When Claims are Fairly Debatable There is No Bad Faith
Post 4986
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Homeowners appealed from the district court’s denial of their breach-of-contract, consequential-damages, and bad-faith claims in Donnie Paul Bradley and Melanie Yvonne Bradley v. Allstate Insurance Company, No. 23-1397, Court of Appeals of Iowa on January 23, 2025 resolved the disputes.
BACKGROUND:
Donnie and Melanie Bradley appealed from the district court’s summary judgment ruling and final judgment following contractual disputes against Allstate Insurance Company. The Bradleys alleged errors in the district court’s interpretation of the insurance policy for their breach-of-contract claim and the granting of summary judgment to Allstate on their consequential damages and bad-faith claims. The dispute arose as a result of:
1. The Bradleys purchased an Allstate insurance policy in 2014 for their Cedar Rapids home.
2. The policy included actual cash value (ACV) and replacement cost value (RCV) coverage.
3. The August 2020 Derecho windstorm caused significant damage to their home.
4. The Bradleys reported the damage, and Allstate acknowledged the losses were covered under the policy.
5. The Bradleys, unhappy with Allstate, demanded appraisal in November 2020.
6. The parties signed an appraisal for the ACV in September 2021, and Allstate paid the Bradleys in accordance with the insurance policy.
7. The Bradleys claimed breach of contract for Allstate denying RCV coverage, alleged bad faith, and demanded consequential and punitive damages.
8. The Bradleys spent more on repairs than Allstate paid out and they continued with litigation.
9. The Bradleys ultimately paid for the repairs by refinancing their home to establish a home equity line of credit and taking out a loan against a retirement account.
10. Allstate was to reimburse the Bradleys for repair costs in excess of ACV-the equivalent of the RCV-if repairs were completed within 180 days of the ACV payment.
CLAIMS AND PROCEEDINGS:
The district court granted summary judgment to Allstate on the consequential damages and bad-faith claims but denied it for the breach-of-contract claim.
The Bradleys withdrew their request for a jury trial, and Allstate eventually paid the RCV from the appraisal.
APPEAL:
The Court of Appeals upheld the district court’s decision that consequential damages were not available under Iowa law.
The Court of Appeals agreed with the district court that the bad-faith claim was fairly debatable and that the Bradleys did not set forth a valid bad-faith claim.
DISPOSITION:
The question of whether the Bradleys were entitled to RCV payments was found to be fairly debatable as a matter of law. The Court concluded that the undisputed facts establish that there was no unreasonable delay in the ACV payment. Allstate reasonably disputed coverage as to the RCV payments on the basis that the explicit terms of the policy require repair to be completed for an RCV payment to be made.
The claim was, in the opinion of the Court of Appeals, fairly debatable because replacement was not completed within 180 days of the ACV payment. The Court of Apeals concluded that the Bradleys could not succeed on their bad faith claim.
ZALMA OPINION
The Iowa Court of Appeals educated the Bradleys and their counsel holding that an insurance policy is a contract with conditions. The Allstate policy provided, as a condition, that to receive the difference between ACV payment and the RCV the repairs must be completed within 180 days of the ACV payment. Although there was a dispute over when the repairs were completed Allstate paid both the ACV and the RCV making the entire claim moot and the other claimed damages were fairly debatable and no evidence to support a bad faith claim.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Post 5255
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In Rochell Provost v. State Of Louisiana Division Of Administrative Law And Louisiana Department Of Insurance, No. 2025 CA 0492, Court of Appeals of Louisiana, First Circuit (December 19, 2025) the Louisiana Department of Insurance (LDI) successfully appealed a district court judgment that reinstated Rochell Provost’s insurance producer license and reversed a $5,000 fine previously assessed against her.
FACTUAL BACKGROUND
The underlying dispute began when Union National Life Insurance Company/Kemper Life terminated Ms. Provost for cause, alleging she had committed fraudulent activity and misappropriated $31,471.39 in company funds. An investigative report supporting these findings was sent to LDI.
Following receipt of the report, LDI notified Ms. Provost of proposed regulatory action concerning ...
Post 5254
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In State Of Montana v. Lila Lynn Lord, 2025 MT 302, No. DA 24-0343, Supreme Court of Montana (December 30, 2025) Lila Lord (Lord) appealed her conviction for Tampering with Evidence following a jury trial in the Seventh Judicial District Court, Richland County. The case centered on a staged burglary in Sidney, Montana, orchestrated by Marie Chris Entzel with the intent to collect insurance proceeds to cover her son’s legal fees. Entzel recruited several individuals — including David Skaw, Lawrence Pohl, Laurie McGregor, and the defendant, Lila Lord — to assist in removing valuable items from her home, causing property damage and theft of items such as an enclosed trailer, boat and trailer, refrigerator, pistol, and television....
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Post 5252
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Post 5250
Posted on December 29, 2025 by Barry Zalma
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He Who Represents Himself in a Lawsuit has a Fool for a Client
In Pankaj Merchia v. United Healthcare Services, Inc., Civil Action No. 24-2700 (RC), United States District Court, District of Columbia (December 22, 2025)
FACTUAL BACKGROUND
Parties & Claims:
The plaintiff, Pankaj Merchia, is a physician, scientist, engineer, and entrepreneur, proceeding pro se. Merchia sued United Healthcare Services, Inc., a Minnesota-based medical insurance company, for defamation and related claims. The core allegation is that United Healthcare falsely accused Merchia of healthcare fraud, which led to his indictment and arrest in Massachusetts, causing reputational and business harm in the District of Columbia and nationwide.
Underlying Events:
The alleged defamation occurred when United ...
Zalma’s Insurance Fraud Letter
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ZIFL Volume 29, Issue 24
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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/
Zalma’s Insurance Fraud Letter
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