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October 16, 2024
Liability Insurer Has Sole Right to Settle Suits Against Insured

Insurer’s Reports to Insurance Support Organization is Privileged

Read the full article at https://lnkd.in/g-9uHEeK, see full video at https://lnkd.in/g_VivpdY and at https://lnkd.in/gNgikU9P, and at https://zalma.com/blog, plus more than 4900 posts.

Post 4912

Allstate Northbrook Indemnity Company (“Allstate”) moved for Judgment on the Pleadings. Plaintiff Zhiwei Chen (“Plaintiff”) opposed and Allstate filed a Reply. After considering the moving, opposing, and reply papers, and the arguments therein, in Zhiwei Chen v. Allstate Northbrook Indemnity Company, No. CV 24-5239-JFW(Ex), United States District Court, C.D. California (October 2, 2024) and the court resolved the motion.

FACTUAL BACKGROUND

On January 16, 2023, Plaintiff was delivering food for Uber when he was involved in an automobile accident. At the time of the accident, Allstate insured Plaintiff’s car under an automobile insurance policy. The Policy provided that Allstate “may settle any claim or suit if [Allstate] believe[s] it is proper.”

After the accident, a claim was made to Allstate against Plaintiff, and Allstate settled that claim. Plaintiff alleged that Allstate reported the claim/accident to LexisNexis, and that Allstate’s reporting of the claim/accident caused an increase in his premiums.

Plaintiff sued Allstate in Los Angeles Superior Court “LASC”), alleging claims for: (1) breach of contract; (2) breach of the implied duty of good faith and fair dealing; (3) insurance fraud; (4) defamation; and (5) intentional infliction of emotional distress. Allstate removed this action to the USDC.

MOTION FOR JUDGMENT ON THE PLEADINGS

Allstate argued that because the Policy gives Allstate the discretion to settle any claim that it believes is proper, Plaintiff cannot succeed on any of his claims

Federal Rule of Civil Procedure 12(c) governs motions for judgment on the pleadings. As with motions brought pursuant to Rule 12(b)(6), in addition to assuming the truth of the facts plead, the court must construe all reasonable inferences drawn from those facts in the nonmoving party’s favor.

THE POLICY GIVES ALLSTATE THE ABSOLUTE DISCRETION TO SETTLE ANY CLAIM

In this case, it is undisputed that the Policy provides that Allstate can “settle any claim or suit if we believe it is proper.” As a result, because Allstate has the contractual right to settle any claim, it cannot be liable under any cause of action alleged by Plaintiff for settling a claim.

The insured’s policy gave the insurer the right to settlement as it deemed expedient and since this type of clause is not unusual in liability insurance policies and is appropriate to the benefit of the insurer and the insured. As a result, an insurer normally cannot be liable to the insured if the insurer does no more than settle a claim or suit within the policy’s limits.

Because Allstate has the right to settle any claim it believes is proper, Plaintiff cannot maintain any cause of action based on Allstate’s exercise of its contractual right to settle the claim made against him.

ALLSTATE REPORTING OF PLAINTIFF’S CLAIM/ACCIDENT IS PRIVILEGED

In addition, Plaintiff cannot maintain a cause of action against Allstate based on Allstate’s reporting that Plaintiff was involved in an accident and that it settled the claim against him because Allstate’s reporting of Plaintiff’s claim/accident is privileged. Specifically, California Insurance Code §791.13 allows an insurer to report personal and privileged information to an “insurance-support organization” when necessary “to perform its function in connection with an insurance transaction involving an individual.” See Cal. Ins. Code §791.13(c)(1)(2).

Plaintiff bases his claim on the fact that Allstate reported information about Plaintiff’s claim/accident to LexisNexis. Plaintiff also alleges that LexisNexis disseminated that information to other insurers who “use[d] the information released by [Allstate] to judge [P]laintiff unfavorably” which led to Plaintiff paying “more for insurance than before.”

The USDC concluded that Allstate’s alleged reporting of Plaintiff’s claim/accident is privileged, and, as a result, cannot support a cause of action against Allstate.

All of Plaintiff’s claims alleged in the Complaint, including claims for breach of contract, breach of the implied duty of good faith and fair dealing, insurance fraud, defamation, and intentional infliction of emotional distress, were dismissed without leave to amend.

ZALMA OPINION

The USDC did away with this odd lawsuit without a need for oral argument because, if the Plaintiff tried to renew his Allstate policy it knew about the claim and if it applied to a different insurer he would be invariably asked to advise the new insurer about his accident history and would be required to disclose it himself. Settling claims against the Plaintiff was why he bought insurance from Allstate, he got what he paid for when they settled the claim, and they reported the claim to an insurance-support organization. The Plaintiff hoped by alleging bad faith he could bludgeon Allstate into paying him off. His attempt failed. In fact, the Plaintiffs actions were designed to deprive the insurer of the benefits of the contract fitting the definition of the tort of bad faith.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:09:24
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What else you may like…
Videos
Posts
September 18, 2026
Expert May Only Testify to What Experience Supports

Insurance Expert May Not Testify to Speculative and Contains Unsupported Conclusions.

Posted on September 18, 2026 by Barry Zalma

See the full video at and at https://rumble.com/v7fmifw-expert-may-only-testify-to-what-experience-supports.html

In Michele A. Over, and The Estate Of Paul R. Over v. State Farm Mutual Automobile Insurance Company, and State Farm Fire And Casualty Company, Civil Action No. 23-cv-02243-PAB-STV, United States District Court, D. Colorado (September 14, 2026) Michele and Paul Over sued State Farm Fire and State Farm Auto over hail-damage and stolen-vehicle claims.

The operative dispute concerned State Farm Auto’s motion to exclude or limit opinions from plaintiffs’ insurance-industry expert, Aaron Castillo. Castillo.

Law

The proponent of expert testimony must establish by a preponderance of the evidence that an expert is qualified and that the opinions are helpful, sufficiently grounded, and reliably derived and applied. Experience-based opinions must explain how the...

00:03:10
September 17, 2026
Convicted on 29 Tax-Refund-Fraud Counts

150 Months in Prison for Tax Fraud
Post 4846

Posted on September 17, 2026 by Barry Zalma

See the full video at https://lnkd.in/g8rh3JBX and https://lnkd.in/gmkdy-9C, In United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.

FACTS

In United States Of America v. Thomas Addaquay, United States Of America v. Thomas Addaquay, Nos. 25-10609, 25-10611, United States Court of Appeals, Eleventh Circuit (September 9, 2026) the Eleventh Circuit affirmed all challenged convictions, the 150-month aggregate sentence, and the challenged $4,123,474.55 restitution award.
FACTS

Thomas Addaquay controlled United Consolidated Accounting and Business Services (UC), nominally a check-cashing business.

The government proved a three-stage tax-refund scheme that converted the resulting refund checks into usable funds through ...

00:05:23
September 14, 2026
Court Enforces Fifth Amendment & Refuses to Compel Answers

Major Fraud Perpetrator Asserts Fifth Amendment Privilege to Avoid Prosecution

Post 5489

Posted on September 14, 2026 by Barry Zalma

Fraudster Refuses to Answer Questions About His Alleged Fraud

See the full video at https://lnkd.in/gvicAMDr and at https://lnkd.in/gvicAMDr

In Great American Insurance Co. v. Gemstone Property Management, LLC, et al., No. 23-cv-9100 (LJL), United States District Court, S.D. New York (September 8, 2026) Great American Insurance Company alleged that it was defrauded through a scheme in which Subin Associates, LLP recruited individuals to stage construction-site injuries, arranged unnecessary medical treatment and litigation funding, and pursued fraudulent personal-injury claims.

Luis Manuel Garcia Salcedo, resulted in a $6 million settlement. Non-party Jose Hernandez allegedly worked as an assistant manager at Subin, operated Hernandez Associates, and owned litigation-funding companies that shared office space with Subin and provided services to its clients.

After Great American ...

00:05:14
October 02, 2026
Announcement About False Claims Act Settlement Results in Damages Suit

Employee Report of Fraud Results in Damages Suit After Qui Tam Suit Settled

No Statutory Hearing Right Arose Because No Dental Commission Complaint License Suspension, Revocation, Or Sanction Occurred.

Post 4855

Posted on October 2, 2026 by Barry Zalma

In Abbas Mohammadi et al. v. William M. Tong et al., No. AC 47598, Court of Appeals of Connecticut (September 29, 2026) Abbas Mohammadi owned and operated Columbia Dental, P.C., which provided dental services through multiple Connecticut offices; Columbia Oral Maxillofacial Imaging, LLC served as the billing entity.

From April 2012 to February 27, 2013, Columbia Dental employed Brittany Ames Mahoney as a dental assistant. During her employment, Mahoney claimed to have discovered certain billing irregularities, including, but not limited to, false and fraudulent reimbursement claims submitted to the Department of Social Services for services rendered to Medicaid beneficiaries. Mahoney filed a complaint and an affidavit in the United States District Court for the District of...

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October 01, 2026
Zalma’s Insurance Fraud Letter – October 1, 2026

Another Anniversary for Barry Zalma, Inc

Posted on October 1, 2026 by Barry Zalma
From October 1, 1979 – 2026

Post 4854

Read the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2026/09/ZIFL-10-01-2026.pdf Forty seven years ago today I left the world of the employed and became an entrepreneur by opening my own law firm. The law practice was incorporated shortly thereafter as Barry Zalma, Inc.

When I opened for business on October 1, 1979, I had no clients and no certainty that I would have any in the future. I had borrowed money from the bank to carry me through the first six months and was concerned about my ability to pay the loan with my third child about to be born.

Much to my surprise and pleasure, on October 1, 1979, at 8:10 a.m., the best claims handler in the London market, Alan Warboys, called from London and provided me with my first case as an independent lawyer to represent Certain Underwriters at Lloyd’s, London. He, and the Lloyd’s Underwriters he represented, showed faith in me as a lawyer and insurance expert. Alan is now, although ...

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September 30, 2026
Suing for Services Provided, and Paid for, is Fraud

Defendants Successfully Moved for Summary Judgment

Post 4854

Posted on September 30, 2026 by Barry Zalma

In Jeffrey Wayne Phillips v. Creative Website Studios, et al., No. 5:23-CV-568-BO-BM, United States District Court, E.D. North Carolina, Western Division (September 28, 2026) the Court needed to rule on the order and memorandum and recommendation (“M&R”) of the Magistrate.

Jeffrey Wayne Phillips had contracted with Creative Website Studios and SR Telecommunications for website and hosting services. He alleged that defendants repeatedly billed him for hosting periods he had already paid for and later took down his website. Phillips claimed the outage prevented him from bidding on U.S. government security contracts and sought roughly $300 million in consequential damages.
LAW

Under North Carolina law, fraud requires a false material representation or concealment, intent and effect of deception, resulting damage, and reasonable reliance. Obtaining property by false pretenses similarly requires an ...

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