Failure to Name a Party as an Additional Insured Defeats Claim
Post 5104
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Contract Interpretation is Based on the Clear and Unambiguous Language of the Policy
In Associated Industries Insurance Company, Inc. v. Sentinel Insurance Company, Ltd., No. 23-CV-10400 (MMG), United States District Court, S.D. New York (June 16, 2025) an insurance coverage dispute arising from a personal injury action in New York State Supreme Court.
The underlying action, Eduardo Molina v. Venchi 2, LLC, et al., concerned injuries allegedly resulting from a construction accident at premises owned by Central Area Equities Associates LLC (CAEA) and leased by Venchi 2 LLC with the USDC required to determine who was entitled to a defense from which insurer.
KEY POINTS
Parties Involved:
CAEA is insured by Associated Industries Insurance Company, Inc. (Plaintiff).
Venchi 2 LLC is insured by Sentinel Insurance Company, Ltd. (Defendant) through its parent entity Venchi U.S. Inc. .
Claims:
Associated sought a summary judgment declaring that Sentinel has a duty to defend and indemnify CAEA in the underlying action, and that Sentinel’s coverage is primary while Associated’s coverage is excess .
Sentinel opposed this and sought a summary judgment for itself, declaring that CAEA does not qualify as an additional insured under the policy held by Venchi U.S., and therefore, Sentinel does not have a duty to defend and indemnify CAEA.
Court’s Decision:
The court denied Associated’s motion for summary judgment and granted Sentinel’s motion for summary judgment.
The court held that CAEA is not entitled to additional-insured coverage under the Sentinel policy, and therefore, Sentinel does not have a duty to defend and indemnify CAEA in the underlying action.
BACKGROUND
On September 20, 2018, Eduardo Molina, a construction worker, allegedly fell from a scaffold while working on a project at 861 Broadway, New York, NY. Molina sued Venchi 2, CAEA, and Transworld Equities, Inc., asserting claims of common law negligence and failure to provide a safe workplace under New York Labor Law and the Industrial Code.
INSURANCE POLICIES
1. Sentinel Policy: Issued to Venchi U.S. for the period October 13, 2017, to October 13, 2018. Venchi U.S. is the only named insured .
2. Associated Policy: Issued to Transworld Equities, Inc. for the period April 16, 2018, to April 16, 2019. CAEA is identified as a named insured .
CONCLUSION
The court concluded that Sentinel does not have a duty to defend and indemnify CAEA in the underlying action, and Sentinel was not required to reimburse Associated for any costs incurred.
DISCUSSION
Under New York law it is well-established that courts determining a dispute over insurance coverage must first look to the language of the policy. The language of the policy is then to be interpreted according to general rules of contract interpretation. An insurance contract is interpreted to give effect to the intent of the parties as expressed in the clear language of the contract.
If a contract is unambiguous, courts are required to give effect to the contract as written and may not consider extrinsic evidence to alter or interpret its meaning. A contract is not ambiguous if the language it uses has a definite and precise meaning, unattended by danger of misconception in the purport of the agreement itself and concerning which there is no reasonable basis for a difference of opinion. Unambiguous provisions of an insurance policy are to be given their plain and ordinary meaning, and the plain and ordinary meaning of words may not be disregarded to find an ambiguity where none exists.
Given the Court’s holding that CAEA is not entitled to additional-insured coverage, the Court further held that:
1. Sentinel does not have a duty to defend and indemnify CAEA in the Underlying Action, which moots Associated’s further request for relief regarding a declaration that Associated’s coverage is excess; and
2. Sentinel is not required to reimburse for costs incurred or that will be incurred in defending and, if necessary, indemnifying CAEA in the Underlying Action.
For the foregoing reasons, the Court granted Sentinel’s motion for summary judgment and denied Associated’s motion for summary judgment was granted.
ZALMA OPINION
A person can only become an “additional insured” on a liability policy if named on the policy itself as an additional insured or by the terms of the contract – even if unnamed – the person or entity is entitled to additional insured rights. The right to a defense did not exist because the court concluded from the clear and unambiguous language of the policy there was no coverage owed by Sentinel to CAEA.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Happy Law Day
ZIFL – Volume 30, Issue 9 – May 1, 2026
Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-may-1-2026-barry-zalma-esq-cfe-2tywc, see the video at at and at https://zalma.com/blog plus more than 5300 posts.
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
ZIFL – Volume 30, Issue 9 – May 1, 2026
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year and is written by Barry Zalma.
DOJ Creates National Fraud Enforcement Division
Will the Feds Take on Insurance Fraud? Possibly as Part of a National Anti-Fraud Effort
On April 7, 2026, the Acting Attorney General, Todd Blanche, issued a memorandum establishing the Department of Justice National Fraud Enforcement Division (NFED). The memo describes an ambitious, but perhaps redundant, vision for this ...
When Abalone Died As a Result of Multiple Causes The Efficient Proximate Cause Requires Payment
Post number 5345
Read the full article at https://www.linkedin.com/pulse/efficient-proximate-cause-doctrine-saves-claim-barry-zalma-esq-cfe-yndlc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
In American Abalone Farms, LLC v. Star Insurance Company et al., H052643, California Court of Appeals, Sixth District (April 27, 2026) the Court of Appeals dealt with an insurance coverage issue that required application of the efficient proximate cause doctrine.
FACTS
American Abalone Farms, LLC ("American Abalone" ) operates an aquaculture farm in Santa Cruz County, California, raising abalone in tanks. In August 2020, the CZU Lightning Complex Fires led to a prolonged power outage and road closures near the farm. As a result, the farm’s water pumps failed, causing the death of most of the ...
Breach of a Specific Condition Precedent Is a Complete Defense
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In United Services Automobile Association and State Farm Mutual Automobile Insurance Company v. Anthony Wenzell, 2026 CO 25 (Colo. Apr. 27, 2026) Anthony Wenzell was rear-ended in a car accident. He had a significant prior 2014 accident that required back surgery.
Wenzell claimed underinsured-motorist (UIM) benefits under three policies: (1) the tortfeasor’s liability policy, (2) his own primary UIM policy with State Farm, and (3) an excess UIM policy issued by USAA (under his brother’s policy, which contained an “other insurance” clause making USAA’s coverage excess over any collectible insurance).
After receiving the claims, both USAA and State Farm repeatedly requested that Wenzell execute comprehensive medical-release authorizations so they could obtain his full medical records and ...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
What Must be Done after Notice of a Claim is Received by the Insurer
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A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...