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 17, 2024
Application Wrongfully Stated No Work on Recreational or Playground Equipment

Policy Does Not Cover Damages Caused by In-Ground Trampoline

Read the full article at https://lnkd.in/gjmpqjey, see the full video at https://lnkd.in/grDHyuUn and at https://lnkd.in/gEFU4bXE and at https://zalma.com/blog plus more than 4800 posts.

Post 4824

United Casualty Insurance Company ("United" ) refused to defend James Snell, a landscaper, in a civil lawsuit alleging that Snell had negligently installed a ground-level trampoline in a client's backyard. Snell sued, contending that United had breached its insurance contract with him in bad faith and seeking a declaratory judgment that United had a duty to defend and indemnify Snell. The district court granted summary judgment for United, holding that the accident did not "arise from" Snell's "landscaping" work within the meaning of his commercial general liability policy.

The Eleventh Circuit resolved the dispute in James Snell, d.b.a. Outdoor Expressions v. United Specialty Insurance Company, No. 22-12581, United States Court of Appeals, Eleventh Circuit (May 28, 2024).

BACKGROUND

Snell's landscaping company is named "Outdoor Expressions," and it is located in Fairhope, Alabama. Snell was hired by the Westons to turn an above ground trampoline into a ground level trampoline.

Snell's site work included excavation of a pit, installation of a drain and drainage sand, excavation of a trench to install a drainage pipe, installation of the drainage pipe and of a drain pump, and, most relevant here, construction of concrete block retainer walls and installation of a wood cap on the retainer walls. The retaining walls aimed to prevent erosion and collapse of the structure; the wood cap was for aesthetics. Then, after all that, Snell unboxed the trampoline, assembled it, and lowered it into the pit.

A few years later, Matthew Burton sued the Westons for injuries his daughter suffered on the Westons' trampoline. Burton alleged that Snell "wantonly assembled, constructed and installed the trampoline in the backyard of the Weston[s]'s home," creating "an unreasonably dangerous condition and structure on the property."  Snell's advised his insurer of the lawsuit only to have United that it would not defend him in the lawsuit because it policy’s obligations were limited to the specified operations that Snell, as insured performs landscaping. It concluded that the injury from the assembly and installation of a Trampoline did not arise from Snell's performance of landscaping, and that there was no coverage for such claims.

In addition the application which predated the policy specifically asked Snell: "do you do any recreational or playground equipment construction or erection?" In response, Snell checked the "No" box.

DISCUSSION

Snell Has The Burden To Show Coverage.

Under Alabama law the party seeking coverage under a policy bears the burden of proving that coverage exists.  In short, the Specified Operations provision (fitting into the gap left by the general coverage provision) describes the contours or boundaries of coverage-it does not purport to take away coverage already granted.

Thus, the Specified Operations provision is a limitation of coverage-not an exclusion.

Snell Has Not Shown That United Had A Duty To Defend Him.

Because Snell's insurance application-which Alabama law requires the Eleventh Circuit to consider part of the policy-expressly disclaims the work he did here. Under Alabama law, insurance contracts are subject to the same rules of interpretation as any other contract. It was undisputed that the trampoline is "recreational equipment."

Accordingly, the Eleventh Circuit concluded that the information Snell provided in his insurance application conclusively established he was not entitled to coverage. The Eleventh Circuit concluded that Snell's insurance application forecloses any duty to indemnify for the same reason it forecloses any duty to defend.

Bad Faith

Generally, to prove a claim for bad faith refusal to pay an insurance claim, the plaintiff has the burden to prove

1. the existence of an insurance contract;
2. an intentional refusal to pay the claim; and
3. the absence of any lawful basis for the refusal and the insurer's knowledge of that fact or the insurer's intentional failure to determine whether there is any lawful basis for its refusal.

The District Court, having found that United had a lawful basis for denying Snell's claim and that Snell's breach of contract claim fails, his claim for bad faith denial also fails.  Snell did not show it was error to grant summary judgment on his bad faith claim.

ZALMA OPINION

The Commercial General Liability insurance policy issued to Mr. Snell, insured Snell against many risks of loss as long as they occurred as a result of his occupation as a landscaper that has no act that did not include any recreational or playground equipment construction or erection. Since the trampoline he installed was clearly an item of recreational or playground equipment thee was no potential for coverage to exist to defend or indemnify Snell for the injuries incurred when a child using the trampoline injured herself.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:08:14
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September 26, 2025
No Way Out After Murder Conviction

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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