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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July 09, 2024

In search of profit, insurers have decimated their professional claims staff. They laid off experienced personnel and replaced them with young, untrained, unprepared people. A virtual clerk replaced the old professional claims handler.

Process and computers replaced hands-on human skill and judgment. Money was saved on the expense side of the business by paying lower salaries. Within three months of firing the experienced claims people gross profit increased. The accountants were happy. The quarterly profits increased. None of the happy people were insurance professionals. None of them understood how a professional claims adjuster saves the insurer by establishing a fair amount of loss, avoiding payment for items not lost or overvalued, and by avoiding losses for which no coverage was provided by the policy.

The promises made by an insurance policy are kept by the professional claims person. Keeping a professional claims staff dedicated to excellence in claims handling is cost-effective over long periods of time. A professional and experienced adjuster will save the insurer millions by resolving disputes, paying claims owed promptly and fairly, and by so doing avoiding litigation and claims of breach of contract and breach of the covenant of good faith and fair dealing.

The professional claims person is an important part of the insurer’s defense against litigation by insureds against insurers for breach of contract and the tort of bad faith. Claims professionals resolve more claims for less money without the need for either party to involve counsel. A happy claimant satisfied with the results of his or her claim will never sue the insurer.

Incompetent or inadequate claims personnel force insureds and claimants to public insurance adjusters and lawyers. Every study performed on claims establishes that claims with an insured or claimant represented by counsel cost the insurer more than those where counsel is not involved.

Prompt, effective, professional claims handling saves money for both the insured and the insurer and fulfills the promises made when the insurer sold the policy.

Insurers who believe they can handle first or third party claims with young, inexpensive, inexperienced and untrained claims handlers should be accosted by angry stockholders whose dividends have plummeted, or will plummet, as a result. When an insurer compromises on claims staff, profits, thin as they may have been previously, will move rapidly into negative territory. Tort and punitive damages will deplete reserves. Insurers will quickly question why they are writing insurance. Those who stay in the business of insurance will either adopt a program requiring excellence in claims handling from every member of their claims staff, or they will fail.

Insurance is a business. It must change — this time for the better — if it is to survive. It must rethink the firing of experienced claims staff and reductions in training to save “expense.” Insurers should, if they wish to succeed, adopt a program to promote excellence in claims handling that can help insurers keep the promises made by the insurance policy and avoid charges of breach of contract and the tort bad faith in both first and third party claims.

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May 26, 2026
He Who Acts as His Own Lawyer Has an Idiot for a Client

Arsonist Tried To Represent Himself, Failed, and Sought Habeas Relief

Post number 5357

Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.

Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed

In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.

FACTS

Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...

00:08:55
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May 11, 2026
Severe Punishment for Failure to Obey Court Orders

Foolish to Repeatedly Disobey Court Orders

All That Remains For Trial Is Plaintiff’s Damages On Each Of These Claims And Establishing Proximate Causation Of Those Damages.

Post number 5348

See the full video at and at and at https://zalma.com/blog plus 5300 posts.

In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).

FACTUAL BACKGROUND

This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...

00:08:27
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May 08, 2026
Ambiguous Contract to Repair not an Assignment

The Right to Negotiate with Insurer is Not an Assignment of Claims

Post number 5347

Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.

Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer

In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.

FACTUAL BACKGROUND

In ...

00:08:02
June 19, 2026
Flood Policy Condition Effective

Flood Policy Limitation of Action Provision Destroys Bad Faith Suit
Post number 5376

Flood Policy Limitation of Action Provision Followed Strictly

Posted on June 19, 2026 by Barry Zalma

In Wayne Gularte, et al. v. Wright National Flood Insurance Company, No. 5:26-cv-01426-PCP, United States District Court, N.D. California (June 15, 2026) Wayne and Doris Gularte alleged that their property sustained flood damage between January 17 and March 23, 2023. They submitted claims to Wright National Flood Insurance Company, which paid part of the claim but denied additional claimed structural losses by email on June 18, 2023.

The Gularte plaintiffs filed suit in state court on December 30, 2025, seeking $12,500 for unpaid structural losses. Wright removed the action to federal court and moved to dismiss.

LAW:

A complaint in Federal Court must plead enough facts to state a plausible claim for relief under Federal Rule of Civil Procedure 8(a)(2), and dismissal under Rule 12(b)(6) is appropriate when the complaint lacks a ...

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June 18, 2026
Payment of All Policy Benefits Does not Defeat Bad Faith in California

Bad Faith With No Breach of Contract

Post number 5375

Essential Condition of a Tort of Bad Faith Ignored in California

Read the full article at https://www.linkedin.com/pulse/payment-all-policy-benefits-does-defeat-bad-faith-zalma-esq-cfe-yhnec and at https://zalma.com/blog.

In Jennifer Bornoff v. State Farm General Insurance Company, B339796, California Court of Appeals, Second District, First Division (May 1, 2026) Bornoff’s business suffered two burglaries in March 2022. She submitted claims promptly, and State Farm never disputed coverage, only valuation.

After months of delay and poor communication, State Farm paid the property-loss benefits about four months later, shortly after Bornoff sued.

ISSUE:

Whether State Farm was entitled to summary adjudication of Bornoff’s bad-faith claim when it had paid all policy benefits but allegedly caused extracontractual economic loss through unreasonable delay.

RULE:

In California, an insurer may be liable for bad faith if it unreasonably delays payment of...

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June 17, 2026
Court Orders Release of Convicted Insurance Fraudster Who Can’t Be Deported

Post number 5374

The Government Must Remove a Noncitizen Within 90 Days of Detention

In Jean Marcel Perez Garcia v. Warden, Florida Side South Detention Facility, et al., No. 2:26-cv-788-JES-DNF John E. Steele United States District Judge United States District Court, M.D. Florida, Fort Myers Division (June 10, 2026) Jean Marcel Perez Garcia, a Cuban citizen, entered the United States in 2003. After convictions for a drug offense and felony insurance fraud, he was ordered removed in 2018 but was later released under supervision.

ICE revoked that supervision in December 2025 and detained him again to execute the removal order. In February 2026, ICE transported him to the U.S.–Mexico border and sought to have him depart to Mexico, but he refused. ICE then continued to detain him for more than six months without showing that any country had agreed to accept him or that travel documents had been secured.
LAW

Under 8 U.S.C. § 1231(a)(1)(A), the government must remove a noncitizen within 90 days after the ...

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