any fraud by Diana, but Della’s impersonation of Sherry did constitute fraud.

Based on Friscia’s report, Prudential referred the case to the Georgia Department of Insurance (the “GDOI”) for further investigation. Prudential’s referral stated that Della was suspected of committing insurance fraud due to her impersonation of Sherry on the cancellation call. The referral further stated Paul “aided and abetted” Della in her attempt to cancel the Policy.

Plaintiffs filed a Complaint in Gaston County District Court requesting a declaratory judgment as to their rights under the Policy. In the Complaint, the Sibling-Plaintiffs alleged Prudential was required to pay out the Policy to the surviving siblings in equal shares, and the payout to Diana was wrongful because she was not the beneficiary on file.

On 21 December 2022, Judge Bell granted both of Prudential’s partial motions for summary judgment.

ANALYSIS

First, the Sibling-Plaintiffs argued that the trial court erred but there was no uncertainty as to the respective legal rights of the parties in the Policy. The evidence in the Record showed Diana submitted a Beneficiary Designation, signed by Sherry, noting Diana as the sole beneficiary of the Policy. Prudential confirmed the information in the Beneficiary Designation and concluded the claim by Diana was valid.

Moreover, the Sibling-Plaintiffs’ own evidence shows they likewise believed Diana was the beneficiary of the Policy.

The Sibling-Plaintiffs have failed because the evidence shows Diana was the beneficiary of the Policy and the judgment was affirmed.

ZALMA OPINION

Because the decedent had fallen out with her sister and wanted to cancel the policy to keep her from benefiting from the decedent’s death, she asked her other sister to cancel the policy. The sister failed to do so and the person the decedent did not want to receive the benefits of the policy got the money. The rest of the family tried to make the decedent’s wishes be honored but could not do so because of the incompetence of the attempt to cancel the policy. Relatives should never get involved in the life insurance held by others.

(c) 2023 Barry Zalma & ClaimSchool, Inc.

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00:09:13
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Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.

KEY POINTS

1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
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No Good Deed Goes Unpunished

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See the full video at https://lnkd.in/gDpGzdR9 and at https://lnkd.in/gbDfikRG, and at https://zalma.com/blog plus more than 5100 posts.

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Default of Settlement Agreement Reduced to Judgment

In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)

Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...

00:07:38
July 15, 2025
Zalma’s Insurance Fraud Letter – July 15, 2025

ZIFL – Volume 29, Issue 14
Post 5118

See the full video at https://lnkd.in/geddcnHj and at https://lnkd.in/g_rB9_th, and at https://zalma.com/blog plus more than 5100 posts.

You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

This issue contains the following articles about insurance fraud:

The Historical Basis of Punitive Damages

It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.

The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.

You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf

Insurer Refuses to Submit to No Fault Insurance Fraud

...

00:08:27
July 16, 2025
There is no Tort of Negligent Claims handling in Alaska

Rulings on Motions Reduced the Issues to be Presented at Trial

Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.

CASE OVERVIEW

In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.

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Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.

Prior to trial Bernier had three remaining claims against State Farm:

1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.

Both Bernier and State Farm dispositive motions before ...

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May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

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/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:

Health Care Fraud Trial Results in Murder for Hire of Witness

To Avoid Conviction for Insurance Fraud Defendants Murder Witness

In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...

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CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.

In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:

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