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 04, 2024

Liars Never Prosper

Read the full article at https://lnkd.in/d9FVCAEG, 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.

Failure to Tell the Truth on an Insurance Application Voids Entire Policy as if it Never Existed
Post 4814

Ms. Stephens demanded that Defendant Great American Assurance Company (“Great American”) provide legal representation for her under an insurance policy (the “Policy”).

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.

The Consumer Complaint

During the first Policy period, in October 2020, Ms. Stephens did a “desktop appraisal” of an Indiana single-family home (the “Property“). A “desktop appraisal” is one that is virtual.

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 about claims. She responded in the negative.

The Complaint Before the Real Estate Appraiser Licensure and Certification Board

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.

DISCUSSION

Ms. Stephens lied on her Renewal Application that she was not aware of any “[c]omplaint, disciplinary action, investigation or license suspension/revocation by any regulatory authority.”

The Consumer Complaint led directly to the Indiana OAG investigation. Ms. Stephens made a material misrepresentation. Her misrepresentation entitled Great American to rescind the policy.

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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Videos
Posts
13 hours ago
Not Fair to Require Tenant to Pay for Damage Insured by Landlord

No Right to Subrogation Against Tenant
Post 5231

Not Fair to Require Tenant to Pay for Damage Insured by LandlordSee the video at https://lnkd.in/gFkrp_6M and at https://lnkd.in/gQdFQBWj and at https://zalma.com/blog plus more than 5200 posts.

See the video at and at

For Insurer to Subrogate Lease Must Require Tenant to Obtain Insurance for the Benefit of the Landlord

In AmGUARD Insurance Co. v. Tyrone Ellis and Shakyra Ellis, U.S. District Court, District of Connecticut Civil No. 3:25-cv-946 (JCH) (November 19, 2025), Judge, Janet C. Hall the defendant’s Motion to Dismiss the Amended Complaint on the basis of Connecticut’s anti-subrogation doctrine required dismissal.

KEY FACTS

Landlord Michael Caldwell, a Connecticut citizen, owned a multi-family building in Windsor, Connecticut. Defendants Tyrone and Shakyra Ellis were residential tenants in the building. On or about March 1, 2025, a fire ...

00:08:28
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November 19, 2025
Stealing from Fellow Church Members is Costly

Debt Resulting from Fraud is Not Dischargeable in Bankruptcy

Post 5230

Read the full article at https://lnkd.in/gpF3y7Vd, see the video at https://lnkd.in/gR5cVcbY and at https://lnkd.in/gch6Q4_V, and at https://zalma.com/blog plus more than 5200 posts.

Knowing Misappropriation and Conversion of Funds is Fraud

In re Matthew Jene Tubbs (Bankr. N.D. Tex., Fort Worth Div., No. 22-42728-MXM-7; Adv. No. 23-04019-mxm), October 15, 2025 .

Key Facts

Plaintiffs (Robles) and Defendant (Tubbs) met through their church; both held leadership roles. In Feb 2021 Robles home suffered major water damage from Winter Storm Uri and insurance paid $173,000.

In the Fall of 2021: Tubbs represented to Mr. Robles that he personally built a newer house and large barn on his parents’ property “with his own hands” (except foundation/insulation). That he had 10 years’ experience overseeing window/door installations at a major home-improvement chain, was a licensed contractor (false) and carried general contractor liability insurance.

Relying on ...

00:08:33
November 17, 2025
Zalma’s Insurance Fraud Letter November 15, 2025

See full video at https://lnkd.in/gtnsH3SW and at https://lnkd.in/geJ4FseF, and at https://zalma.com/ and at https://lnkd.in/gC2wmzqZ.

ZIFL-Volume 29 Number 22

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post 5228

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/

Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/11/ZIFL-11-15-2025-1.pdf

Man Bites Dog Story – Hertz Sues Alleged Fraudsters

Hertz Successfully Refuses to Pay Alleged Fraudulent Health Care Providers

Proactive Victim of Fraud Defeats Health Care Providers

More McClenny Moseley & Associates Issues

This is ZIFL’s thirty eighth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana and what appears to be ...

00:10:34
October 31, 2025
The Zalma Philosophy of Claims Handling – Part 9

The Professional Claims Handler
Post 5219

Posted on October 31, 2025 by Barry Zalma

An Insurance claims professionals should be a person who:

Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.

How to Create Claims Professionals

To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...

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October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail

Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.

My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
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