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 28, 2025
Hurricane Victims in Louisiana Deprived of Adequate Counsel

McClenny Moseley & Associates is not Responsible for All Case Failures
Post 5059

Court Concludes There is No Excuse for Failure to Promptly Serve a Governmental Agency

Read the full article at https://lnkd.in/gmFRP8Ef, see the full video at https://lnkd.in/gjrj3NVk and at https://lnkd.in/gGCbuy8Y, and at https://zalma.com/blog plus more than 5050 posts.

In Jimmie Legros v. Weston Property & Casualty Insurance Co, No. 6:22-CV-04401, United States District Court, W.D. Louisiana, Lafayette Division (April 3, 2025) after Weston became insolvent the suit was amended to change the defendant to the Louisiana Insurance Guaranty Association (“LIGA”) late.

LIGA moved to Dismiss and the Magistrate judge concluded that the evidence, the law, and the arguments of the parties, recommended that the Motion to Dismiss be granted.

FACTS AND PROCEDURAL HISTORY

Plaintiff filed the present action on August 25, 2022, against Weston Property & Casualty Insurance Company after suffering property damage during Hurricane Laura. The case was stayed from October 21, 2022, to March 30, 2023, due to the suspension and termination of Plaintiff’s prior counsel. On November 30, 2023, Plaintiff’s current counsel enrolled and on February 5, 2024, Plaintiff filed a Motion to Substitute party requesting that LIGA be substituted as Defendant for Weston Property & Casualty Insurance Company which was granted on May 22, 2024.

LIGA moved to dismiss because they were not properly served until 134 days after their substitution in violation of Federal Rule of Civil Procedure 4(m). Plaintiff conceded that LIGA was not served within 90 days as required by Rule 4(m) but requests the Court to deny LIGA’s Motion as Plaintiff can establish good cause of the delayed service as this case was due to Plaintiff’s prior counsel.

LAW AND ANALYSIS

Federal Rule of Civil Procedure 4(m) provides that “[i]f a defendant is not served within 90 days after the complaint is filed, the court-on motion or on its own after notice to the plaintiff-must dismiss the action without prejudice against that defendant or order that service be made within a specified time.” The district court has broad discretion in determining whether to dismiss an action for insufficient service under Rule 12(b)(5).

It is undisputed that LIGA was not served within the required 90 days once it was substituted as Defendant. To establish good cause, a litigant must demonstrate at least as much as would be required to show excusable neglect, as to which simple inadvertence or mistake of counsel or ignorance of the rules usually does not suffice.

Plaintiff contends he can establish good cause for delayed service. Specifically, per Plaintiff, this matter was previously handled by McClenny Moseley & Associates (“MMA”) and upon their dismissal by the various courts in multiple jurisdictions many clients were left without representation for extended periods of time.

According to Plaintiff, the delay in effecting service was due to the extraordinary circumstances resulting from MMA having to withdraw from the handling of thousands of files. While the Court was sympathetic to the plaintiffs who were left without representation following MMA’s suspension and the need for additional time to organize, sort, and process the multitude of cases, it does not excuse Plaintiff’s delay in service or failure to properly request an extension.

LIGA was substituted as Defendant well after MMA was removed from this case and after Plaintiff had secured new counsel. It was not until May 22, 2024 that LIGA was substituted as Defendant for Weston Property & Casualty Insurance Company after their insolvency in August 2022. For the next four months, the record shows that no action was taken to advance this matter. No request for an extension of time to effect service was made; rather, LIGA was served on October 3, 2024 – 134 days after it was substituted as Defendant.

The Court concluded that Plaintiff failed to establish the requisite good cause to excuse his failure to effect service in a timely manner. Plaintiff’s counsel entered their appearance in this matter almost a full year before effecting service. Accordingly, the Court recommends that LIGA’s Motion to Dismiss be granted.

ZALMA OPINION

LIGA is a governmental agency easy to serve with a complaint. For reasons known only to counsel it took almost twice the time required by Federal Rules, 134 days to serve the defendant. New counsel tried to blame old counsel, MMA, for the delay, even though they had successfully moved to change the name of the defendant to LIGA from Weston and then did nothing to effect the service for 134 days when it could have been done immediately. That violation of the rules required dismissal and for once the fault did not belong to MMA who is now in bankruptcy. The plaintiff Jimmie Legros is not without a remedy since the court has already found the dismissal was due to the failure to act of current counsel.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:38
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11 hours ago
Sovereign Immunity Prevents Suit Against USA

Chutzpah: After Criminal Prosecution Defendant Sues USA
Post 5164

See the full video at https://lnkd.in/g_QAZY-d and at https://lnkd.in/gbF7vMxG and at https://zalma.com/blog plus more than 5150 posts.

Dr. Segun Patrick Adeoye, a medical doctor, filed a lawsuit against the United States of America, seeking damages for alleged violations during his criminal prosecution. He was acquitted by a jury but claims to have suffered significant harm, including financial losses, damage to his professional reputation, and personal distress.

In Dr. Segun Patrick Adeoye v. The United States Of America, Civil Action No. 4:25-cv-83, United States District Court, E.D. Texas, Sherman Division (July 23, 2025) the USDC dismissed Adeoye’s suit.

FACTUAL BACKGROUND

Dr. Adeoye was indicted on charges of conspiracy to commit wire fraud and money laundering. The indictment alleged that he and his co-conspirators obtained at least seventeen million dollars through various fraudulent schemes. Despite being acquitted, Dr. Adeoye claims that his ...

00:07:56
11 hours ago
Amount of Loss Set by Appraisal Award

Payment of Appraisal Award Defeats Claim of Bad Faith
Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

Hurricane Damage to Dwelling Established by Appraisal Award

In Homeowners Of America Insurance Company v. Emilio Menchaca, No. 01-23-00633-CV, Court of Appeals of Texas, First District (July 31, 2025) after a hurricane Homeowners of America Insurance Company (“HAIC”) estimated that the cost of covered repair to Menchaca’s house was $3,688.54, which was less than his deductible, and therefore no payment would be made.

FACTS

After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

On August 23, 2018, Menchaca’s counsel ...

00:08:45
August 07, 2025
Amount of Loss Set by Appraisal Award

Payment of Appraisal Award Defeats Claim of Bad Faith
Post 5163

Read the full article at https://lnkd.in/dNpKKcYx, see the full video at https://lnkd.in/dNgwRP8q and at https://lnkd.in/dA9dvd-D, and at https://zalma.com/blog plus more than 5150 posts.

Hurricane Damage to Dwelling Established by Appraisal Award

In Homeowners Of America Insurance Company v. Emilio Menchaca, No. 01-23-00633-CV, Court of Appeals of Texas, First District (July 31, 2025) after a hurricane Homeowners of America Insurance Company (“HAIC”) estimated that the cost of covered repair to Menchaca’s house was $3,688.54, which was less than his deductible, and therefore no payment would be made.

FACTS

After Menchaca retained counsel HAIC advised that, under the terms of the policy, Menchaca was required to first invoke the appraisal process prior to filing suit, and that HAIC reserved the right to request that Menchaca and any adjuster hired on his behalf submit to an Examination Under Oath (“EUO”).

On August 23, 2018, Menchaca’s counsel ...

00:08:45
July 16, 2025
There is no Tort of Negligent Claims handling in Alaska

Rulings on Motions Reduced the Issues to be Presented at Trial

Read the full article at https://lnkd.in/gwJKZnCP and at https://zalma/blog plus more than 5100 posts.

CASE OVERVIEW

In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.

FACTS

Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.

Prior to trial Bernier had three remaining claims against State Farm:

1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.

Both Bernier and State Farm dispositive motions before ...

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May 15, 2025
Zalma's Insurance Fraud Letter - May 15, 2025

ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional

See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.

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/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:

Health Care Fraud Trial Results in Murder for Hire of Witness

To Avoid Conviction for Insurance Fraud Defendants Murder Witness

In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...

May 15, 2025
CGL Is Not a Medical Malpractice Policy

Professional Health Care Services Exclusion Effective

Post 5073

See the full video at https://lnkd.in/g-f6Tjm5 and at https://lnkd.in/gx3agRzi, and at https://zalma.com/blog plus more than 5050 posts.

This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.

In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:

Insurance Coverage Dispute:

Travelers issued a Commercial General Liability ...

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