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July 26, 2024
Sexual Abuse of Child Excluded

Clear & Unambiguous Exclusions Must Be Enforced
Post 4843

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The Plaintiff insurance company seeks a declaration that it has no duty to defend or indemnify Jacob Jackson or his wife, Stacy Jackson, for claims asserted against them in civil lawsuits which allege that Mr. Jackson sexually abused and exploited minors.

In American Strategic Insurance Corp, a foreign insurer v. Jacob Jackson, individually, Inspirit Athletics, Inc, et al., No. 3:23-cv-05461-RJB, United States District Court, W.D. Washington, Tacoma (July 24, 2024) the insurer proved that criminal charges against Mr. Jackson, including for rape of a child in the third degree, child molestation in the third degree, and communication with a minor for immoral purposes are now pending in Pierce County, Washington Superior Court (“criminal case”). Trial on the criminal charges is set to begin on November 19, 2024.

The Insurer moved for partial summary judgment on its claims against Mr. and Mrs. Jackson only as they relate to Jane Doe 20, as Guardian ad Litem for John Doe 20, et. al. v. Inspirit Athletics, Inc., et.al., Pierce County, Washington Superior Court case number 23-208692-4 (“John Doe 20 lawsuit”).

FACTS

The Plaintiff issued a homeowners insurance policy (“primary policy”) to Mr. and Mrs. Jackson. This primary policy was in effect between September 16, 2019 – September 16, 2022. In addition to the primary policy, the Plaintiff also issued an umbrella liability policy to the Jacksons. The Plaintiff accepted defense of the civil lawsuit at issue for the Jacksons pursuant to a reservation of rights. It then sued seeking a declaration that it owes no duty to defend or indemnify the Jacksons for any of the claims asserted against them in the John Doe 20 lawsuit.

ALLEGATIONS IN THE UNDERLYING LAWSUIT

According to the complaint filed in the John Doe 20 lawsuit, Mr. Jackson was the head boys’ basketball coach for Sumner High School, located in Sumner, Washington, from 2016 to September of 2022. Mr. Jackson is also alleged to be the CEO of Inspirit Athletics, Inc. d/b/a/ Sterling Athletics (“Sterling”) a sports equipment manufacturing and marketing company.

The John Doe 20 lawsuit contended that Mr. Jackson met John Doe 20 when he was around 10 years old and over the next several years showered John Doe 20 with attention and gifts of athletic equipment, Sterling clothing and gear. Mr. Jackson socialized with the family. While John Doe 20 was in the Jackson’s closet, Mr. Jackson stripped naked, cornered John Doe 20 in the closet, and began masturbating in front of John Doe 20. Mr. Jackson then allegedly forced himself on John Doe 20, grabbing his genitalia and masturbating John Doe 20. The John Doe 20 lawsuit makes claims for sexual exploitation of children and false imprisonment against Mr. Jackson.

INSURANCE POLICIES

As stated above, there are two insurance policies which are the subject of this case: the primary policy and umbrella policy. Both policies exclude “‘bodily injury’ . . . arising out of sexual molestation, …” as well as “‘bodily injury’ . . . resulting from any illegal or criminal act performed by, at the direction of, or in conspiracy with any ‘insured.’ This exclusion applies regardless of whether the insured is charged with a crime.”
Relevant Umbrella Policy Provisions

The umbrella policy also contains several exclusions that the Plaintiffs maintain are relevant. For example, it excludes “‘bodily injury’ . . . and ‘personal injury’ unless such liability is also covered under the applicable underlying insurance.” The umbrella policy excludes “‘bodily injury’ which is expected or intended by an ‘insured’” and “‘bodily injury’ and ‘personal injury’ arising out of: sexual molestation, corporal punishment or mental abuse”

DISCUSSION

In Washington, an insurance policy is construed as a contract and given fair, reasonable, and sensible construction as would be given to the contract by the average person purchasing insurance.

The Plaintiff’s motion for summary judgment regarding the duty to defend should be granted. The Plaintiff has no duty to defend the Jacksons in the John Doe 20 lawsuit. Neither the primary policy nor the umbrella policy (which only provides coverage if the primary policy does) could conceivably cover the allegations in the complaint.

DUTY TO INDEMNIFY

If there is no duty to defend, then there is no duty to indemnify. Therefore the Plaintiff’s partial motion for summary judgment should be granted. Plaintiff American Strategic Insurance Corp’s Motion for Summary Judgment Is Granted.

ZALMA OPINION

Liability insurance is designed to protect an insured only against fortuitous acts. Sexually molesting a child can never be fortuitous. It is an intentional act that is both immoral and illegal and excluded by clear and unambiguous language in the homeowners and umbrella policy. The couple should be forced to pay whatever assets they have to the families of the abused children as well as serve time in prison. Insurance is not designed to make it easy to commit crimes at all, and especially crimes against minor children.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:08:24
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January 02, 2026
Zalma’s Insurance Fraud Letter – January 2, 2026

Posted on January 2, 2026 by Barry Zalma
ZIFL – Volume 30 Number 1

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

See the video at https://rumble.com/v73nifg-zalmas-insurance-fraud-letter-january-2-2026.html and at https://youtu.be/vZC1e-_qwDg

Supreme Court of Louisiana Removes Judge

Judge Who Lied to Get Elected Cannot Serve

In In Re: Judge Tiffany Foxworth-Roberts, No. 2025-O-01127, Supreme Court of Louisiana (December 11, 2025) the Louisiana Supreme Court in an opinion by Chief Justice Weimer dealt with the recommendation of the Judiciary Commission of Louisiana (Commission) that Judge Tiffany Foxworth-Roberts be removed from office for:

1. making false and misleading statements regarding her judicial campaigns;
2. making false and misleading statements to police investigating the reported burglary of her car; and
3. withholding information and providing false, incomplete, or misleading information during the investigation by the Office of Special Counsel (OSC), as well as in the proceedings before the Commission....

00:08:13
December 30, 2025
Montana Lawyer Commits Insurance Fraud and Receives Minimal Punishment

Montana County Attorney Admits to Insurance Fraud & Is Only Suspended from Practice for 60 Days
Post 5251

Read the full article at https://lnkd.in/gnBaCjmv, see the video at https://lnkd.in/gfpVsyAd and at https://lnkd.in/gC73Nd8z, and at https://zalma.com/blog plus more than 5250 posts.

A Lawyer Who Commits Insurance Fraud and Pleas to a Lower Charge Only Suspended

In The Matter Of: Naomi R. Leisz, Attorney at Law, No. PR 25-0150, Supreme Court of Montana (December 23, 2025) the Montana Office of Disciplinary Counsel (ODC) filed a formal disciplinary complaint with the Commission on Practice (Commission) against Montana attorney Naomi R. Leisz.

On September 25, 2025, Leisz tendered a conditional admission and affidavit of consent. Leisz acknowledged the material facts of the complaint were true and she had violated the Montana Rules of Professional Conduct as alleged by ODC.

ADMISSIONS

Leisz admitted that in April 2022, her minor son was involved in a car accident in which he hit a power pole. Leisz’s son ...

00:08:27
December 30, 2025
Montana Lawyer Commits Insurance Fraud and Receives Minimal Punishment

Montana County Attorney Admits to Insurance Fraud & Is Only Suspended from Practice for 60 Days
Post 5251

Read the full article at https://lnkd.in/gnBaCjmv, see the video at https://lnkd.in/gfpVsyAd and at https://lnkd.in/gC73Nd8z, and at https://zalma.com/blog plus more than 5250 posts.

A Lawyer Who Commits Insurance Fraud and Pleas to a Lower Charge Only Suspended

In The Matter Of: Naomi R. Leisz, Attorney at Law, No. PR 25-0150, Supreme Court of Montana (December 23, 2025) the Montana Office of Disciplinary Counsel (ODC) filed a formal disciplinary complaint with the Commission on Practice (Commission) against Montana attorney Naomi R. Leisz.

On September 25, 2025, Leisz tendered a conditional admission and affidavit of consent. Leisz acknowledged the material facts of the complaint were true and she had violated the Montana Rules of Professional Conduct as alleged by ODC.

ADMISSIONS

Leisz admitted that in April 2022, her minor son was involved in a car accident in which he hit a power pole. Leisz’s son ...

00:08:27
December 31, 2025
“Sudden” is the Opposite of “Gradual”

Court Must Follow Judicial Precedent
Post 5252

Read the full article at https://www.linkedin.com/pulse/sudden-opposite-gradual-barry-zalma-esq-cfe-h7qmc, see the video at and at and at https://zalma.com/blog plus more than 5250 posts.

Insurance Policy Interpretation Requires Application of the Judicial Construction Doctrine

In Montrose Chemical Corporation Of California v. The Superior Court Of Los Angeles County, Canadian Universal Insurance Company, Inc., et al., B335073, Court of Appeal, 337 Cal.Rptr.3d 222 (9/30/2025) the Court of Appeal refused to allow extrinsic evidence to interpret the word “sudden” in qualified pollution exclusions (QPEs) as including gradual but unexpected pollution. The court held that, under controlling California appellate precedent, the term “sudden” in these standard-form exclusions unambiguously includes a temporal element (abruptness) and cannot reasonably be construed to mean ...

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December 29, 2025
Doctor Accused of Insurance Fraud Sues Insurer Who Accused Him

Lack of Jurisdiction Defeats Suit for Defamation

Post 5250

Posted on December 29, 2025 by Barry Zalma

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He Who Represents Himself in a Lawsuit has a Fool for a Client

In Pankaj Merchia v. United Healthcare Services, Inc., Civil Action No. 24-2700 (RC), United States District Court, District of Columbia (December 22, 2025)

FACTUAL BACKGROUND
Parties & Claims:

The plaintiff, Pankaj Merchia, is a physician, scientist, engineer, and entrepreneur, proceeding pro se. Merchia sued United Healthcare Services, Inc., a Minnesota-based medical insurance company, for defamation and related claims. The core allegation is that United Healthcare falsely accused Merchia of healthcare fraud, which led to his indictment and arrest in Massachusetts, causing reputational and business harm in the District of Columbia and nationwide.

Underlying Events:

The alleged defamation occurred when United ...

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December 15, 2025
Zalma’s Insurance Fraud Letter – December 15, 2025

Zalma’s Insurance Fraud Letter

Read the full article at https://lnkd.in/dG829BF6; see the video at https://lnkd.in/dyCggZMZ and at https://lnkd.in/d6a9QdDd.

ZIFL Volume 29, Issue 24

Subscribe to the e-mail Version of ZIFL, it’s Free! https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

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/

Zalma’s Insurance Fraud Letter

Merry Christmas & Happy Hannukah

Read the following Articles from the December 15, 2025 issue:

Read the full 19 page issue of ZIFL at ...

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