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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Motion for Summary Judgment Requires Evidence Establishing Defenses
Post 5223
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In Michael Tillema, Kim Til- Lema v. Meridian Security Insurance Company, No. SA-24-CV-00661-JKP, United States District Court, W.D. Texas, San Antonio Division (October 7, 2025) Plaintiffs Michael Tillema and Kim Til-Lema claimed coverage from Meridian Security Insurance Company for benefits for alleged wind and hail damage from a storm on April 26, 2022.
Meridian Security Insurance Company denied the claim, citing inspection reports and weather data indicating no hail event occurred on the alleged date. Plaintiffs hired an independent contractor, who also found no hail within one mile of the property on the ...
Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers
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Proactive Victim of Fraud Defeats Health Care Providers
In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.
FACTUAL BACKGROUND
Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.
Plaintiff also ...
Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers
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Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
Proactive Victim of Fraud Defeats Health Care Providers
In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.
FACTUAL BACKGROUND
Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.
Plaintiff also moved...
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 ...
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 ...
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 ...
