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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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August 22, 2024
A Dog is Nothing More than a Dog

A Dog That Lives at a House is not a Part of the Property
Post 4859

Read the full article at https://lnkd.in/gQvs8U8P, see the full video at https://lnkd.in/gn5RCZ7F and at https://lnkd.in/ge3Ekfe5, and at https://zalma.com/blog plus more than 4850 posts.

Lana Sloan appealed from summary judgment entered in favor of Farm Bureau Town and Country Insurance Company of Missouri (“Farm Bureau”) while she sought medical payments for injuries she received from a less than obedient and loving dog.

In Lana Sloan v. Farm Bureau Town And Country Insurance Company Of Missouri, and Jesse Clark, Joseph Webb, and Bobbette Webb, No. SD37751, Court of Appeals of Missouri, Southern District, In Division (August 15, 2024) summary judgment established a dog was not a part of the premises.

BACKGROUND

Joseph Webb owns residential property insured by Farm Bureau. Webb leased the insured premises to Jesse Clark, who owns a dog. Webb neither owns nor cares for the dog. Clark’s dog bit Sloan while she was walking on a public roadway not on the insured premises.

The Farm Bureau policy provides coverage for medical payments to non-insureds when such person sustains bodily injury on an insured premises with the permission of any insured, or elsewhere, if the bodily injury: Arises out of a condition on the insured premises.

The only dispute was whether Sloan’s injuries arose out of a condition on the insured premises. The circuit court found the dog was not a condition on the insured premises.

APPLICABLE LAW

The statutes allow penalties to be assessed against an insurer when it refuses to make payment, upon demand and in accordance with the policy, vexatiously, willfully, and without reasonable cause. Where an insurer had no duty to pay under the insurance policy, there cannot be a claim for vexatious refusal to pay.

DISCUSSION

It is apparent that “premises” contemplates the land. A dog, whether permanently kenneled or tethered on the property, is not a part of the premises.

There is a serious distinction between real property and domestic animals kept on that property. The Court of Appeals concluded that Sloan’s injuries did not arise out of a condition on the insured premises.

ZALMA OPINION

A dog is a living breathing animal. It can live at a piece of real property, just like an owner or tenant may live at the premises but neither the owner, tenant, nor pets are part of the property. Sloan needed to prove that her injuries arose out of a condition of the insured premises but could not and the judgment, therefore, in favor of the insurer was affirmed.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:08:36
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14 hours ago
Man Bites Dog Story – Hertz Sues Alleged Fraudsters

Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers

Post 5222

Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

Proactive Victim of Fraud Defeats Health Care Providers

In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.

FACTUAL BACKGROUND

Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.

Plaintiff also ...

00:06:28
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14 hours ago
Man Bites Dog Story – Hertz Sues Alleged Fraudsters

Hertz Succesfully Refuses to Pay Alleged Fraudulent Health Care Providers

Post 5222

Read the full article at https://www.linkedin.com/pulse/man-bites-dog-story-hertz-sues-alleged-fraudsters-zalma-esq-cfe-efbgc, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.

Proactive Victim of Fraud Defeats Health Care Providers

In Hertz Vehicles, LLC v. Alignment Chiropractic, P.C., et al, Index No. 157368/2024, 2025 NY Slip Op 33627(U), Motion Seq. No. 001, NYSCEF Doc. No. 46, Supreme Court, New York County (September 30, 2025) Plaintiff alleged it is not obligated to pay no-fault benefits for the medical treatment of defendants for injuries while occupants of a 2023 Hyundai, owned and self-insured by Hertz.

FACTUAL BACKGROUND

Plaintiff moved for a default judgment against defendants Alignment Chiropractic, P.C., and many other alleged health care providers.

Plaintiff also moved...

00:06:28
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November 05, 2025
Not Nice to Shop the Federal Court to Avoid State Court

Who’s on First? State or Federal Court

Post 5222

Read the full article at https://lnkd.in/gWj97cFs, see the video at https://lnkd.in/gtS6CpUX and at https://lnkd.in/gQEAeyHc,

Conflict Between State & Federal Court Requires Abstention

See the video at https://lnkd.in/gtS6CpUX and at https://lnkd.in/gQEAeyHc,

Conflict Between State & Federal Court Requires Abstention

Hector David Campoverde was injured at a Brooklyn construction site in 2015. Campoverde was an employee of Vazquez Bro Restoration Inc., a subcontractor for C.C.C. Renovation Inc., which was itself a subcontractor for general contractor L&M Builders Group LLC. In Starr Indemnity & Liability Company v. Scottsdale Insurance Company, No. 24-CV-3309 (PKC) (TAM), United States District Court, E.D. New York (September 30, 2025) was asked to determine whether one or more of the involved insurers is obligated to indemnify Campoverde, and in what order Camporverde can receive indemnity, from one or more insurer.

Underlying Incident:

Campoverde sued the ...

00:07:43
October 31, 2025
The Zalma Philosophy of Claims Handling – Part 9

The Professional Claims Handler
Post 5219

Posted on October 31, 2025 by Barry Zalma

An Insurance claims professionals should be a person who:

Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.

How to Create Claims Professionals

To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...

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October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail

Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.

My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
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