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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June 03, 2024
Liars Never Prosper

Failure to Tell the Truth on an Insurance Application Voids Entire Policy as if it Never Existed

Read the full article at https://lnkd.in/dNY7bhPd, see the full video at https://lnkd.in/dXAEHycy and at https://lnkd.in/dVefzJ3m and at https://zalma.com/blog plus more than 4800 posts.

Post 4814

Ms. Stephens demanded that Defendant Great American Assurance Company (“Great American”) provide legal representation for her under an insurance policy (the “Policy”) it issued related to a professional disciplinary hearing and Great American refused and asserted that she lied on the application for insurance causing the policy to be void.

In Accent Consulting Group, Incorporated, Brenda Marie Stephens v. Great American Assurance Company – Great American Assurance Company v. Accent Consulting Group, Incorporated, Brenda Marie Stephens, No. 1:22-cv-01767-JMS-CSW, United States District Court, S.D. Indiana, Indianapolis Division (May 20, 2024) resolved the dispute.

CROSS-MOTIONS FOR SUMMARY JUDGMENT

Ms. Stephens purchased a claims-made and reported Real Estate Professional Errors and Omissions Insurance Policy (the “Policy“). To receive coverage, the Policy required Ms. Stephens to report in writing any claims or disciplinary actions against her during the policy period or extended reporting period. Although the Policy provided for reimbursement of “reasonable attorneys’ fees, costs and expenses incurred in responding to a Disciplinary Action,” the Policy specifically stated that Great American “shall not be obligated to defend any Disciplinary Action.” The Policy ran from April 2020 to April 2021.
The Consumer Complaint

During the first Policy period, in October 2020, Ms. Stephens agreed to and did perform a “desktop appraisal” of an Indiana single-family home (the “Property“). A “desktop appraisal” is one that is virtual, not requiring a “physical inspection of the property by the appraiser.”

The next month, in November 2020, the Property’s owners filed a complaint (the “Consumer Complaint“) against Ms. Stephens with the Office of the Indiana Attorney General (“Indiana OAG“). The Consumer Complaint alleged that Ms. Stephens’ appraisal was “20% below contracted sales price and thus the sale was lost.”

The Insurance Renewal Application

Less than six months after the Complaint and Indiana OAG correspondence, on March 16, 2021, Ms. Stephens applied to renew Accent’s insurance Policy with Great American. The Renewal Application asked whether Ms. Stephens was “aware of any of the following in the past 12 months: . . . [c]omplaint, disciplinary action, investigation or license suspension/revocation by any regulatory authority.” She responded in the negative.

The Complaint Before the Real Estate Appraiser Licensure and Certification Board

Later that autumn, on November 1, 2021, the Indiana OAG filed a complaint against Ms. Stephens before the Real Estate Appraiser Licensure and Certification Board (“REAB“). The Indiana OAG eventually demanded “disciplinary sanctions.”

The Request for Insurance Coverage

After the filing of the REAB Complaint, Ms. Stephens requested legal representation from Great American. Great American denied the application because Ms. Stephens received the Consumer Complaint in November 2020, during the first Policy period, but did not report it until November 2021, the following year during the renewed Policy period.

This Litigation

Because she was denied insurance coverage, she sued Great American for breach of contract and bad faith. Great American sought to add a claim for rescission of the Policy.

Great American noted Ms. Stephens’s admission that “as of November 23, 2020, [she] had knowledge of, and was aware of, the allegations of the” Consumer Complaint. The Court granted the motion to amend, noting that Ms. Stephens “fail[ed] to address or even allege diligence or delay on the part of Great American,” and “[n]owhere in [her] twenty-two paged response [was] there any analysis under the rules applicable” to the motion.

DISCUSSION

Great American argued that Ms. Stephens answered on her Renewal Application that she was not aware of any “[c]omplaint, disciplinary action, investigation or license suspension/revocation by any regulatory authority.” Great American argued that Ms. Stephens’s answer was “false” and “material,” entitling it to rescind the Policy.

Great American argued that “(1) [Ms.] Stephens’ answer [on] the Renewal Application was false because, prior to executing the application . . . [Ms.] Stephens knew about the Consumer Complaint and the Indiana OAG’s resulting investigation; and (2) this false statement was material to the risk insured by the Policy.” It also contended that Ms. Stephens’s false statement and nondisclosure was material and it is entitled to judgment as a matter of law.

In this case, the Consumer Complaint led directly to the Indiana OAG investigation, the Indiana OAG investigation led directly to the REAB Complaint. Regardless of Ms. Stephens’ intent, which Indiana law disregards, she made a material misrepresentation. Her misrepresentation entitled Great American to rescind the policy.

Great American Assurance’s Cross-Motion for Summary Judgment was granted. Conversely, Ms. Stephens’s Motion for Summary Judgment was denied. The court ordered Great American to return the premium paid and rescinded the policy from its inception.

ZALMA OPINION

When a person misrepresents a material fact on an application for insurance an insurer may rescind the policy from its inception, return the premium and deal with the policy as if it never existed. Ms. Stephens lied on the application and that fact was the basis for the defense of rescission. Rescission is an equitable remedy that concludes it is not fair to require an insurer to defend or indemnify an insured who obtained the insurance by false statements on an application.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:08:55
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Intentionally Shooting a Woman With A Rifle is Murder

Post 5196

See the full video at and at and at https://zalma.com/blog and more than 5150 posts.

You Plead Guilty You Must Accept the Sentence

In Commonwealth Of Pennsylvania v. Mark D. Redfield, No. 20 WDA 2025, No. J-S24010-25, Superior Court of Pennsylvania (September 19, 2025) the appellate court reviewed the case of Mark D. Redfield, who pleaded guilty to third-degree murder for killing April Dunkle with malice using a rifle.

Affirmation of Sentence:

The sentencing court’s judgment was affirmed, and jurisdiction was relinquished, concluding no abuse of discretion occurred.

Reasonable Inference on Trigger Pulling:

The sentencing court reasonably inferred from the guilty plea facts that the appellant pulled the trigger causing the victim’s death, an inference supported by the record and consistent with the plea.

Guilty Plea Facts:

The appellant admitted during the plea hearing...

00:07:16
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September 25, 2025
Prelitigation Communications Privileged

The Judicial Proceedings Privilege
Post 5196

Posted on September 25, 2025 by Barry Zalma

See the full video at and at

Judicial Proceeding Privilege Limits Litigation

In David Camp, and Laura Beth Waller v. Professional Employee Services, d/b/a Insurance Branch, and Brendan Cassity, CIVIL No. 24-3568 (RJL), United States District Court, District of Columbia (September 22, 2025) a defamation lawsuit filed by David Camp and Laura Beth Waller against Insurance Branch and Brendon Cassity alleging libel based on statements made in a letter accusing them of mishandling funds and demanding refunds and investigations.

The court examined whether the judicial proceedings privilege applieD to bar the defamation claims.

Case background:

Plaintiffs Camp and Waller, executives of NOSSCR and its Foundation, sued defendants Insurance Branch and Cassity over a letter alleging financial misconduct and demanding refunds and audits. The letter ...

00:07:56
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September 24, 2025
Untrue Application for Insurance Voids Policy

Misrepresentation or Concealment of a Material Fact Supports Rescission

Post 5195

Don’t Lie to Your Insurance Company

See the full video at and at https://rumble.com/v6zefq8-untrue-application-for-insurance-voids-policy.html and at https://zalma.com/blog plus more than 5150 posts.

In Imani Page v. Progressive Marathon Insurance Company, No. 370765, Court of Appeals of Michigan (September 22, 2025) because defendant successfully established fraud in the procurement, and requested rescission, the Court of Appeals concluded that the Defendant was entitled to rescind the policy and declare it void ab initio.

FACTS

Plaintiff's Application:

Plaintiff applied for an insurance policy with the defendant, indicating that the primary use of her SUV would be for "Pleasure/Personal" purposes.

Misrepresentation:

Plaintiff misrepresented that she would not use the SUV for food delivery, but records show she was compensated for delivering food.

Accident:

Plaintiff's SUV was involved in an accident on August ...

00:07:48
September 09, 2025
The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma

See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.

The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime

See the full video at and at

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ­­­Perpetrators than any Other Crime.

How Elderly Doctors Fund their ...

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September 08, 2025
The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma

See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.

The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime

See the full video at and at

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the ­­­Perpetrators than any Other Crime.

How Elderly Doctors Fund their ...

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September 03, 2025

Barry Zalma: Insurance Claims Expert Witness
Posted on September 3, 2025 by Barry Zalma
The Need for a Claims Handling Expert to Defend or Prove a Tort of Bad Faith Suit

© 2025 Barry Zalma, Esq., CFE

When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.

On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive ...

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