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 27, 2024
Damage While Fleeing Police Excluded

Exclusion Does Not Invalidate Policy

Read the full article at https://lnkd.in/gc4XEkP9, see the full video at https://lnkd.in/gnZwe9h6 and at https://lnkd.in/gT6-vh-d and at https://zalma.com/blog plus more than 4800 posts.

Post 4822

THE DISPUTE

Jerquavius Berry purchased a vehicle from Gerald Jones Ford, LLC. The Dealership sued General Security and Berry, seeking a declaratory judgment regarding General Security’s insurance coverage.

In General Security Indemnity Company Of Arizona v. Gerald Jones Ford, LLC. No. A24A0477, Court of Appeals of Georgia, Fifth Division (June 18, 2024) the Georgia Court of Appeals read the policy and ruled based on its wording.

Both moved for summary judgment. The trial court granted the Dealership’s motion and denied General Security’s motion. General Security appealed. The Court of Appeals decision turned on whether a denied claim renders an insurance policy “invalid.”

FACTS

In order to purchase the vehicle, Berry presented evidence of an insurance policy with Falls Lake National Insurance Company (“Falls Lake”) to the Dealership. Three days after he purchased the vehicle, while fleeing police in Virginia, Berry crashed the vehicle, causing a total loss. Berry was later found guilty of crimes.

Perhaps because Berry was in jail and did not respond to Exeter’s inquiry it rejected the note and returned it to the Dealership. The Dealership made a claim for the vehicle under Berry’s Falls Lake insurance policy. The Falls Lake policy provided that claims for Berry’s property damage were excluded from coverage because Berry was fleeing police when the vehicle sustained a total loss.

The Dealership submitted a claim for Berry’s vehicle to General Security, but General Security denied the claim, stating that the loss did not fall within the policy’s coverage. The Dealership filed the underlying declaratory judgment action against General Security. The Dealership’s insurance policy with General Security provided coverage for insured vehicles until the vehicle was sold or leased by the Dealership or if the buyer’s insurance proved to be invalid at the time of loss to the covered vehicle.

DISCUSSION

Since Berry provided evidence of insurance and the Dealership was not fully paid the only dispute at issue was whether Berry’s Falls Lake policy was invalid at the time of the loss.

The Court of Appeals undertook a three-step process in the construction of the contract:

1. The first of which is to determine if the instrument’s language is clear and unambiguous,
2. If the language is unambiguous, the court simply enforces the contract according to the terms and
3. Looks to the contract alone for the meaning.

When a contract term is not expressly defined, the court looks to the usual and common meaning of the term. A policy is invalid when coverage applies but becomes invalidated through the actions of the insured.

The Falls Lake insurance policy does not contain a coverage exclusion for fleeing police for a bodily or property injury to others only damage to the vehicle. Had Berry caused a bodily or property injury to another while fleeing the police, that third party’s claim would not have been excluded. The Falls Lake policy was in full force and effect at the time of the occurrence and coverage was not invalidated; it simply did not apply.

ZALMA OPINION

Where the language of an insurance policy unambiguously governs the factual scenario before the court, the court need only to apply the terms of the contract as written. The General Security policy language unambiguously does not cover such claims unless the purchaser’s insurance policy was invalid at the time of the loss. Since Berry’s policy with Falls Lake was not invalid at the time of the loss the trial court erred by granting summary judgment to the Dealership. Accordingly, the Court of Appeals reversed the trial court.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:08:07
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August 27, 2026
Offer Made and Accepted Creates Enforceable Contract

Policy Limits Demand Accepted Settles Claim

Post 5434

Posted on August 26, 2026 by Barry Zalma

See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute

In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange,  The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.

FACTUAL BACKGROUND

Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.

Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...

00:08:28
August 26, 2026
Offer Made and Accepted Creates Enforceable Contract

Policy Limits Demand Accepted Settles Claim

Post 5434

Posted on August 26, 2026 by Barry Zalma

See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute

In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange,  The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.

FACTUAL BACKGROUND

Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.

Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...

00:08:28
July 22, 2026
The Real Cost of Fraud

The Largest Residential Burglary of All Time
Post 5407

Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma

See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection 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.

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection 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.

After ...

00:12:33
September 04, 2026

Qui Tam Relators are not officers of the United States

Posted on September 4, 2026 by Barry Zalma

Attempt to use Constitution to Stop a Qui Tam False Claims Act Case

Post 5486

FCA’s Qui Tam Provisions do not Violate the Appointments Clause.

In United States Of America, Clarissa Zafirov, ex rel; Dr. v. Florida Medical Associates, LLC, d.b.a. Vipcare, Physician Partners, LLC, Anion Technologies, LLC, Freedom Health, Inc., Optimum Healthcare, Inc., Physician Partners Specialty Services, LLC, et al., No. 24-13581, United States Court of Appeals, Eleventh Circuit (September 1, 2026).

The False Claims Act (“FCA”) allows the Attorney General to bring civil suits against perpetrators of fraud against the government. This case involves another portion of the FCA-the qui tam provisions-which allow people, called relators, who have knowledge about fraud against the government to pursue a case against the perpetrator of the fraud.

Dr. Clarissa Zafirov filed a qui tam action under the False Claims Act on behalf of...

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September 03, 2026
Res Judicata Produces Certainty

Posted on September 3, 2026 by Barry Zalma

You Only Get One Chance to Sue

Post 5484

In David Cromp v. Johnny Harkrider, Monique Harkrider, and their Marital Community, dba Able Plumbing Plus, No. 61678-5-II, Court of Appeals of Washington, Division 2 (August 25, 2026) David Cromp hired Able Plumbing Plus in 2018 to install plumbing, including two toilets, at his residence. In 2019, both toilets allegedly leaked, causing damage. Insurance claims were submitted through Able’s contractor policy, but the insurer eventually denied the claims.

Cromp sued Able in 2022 for breach of contract based on the allegedly defective toilet installation. During that case, Cromp attempted to add claims related to Able’s conduct during the insurance claim process, including fraud, bad faith, tortious conduct, and bond-related claims, but the superior court denied leave to amend. The 2022 breach-of-contract claim was later dismissed with prejudice on summary judgment as time-barred.

On the same day the 2022 case was dismissed, Cromp filed a ...

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September 02, 2026
A Charge of Insurance Fraud is not Grounds for Deportation

Habeas Corpus Petition Granted

Post 5483

Posted on September 2, 2026 by Barry Zalma

Over Staying Visa & Charge of Insurance Fraud Still Entitled to Habeas Relief and a Bond Hearing

In Hernan Guillermo Palomino-Crespo v. Warden, Glades County Detention Center et al., No. 2:26-cv-02322-SPC-NPM, United States District Court, M.D. Florida, Fort Myers Division (August 26, 2026) Hernan Guillermo Palomino-Crespo’s Amended Petition for Writ of Habeas Corpus, the government’s response and Palomino-Crespo’s reply.

FACTUAL BACKGROUND

Palomino-Crespo is a native and citizen of Colombia who lawfully entered the United States on a B-2 non-immigrant visa on February 24, 2017. He resides in Miami, Florida with his wife and two minor children, owns and operates a residential restoration and remodeling business, and files U.S. tax returns.
On June 4, 2026, the State of Florida charged Palomino-Crespo with insurance fraud.

Palomino-Crespo claimeds he did not meet the requirements for mandatory detention under § ...

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