No Coverage When Vehicle not Identified in the Policy
Post 4994
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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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Happy Law Day
ZIFL – Volume 30, Issue 9 – May 1, 2026
Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-may-1-2026-barry-zalma-esq-cfe-2tywc, see the video at at and at https://zalma.com/blog plus more than 5300 posts.
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
ZIFL – Volume 30, Issue 9 – May 1, 2026
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year and is written by Barry Zalma.
DOJ Creates National Fraud Enforcement Division
Will the Feds Take on Insurance Fraud? Possibly as Part of a National Anti-Fraud Effort
On April 7, 2026, the Acting Attorney General, Todd Blanche, issued a memorandum establishing the Department of Justice National Fraud Enforcement Division (NFED). The memo describes an ambitious, but perhaps redundant, vision for this ...
When Abalone Died As a Result of Multiple Causes The Efficient Proximate Cause Requires Payment
Post number 5345
Read the full article at https://www.linkedin.com/pulse/efficient-proximate-cause-doctrine-saves-claim-barry-zalma-esq-cfe-yndlc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
In American Abalone Farms, LLC v. Star Insurance Company et al., H052643, California Court of Appeals, Sixth District (April 27, 2026) the Court of Appeals dealt with an insurance coverage issue that required application of the efficient proximate cause doctrine.
FACTS
American Abalone Farms, LLC ("American Abalone" ) operates an aquaculture farm in Santa Cruz County, California, raising abalone in tanks. In August 2020, the CZU Lightning Complex Fires led to a prolonged power outage and road closures near the farm. As a result, the farm’s water pumps failed, causing the death of most of the ...
Breach of a Specific Condition Precedent Is a Complete Defense
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In United Services Automobile Association and State Farm Mutual Automobile Insurance Company v. Anthony Wenzell, 2026 CO 25 (Colo. Apr. 27, 2026) Anthony Wenzell was rear-ended in a car accident. He had a significant prior 2014 accident that required back surgery.
Wenzell claimed underinsured-motorist (UIM) benefits under three policies: (1) the tortfeasor’s liability policy, (2) his own primary UIM policy with State Farm, and (3) an excess UIM policy issued by USAA (under his brother’s policy, which contained an “other insurance” clause making USAA’s coverage excess over any collectible insurance).
After receiving the claims, both USAA and State Farm repeatedly requested that Wenzell execute comprehensive medical-release authorizations so they could obtain his full medical records and ...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
What Must be Done after Notice of a Claim is Received by the Insurer
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A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...