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September 10, 2024
It's Not Nice to Set Your Ex-Wife on Fire

Domestic Abuse Exception to Intentional Act Exclusion
Post 4888

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Brenda Welch owned a home in Lynnwood, and lived there throughout her marriage to David Morgan. The home was subject to a mortgage held by CitiMortgage Inc. During their marriage, Welch and her ex-husband David Morgan had one child together, K.W.

On May 21, 2014, the court finalized their divorce, awarding Morgan the family home and requiring that he “either sell the property or refinance the debts into his sole name within three (3) years of February 25, 2014.” After the divorce, Welch met a new partner and moved in with him. Still, Welch and Morgan shared custody of K.W., and their parenting plan called for joint decision-making.

On November 16, 2014, Welch went to the Lynnwood home at a prearranged time to pick up K.W. from Morgan’s care. But K.W. was not there. Instead, Morgan attacked Welch, beat her unconscious, doused her in gasoline, and set her and the house on fire. Welch survived but suffered significant mental and physical injuries. The fire destroyed the house.

In Brenda Welch v. Pemco Mutual Insurance Company, No. 85466-6-I, Court of Appeals of Washington (September 3, 2024) PEMCO Mutual Insurance Company denied Brenda Welch insurance coverage for loss incurred after her ex-husband assaulted her and burned down their former marital home. PEMCO determined that the loss was intentional and rejected Welch’s argument that the loss arose from an act of domestic abuse, an exception to the intentional loss exclusion. Welch sued PEMCO. The trial court dismissed Welch’s claims at summary judgment.

THE INSURANCE CLAIM

At the time of the fire, Morgan had not yet sold or refinanced the Lynnwood home. So, the deed still named Welch as an owner and obligor on the mortgage. Welch and Morgan held an all-risk insurance policy on the property through PEMCO. The policy named both Welch and Morgan as insureds. It also listed CitiMortgage as a mortgagee.

The PEMCO policy excluded coverage for “any loss arising out of any act committed by or at the direction of an insured with the intent to cause a loss.” But it has an exception to that intentional loss exclusion for acts of “domestic abuse,” which provides that the exclusion “will not apply to deny an insured’s claim for an otherwise covered property loss if such loss is caused by an act of domestic abuse by another insured under the policy.”

A jury found Morgan guilty of attempted first degree murder domestic violence and first degree arson domestic violence. The trial court sentenced him to 260 months in prison. Welch then sued Morgan for her injuries from the assault. Morgan did not respond, and the trial court entered a default order and judgment against Morgan for $5.06 million. Welch also claimed coverage under the PEMCO policy. And CitiMortgage claimed coverage for the outstanding balance on the mortgage. PEMCO estimated the repair or replacement cost of the damage to the home was $463,732.82.

In June 2016, PEMCO found coverage for CitiMortgage but PEMCO denied Welch’s claim. It explained that the intentional loss provision “precludes coverage not only to the arsonist but to any insured, including Ms. Welch.”

Welch sued PEMCO. The trial court granted in part and denied in part PEMCO’s motion. The court denied PEMCO’s motion on the applicability of the domestic abuse exception. It concluded that Welch and Morgan were not family, so the domestic abuse exception to the intentional loss exclusion did not apply.

ANALYSIS

The Court of Appeals must construe insurance policies as the average person purchasing insurance would. That is, give the language a fair, reasonable, and sensible construction. And the Court of Appeals give undefined terms their plain, ordinary, and popular meaning. The Court of Appeal may turn to the dictionary definition of an undefined term to determine its plain meaning.

Welch’s policy excludes coverage for intentional loss unless “an act of domestic abuse by another insured under the policy” causes the loss. The PEMCO policy language parallels former RCW 48.18.550 (1998), the statute in effect when Morgan tried to kill Welch and burned down the house.

RCW 48.18.550(3) requires insurers to cover intentional loss caused by an act of domestic abuse by another insured under the policy. Modern editions of the dictionary define “family” as “the basic unit in society traditionally consisting of two parents rearing their children,” or “[a] group consisting of parents and their children.” Merriam-Webster Dictionary, (last visited Aug. 20, 2024). Welch meets these definitions because she and Morgan were raising K.W. under a parenting plan that granted them shared custody and called for joint decision-making. As such, they were two parents rearing their child.

An average person purchasing insurance would understand the term “family” under the more modern definition. Because Welch and Morgan share a child that they were raising together, Welch is “family” under the policy’s domestic abuse exception to the intentional loss exclusion. Therefore, the trial court erred by granting summary judgment for PEMCO and refusing to grant partial summary judgment for Welch. Therefore, Summary judgment for PEMCO was reversed and the trial court was directed to enter partial summary judgment for Welch for breach of contract

ZALMA OPINION

The exception to the exclusion was found to apply because – although divorced and no longer married – since Welch and Morgan still had joint custody of a child they fit a dictionary definition of “family” sufficient to allow Ms. Welch to recover her share of the insurance recovery over that paid to the mortgagee. Her ex-husband gets nothing and she will never recover the $5 million judgment she obtained against her ex-husband who will be in jail a long, long time.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:10:29
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Zalma’s Insurance Fraud Letter – September 15, 2024

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Read the full article at https://lnkd.in/gtg-zFF2, see the full 18 page pdf at https://lnkd.in/gTy3ziYk, see the full video at https://lnkd.in/gnxQxy4M and at https://lnkd.in/gNcrs22f and at https://zalma.com/blog.

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22 hours ago
Zalma’s Insurance Fraud Letter – September 15, 2024

Zalma’s Insurance Fraud Letter – September 15, 2024
Posted on September 16, 2024 by Barry Zalma
ZIFL Volume 28 Number 18

Read the full article at https://lnkd.in/gtg-zFF2, see the full 18 page pdf at https://lnkd.in/gTy3ziYk, see the full video at https://lnkd.in/gnxQxy4M and at https://lnkd.in/gNcrs22f and at https://zalma.com/blog.

See the full video at and at

Subscribe here: https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D
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September 13, 2024
It is Dangerous for Insurance Fraudster to Ignore Court Orders

Court Orders DOJ to Indict Serial Fraudster for Criminal Contempt
Post 4890

Read the full article at https://lnkd.in/gANKyfm5, see the full video at https://lnkd.in/gHJncZe8 and at https://lnkd.in/gXjP5eUQ and at https://zalma.com/blog plus more than 4850 posts.

September 13, 2024

The USDC described Defendant Alberto Marzan as a serial fraudster who has largely managed to dodge accountability for victimizing individuals in the entertainment industry. Plaintiff Michaleen Josephs sued Marzan and his company, Press Media Group (“PMG”), after Marzan fraudulently induced Josephs to issue a series of bogus investments and other payments. When Marzan failed to respond, the Court entered default judgment for Josephs and awarded damages and equitable relief, including a requirement that Marzan divest from his enterprises and provide any future potential investors, employees, or business associates with copies of the Court’s default judgment order and his 2014 guilty plea for insurance fraud.

In Michaleen Josephs v. ...

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September 11, 2024

Intentional Acts, Insurance Claims & Exclusions
Insurance Requires a Fortuitous Act

Available only to subscribers to Excellence in Claims Handling at Subscribe to “Excellence in Claims Handling” at https://barryzalma.substack.com/subscribe for only $5 a month or $50 a year.
It includes the following: "In 1978, the California Supreme Court in Clemmer v. Hartford Insurance Co.71 dealt with a shooting that resulted in the death of the victim.

Regardless, it still led to a finding by the Supreme Court of California of a need for defense and indemnity. The court concluded that Hartford had no duties with regard to Dr. Lovelace’s intentional acts in the killing of Dr. Clemmer but was obligated to defend him. If there was a finding of nonintentional conduct in the shooting, however, it would be obligated to defend and its refusal to do so was wrongful."

August 30, 2024

Go to my Interview on the Art of Adjusting Podcast
Barry Zalma, Esq., CFE
Insurance claims expert, consultant at Barry Zalma, Inc. and author/Publisher at ClaimSchool, Inc.
August 30, 2024

Posted on August 30, 2024 by Barry Zalma

See the video at:

In this episode, Chantal Roberts and William Auten welcome Barry Zalma, a seasoned insurance industry professional with over 56 years of experience. The trio discusses the changing role of insurance adjusters, their relationship with policyholders, and the current challenges faced by the industry.

Barry shares his journey from a military investigator to a trainee adjuster and recounts significant cases that shaped his career. Barry focuses on the critical importance of effective and fair claims handling for the profitability of insurance companies and the detrimental impact of poor handling practices. The team also grapple insurance fraud, the adversarial nature of the legal system, and the ...

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July 15, 2024
Present as Real a Free and Imaginary Oral Estimate as Proof of Claim is Fraud

False Swearing & Fraud in Claim Presentation Voids Policy

Read the full article at https://lnkd.in/gXTmBN9m, See the full video at https://lnkd.in/gt8Qd6hB and at https://lnkd.in/gzuf8PWP, and at https://zalma.com/blog.

NEVER LIE TO YOUR INSURER ABOUT THE EXTENT OF DAMAGE

Post 4833

An insurance coverage dispute that arose from a pipe burst in the historic Pittsfield Building in downtown Chicago. On December 17, 2016, two pipes burst on the tenth floor of the Pittsfield Building, causing water damage to the first ten floors. After the loss event, the Pittsfield Entities filed a claim for the damage with their insurer, The Travelers Indemnity Company (“Travelers”) and could not agree on the extent of damage.

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