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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July 22, 2026
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Post 5407

Fraud & the Fear of Bad Faith Suits
Posted on July 22, 2026 by Barry Zalma

See the full video at https://lnkd.in/gWQQEySW and at https://lnkd.in/gyhdK6wv

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection 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.

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection 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.

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July 20, 2026
Search Warrant Produces Evidence of Insurance Fraud

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Post 5397

Posted on July 20, 2026 by Barry Zalma

See the video and at https://lnkd.in/gNUs2XzT and at https://lnkd.in/g2MawyzX

Magistrate Issues a Search Warrant if there is a Fair Probability that Contraband or Evidence of a Crime will be Found in a Particular Place.

In United States Of America v. Frank Suess, et al., CRIMINAL No. 3:24-308, United States District Court, M.D. Pennsylvania (July 16, 2026) a federal grand jury indicted Frank Suess, Melissa Driscoll, and others in a 55-count health care fraud and anti-kickback prosecution arising from an alleged scheme involving medically unnecessary prescription “foot baths.”

As part of the investigation, the FBI obtained an August 19, 2022 warrant to search Driscoll’s Sterling Pharmacy Yahoo email account for emails from January 1, 2018 through December 31, 2020. Driscoll moved to suppress the resulting evidence, arguing that the warrant lacked probable cause, was overbroad, and rested on material misstatements and omissions.

LAW:

The ...

00:08:22
July 17, 2026
The Great Jewel Theft

Fraud Shouldn’t Pay

Post 5396

See the video and at https://rumble.com/v7ctgmq-the-great-jewel-theft.html at https://youtu.be/aRbQ2sJfGwA

This is a Fictionalized True Crime Story of Insurance Fraud explaining why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is one of a collection 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.

The Insured purchased, for the first time in his life, a policy of Personal Articles Floater Insurance (PAF) scheduling $125,000 worth of ladies jewelry. He advised the insurer that the jewelry was always kept in a class E safe at his residence. He also told the insurer that he was employed full time as the owner of a gasoline service station and that he had never been canceled or suffered a previous loss.

One month after the policy was ...

00:09:42
9 hours ago
Plaintiff Sues Because State Employees Stigmatized Her

Day Care Owner Loses Subsidies Because She Criticized State

Post 5421

Posted on August 11, 2026 by Barry Zalma

First Amendment Right Will be Allowed to Go to Trial

In Betsey J. Grant v. Maine State Department Of Heath And Human Services, No. 1:25-cv-00490-JAW, United States District Court, D. Maine (August 6, 2026), Betsey J. Grant, a licensed childcare provider and operator of Tiny Tikes Daycare in Trenton, Maine, sued Maine DHHS and several employees after she publicly criticized DHHS before Maine’s Government Oversight Committee and alleged that officials retaliated against her.

She claimed DHHS imposed and extended a conditional license, published stigmatizing information, interfered with subsidies and program funding, removed her from a food program, rescinded an expansion grant, and used biased or falsified evidence in licensing proceedings. Following the March 10, 2023, GOC testimony, Ms. Grant alleges that foster children's subsidies (approximately $30,000) were withheld; she was removed from the ...

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August 05, 2026
It Doesn’t Pay to Lie in an Application for Insurance

Rescission for Material Misrepresentation
Post 5418

Posted on August 5, 2026 by Barry Zalma

An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.

In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units. After an underlying personal injury action was filed, Union Mutual determined that the property actually contained three apartment units and rescinded the policies on the ground that the defendants had made a material misrepresentation in the applications.
LAW:

A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true ...

post photo preview
August 05, 2026
It Doesn’t Pay to Lie in an Application for Insurance

Rescission for Material Misrepresentation
Post 5418

Posted on August 5, 2026 by Barry Zalma

An Insurer May Rescind An Insurance Policy Where The Applicant Made A Material Misrepresentation In The Application.

In Union Mutual Fire Insurance Company v. 844 Knickerbocker, LLC, et al. No. 2024-10359, Index No. 602824/22, 2026 NY Slip Op 04789, Supreme Court of New York, Second Department (July 29, 2026) Union Mutual Fire Insurance Company issued commercial insurance policies to 844 Knickerbocker, LLC, and Sanjaya Mallick based on applications stating that the insured property contained two apartment units.

LAW:

A misrepresentation is material if the insurer would not have issued the same policy, or would have issued it only on different terms, had the true facts been disclosed. To establish materiality as a matter of law, the insurer must submit documentation of its underwriting practices, such as manuals, guidelines, bulletins, or rules addressing similar risks.

DISCUSSION/ANALYSIS:

As a result, the...

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