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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 27, 2025
For a Suit to Survive There Must be Facts

Dismissal for Failure to Allege Facts to Establish Breach of Contract

Post 5005

Read the full article at https://lnkd.in/gRJ8vggM, see the full video at https://lnkd.in/gEwNjztD and at https://lnkd.in/gGb947FR and https://zalma.com/blog plus more than 5000 posts.

Boat Owner Only Gets Insurance he Asked the Broker to Obtain

After a boating accident in Greece the boat owner, Nicholas Galakatos (“plaintiff” or “Galakatos”), made claims against defendants, Marsh & McLennan Companies, Inc. and others (collectively, “defendants”) for negligence, breach of contract and breach of fiduciary duty. The case arose from a boating accident in Greece involving Galakatos’ boat, “Galani,” which collided with another vessel in September 2018. This resulted in damage to both vessels and personal injuries to some passengers.

Nicholas Galakatos v. Marsh & McLennan Companies, et al., Civil Action No. 24-11259-NMG, United States District Court, D. Massachusetts (February 24, 2025)

Court’s Decision

The court granted the defendants’ motion to dismiss. The court found that Galakatos failed to state a viable claim for breach of contract because he did not allege any specific provision of the purported agreement that the defendants allegedly breached.

Background

Plaintiff is a resident of Massachusetts and Vermont and owns property in Greece. In 2015, he purchased a boat (“Galani”) to use in Greece. Defendants are associated entities that offer professional services including insurance brokerage. Plaintiff retained defendants’ insurance brokerage services for the first time in 2006 and have purportedly relied since then on their advice to procure insurance.

Plaintiff purchased a one-year, $10,000,000 excess coverage liability policy from American International Group (“AIG”). The AIG policy was to provide coverage for losses sustained “anywhere in the world.” Plaintiff also purchased third party liability insurance for Galani from Groupama Insurances (“Groupama”) in May, 2018. He contends that he disclosed his ownership of Galani and his Groupama insurance policy to defendants that same month.

In September, 2018, Galani collided with another vessel off the coast of Greece, resulting in damage to both vessels, as well as personal injuries to some passengers aboard the other vessel. Plaintiff informed defendants of the accident, and they requested information concerning all of his property and liability exposures, even those for which it may not be providing coverage.

The collision spawned litigation as a result of which plaintiff paid an undisclosed amount in settlement of claims against him. He then made a claim on his AIG policy, which was denied, allegedly because defendants failed to add the Groupama policy to the AIG policy.

Plaintiff sued claiming defendants failed to place and procure adequate liability insurance coverage for Galani.

Legal Standard

Under Massachusetts law, breach of contract claim requires a plaintiff to demonstrate that 1) a valid, binding contract existed, 2) the defendant breached the terms of the contract and 3) the plaintiffs sustained damages as a result of the breach. Similarly, a breach of contract claim under New York law requires a plaintiff to allege 1) the existence of a contract, 2) the defendant’s breach of his or her contractual obligations and 3) damages resulting from the breach.

Galakatos failed to state a viable claim for breach of contract because his complaint does not allege any specific provision of the purported agreement between plaintiff and defendants that defendants allegedly breached.

Plaintiff’s negligence claim is deficient because he does not allege that defendant was duty-bound to procure insurance in the manner he asserted. According to the complaint, defendant had a duty of care to plaintiff to procure adequate third party liability insurance for Galani up to $20 million.
Breach of Fiduciary Duty

Finally, defendant contends that plaintiff’s breach of fiduciary duty claim is not actionable because the complaint does not allege sufficient facts to show that a fiduciary relationship existed between plaintiff and defendants. A fiduciary duty between a broker and an insured arises only in the narrow instance where there is a “special circumstance” or “special relationship” between them which, ordinarily, is a question of fact. Because, Plaintiff failed to state a claim for breach of fiduciary duty he did not adequately allege a fiduciary relationship existed between him and defendants.

ZALMA OPINION

Galakatos’ complaint was that he received the insurance he asked Marsh to acquire rather than the insurance coverage he needed. Insurance brokers, like Marsh, owe a duty to buy the insurance requested by the insured. The facts alleged revealed that they did so and that there was no allegation of a special relationship requiring that Marsh deal with the insured as a fiduciary. Insurance brokers are not required to be clairvoyant and purchase the coverage the insured, like Galakatos, needed rather than what he ordered.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:50
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Post 5196

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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.

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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:

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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

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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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