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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September 05, 2024
THE COVENANT OF GOOD FAITH IS AN ETHICAL DOCTRINE

Ethics and the Reservation of Rights

Post 4867
https://www.linkedin.com/pulse/covenant-good-faith-ethical-doctrine-barry-zalma-esq-cfe-mvcnf/

September 5, 2024

Posted on September 5, 2024 by Barry Zalma

See the full video at and at https://youtu.be/yhR2vLQ4vAc

An insurer that reserves its rights under a policy of An insurer that reserves its rights under a policy of insurance will usually raise a request by the insured for independent counsel. However, unless the reservation actually raises the need for the application of the ethical duty of an attorney to avoid representing conflicting interests, there is no obligation to retain independent counsel. If that duty exists independent counsel is required. If there is no conflict the insurer may assert its right to control the defense of the insured with counsel of its choice.

FACTUAL BACKGROUND

In Federal Insurance Company v. MBL, Inc., 219 Cal.App.4th 29, after soil and groundwater ...

00:09:03
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16 hours ago
No Coverage for UIM if not Purchased

Claim Insurer Defrauded Insured Needs Evidentiary Allegations

Post 5201

Read the full article at https://www.linkedin.com/pulse/coverage-uim-purchased-barry-zalma-esq-cfe-hekvc, see the full video at and at and at https://zalma.com/blog plus more than 5200 posts.

It Doesn’t Pay to Accuse an Insurer of Fraud Without Evidence

In Yarisleidy Suarez Rodriguez v. Safeco Insurance Company Of America, Civil Action No. 3:25-CV-00154-GNS, United States District Court, W.D. Kentucky, Louisville Division (September 30, 2025) an insured accused her insurer for fraud in not honoring underinsured motorist coverage.

Case Background:

Plaintiff Yarisleidy Suarez Rodriguez (the Insured) filed a claim for underinsured motorist (UIM) benefits with Defendant Safeco Insurance Company of Illinois, which was denied. Rodriguez alleged that her policy included UIM coverage, which Safeco fraudulently removed without her knowledge.
Legal ...

00:07:50
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16 hours ago
No Coverage for UIM if not Purchased

Claim Insurer Defrauded Insured Needs Evidentiary Allegations

Post 5201

Read the full article at https://www.linkedin.com/pulse/coverage-uim-purchased-barry-zalma-esq-cfe-hekvc, see the full video at and at and at https://zalma.com/blog plus more than 5200 posts.

It Doesn’t Pay to Accuse an Insurer of Fraud Without Evidence

In Yarisleidy Suarez Rodriguez v. Safeco Insurance Company Of America, Civil Action No. 3:25-CV-00154-GNS, United States District Court, W.D. Kentucky, Louisville Division (September 30, 2025) an insured accused her insurer for fraud in not honoring underinsured motorist coverage.

Case Background:

Plaintiff Yarisleidy Suarez Rodriguez (the Insured) filed a claim for underinsured motorist (UIM) benefits with Defendant Safeco Insurance Company of Illinois, which was denied. Rodriguez alleged that her policy included UIM coverage, which Safeco fraudulently removed without her knowledge.
Legal ...

00:07:50
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October 03, 2025
Insurer’s Attempt to Obtain Summary Judgment Fails

To Prove Fraud Admissible Evidence is Required
Post 5200

See the full video at https://lnkd.in/g9cmMseN and at https://lnkd.in/g5eAYwdN, and at https://zalma.com/blog plus more than 5200 posts.

Allegations That Health Care Providers Assist in No Fault Fraud Escape MSJ

In NATIONWIDE GENERAL INSURANCE COMPANY, NATIONWIDE MUTUAL INSURANCE COMPANY, and any and all of their subsidiaries, affiliates and/or parent companies. Plaintiffs v. BILLEESHA BROWN, MANUEL A. CRUZ, ALGELIS TATIS, The “Individual Defendants”, et al and the “Healthcare Provider Defendants”, Index No. 618243/2023, 2025 NY Slip Op 33374(U), Motion Seq. No. 003, Supreme Court, Nassau County (September 15, 2025) dealt with a motion for summary judgment (MSJ) filed by the insurers.

Case Overview:

This is a declaratory judgment action where the plaintiff, NATIONWIDE GENERAL INSURANCE COMPANY, seeks a determination that it is not obligated to provide first-party automobile insurance coverage, including No Fault benefits and/or uninsured/underinsured ...

00:08:10
September 09, 2025
The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma

See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.

The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime

See the full video at and at

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is 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.

How Elderly Doctors Fund their ...

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September 08, 2025
The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma

See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.

The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime

See the full video at and at

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is 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.

How Elderly Doctors Fund their ...

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September 03, 2025

Barry Zalma: Insurance Claims Expert Witness
Posted on September 3, 2025 by Barry Zalma
The Need for a Claims Handling Expert to Defend or Prove a Tort of Bad Faith Suit

© 2025 Barry Zalma, Esq., CFE

When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.

On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive ...

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