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.
To Prove Fraud Material False Statements Must be Proved
Post number 5389
Posted on July 8, 2026 by Barry Zalma
See the video at and at
Materiality Must Be Judged Objectively.
In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended a tour van driver and related defendants in an underlying auto-collision action brought by Silver Bird Auto Leasing, LLC after a low-speed collision involving Silver Bird’s McLaren and a tour van.
Silver Bird alleged the McLaren was making a legal turn and sought damages including repair costs, loss of use, and diminution in value. The defendants’ insurer later became insolvent, and CIGA took over the defense and ultimately paid $25,000 to settle the underlying action.
After settlement, Heath & Yuen filed a ...
To Prove Fraud Material False Statements Must be Proved
Post number 5389
Posted on July 8, 2026 by Barry Zalma
See the video at and at
Materiality Must Be Judged Objectively.
In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended a tour van driver and related defendants in an underlying auto-collision action brought by Silver Bird Auto Leasing, LLC after a low-speed collision involving Silver Bird’s McLaren and a tour van.
Silver Bird alleged the McLaren was making a legal turn and sought damages including repair costs, loss of use, and diminution in value. The defendants’ insurer later became insolvent, and CIGA took over the defense and ultimately paid $25,000 to settle the underlying action.
After settlement, Heath & Yuen filed a ...
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 ...
Coverage for Damage to Vacant Dwelling Limited
Post number 5388
Vandalism Damage to Vacant Dwelling Excluded
Posted on July 7, 2026 by Barry Zalma
In Tyrone Williamson v. Farmers Insurance Co., 2026-Ohio-2530, C. A. No. 30717, Court of Appeals of Ohio, Second District, Montgomery (July 2, 2026) Tyrone Williamson owned a duplex in Dayton, Ohio that he rented as two separate units. While the units were unoccupied by tenants, break-ins occurred in February, March, and April 2024, causing damage to doors, windows, walls, plumbing, flooring, fencing, lighting, a ceiling fan, grass, and other parts of the property, and resulting in the theft of items including tools, generators, a power washer, an air-conditioning unit, car wheels, and a radio.
Farmers Insurance paid approximately $17,000 for some damage from the first break-in but denied other claimed losses, including additional property damage, stolen personal property, and lost rent.
The trial court granted summary judgment to Farmers Insurance on Williamson’s ...
Court Allows itself to be Abused by Convicted Murderer and Insurance Fraudster
A Prisoner Has a Limited Right to file a Habeas Petition but Must do so Properly
Post number 5387
Posted on July 6, 2026 by Barry Zalma
Court Allows itself to be Abused by Convicted Murderer and Insurance Fraudster
A Prisoner Has a Limited Right to file a Habeas Petition but Must do so Properly
Post number 5387
In Tami Duvall v. State Of Indiana, No. 1:25-cv-01239-SEB-TAB, United States District Court, S.D. Indiana, Indianapolis Division (July 1, 2026) Indiana prisoner Tami Duvall filed a habeas petition under 28 U.S.C. § 2254 challenging her 2011 Indiana convictions for murder, insurance fraud, and obstruction of justice.
Law:
Federal Rule of Civil Procedure 15(a) governs amendment of pleadings, allowing amendment as of course within specified time limits and otherwise permitting amendment with leave of court when justice so requires.
Federal Rule of Civil Procedure 12(f) permits the Court to strike redundant matter. Rule 5 of the Rules ...
It is a Crime to Lie to Your Insurer That Accident Happened After Policy Inception
Post number 5386
Posted on July 3, 2026 by Barry Zalma
Conviction for Fraud Affirmed Because Evidence Overwhelming
In State Of Washington v. Saleem Mumin Robinson, No. 87244-3-I, Court of Appeals of Washington, Division 1 (June 29, 2026) Saleem Robinson was involved in an automobile collision on May 18, 2021. The other driver, Mohamed Waggeh, photographed Robinson’s documents and later reported the collision to GEICO, identifying the time as approximately 12:40 p.m.
That same day, at 6:06 p.m., more than five hours after the accident, Robinson purchased Progressive insurance for the vehicle involved in the collision.
The next morning, Robinson called Progressive to report the claim and stated that the accident occurred around 6:15 p.m. Progressive recorded that call without advising Robinson that it was being recorded. Progressive later conducted a special investigative unit investigation the claim because it was submitted shortly ...
