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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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May 02, 2025
Pre-Suit Notice to Hospital Required

Failure to Comply with Tort Claims Act Defeats Suit

Post 5064

Read the full article at https://www.linkedin.com/pulse/pre-suit-notice-hospital-required-barry-zalma-esq-cfe-is3hc, see the full video at https://rumble.com/v6stk1f-pre-suit-notice-to-hospital-required.html and at https://youtu.be/EYCmc8GLcIo, and at https://zalma.com/blog plus more than 5050 posts.

In April Holifield And Jeffery Holifield v. Highland Community Hospital, No. 2023-CA-01342-COA, Court of Appeals of Mississippi (April 15, 2025) the Court of Appeals highlighted the issues surrounding proper notice under the Mississippi Tort Claims Act (MTCA) and the relationship between HCH and Forrest General Hospital (FGH).

FACTUAL BACKGROUND

Filing of Complaint

The Holifields filed a medical-negligence complaint against HCH on April 5, 2023, for injuries sustained during a procedure on November 5, 2021. Prior communication with HCH’s insurer was initiated by their attorney in January 2022.

Notice of Claim Issues

A notice-of-claim letter was sent to HCH on October 5, 2022, but there was uncertainty regarding its receipt. After discovering a change in administration, a new letter was delivered to the current administrator on October 28, 2022.

HCH’s Defense

HCH moved to dismiss the case on May 24, 2023, claiming it is not a separate entity from FGH and thus not capable of being sued under the MTCA.

Plaintiffs’ Motion to Amend

The plaintiffs sought to amend their complaint to substitute FGH for HCH, asserting that both entities received proper notice. HCH countered that FGH had not received any notice, and the statute of limitations had expired.

Trial Court’s Ruling

The circuit court denied the motion to amend on October 30, 2023, stating that HCH is a division of FGH and that the plaintiffs failed to serve proper notice to FGH’s chief executive officer before the statute of limitations expired.

DISCUSSION

Both of the trial court’s rulings at issue on appeal require a determination whether the Holifields properly served presuit notice on FGH in accordance with the MTCA.

One does not have to be a lawyer to sense that the organization, funding and operation of Memorial Hospital at Gulfport are matters capable of accurate and ready determination by resort to sources whose accuracy cannot reasonably be questioned.

In the context of an MTCA case, pre-suit notice either does or does not occur prior to the filing of a complaint. There is little that can be pleaded in an amended complaint that can cure the failure to give proper pre-suit notice of an MTCA claim. The Holifields did not provide the statutorily required notice to FGH under the MTCA. The Court of Appeals concluded that trial court did not err in denying the motion to amend the complaint.

APPEAL OUTCOME

The Court of Appeals affirmed the dismissal, emphasizing that the failure to provide notice under the MTCA warranted dismissal of the case with prejudice.

The circuit court granted HCH’s motion to dismiss or for summary judgment and entered a final judgment of dismissal with prejudice on October 31, 2023. The circuit court also addressed the Mississippi Supreme Court’s recent holding in University of Mississippi Medical Center v. Aycock, 369 So.3d 534 (Miss. 2023), that although the plaintiffs there had “never filed the statutorily required notice with the hospital’s chief executive officer,” the case should be remanded to allow plaintiffs an opportunity to “establish equitable estoppel or waiver based on the medical center’s conduct by competent evidence.” The trial court concluded that Aycock was “distinguishable” because the Holifields “had no communication with FGH (only with a claims representative working on behalf of FGH),” and “HCH committed no acts or made no communicat[ions] which could have given Plaintiffs occasion to say they ‘relied’ upon such acts or communications in good faith or to their detriment.”

ZALMA OPINION

States, like Mississippi enacted statutes limiting suits against doctors and hospitals unless the plaintiff first gives written notice to the Defendant(s) of the intent to sue and providing an opportunity to create an opportunity for an early settlement. The plaintiffs failed to give notice to the correct parties before filling suit, a statutory condition precedent to maintaining a suit against the hospitals.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:06:59
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January 02, 2026
Zalma’s Insurance Fraud Letter – January 2, 2026

Posted on January 2, 2026 by Barry Zalma
ZIFL – Volume 30 Number 1

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

See the video at https://rumble.com/v73nifg-zalmas-insurance-fraud-letter-january-2-2026.html and at https://youtu.be/vZC1e-_qwDg

Supreme Court of Louisiana Removes Judge

Judge Who Lied to Get Elected Cannot Serve

In In Re: Judge Tiffany Foxworth-Roberts, No. 2025-O-01127, Supreme Court of Louisiana (December 11, 2025) the Louisiana Supreme Court in an opinion by Chief Justice Weimer dealt with the recommendation of the Judiciary Commission of Louisiana (Commission) that Judge Tiffany Foxworth-Roberts be removed from office for:

1. making false and misleading statements regarding her judicial campaigns;
2. making false and misleading statements to police investigating the reported burglary of her car; and
3. withholding information and providing false, incomplete, or misleading information during the investigation by the Office of Special Counsel (OSC), as well as in the proceedings before the Commission....

00:08:13
December 30, 2025
Montana Lawyer Commits Insurance Fraud and Receives Minimal Punishment

Montana County Attorney Admits to Insurance Fraud & Is Only Suspended from Practice for 60 Days
Post 5251

Read the full article at https://lnkd.in/gnBaCjmv, see the video at https://lnkd.in/gfpVsyAd and at https://lnkd.in/gC73Nd8z, and at https://zalma.com/blog plus more than 5250 posts.

A Lawyer Who Commits Insurance Fraud and Pleas to a Lower Charge Only Suspended

In The Matter Of: Naomi R. Leisz, Attorney at Law, No. PR 25-0150, Supreme Court of Montana (December 23, 2025) the Montana Office of Disciplinary Counsel (ODC) filed a formal disciplinary complaint with the Commission on Practice (Commission) against Montana attorney Naomi R. Leisz.

On September 25, 2025, Leisz tendered a conditional admission and affidavit of consent. Leisz acknowledged the material facts of the complaint were true and she had violated the Montana Rules of Professional Conduct as alleged by ODC.

ADMISSIONS

Leisz admitted that in April 2022, her minor son was involved in a car accident in which he hit a power pole. Leisz’s son ...

00:08:27
December 30, 2025
Montana Lawyer Commits Insurance Fraud and Receives Minimal Punishment

Montana County Attorney Admits to Insurance Fraud & Is Only Suspended from Practice for 60 Days
Post 5251

Read the full article at https://lnkd.in/gnBaCjmv, see the video at https://lnkd.in/gfpVsyAd and at https://lnkd.in/gC73Nd8z, and at https://zalma.com/blog plus more than 5250 posts.

A Lawyer Who Commits Insurance Fraud and Pleas to a Lower Charge Only Suspended

In The Matter Of: Naomi R. Leisz, Attorney at Law, No. PR 25-0150, Supreme Court of Montana (December 23, 2025) the Montana Office of Disciplinary Counsel (ODC) filed a formal disciplinary complaint with the Commission on Practice (Commission) against Montana attorney Naomi R. Leisz.

On September 25, 2025, Leisz tendered a conditional admission and affidavit of consent. Leisz acknowledged the material facts of the complaint were true and she had violated the Montana Rules of Professional Conduct as alleged by ODC.

ADMISSIONS

Leisz admitted that in April 2022, her minor son was involved in a car accident in which he hit a power pole. Leisz’s son ...

00:08:27
December 31, 2025
“Sudden” is the Opposite of “Gradual”

Court Must Follow Judicial Precedent
Post 5252

Read the full article at https://www.linkedin.com/pulse/sudden-opposite-gradual-barry-zalma-esq-cfe-h7qmc, see the video at and at and at https://zalma.com/blog plus more than 5250 posts.

Insurance Policy Interpretation Requires Application of the Judicial Construction Doctrine

In Montrose Chemical Corporation Of California v. The Superior Court Of Los Angeles County, Canadian Universal Insurance Company, Inc., et al., B335073, Court of Appeal, 337 Cal.Rptr.3d 222 (9/30/2025) the Court of Appeal refused to allow extrinsic evidence to interpret the word “sudden” in qualified pollution exclusions (QPEs) as including gradual but unexpected pollution. The court held that, under controlling California appellate precedent, the term “sudden” in these standard-form exclusions unambiguously includes a temporal element (abruptness) and cannot reasonably be construed to mean ...

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December 29, 2025
Doctor Accused of Insurance Fraud Sues Insurer Who Accused Him

Lack of Jurisdiction Defeats Suit for Defamation

Post 5250

Posted on December 29, 2025 by Barry Zalma

See the video at and at

He Who Represents Himself in a Lawsuit has a Fool for a Client

In Pankaj Merchia v. United Healthcare Services, Inc., Civil Action No. 24-2700 (RC), United States District Court, District of Columbia (December 22, 2025)

FACTUAL BACKGROUND
Parties & Claims:

The plaintiff, Pankaj Merchia, is a physician, scientist, engineer, and entrepreneur, proceeding pro se. Merchia sued United Healthcare Services, Inc., a Minnesota-based medical insurance company, for defamation and related claims. The core allegation is that United Healthcare falsely accused Merchia of healthcare fraud, which led to his indictment and arrest in Massachusetts, causing reputational and business harm in the District of Columbia and nationwide.

Underlying Events:

The alleged defamation occurred when United ...

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December 15, 2025
Zalma’s Insurance Fraud Letter – December 15, 2025

Zalma’s Insurance Fraud Letter

Read the full article at https://lnkd.in/dG829BF6; see the video at https://lnkd.in/dyCggZMZ and at https://lnkd.in/d6a9QdDd.

ZIFL Volume 29, Issue 24

Subscribe to the e-mail Version of ZIFL, it’s Free! https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D

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/

Zalma’s Insurance Fraud Letter

Merry Christmas & Happy Hannukah

Read the following Articles from the December 15, 2025 issue:

Read the full 19 page issue of ZIFL at ...

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