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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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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
