Zalma on Insurance
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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 08, 2025
The Insured Bears The Burden to Prove Loss Due to Peril Insured Against

Lack of Evidence Supports Motion for Summary Judgment in Favor of Insurer

Post 4968

To Prove a Claim for Hailstorm Damage Admissible Evidence of Covered Loss is Needed from Insured

Kimberly and Michael Cutchall sued their homeowner’s insurance provider, Chubb Lloyd’s Insurance Company of Texas. Chubb disputed that there was water damage caused by a storm and claims that it already issued payment to the Cutchalls for all of the covered losses.

In Kimberly Cutchall and Michael Cutchall v. Chubb Lloyd’s Insurance Company Of Texas, Civil Action No. 23-3745, United States District Court, S.D. Texas, (December 31, 2024) the USDC ruled on the insurer’s Motion for Summary Judgment.

BACKGROUND

The Insurance Claim

Kimberly and Michael Cutchall were insured by Chubb providing coverage for certain type of damages to their home. The policy insured against “risks of physical loss to the property,” subject to several exceptions.

In September 2021, the Cutchalls submitted an insurance claim to Chubb for water damage to their house. Chubb retained Nelson Forensics, LLC to inspect the Cutchalls’ house. The report from Nelson Forensics concluded that the moisture in the house was due to deterioration or deficiencies in the way the house was built, not storm damage.

Nelson Forensics prepared a supplemental. The report stated that the roof damage was “unrelated to wind or hail from any storm event.”

Chubb sent a letter to the Cutchalls explaining the results of its investigation, including that the damage to the Cutchalls’ house was “a result of several different causes of loss including a hail event prior to 2020, roof distress unrelated to wind or hail, as built defects, changes in temperatures between the interior and the attic space, prior plumbing leaks, and localized movement.” Chubb issued a $27,385.81 payment to the Cutchalls for covered damages. The Cutchalls never cashed the check.

THE LITIGATION

The Cutchalls sued Chubb for breach of contract and bad faith and designated Mr. Halliday and independent adjuster, Brandon Allen, as an expert. Chubb retained a meteorologist, David Finfrock, to assess whether a hailstorm could have damaged the Cutchalls’ home on August 16, 2021, as Mr. Allen contended. After analyzing the data relied upon by Mr. Allen, along with multiple other sources of weather data, Mr. Finfrock concluded that “there is no evidence of hail at [the Cutchalls’ address] ¶ 16 August 2021.”

Chubb filed a motion for summary judgment on all of the Cutchalls’ claims.

THE SUMMARY JUDGMENT MOTION

Chubb filed its motion for summary judgment nearly a year after removing the case and the Cutchalls had not requested any depositions.
The Breach of Contract Claim

The Cutchalls’ breach of contract claim failed for two reasons: first, the Cutchalls have failed to point to evidence raising a dispute about whether their claim was covered; and second, the Cutchalls have failed to distinguish between covered and uncovered damages.

Failure to Identify Covered Loss

Under Texas law, the insured bears the burden of establishing that its claim is covered by the policy. Unconfirmed rumors of loss are insufficient to satisfy that burden.

Two of Chubb’s experts established that there were no hail or wind storms at the Cutchalls’ address during the policy period that could have caused the damage they claimed to their house.

No reasonable juror could believe the Cutchalls’ lack of evidence over Chubb’s. Because no genuine dispute existed over whether a covered loss occurred during the policy period, summary judgment on the Cutchalls’ breach of contract claim was granted.

The Extra-Contractual Claims

An insurer breaches its duty of good faith and fair dealing by denying a claim when the insurer’s liability has become reasonably clear. Chubb investigated the Cutchalls’ claim and concluded that the covered losses, minus the deductible, amounted to $27,385.81. Chubb issued a payment in that amount. The Cutchalls never cashed the check. The Cutchalls have failed to raise a genuine dispute of material fact as to whether they suffered additional losses covered by the policy.

All of the Cutchalls’ claims are dismissed with prejudice.

ZALMA OPINION

It is axiomatic that not every damage to a dwelling is covered under a homeowners policy. Chubb’s experts established some damage but not the excessive damage claimed by the Cutchalls. Chubb’s motion for summary judgment contained convincing evidence that there was no covered loss causing damage to the Cutchalls home and there was insufficient, if any, evidence provided by the Cutchalls establishing a covered law. It is insufficient to prove a loss to rely on two adjusters whose lack of expertise and conclusions based on inadequate evidence, is insufficient.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:22
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15 hours ago
Not Fair to Require Tenant to Pay for Damage Insured by Landlord

No Right to Subrogation Against Tenant
Post 5231

Not Fair to Require Tenant to Pay for Damage Insured by LandlordSee the video at https://lnkd.in/gFkrp_6M and at https://lnkd.in/gQdFQBWj and at https://zalma.com/blog plus more than 5200 posts.

See the video at and at

For Insurer to Subrogate Lease Must Require Tenant to Obtain Insurance for the Benefit of the Landlord

In AmGUARD Insurance Co. v. Tyrone Ellis and Shakyra Ellis, U.S. District Court, District of Connecticut Civil No. 3:25-cv-946 (JCH) (November 19, 2025), Judge, Janet C. Hall the defendant’s Motion to Dismiss the Amended Complaint on the basis of Connecticut’s anti-subrogation doctrine required dismissal.

KEY FACTS

Landlord Michael Caldwell, a Connecticut citizen, owned a multi-family building in Windsor, Connecticut. Defendants Tyrone and Shakyra Ellis were residential tenants in the building. On or about March 1, 2025, a fire ...

00:08:28
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November 19, 2025
Stealing from Fellow Church Members is Costly

Debt Resulting from Fraud is Not Dischargeable in Bankruptcy

Post 5230

Read the full article at https://lnkd.in/gpF3y7Vd, see the video at https://lnkd.in/gR5cVcbY and at https://lnkd.in/gch6Q4_V, and at https://zalma.com/blog plus more than 5200 posts.

Knowing Misappropriation and Conversion of Funds is Fraud

In re Matthew Jene Tubbs (Bankr. N.D. Tex., Fort Worth Div., No. 22-42728-MXM-7; Adv. No. 23-04019-mxm), October 15, 2025 .

Key Facts

Plaintiffs (Robles) and Defendant (Tubbs) met through their church; both held leadership roles. In Feb 2021 Robles home suffered major water damage from Winter Storm Uri and insurance paid $173,000.

In the Fall of 2021: Tubbs represented to Mr. Robles that he personally built a newer house and large barn on his parents’ property “with his own hands” (except foundation/insulation). That he had 10 years’ experience overseeing window/door installations at a major home-improvement chain, was a licensed contractor (false) and carried general contractor liability insurance.

Relying on ...

00:08:33
November 17, 2025
Zalma’s Insurance Fraud Letter November 15, 2025

See full video at https://lnkd.in/gtnsH3SW and at https://lnkd.in/geJ4FseF, and at https://zalma.com/ and at https://lnkd.in/gC2wmzqZ.

ZIFL-Volume 29 Number 22

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post 5228

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/

Read the full 20 page issue of ZIFL at http://zalma.com/blog/wp-content/uploads/2025/11/ZIFL-11-15-2025-1.pdf

Man Bites Dog Story – Hertz Sues Alleged Fraudsters

Hertz Successfully Refuses to Pay Alleged Fraudulent Health Care Providers

Proactive Victim of Fraud Defeats Health Care Providers

More McClenny Moseley & Associates Issues

This is ZIFL’s thirty eighth installment of the saga of McClenny, Moseley & Associates and its problems with the federal courts in the State of Louisiana and what appears to be ...

00:10:34
October 31, 2025
The Zalma Philosophy of Claims Handling – Part 9

The Professional Claims Handler
Post 5219

Posted on October 31, 2025 by Barry Zalma

An Insurance claims professionals should be a person who:

Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.

How to Create Claims Professionals

To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...

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October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
October 20, 2025
The Zalma Philosophy of Claims Handling – Part I

The History Behind the Creation of a Claims Handling Expert

The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail

Post 5210

This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.

My Training to be an Insurance Claims Adjuster

When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.

I was initially sat at a desk reading a text-book on insurance ...

post photo preview
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