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October 23, 2024
Failure to Plead an Identifiable Theory of Liability Requires Dismissal

When Insurer Settles Claim Against Insured for Less Than Policy Limits it Fulfills its Obligations Under the Policy
Post 4916

Read the full article at https://lnkd.in/gHuD6iUt, see the full video at https://lnkd.in/gnUkfHjP and at https://lnkd.in/gabuJACD and at https://zalma.com/blog plus more than 4900 posts.

Raymond Kvalvog challenged the dismissal of his claims against his insurer, Secura Supreme Insurance Company. Kvalvog argued that his complaint states a claim upon which relief can be granted because it alleges Secura (1) breached its duty of good faith by failing to inform Kvalvog of his right to withdraw from the liability coverage he invoked and take over his defense, (2) breached its duty of good faith by failing to properly evaluate the claims against Kvalvog, and (3) failed to pay Kvalvog $17,500 in uninsured-motorist benefits.

In Raymond Kvalvog v. Secura Supreme Insurance Company, No. A24-0226, Court of Appeals of Minnesota (October 14, 2024) the Court of Appeals resolved the allegations.

FACTS

After a tragic automobile accident where Kvalvog’s son was driving an automobile as part of a high school athletic trip. The passengers in the automobile included Kvalvog’s other son and Mark Schwandt. As a result of the accident, Kvalvog’s sons died and Schwandt was injured. At the time of the accident, Secura provided automobile insurance coverage to Kvalvog that included liability coverage.

Kvalvog brought a wrongful-death action against, among others, the school and a coach who was driving a different vehicle as part of the school trip only to lose.

Schwandt later commenced a separate action against Kvalvog, the school, the coach, and Schwandt’s own insurer (the underlying action), asserting in part that Kvalvog was liable for Schwandt’s substantial injuries. Kvalvog tendered the defense of the underlying action to Secura, which appointed a lawyer to defend Kvalvog. The case settled with Secura paying less than the policy limits in exchange for a release of all claims against Kvalvog.

The district court granted Secura’s motion reasoning that Secura had the right to settle the claims against Kvalvog, did so within his policy limits.

Kvalvog asserts that his complaint supports three theories of liability, the first two of which are premised on Secura’s claimed breach of its duty of good faith.

The district court granted Secura’s motion to dismiss, determining that Secura did not breach their duty of good faith by settling the claims at mediation within policy limits and that the complaint did not state a viable claim for $17,500 in uninsured-motorist benefits.

DECISION

A complaint is subject to dismissal if it fails to state a claim upon which relief can be granted. Kvalvog’s complaint fails to state a legally sufficient claim that Secura breached its duty of good faith.

An insurance policy, like other contracts, is governed by its terms. But Minnesota law imposes an additional duty of good faith on a liability insurer that assumes control of the right of settlement of claims against its insured. This duty arises because an insured and insurer may have conflicting interests, with an insurer being obligated to represent an insured’s best interests and to defend and indemnify while also wanting settlement at the lowest possible figure. An insurer’s right to control the negotiations for settlement must be subordinated to the purpose of the insurance contract-to defend and indemnify the insured within the limits of the insurance contract

Secura Did Not Have A Duty To Inform Kvalvog That He Could Withdraw From The Coverage He Invoked.

A liability insurer’s duty of good faith springs from the purpose of the insurance contract-to defend and indemnify the insured within the limits of the insurance contract. If an insured is clearly liable the insurer must attempt to settle with the injured party. A liability insurer’s obligations are tethered to a purpose: protecting an insured’s financial interests and ensuring that the insured receives the full benefits it is entitled to under the policy.

Creating the duty advanced by Kvalvog would do the opposite. Such a duty would run counter to an insurer’s other rights and obligations.

Secura Is Not Liable For Any Failure To Investigate.

Kvalvog has not stated a claim for a breach of the duty of good faith on which relief can be granted. Kvalvog’s theories of liability, failing to advise him that he could fire the appointed lawyer, are not viable under Minnesota law.
Kvalvog’s Complaint Fails To State A Legally Sufficient Claim For Uninsuredmotorist Benefits.

Without an identified liability theory, the complaint does not provide fair notice of the basis for Kvalvog’s uninsured motorist claim. It was appropriately dismissed.

ZALMA OPINION

Liability insurance provides for a defense of the insured. It does not, nor should it, provide for the insured’s attempt to gain a judgment against a third party or UM coverage when the responsible party is insured. No good deed was punished – Secura settled the claim against Kvalvog only to be sued for doing what the policy required it to do.

(c) 2024 Barry Zalma & ClaimSchool, Inc.

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00:08:46
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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
3 hours ago
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair. The defendant denied negligence and alleged comparative negligence. After a two-day jury trial in November 2023, the jury returned a defense verdict.

The trial court denied Ojekwe’s motion to set aside the verdict and for a new trial, and he appealed.

LAW

A trial court’s refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of ...

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3 hours ago
Unwise for a Appellant to Represent Himself.

Inadequately Briefed Issues Defeats Appeal

Post 4852

Issues on Appeal Must be Adequately Briefed

Posted on September 25, 2026 by Barry Zalma

In Emy Ojekwe v. Connecticut Transit District Consortium, No. AC 47389, Court of Appeals of Connecticut (September 22, 2026) Emy Ojekwe alleged that he was injured on September 24, 2020, while leaving a bus operated by Connecticut Transit District Consortium, doing business as Greater Bridgeport Transit Authority.

According to his complaint, the wheelchair ramp began to rise before he had fully exited, causing his wheelchair to fall backward and allegedly injuring several parts of his body and damaging the wheelchair.

LAW

Refusal to set aside a verdict because of counsel’s improper remarks is reviewed for abuse of discretion.

Appellate claims receiving only cursory treatment, without record citations, supporting authority, or legal analysis, are inadequately briefed.

DISCUSSION

Improper opening remarks.

Defense counsel referred to Ojekwe’s national origin,...

September 24, 2026
Restitution Sentence Affirmed

Psychiatrist Who Was Convicted of Fraud Asked the First Circuit to Reduce his Punishment
Post 4851

Posted on September 24, 2026 by Barry Zalma

Fraud to Private and Public Health Insurers Doesn’t Pay

In United States v. Gustavo Kinrys, Nos. 24-1592, 24-1716, United States Court of Appeals, First Circuit (September 21, 2026) Gustavo Kinrys, a Massachusetts psychiatrist, submitted fraudulent claims to private and public health insurers from 2015 through 2018, including bills for more than 1,000 sessions when he or the purported patient was outside the country. When insurers requested supporting records, he delayed through a fictitious office manager and created false documentation.

A jury convicted Kinrys on fourteen counts. The district court imposed a 99-month sentence, calculated intended loss at slightly more than $19 million based on billed amounts, ordered $6,537,309.59 in restitution, and ordered $6,527,391.19 in forfeiture.

At sentencing, the district court calculated Kinrys’s base offense level to be ...

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