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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February 13, 2025
Progressive Obtains Judgment of no Coverage

No Coverage When Vehicle not Identified in the Policy
Post 4994

Read the full article at https://lnkd.in/gR4QU586, see the full video at https://lnkd.in/gejUnkjZ and at https://lnkd.in/gsZjYCF4, and at https://zalma.com/blog plus more than 4950 posts.

In Progressive Specialty Insurance Company v. Willie Richardson, No. 7:24-cv-0974-RDP, United States District Court, N.D. Alabama, Western Division (February 5, 2025) Plaintiff Progressive Specialty Insurance Company’s (“Progressive”) moved the USDC for Default Judgment. Progressive seeks entry of default declaratory judgment against Defendant.

Key Points:

1 The vehicle involved in the accident was a 2015 Nissan Pathfinder, which was not listed as a covered auto under the Alabama Auto Policy issued to the Defendant.
2 Progressive argued that the vehicle does not qualify as a “covered auto” because it was not shown on the Declarations Page, was not an additional or replacement auto, and was not a trailer owned by the insured.
3 The Defendant failed to respond to the complaint that was properly served on the defendant, leading to a default judgment.

BACKGROUND

Progressive Specialty Insurance Company (“Progressive”) filed a Complaint on July 19, 2024, seeking a declaratory judgment that it does not have any insurance coverage duties to defend or indemnify Willie Richardson (“Defendant”) in a lawsuit pending against him in the Supreme Court of the State of New York, County of Queens. The lawsuit involves a pedestrian, Estefania Aragones, who was allegedly struck by a vehicle owned by the Defendant on May 12, 2021.

The vehicle which allegedly struck Aragones was a 2015 Nissan Pathfinder. Progressive alleged that title documentation reflected that Defendant was the owner of that vehicle, had purchased it on July 4, 2018, and obtained title to it on July 17, 2018.

Progressive alleged that the vehicle involved in the alleged May 12, 2021 accident would not qualify as a “covered auto” because it was not shown on the Declarations Page for the coverages under that policy. Progressive further alleged that the vehicle would not qualify as an “additional auto” because Defendant had owned it for nearly three years but had never sought coverage from Progressive for it.

Standard of Review

When a defendant has failed to plead or defend, a district court may enter judgment by default. Fed.R.Civ.P. 55(b)(2).

Analysis

The federal Declaratory Judgment Act limits relief to actual cases or controversies. That is, under the facts alleged, there must be a substantial continuing controversy between parties having adverse legal interests. In order to demonstrate that there is a case or controversy that satisfied Article III’s standing requirement when a plaintiff is seeking declaratory relief – as opposed to seeking damages for past harm – the plaintiff must allege facts from which it appears that there is a substantial likelihood that he will suffer injury in the future.

These allegations, which are now admitted based on Defendant’s default, are sufficient to establish that Progressive does not have liability insurance coverage duties either to defend or indemnify Defendant under the Alabama Auto Policy issued to Defendant, Policy No. 937522831.

Conclusion:

The court concluded that Progressive does not owe any liability insurance coverage duties to defend or indemnify the Defendant in the underlying case.

The Clerk of Court entered default on December 17, 2024. On that same date, a Notice of Ability to Request Pro Bono Counsel was issued to Defendant. This notice provided that Defendant had thirty (30) days from the date of the notice to request appointment of pro bono counsel. Despite this notice, Defendant has not filed a request for appointment of pro bono counsel or otherwise responded to this action.

For the reasons explained above, Progressive’s Motion for Default Judgment granted.

ZALMA OPINION

Insurance, as I have said often, is a contract just like any other contract. The Progressive contract provides coverage only for accidents that occur with a vehicle identified in the policy as an insured vehicle. The Nissan Pathfinder was not identified on the policy and, therefore, judgment was entered in favor of Progressive who owed nothing to the Defendant.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:06:56
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September 26, 2025
No Way Out After Murder Conviction

Intentionally Shooting a Woman With A Rifle is Murder

Post 5196

See the full video at and at and at https://zalma.com/blog and more than 5150 posts.

You Plead Guilty You Must Accept the Sentence

In Commonwealth Of Pennsylvania v. Mark D. Redfield, No. 20 WDA 2025, No. J-S24010-25, Superior Court of Pennsylvania (September 19, 2025) the appellate court reviewed the case of Mark D. Redfield, who pleaded guilty to third-degree murder for killing April Dunkle with malice using a rifle.

Affirmation of Sentence:

The sentencing court’s judgment was affirmed, and jurisdiction was relinquished, concluding no abuse of discretion occurred.

Reasonable Inference on Trigger Pulling:

The sentencing court reasonably inferred from the guilty plea facts that the appellant pulled the trigger causing the victim’s death, an inference supported by the record and consistent with the plea.

Guilty Plea Facts:

The appellant admitted during the plea hearing...

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September 25, 2025
Prelitigation Communications Privileged

The Judicial Proceedings Privilege
Post 5196

Posted on September 25, 2025 by Barry Zalma

See the full video at and at

Judicial Proceeding Privilege Limits Litigation

In David Camp, and Laura Beth Waller v. Professional Employee Services, d/b/a Insurance Branch, and Brendan Cassity, CIVIL No. 24-3568 (RJL), United States District Court, District of Columbia (September 22, 2025) a defamation lawsuit filed by David Camp and Laura Beth Waller against Insurance Branch and Brendon Cassity alleging libel based on statements made in a letter accusing them of mishandling funds and demanding refunds and investigations.

The court examined whether the judicial proceedings privilege applieD to bar the defamation claims.

Case background:

Plaintiffs Camp and Waller, executives of NOSSCR and its Foundation, sued defendants Insurance Branch and Cassity over a letter alleging financial misconduct and demanding refunds and audits. The letter ...

00:07:56
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September 24, 2025
Untrue Application for Insurance Voids Policy

Misrepresentation or Concealment of a Material Fact Supports Rescission

Post 5195

Don’t Lie to Your Insurance Company

See the full video at and at https://rumble.com/v6zefq8-untrue-application-for-insurance-voids-policy.html and at https://zalma.com/blog plus more than 5150 posts.

In Imani Page v. Progressive Marathon Insurance Company, No. 370765, Court of Appeals of Michigan (September 22, 2025) because defendant successfully established fraud in the procurement, and requested rescission, the Court of Appeals concluded that the Defendant was entitled to rescind the policy and declare it void ab initio.

FACTS

Plaintiff's Application:

Plaintiff applied for an insurance policy with the defendant, indicating that the primary use of her SUV would be for "Pleasure/Personal" purposes.

Misrepresentation:

Plaintiff misrepresented that she would not use the SUV for food delivery, but records show she was compensated for delivering food.

Accident:

Plaintiff's SUV was involved in an accident on August ...

00:07:48
September 09, 2025
The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma

See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.

The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime

See the full video at and at

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is 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.

How Elderly Doctors Fund their ...

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September 08, 2025
The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma

See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.

The Dishonest Chiropractor/Physician

How a Need for Profit Led Health Care Providers to Crime

See the full video at and at

This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is 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.

How Elderly Doctors Fund their ...

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September 03, 2025

Barry Zalma: Insurance Claims Expert Witness
Posted on September 3, 2025 by Barry Zalma
The Need for a Claims Handling Expert to Defend or Prove a Tort of Bad Faith Suit

© 2025 Barry Zalma, Esq., CFE

When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.

On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive ...

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