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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April 03, 2025
Gap in Coverage not Bad Faith

USDC Dismisses Multiple Counts Against Insurer

Post 5038

See the full video at https://rumble.com/v6rjvsl-gap-in-coverage-not-bad-faith.html and at https://youtu.be/P9hzlsS8O4g, and at https://zalma.com/blog plus more than 5000 posts.

Vincent Cusumano and Vincent Cusumano Architect P.C. (VCA), alleged that the defendants, Berkshire Hathaway issued a professional liability policy with a three-month gap in coverage, which precluded coverage for claims arising from prior work. The plaintiffs asserted thirteen causes of action, including breach of contract, promissory estoppel, and common law fraud.

In Vincent Cusumano Architect P.C. and Vincent Cusumano v. Berkshire Hathaway Direct Insurance Company d/b/a Three By Berkshire Hathaway, Todd Sharpee, John Does 1-10 names being fictitious and unknown, and ABC Corps. 1-10 names being fictitious and unknown, Civil Action No. 23-cv-22970 (JXN)(JSA), United States District Court, D. New Jersey (March 29, 2025) dismissed multiple causes of action.

COUNTS DISMISSED

The court dismissed several counts in the case for the following reasons:

1. Declaratory Judgment (Count 1):

The court found that the declaratory judgment claim was duplicative of the breach of contract claim. Since the breach of contract claim would resolve the same issue, the declaratory judgment was deemed unnecessary.

2. Specific Performance (Count 2):

The court dismissed this claim because specific performance is an equitable remedy, not an independent cause of action. Plaintiffs cannot amend their complaint through opposition briefs.
3. Breach of Contract (Count 3):

The court dismissed this claim because the plaintiffs failed to identify a provision within the insurance contract that the defendants breached. The policy’s terms were clear and did not cover the underlying claim.

4. Quantum Meruit/Unjust Enrichment (Count 5):

The court dismissed this claim because the existence of an express and enforceable contract (the Berkshire Policy) precludes a claim for unjust enrichment.
5. Breach of Covenant of Good Faith and Fair Dealing (Count 6):

The court dismissed this claim as it was duplicative of the breach of contract claim and failed to establish bad faith under New Jersey law.

Common Law Fraud (Count 7):

6. The court dismissed this claim because the plaintiffs could not establish reasonable reliance in the face of clear contradictory language in the insurance policy.

7. Breach of Fiduciary Duty (Count 12):

The court dismissed this claim because the insurance agent owed a fiduciary duty to the insurance company, not to the insured.

The USDC determined that the suit can proceed on the remaining counts but concluded that the 7 counts dismissed were not viable.

ZALMA OPINION

When a person or entity sues an insurance company they often throw in the kitchen sink of causes of action. The architect did just that and found that seven of at least 13 causes of action were not viable and the remaining counts will face either an additional motion for summary judgment or at trial.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:05:38
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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...

00:07:16
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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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