Exclusion Establishes that There is No Duty to Defend Off Site Injuries
Post 5103
Read the full article at https://lnkd.in/geje73Gh, see the full video at https://lnkd.in/gnQp4X-f and at https://lnkd.in/gPPrB47p, and at https://zalma.com/blog plus more than 5100 posts.
Attack by Vicious Dog Excluded
In Foremost Insurance Company, Grand Rapids, Michigan v. Michael B. Steele and Sarah Brown and Kevin Lee Price, Civil Action No. 3:24-CV-00684, United States District Court, M.D. Pennsylvania (June 16, 2025)
Foremost Insurance Company (“Foremost”) sued Michael B. Steele (“Steele”), Sarah Brown (“Brown”), and Kevin Lee Price (“Price”) (collectively, “Defendants”). Foremost sought declaratory relief in the form of a declaration that
1. it owes no insurance coverage to Steele and has no duty to defend or indemnify Steele in an underlying tort action and
2. defense counsel that Foremost has assigned to Steele in the underlying action may withdraw his appearance.
Presently before the Court are two motions for entry of a default judgment filed by Foremost against Price and Steele respectively.
BACKGROUND
On October 5, 2023, Brown sued Price and Steele asserting claims of negligence and negligence per se. Brown alleged that she was outside of her residence and at the same time, Price was outside of the property he rents from Steele with his dog Miami. Without provocation, Miami suddenly got loose and attacked Brown, causing her injuries.
Miami had a bad history by previously getting loose and attacking humans without provocation. Brown contended that Steele knew that Miami was dangerous because when Steele collects rent from Price, he does not enter the residence due to the danger of Miami’s presence.
After the incident, the Larksville police cited Price for violations of the Pennsylvania Dog Law and Larksville Borough Ordinances.
THE INSURANCE
Foremost insured Steele under the Dwelling Fire One Policy Vacant or Unoccupied, policy number 381-0091679411-07. Under the Foremost policy, Foremost is required to insure Steele for accidents, including bodily injuries to other persons and medical costs related thereto as well as property damage, at covered premises. One such covered premise is the property that Defendant Price rented from Defendant Steele when the incident leading to the Brown Litigation occurred.
The Foremost policy includes certain exclusions including one that explicitly excludes coverage for bodily injury or property damage that results from the actions that occur on insured premises of (1) any animal which the insured (or the insured’s family member or employee) is aware has a prior history of biting or attacking humans or other animals or (2) any dog that is deemed dangerous as defined by Pennsylvania Public Law 784, as amended.
DISCUSSION
Foremost asserted that there was no coverage available to Steele because the exclusions related to dangerous animals apply because Steele was aware of Miami’s history of attacking and biting people. Consequently, Foremost alleged that Steele is not entitled to coverage related to the Brown Litigation and the counsel it has thus far provided to Steele should be permitted to withdraw.
Foremost requests a declaratory judgment that it has no duty to defend or indemnify Steele or Price as a result of pending state court litigation. According to Pennsylvania law, an insurer’s duty to defend or indemnify an insured in litigation is triggered by the language and factual allegations in the underlying complaint.
It should be, and was, obvious that when the clear and unambiguous terms of the policy do not provide for off-site injuries and when the injuries which occurred in this case occurred off-site, an insurer owes no duty to defend or indemnify the insured.
The Brown Complaint filed against Steele and Price in state court alleges Brown was outside of her residence when Price was outside of the property he rents from Steele with Miami. On the face of the complaint, the injuries took place at a place which is not an insured premise, as defined by the Foremost policy.
Therefore, Steele and Price are not entitled to defense or indemnification by Foremost. Given Steele and Price’s repeated failures to answer, respond or defend this case, the Court granted Foremost’s motions and entered declaratory judgments in favor of Foremost against Steele and Price, providing that Foremost has no duty or obligation to defend or indemnify Steele or Price.
ZALMA OPINION
When the insured took his vicious dog off his premises and it viciously attacked a woman causing serious injuries she sued the insured. Foremost, the dog owner’s insurer obtained an order that it need not defend or indemnify the insured because a clear and unambiguous exclusion excluded coverage for dog bites off premises. Insurance companies that write clear and unambiguous policies are entitled to seek court orders to enforce the language of their policy.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.
Subscribe to my substack at https://barryzalma.substack.com/subscribe
Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://lnkd.in/gwEYk.
ZIFL – Volume 29, Issue 15
Read the full issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-08-01-2025.pdf, at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-august-1-2025-barry-zalma-esq-cfe-eailc, see the full video at and at and at https://zalma.com/blog plus more than 5150 posts.
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post 5159
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/
Read the full 24 Page August 1, 2025 issue of ZIFL at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-08-01-2025.pdf
The Contents of the August 1, 2025 Issue of ZIFL Includes
No Good Deed Goes Unpunished
GEICO Sued Fraudulent Health Care ...
Unjust Enrichment is an Non-Contract Remedy
Post 5158
See the full video at https://lnkd.in/gv2iv_St and at https://lnkd.in/gdqVihMa, and at https://zalma.com/blog plus more than 5150 posts.
When an Insurer is Defrauded it Should Sue For Fraud Only
MONY Life Insurance Company v. Bernard R. Perez, No. 23-10770, United States Court of Appeals, Eleventh Circuit (July 23, 2025) resulted in a decision that allows an insured of a Disability Insurance policy to successfully defraud his insurer.
The case involved a dispute between MONY Life Insurance Company and Bernard R. Perez, an ophthalmologist, over a disability insurance contract. Perez was diagnosed with throat cancer in 2011 and began receiving monthly disability benefits from MONY. However, MONY later suspected Perez of dishonesty in his disability claims and discontinued payments in 2018.
FACTS
In 1987, ophthalmologist Bernard R. Perez formed a for-profit medical practice in Tampa, Florida. Soon thereafter, in June 1988, Perez applied for, and, in September 1988, was ...
Unjust Enrichment is an Non-Contract Remedy
Post 5158
See the full video at https://lnkd.in/gv2iv_St and at https://lnkd.in/gdqVihMa, and at https://zalma.com/blog plus more than 5150 posts.
When an Insurer is Defrauded it Should Sue For Fraud Only
MONY Life Insurance Company v. Bernard R. Perez, No. 23-10770, United States Court of Appeals, Eleventh Circuit (July 23, 2025) resulted in a decision that allows an insured of a Disability Insurance policy to successfully defraud his insurer.
The case involved a dispute between MONY Life Insurance Company and Bernard R. Perez, an ophthalmologist, over a disability insurance contract. Perez was diagnosed with throat cancer in 2011 and began receiving monthly disability benefits from MONY. However, MONY later suspected Perez of dishonesty in his disability claims and discontinued payments in 2018.
FACTS
In 1987, ophthalmologist Bernard R. Perez formed a for-profit medical practice in Tampa, Florida. Soon thereafter, in June 1988, Perez applied for, and, in September 1988, was ...
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 ...
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 ...
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 ...
