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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 18, 2024
Auto Insurance only Available for Drivers Listed in Policy

Scheduled Driver Endorsement Eliminates Coverage for Accident

Read the full article at https://lnkd.in/gPDaNk_y, see the full video at https://lnkd.in/ghZ-yQd9 and at https://lnkd.in/gathAeRF and at https://zalma.com/blog plus more than 4800 posts.

Post 4825

Brandyn Washington and Stephan Jomar Gonzalez were involved in a car accident in Davenport, Florida. Washington sued and asserted that Gonzalez was driving the truck involved in the accident.

In Prime Property And Casualty Insurance Company v. Coexi Trucking, LLC, Stephan Jomar Gonzalez, Brandyn Washington and W. Aleman Trucking LLC, No. 6:22-cv-1668-JSS-DCI, United States District Court, M.D. Florida, Orlando Division (June 4, 2024) the court considered the insurer’s motion for summary judgment asserting no coverage for defense or indemnity of the defendants.

BACKGROUND

Before the accident, Plaintiff issued an insurance policy to Coexi (the Policy) that contained a Scheduled Drivers Endorsement. This Endorsement changed the terms and conditions of the Policy issued and provided that “No coverage shall be provided under this Policy for any covered Auto which is being used or operated by anyone other than the driver(s) or operator(s) named below.”

The Policy was in effect at the time of the accident. The insurer established that Gonzalez was not a scheduled driver under the Policy and explained why it was appropriate to issue a declaration that it had no obligation to defend or indemnify Defendants in connection with the accident between Washington and Gonzalez that occurred on January 4, 2022.

ANALYSIS

In support of its Motion, the insurer argued that it was undisputed that Gonzalez was the driver at the time of the accident and further stated that Washington admitted such in his underlying state court complaint and Answer in this action. Plaintiff further argued that coverage under the Policy is limited to drivers listed in the Policy’s Scheduled Drivers Endorsement.

The USDC concluded that the Policy must be construed considering its plain meaning. Gonzalez’s name is not listed on the Scheduled Drivers Endorsement. Since Gonzalez was not listed as a scheduled driver, no coverage under the Policy exists for the accident at issue and Plaintiff’s Motion for Final Summary Judgment was granted, and pursuant to the terms and conditions of the Policy, the insurer had no obligation to defend or indemnify Defendants in connection with the automobile accident between Brandyn Washington and Stephan Jomar Gonzalez that occurred on January 4, 2022.

ZALMA OPINION

Insurance policies are contracts that must be interpreted as written. The policy limited its coverage to people named on the policy that were named after the insurer examined the risks posed by each driver. Since Gonzalez was not named in the policy there was never an ability for there to be coverage for the accident.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:05:27
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8 hours ago
Zalma’s Insurance Fraud Letter – November 1, 2025

ZIFL – Volume 29, Issue 21

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

Post 5220

Read the full article at https://lnkd.in/gRMJpi4s, see the video at https://lnkd.in/gwGSd6ZA & at https://lnkd.in/gbDiuFJy, and at https://zalma.com/blog plus more than 5200 posts.

See the video at & at https://rumble.com/v711hr0-zalmas-insurance-fraud-letter-november-1-2025.html

See the full 18 page issue of ZIFL at ZIFL-11-01-2025

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/

Conviction for Health Insurance Fraud Upheld

Physician Conspired with Bonavilla to Effect Health Insurance Fraud

Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on ...

00:10:22
October 31, 2025
The Zalma Philosophy of Claims Handling – Part 8

The Professional Claims Handler

Post 5218

Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-8-barry-zalma-esq-cfe-zdwsc, see the full video at https://rumble.com/v70zl4s-the-zalma-philosophy-of-claims-handling-part-8.html and at https://youtu.be/MIYcF71ffRQ, and at https://zalma.com/blog plus more than 5200 posts.

Claims Commandment X – Thou Shall Not Pretend to be a Lawyer

Some experienced and professional claims people know the law in their area of expertise better than most lawyers.

Adjusters should be adjusters and leave lawyering to lawyers. Similarly, lawyers should be lawyers and never try to be adjusters.

Claims Commandment XI – Thou Shall Empathize With the Claimant

Everyone presenting a claim is unhappy, disturbed, shocked, injured and needs help.

Empathy is identification with and understanding of another’s situation, feelings, and motives. It is the ability to understand another person’s circumstances, point of view, thoughts, and feelings....

00:11:08
October 28, 2025
The Zalma Philosophy of Claims Handling – Part 6

HOW TO CREATE AN EXCELLENCE IN CLAIMS HANDLING PROGRAM

See the full video at https://rumble.com/v70wb2i-the-zalma-philosophy-of-claims-handling-part-6.html and at https://youtu.be/tL5nDKPEs40 and at https://zalma.com/blog plus more than 5200 posts.

Post 5217

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.

An Excellence in Claims Handling program begins with a statement in the insurer’s claims manual or statement of professionalism that it is dedicated to providing excellence in claims handling to every insured who presents a claim.

The excellence in claims handling program should include, at a minimum:

A series of lectures supported by text materials explaining:
A definition of insurance.
How to read and understand an insurance policy.
How to interview an insured, witness, or claimant.
How to assist an insured in the insured’s obligation to ...

00:08:40
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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