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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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January 03, 2025
Unhappy After Making Deal to Avoid Fraud Conviction

No Right to Change Plea Bargain Accepted by Judge

Post 4964

See the full video at https://rumble.com/v657cpg-unhappy-after-making-deal-to-avoid-fraud-conviction.html and at https://youtu.be/vgJnBIJ2QAM, and https://zalma.com/blog plus more than 4950 posts.

Defendant Got a Great Plea Deal and Tried to Set it Aside Without Success

Michele Seegars appealed from an order denying her motion for post-conviction relief (PCR) without an evidentiary hearing claiming ineffective assistance of counsel at a plea hearing resulting in her guilty plea to theft of services.

In State Of New Jersey v. Michele A. Seegars, No. A-3721-22, Superior Court of New Jersey, Appellate Division (December 30, 2024) Seegars tried to set aside a judgment rendered as part of a plea agreement to a crime less than the charged insurance fraud.

FACTS

In July 2018, defendant was involved in a two-car motor vehicle accident in Kearny. After the accident, defendant filed a property damage claim against the other driver, who was insured by York Risk Services Group, Inc. York denied responsibility for the accident on the part of its insured. Shortly before the accident occurred, defendant’s automobile insurance coverage provided by Progressive Insurance Company had lapsed. On the day after the accident, defendant contacted Progressive seeking to renew her automobile insurance policy. Defendant falsely represented to Progressive that she had not been involved in any car accidents during the short period of time coverage had lapsed. Progressive determined defendant was involved in the subject accident during the lapse period and advised her by letter that her automobile insurance would not be renewed. Progressive, as required by statute, also referred the matter to the Essex County Prosecutor’s Office for investigation for insurance fraud.

THE CHARGES

Defendant was later charged with third-degree insurance fraud arising from the alleged false information she provided to her auto insurance company. In January 2020 defendant pled guilty pursuant to a plea agreement to a lesser charge of theft of services a disorderly persons offense. The judge accepted the plea and imposed a sentence of one day jail credit and no probation was imposed.

Defendant filed a timely pro se PCR petition. In further support of her PCR application, defendant presented: (1) the two letters she received from York; and (2) an affidavit certifying she informed her trial attorney of her innocence before the plea. Defendant claimed she never had the opportunity to present evidence of her innocence to her trial attorney for review and investigation prior to the plea hearing. She stated she thought her guilty plea was for a “violation,” not a crime.

The State opposed the petition arguing the documents submitted by the defendant were not “exculpatory.” In addition, the State asserted that defendant’s affidavit was in “stark contrast” to her testimony at the plea hearing.

After oral argument, Judge Callahan concluded that defendant failed to present a prima facie case which would require an evidentiary hearing because she failed to raise any genuine issues of fact not already in the record.

ANALYSIS

A defendant is not entitled to an evidentiary hearing if the allegations are too vague, conclusory, or speculative to warrant an evidentiary hearing. The Appellate Division concurred with Judge Callahan’s finding that defendant’s claim of innocence was not based on exculpatory evidence and that no credible evidence exists supporting her position that the fault of the other driver excused her from disclosing the accident in response to the direct question from Progressive asking whether she was in any prior accidents before the date she applied for the policy renewal. The Appellate Division concluded, as the trial judge, that counsel’s failure to consider this evidence was not a mistake that would have impacted the likelihood of success at trial and did not make it less likely that defendant would have entered the guilty plea.

No evidence was presented by defendant that plea counsel affirmatively advised her that the guilty plea would have no effect concerning her future employment prospects. A review of the evidence considered by the trial judge as part of the PCR application revealed the evidence against her was strong and the likelihood that defendant would have been convicted on the original third-degree insurance fraud charge.

Therefore, the judge did not abuse his discretion by failing to hold an evidentiary hearing. Defendant failed to satisfy her burden to present a prima facie case requiring a hearing.

ZALMA OPINION

Every lawyer learns that it is important to be silent after you obtain a favorable ruling from a court. Seegars, facing a trial and with high potential for conviction and five year jail sentence agreed to conviction of a lesser crime, no jail time, no fine and no probation for which her counsel should have received a medal. She still obtained a criminal conviction that made it difficult to work in her profession. She was lucky the appellate division did not set aside the conviction where she could be tried and convicted of insurance fraud and sentenced to five years in jail since she clearly tried to defraud her insurer Progressive.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:39
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August 27, 2026
Offer Made and Accepted Creates Enforceable Contract

Policy Limits Demand Accepted Settles Claim

Post 5434

Posted on August 26, 2026 by Barry Zalma

See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute

In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange,  The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.

FACTUAL BACKGROUND

Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.

Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...

00:08:28
August 26, 2026
Offer Made and Accepted Creates Enforceable Contract

Policy Limits Demand Accepted Settles Claim

Post 5434

Posted on August 26, 2026 by Barry Zalma

See the full video at https://lnkd.in/g-ZtsSgK and at https://lnkd.in/ghMBdYWR
A Contingent Offer Accepted Ends the Dispute

In Farmers Insurance Exchange, a California Reciprocal Insurance Exchange,  The Superior Court For The County Of San Bernardino, Kathleen Ann Wood, E087128, California Court of Appeals, (July 9, 2026) Farmers Insurance Exchange insured Doyle Archer under an automobile policy with bodily injury limits of $15,000 per person and $30,000 per accident.

FACTUAL BACKGROUND

Archer rear-ended Kathleen Ann Wood at a red light, causing Wood to assert a bodily injury claim against him. Wood’s counsel sent Farmers a pre-litigation settlement demand offering to resolve Wood’s claim for the available policy limits, stating that if the $100,000 demand exceeded the policy, the offer was for the policy limits.

Farmers timely responded in writing, agreed to pay Wood the $15,000 per-person policy limit, and provided the requested ...

00:08:28
July 22, 2026
The Real Cost of Fraud

The Largest Residential Burglary of All Time
Post 5407

Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma

See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection designed to help to Understand How Insurance Fraud in America is Costing Everyone who Buys Insurance Thousands of Dollars Every year and Why Insurance Fraud is Safer and More Profitable for the Perpetrators than any Other Crime.

After ...

00:12:33
September 11, 2026
Arson for Profit is Ground to Deny Claim

Communications with Arson Investigation is Privileged

Post 5488

Posted on September 11, 2026 by Barry Zalma

ACE Was Not Required To Produce Any Disputed Document Because Each Was Protected By The Attorney-Client Privilege, or The Work-Product Doctrine.

See the full video at and at https://rumble.com/v7fbzvo-arson-for-profit-is-ground-to-deny-claim.html

In Rubesne Resources LLC, a Colorado Limited Liability Company v. ACE Property And Casualty Insurance Company, a Foreign Corporation, Civil Action No. 1:24-cv-02300-DDD-SBP, United States District Court, D. Colorado (August 30, 2026) Rubesne Resources LLC sought insurance coverage from ACE Property and Casualty Company after a January 5, 2024 fire destroyed its business.

South Metro Fire Rescue classified the ignition as intentional, and ACE’s retained expert concluded that gasoline had been poured in multiple areas and ignited. ACE retained coverage and subrogation counsel, National Subrogation Services, and a cause-and-origin expert ...

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September 11, 2026

Arson for Profit is Ground to Deny Claim

Posted on September 11, 2026 by Barry Zalma

Communications with Arson Investigation is Privileged

Post 5488

ACE Was Not Required To Produce Any Disputed Document Because Each Was Protected By The Attorney-Client Privilege, or The Work-Product Doctrine.

See the full video at and at https://rumble.com/v7fbzvo-arson-for-profit-is-ground-to-deny-claim.html

In Rubesne Resources LLC, a Colorado Limited Liability Company v. ACE Property And Casualty Insurance Company, a Foreign Corporation, Civil Action No. 1:24-cv-02300-DDD-SBP, United States District Court, D. Colorado (August 30, 2026) Rubesne Resources LLC sought insurance coverage from ACE Property and Casualty Company after a January 5, 2024 fire destroyed its business.

South Metro Fire Rescue classified the ignition as intentional.

After reviewing the disputed documents in camera, the court found that each was protected.

LAW

Colorado Revised Statutes § 10-4-1003 requires ...

September 10, 2026
Failure to Plead a Facially Plausible Claim Requires Dismissal

Referral of Claims to its SIU Is Not Bad Faith

Post 5487

Posted on September 10, 2026 by Barry Zalma

In WIZ Collision, LLC, on behalf of itself and as assignee of Jawara Small, Chester Street LLC, and Aziz Brooks v. GEICO Corporation, No. 25-cv-4201 (KAM)(JAM), United States District Court, E.D. New York (August 28, 2026) Wiz Collision, a New York City auto-body shop, regularly repaired vehicles and submitted insurance claims for customers. It alleged that GEICO repeatedly approved claims and repairs, then referred certain claims to its Special Investigations Unit, stopped issuing payments, and delayed resolution despite ultimately finding no fraud.

Wiz Collision sued on its own behalf and as purported assignee of three customers, asserting contract, good-faith, consumer-protection, and injunctive claims. GEICO removed the case and moved to dismiss under Rule 12(b)(6).
LAW

Under Rule 12(b)(6), a complaint must plead facts supporting a facially plausible claim. Article III standing requires a concrete injury, ...

post photo preview
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