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 ...
Zalma’s Insurance Fraud Letter – August 15, 2025
Posted on August 15, 2025 by Barry Zalma
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
ZIFL Volume 29, Issue 16
Post 5169
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See the full video at https://lnkd.in/gKmEeN7f and at https://lnkd.in/gV687Vt9
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication. It is provided FREE to anyone who visits the site at https://lnkd.in/gVT5G9s
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
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Post 5169
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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...
Award Signed by Two of Three Appraisers Binding on Insured and Insurer
Post 5168
See the full video at https://rumble.com/v6xj16m-appraisal-award-sets-amount-of-loss.html and at https://youtu.be/XBy4m31c0AM, and at https://zalma.com/blog plus more than 5150 posts.Dispute Over Extent of Damages is not Bad Faith
Kelly Mallady filed a lawsuit against Homeowners of America Insurance Company due to damages sustained from a nearby explosion in January 2020 that the insurer rejected in part.
In Kelly Mallady v. Homeowners Of America Insurance Company, No. 14-24-00147-CV, Court of Appeals of Texas, Fourteenth District (August 7, 2025) resolution was obtained of the disputes.
CASE BACKGROUND:
1 Mallady’s homeowners insurance policy was effective from September 15, 2019, to September 15, 2020 .
2 The initial claim was acknowledged, and an independent adjuster estimated the property damage to be $13,014.79, covering only the dwelling and fence.
3 Mallady invoked appraisal, demanding $247,860.40 for property and contents damages, plus...
Exclusions Defeat Claim for Defense & Indemnity
Genuine Dispute Dispels Claim of Bad Faith
Post 5167
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In Diversified Restaurant Group, LLC, et al. v. Houston Casualty Company, et al., No. 25-cv-02344-EMC, United States District Court, N.D. California (July 31, 2025) Diversified Restaurant Group, LLC (DRG) and Golden Gate Bell, LLC (GGB) sued Houston Casualty Company (HCC), Pennsylvania Manufacturers Indemnity Company (PMIC), and Manufacturer’s Alliance Insurance Company (MAIC) around the denial of insurance coverage for a lawsuit filed by a former employee who alleged sexual harassment and assault by a supervisor.
Insurance Policies and Denial of Coverage:
DRG and GGB had insurance policies with PMIC and MAIC, which included general liability, workers’ compensation, and employer’s liability coverage. Both PMIC and MAIC denied coverage for the underlying lawsuit, citing various exclusions in their policies.
Exclusions:
The PMIC policy ...
Rulings on Motions Reduced the Issues to be Presented at Trial
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CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
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/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
