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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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May 20, 2024
Unique Insurance Fraud In Louisiana

Three Cases Dismissed Because of Suit Against an Insurer who Did Not Insure the Plaintiff

Read the full article at https://lnkd.in/gwy59pYF, see the full video at https://lnkd.in/gAGT2vrJ and at https://lnkd.in/g2JEXuk8, and https://zalma.com/blog plus more than 4800 posts.

Post 4804

Texas Law Firm McClenny, Moseley & Associates (MMA) has had serious problems with the US District Courts in Louisiana and what appears to be an effort to profit from what some Magistrate and District judges indicate may be criminal conduct to profit from insurance claims relating to hurricane damage to the public of the state of Louisiana. In April and May several cases have been the subject of motions for Summary Judgment from insurers who were sued by MMA who was sanctioned by the District Courts and new lawyers took over the cases only to find the plaintiffs had no right to sue since they were not insured by the insurer defendants. For a representative sample note the information from the following three cases:

1. In Ave Duruisseau v. Farmers Property & Casualty Insurance Co, No. 6:22-CV-03860, United States District Court, W.D. Louisiana, Lafayette Division (April 26, 2024) Summary Judgment was granted because Farmers did not insure Plaintiff’s property.

2. In Hester Cole v. Foremost Insurance Company Grand Rapids Michigan, No. 2:22-CV-03514 United States District Court, W.D. Louisiana, Lake Charles Division (April 26, 2024) the court granted Summary Judgment because Foremost did not insure Plaintiff’s property on August 27, 2020.

3. In Terry Ramirez v. Atlantic Casualty Insurance Co, No. 2:22-CV-04797, United States District Court, (May 7, 2024), dealt with a Motion for Summary Judgment filed by defendant Atlantic Casualty Insurance Company (“Atlantic Casualty”). The motion was unopposed. The details were a little different.

All cases filed by plaintiff’s counsel were suspended due to concerns about misconduct committed by that firm.

Plaintiff cannot maintain a claim for breach of contract against Atlantic Casualty. In the absence of a valid contractual claim, plaintiff’s bad faith claims must also fail. The Motion for Summary Judgment was granted.

The result of these three cases indicates that the MMA firm had a problem with the truth and filed suits on behalf of people who were not insured by the insurer defendant and was, as a result, a suit based on fraudulent allegations.

ZALMA OPINION

The last 28 issues of Zalma’s Insurance Fraud Letter has described the problems faced by MMA and insurers in the state of Louisiana who were required to defend false and fraudulent lawsuits.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:07:10
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12 hours ago
Public Adjuster Immediately Retained but Insurer Not Notified

Insured Must Give Prompt Notice of Loss
Post 5256

Read the full article at https://lnkd.in/gBXRbKXD, see the video at https://lnkd.in/g4DKfUDz and at https://lnkd.in/g65V_RQ7 and at https://zalma.com/blog plus more than 5250 posts.

Once The Insured Knows There is Damage It is Obligated to Report the Loss to the Insurer

In Greater St. Stephen Ministries, Inc. v. Mt. Hawley Insurance Company, No. 24-cv-3130 (AS), United States District Court, S.D. New York (January 2, 2026) resolved a case brought by a church against an insurance company for denying coverage after Hurricane Ida. After discovery, the insurance company moved for summary judgment because it claimed the insured breached a material condition of the policy.

BACKGROUND

Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...

00:09:19
12 hours ago
Public Adjuster Immediately Retained but Insurer Not Notified

Insured Must Give Prompt Notice of Loss
Post 5256

Read the full article at https://lnkd.in/gBXRbKXD, see the video at https://lnkd.in/g4DKfUDz and at https://lnkd.in/g65V_RQ7 and at https://zalma.com/blog plus more than 5250 posts.

Once The Insured Knows There is Damage It is Obligated to Report the Loss to the Insurer

In Greater St. Stephen Ministries, Inc. v. Mt. Hawley Insurance Company, No. 24-cv-3130 (AS), United States District Court, S.D. New York (January 2, 2026) resolved a case brought by a church against an insurance company for denying coverage after Hurricane Ida. After discovery, the insurance company moved for summary judgment because it claimed the insured breached a material condition of the policy.

BACKGROUND

Greater St. Stephen Ministries, Inc., a church located in Louisiana, owned property that suffered damage from Hurricane Ida on August 29, 2021. The property was insured under a policy with Mt. Hawley Insurance Company, which required the insured to provide “prompt notice” of any loss or damage, ...

00:09:19
January 07, 2026
Broker's Failure to Obtain Insurance Ordered Causes Litigation

New Trial Because Jury Used Policy That Provides No Coverage to Assess Damages

Post 5255

Read the full article at https://lnkd.in/drG3xH2R, see the video at https://lnkd.in/d6p8e-9p and at https://lnkd.in/dgPsQ3Sn, and at https://zalma.com/blog plus more than 5250 posts.

In Brown & Brown of Florida, Inc. v. Houligan’s Pub & Club, Inc., and Ormond Wine Company, LLC, Nos. 5D2024-2352, 5D2024-2458, Florida Court of Appeals (January 2, 2026) the Court of Appeals was faced with a case of first impression that involved damages from a hurricane that hit the East Coast of Florida almost a decade ago and the extent to which an insurance broker is responsible for paying for such damages.

The jury entered a verdict in favor of the insurance broker on the insured’s claim that it was negligent in failing to procure insurance, but it found in favor of the insured on claims of breach of fiduciary duty and negligent misrepresentation.

The insurance broker does not contest it breached its duties on these two claims, only ...

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December 31, 2025
“Sudden” is the Opposite of “Gradual”

Court Must Follow Judicial Precedent
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Read the full article at https://www.linkedin.com/pulse/sudden-opposite-gradual-barry-zalma-esq-cfe-h7qmc, see the video at and at and at https://zalma.com/blog plus more than 5250 posts.

Insurance Policy Interpretation Requires Application of the Judicial Construction Doctrine

In Montrose Chemical Corporation Of California v. The Superior Court Of Los Angeles County, Canadian Universal Insurance Company, Inc., et al., B335073, Court of Appeal, 337 Cal.Rptr.3d 222 (9/30/2025) the Court of Appeal refused to allow extrinsic evidence to interpret the word “sudden” in qualified pollution exclusions (QPEs) as including gradual but unexpected pollution. The court held that, under controlling California appellate precedent, the term “sudden” in these standard-form exclusions unambiguously includes a temporal element (abruptness) and cannot reasonably be construed to mean ...

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December 29, 2025
Doctor Accused of Insurance Fraud Sues Insurer Who Accused Him

Lack of Jurisdiction Defeats Suit for Defamation

Post 5250

Posted on December 29, 2025 by Barry Zalma

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He Who Represents Himself in a Lawsuit has a Fool for a Client

In Pankaj Merchia v. United Healthcare Services, Inc., Civil Action No. 24-2700 (RC), United States District Court, District of Columbia (December 22, 2025)

FACTUAL BACKGROUND
Parties & Claims:

The plaintiff, Pankaj Merchia, is a physician, scientist, engineer, and entrepreneur, proceeding pro se. Merchia sued United Healthcare Services, Inc., a Minnesota-based medical insurance company, for defamation and related claims. The core allegation is that United Healthcare falsely accused Merchia of healthcare fraud, which led to his indictment and arrest in Massachusetts, causing reputational and business harm in the District of Columbia and nationwide.

Underlying Events:

The alleged defamation occurred when United ...

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December 15, 2025
Zalma’s Insurance Fraud Letter – December 15, 2025

Zalma’s Insurance Fraud Letter

Read the full article at https://lnkd.in/dG829BF6; see the video at https://lnkd.in/dyCggZMZ and at https://lnkd.in/d6a9QdDd.

ZIFL Volume 29, Issue 24

Subscribe to the e-mail Version of ZIFL, it’s Free! https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

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/

Zalma’s Insurance Fraud Letter

Merry Christmas & Happy Hannukah

Read the following Articles from the December 15, 2025 issue:

Read the full 19 page issue of ZIFL at ...

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