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 ...

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March 11, 2026
Public Adjusters Attempt to Represent an Insured Subject to APA Clause

Anti-Public Adjuster Clause Is Effective in New York

Post number 5301

Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster

In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.

FACTS

NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...

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March 11, 2026
Public Adjusters Attempt to Represent an Insured Subject to APA Clause

Anti-Public Adjuster Clause Is Effective in New York

Post number 5301

Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster

In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.

FACTS

NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...

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March 10, 2026
Acting as Your Own Lawyer is Foolish

Proof of Highly Contaminated Water is Required for Extra Payments

Post number 5300

Read the full article at https://www.linkedin.com/pulse/acting-your-own-lawyer-foolish-barry-zalma-esq-cfe-mbg0c, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.

Acting as Your Own Lawyer is Foolish

Evidence of Breach of Contract Survives Dismissal of All Other Charges

In Lee Lifeng Hsu and Jane Yuchen Hsu v. State Farm Fire And Casualty Company, C. A. No. N24C-09-020 CLS, Superior Court of Delaware (February 27, 2026) a claim to State Farm who paid approximately $61,000 after assessments but denied coverage for additional items including ceramic tiles, the kitchen floor ceiling, underlayment plywood, and numerous personal property items resulted in suit by the Hsu’s acting in pro per.
Facts

Lee Lifeng Hsu and Jane Yuchen Hsu (“Plaintiffs”) purchased a homeowners’ insurance policy from State Farm Fire...

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March 16, 2026
Zalma’s Insurance Fraud Letter – March 15, 2026

ZIFL – Volume 30, Issue 6
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post number 5304

Posted on March 16, 2026 by Barry Zalma

Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th 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/ This issue contains the following articles about insurance fraud:

There is no Statutory Right to Defraud an Insurer

Fraudsters Attempt to Use Statute to Force Payment Fails

In Connecticut General Life Insurance Co. et al. v. East Coast Advanced Plastic Surgery, LLC, No. 25 Civ. 1686 (PAE), United States District Court, S.D. New York (February 24, 2026) a dispute between Connecticut General Life Insurance Company and its subsidiary Cigna Health and Life Insurance Company (collectively, “Cigna”) and East Coast Advanced Plastic Surgery, LLC (“ECAPS”), a New Jersey-based medical ...

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March 13, 2026
Fraudster Fails as a Jail House Lawyer

Chutzpah of Fraud Perpetrator Still Gets 36 years in Prison

Post number 5303

Read the full article at https://www.linkedin.com/pulse/fraudster-fails-jail-house-lawyer-barry-zalma-esq-cfe-araye and at https://zalma.com/blog plus more than 5200 posts.

Prisoner Should Know Better Than Representing Himself

In The People v. Roderick Nathaniel Washington, B330868, California Court of Appeals, Second District, Eighth Division (March 5, 2026) Roderick Nathaniel Washington was convicted by a jury on numerous counts related to credit card and unemployment insurance fraud.

The investigation revealed that Washington orchestrated two main types of fraud. The first involved credit cards: police searches at the residences of Washington’s girlfriend and his daughter uncovered hundreds of credit profiles, personal identifying information, mail addressed to Washington, fraudulent licenses and credit cards, and forged reports.

FACTUAL BACKGROUND

Bank Fraud

Washington opened multiple accounts in the names of others, including deceased ...

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March 12, 2026
Accepting Plaintiff’s Allegations as True The Court Finds Standing

Denying a Claim in the State Gives Court Standing
Post number 5302

Posted on March 12, 2026 by Barry Zalma

In 5th LLC v. Kemah Capital Holdings, LLC d/b/a Kemah Marine and Clear Spring Property and Casualty Company, No. CIV-25-364-D, United States District Court, W.D. Oklahoma (March 10, 20260

FACTUAL BACKGROUND

Plaintiff 5th LLC purchased an insurance policy for its Moonen 83 yacht, covering the period from October 27, 2022, to October 27, 2023. On December 24, 2022, the yacht sustained damage due to seawater intrusion, which Plaintiff alleges should be covered under the policy. Plaintiff filed a claim that was denied three times, each denial referencing Kemah Capital Holdings and signed by a Kemah representative acting on behalf of Clear Spring Property & Casualty Company.

Kemah asserted it had an agreement with Clear Spring to market, broker, and underwrite insurance on Clear Spring’s behalf.

LEGAL ISSUES

Defendant Kemah Capital sought dismissal on three grounds: lack of personal jurisdiction, lack of subject matter ...

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