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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 21, 2024
Never Delay Responding to Requests for Admission in Arizona

Requests for Admission Deemed Admitted in Arizona if Not Responded to Within 30 Days

Read the full article at https://lnkd.in/gFaFwFTY, see the full video at https://lnkd.in/gPvzTw_3 and at https://lnkd.in/gy6u9uGk and at https://zalma.com/blog plus more than 4800 posts.

Post 4828

Rose Karam, an insured, appealed from the superior court’s grant of summary judgment in favor of her residential property insurer, Mercury Casualty Co. In Rose A. Karam v. Mercury Casualty Company, No. 2 CA-CV 2023-0112, Court of Appeals of Arizona, Second Division (May 31, 2024) her suit against Mercury was defeated by admission that she had no case because she responded late to requests.

FACTUAL BACKGROUND

Karam was an insured under a Mercury homeowner’s policy. After suffering a fire at her home, Karam filed a property loss and damage claim under the policy, citing damage to a piano and a wall mirror. Following receipt of payments by Mercury Karam complained to Mercury that she was underpaid for personal property losses.

Two years later, Karam sued Mercury for insurance fraud, consumer fraud, and breach of contract. Thereafter, on August 30, 2022, Mercury served Karam with a set of discovery requests including interrogatories and requests for admission. Karam’s response to the requests for admission were due within thirty days of service she provided her responses months later on December 1, 2022.

Mercury moved for summary judgment. By its motion, Mercury asserted, in part, that because Karam’s responses to the requests for admission were untimely, the requests were deemed admitted. Due to those admissions-including that Karam had been fully and fairly paid for her losses, that Mercury had not breached the insurance policy, and that Karam had suffered no damages-Mercury claimed it was entitled to judgment as a matter of law on Karam’s breach of contract claim.

The court further determined that, even considering her actual, albeit untimely, responses to the requests for admission, Karam “failed to produce admissible evidence creating a genuine issue of fact for trial.”

DISCUSSION

The Court of Appeals will only affirm a grant of summary judgment if the evidence produced in support of the defense or claim has so little probative value that no reasonable person could find for its proponent.

Admissions

Arizona Rule 36(a)(1) provides that “[a] party may serve on any other party a written request to admit . . . the truth of any matters . . . relating to . . . facts, the application of law to fact, or opinions about either; and . . . the genuineness of any described documents.” The purpose of requests for admission is to expedite the trial and to relieve parties of unnecessary costs in proving facts.

Once a party is served with requests for admission, failure to respond within 30 days the rule provides “[a] matter admitted under this rule is conclusively established unless the court, on motion, permits the admission to be withdrawn or amended.”

Karam conceded on appeal that she did not respond to Mercury’s requests for admission within the required thirty-day period. Therefore the superior court did not abuse its discretion in deeming the statements in the requests for admission admitted.

Karam effectively admitted that she had been fully and fairly compensated for the claims she submitted, that Mercury did not breach the insurance policy, and that she did not otherwise have damages. Those admissions – even each standing alone – defeat a claim for breach of the insurance policy.

Given the allegations in Karam’s complaint and her admissions made by operation of law, there remained no material issue in dispute and Karam can no longer carry her burden of proof in this action.

Mercury was entitled to summary judgment and the court did not err in granting Mercury’s motion.

ZALMA OPINION

A lawyer practicing in Arizona that does not comply with the rules concerning Requests for Admission will always lose because his opponent will always send a Request including the ultimate facts about the case. Mercury’s counsel took advantage of the Arizona rule and obtained admissions that resulted in the resolution of the case in its favor. Karam is not without a remedy, she has a cause of action against her lawyer.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:06:29
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July 18, 2025
Solomon Like Decision: No Duty to Defend – Potential Duty to Indemnify

Concurrent Cause Doctrine Does Not Apply When all Causes are Excluded
Post 5119

Death by Drug Overdose is Excluded

See the full video at https://lnkd.in/geQtybUJ and at https://lnkd.in/g_WNfMCZ, and at https://zalma.com/blog plus more than 5100 posts.

Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.

KEY POINTS

1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
3. Duty to Indemnify: The court could not determine at this stage whether the Plaintiff had a duty to ...

00:08:21
July 17, 2025
No Good Deed Goes Unpunished

GEICO Sued Fraudulent Health Care Providers Under RICO and Settled with the Defendants Who Failed to Pay Settlement

See the full video at https://lnkd.in/gDpGzdR9 and at https://lnkd.in/gbDfikRG, and at https://zalma.com/blog plus more than 5100 posts.

Post 5119

Default of Settlement Agreement Reduced to Judgment

In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)

Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...

00:07:38
July 15, 2025
Zalma’s Insurance Fraud Letter – July 15, 2025

ZIFL – Volume 29, Issue 14
Post 5118

See the full video at https://lnkd.in/geddcnHj and at https://lnkd.in/g_rB9_th, and at https://zalma.com/blog plus more than 5100 posts.

You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

This issue contains the following articles about insurance fraud:

The Historical Basis of Punitive Damages

It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.

The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.

You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf

Insurer Refuses to Submit to No Fault Insurance Fraud

...

00:08:27
July 16, 2025
There is no Tort of Negligent Claims handling in Alaska

Rulings on Motions Reduced the Issues to be Presented at Trial

Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.

CASE OVERVIEW

In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.

FACTS

Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.

Prior to trial Bernier had three remaining claims against State Farm:

1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.

Both Bernier and State Farm dispositive motions before ...

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May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

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/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:

Health Care Fraud Trial Results in Murder for Hire of Witness

To Avoid Conviction for Insurance Fraud Defendants Murder Witness

In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.

In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:

Insurance Coverage Dispute:

Travelers issued a Commercial General Liability ...

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