Arson by Insured’s Management Voids Coverage
Post 5156
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Corporate Owners are not Innocent Co-Insureds
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Arson by Insured’s Management Voids Coverage
Post 5156
Arson for Profit by Corporate Entity Management Voids Policy
Following a fire that destroyed The Press Bar and Parlor in St. Cloud, Minnesota the insurer denied coverage after its determination that Andrew Welsh – a controlling officer of the insured intentionally set the fire and submitted a false proof of loss.
In Timeless Bar, Inc., doing business as The Press Bar and Parlor; Horseshoe Club, LLC; Jessie Welsh v. Illinois Casualty Company, No. 24-2245, United States Court of Appeals, Eighth Circuit (July 22, 2025)
BACKGROUND
In 2016, Andrew and Jessie Welsh purchased The Press Bar and Parlor. They managed the business through two legal entities: Horseshoe Club, LLC, which owned the real estate, and Timeless Bar, Inc., which operated the bar.
Incident and Legal Proceedings
The Press Bar and Parlor in St. Cloud, Minnesota was destroyed by fire on February 17, 2020. Law enforcement found that Andrew Welsh, a controlling officer of the insured, intentionally set the fire.
ICC denied the claim based on three policy provisions: Concealment, Misrepresentation or Fraud; Dishonesty Exclusion; and Intentional Acts Exclusion.
Court’s Decision
The District Court concluded Andrew’s conduct barred recovery under the policy.
KEY LEGAL POINTS
Jessie Welsh’s claims were dismissed due to lack of standing as a non-insured. Andrew’s conduct was deemed attributable to both business entities.
CONCLUSION
The court affirmed the district court’s judgment, denying coverage for the loss or damage caused by the fire.
Coverage under the policy was subject to a number of conditions. One of the listed conditions is categorized as “concealment, misrepresentation or fraud.” The policy refused to allow an insured to recover for a fire intentionally caused by the insured.
As noted by the district court, the policy determination of whether coverage should be extended to innocent, nonnamed business owners rests with the state legislature, not the federal courts.
ZALMA OPINION
When a person in control of two corporate entities commits arson-for-profit he, and the corporations he controlled, committed fraud when a proof of loss was submitted saying the fire was accidental. The corporate entities could not be “innocent” co-insureds when they were controlled by the arsonist. In this case crime didn’t pay.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Court Understands the Importance of Appraisal
Post 5188
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Appraisal Clauses Provide A Less Expensive, More Efficient Alternative To Litigation For Resolving Insurance-Claim Disputes
In Rockbrook Place Townhomes Association, Inc. v. Lio Insurance Company, CIVIL No. 4:24-CV-1021-SDJ, United States District Court, E.D. Texas, Sherman Division (September 3, 2025) the USDC compels appraisal and stops litigation.
Summary:
This insurance-coverage dispute between Rockbrook Place Townhomes Association, Inc. (“Rockbrook”) and LIO Insurance Company (“LIO”). The dispute arises from alleged hail damage to Rockbrook’s property, the key points are as follows:
Background:
Rockbrook owns property in Lewisville, Texas, insured by LIO. Rockbrook requested a reinspection and demanded over $4.5 million for roof replacements, which ...
Life Insurer Took Advantage of Plaintiff But Damages not Proved
Post 5187
Read the full article at https://www.linkedin.com/pulse/insurer-liable-only-1-damages-barry-zalma-esq-cfe-chbnc, see the full video at https://rumble.com/v6yoz9y-insurer-liable-but-only-for-1-damages.html and at https://youtu.be/OaX51GsfLcg, and at https://zalma.com/blog plus more than 5150 posts.
In Malcolm Wiener v. AXA Equitable Life Insurance Company, No. 24-1316, United States Court of Appeals, Fourth Circuit (September 3, 2025) the Fourth Circuit’s opinion addressed the sufficiency of evidence for a jury’s damages award in a negligence case involving AXA Equitable Life Insurance and Malcolm Wiener. AXA was found liable for negligence yet the court affirmed the trial court’s conclusion that the jury lacked sufficient evidence to reasonably calculate Wiener’s damages beyond minimal damages.
AXA liable for negligence but damages unsupported:
The court affirmed AXA’s negligence liability but ruled the jury’s $16 million damages award was ...
In Georgia Stormwater is a Pollutant
Stormwater Alone—Even Uncontaminated—Constitutes a Pollutant
Post 5186
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In Auto-Owners Insurance Company v. Tabby Place Homeowners Association, Inc., et al., Civil Action No. 4:21-cv-346, United States District Court, S.D. Georgia (September 3, 2025) found no coverage.
The decision of the USDC presents a detailed judicial opinion on a declaratory judgment action involving Auto-Owners Insurance Company, Tabby Place Homeowners Association (HOA), and various property owners. The central issue concerned whether Auto-Owners had a duty to defend or indemnify the HOA in an underlying lawsuit brought by property owners alleging property damage from stormwater flooding linked to the HOA’s stormwater retention ponds.
BACKGROUND AND PARTIES INVOLVED
The underlying litigation involved property ...
How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma
See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.
The Dishonest Chiropractor/Physician
How a Need for Profit Led Health Care Providers to Crime
See the full video at and at
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is 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.
How Elderly Doctors Fund their ...
How a Need for Profit Led Health Care Providers to Crime
Post 5185
Posted on September 8, 2025 by Barry Zalma
See the full video at https://lnkd.in/gePN7rjm and at https://lnkd.in/gzPwr-9q
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers.
The Dishonest Chiropractor/Physician
How a Need for Profit Led Health Care Providers to Crime
See the full video at and at
This is a Fictionalized True Crime Story of Insurance Fraud from an Expert who explains why Insurance Fraud is a “Heads I Win, Tails You Lose” situation for Insurers. The story is 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.
How Elderly Doctors Fund their ...
Barry Zalma: Insurance Claims Expert Witness
Posted on September 3, 2025 by Barry Zalma
The Need for a Claims Handling Expert to Defend or Prove a Tort of Bad Faith Suit
© 2025 Barry Zalma, Esq., CFE
When I finished my three year enlistment in the US Army as a Special Agent of US Army Intelligence in 1967, I sought employment where I could use the investigative skills I learned in the Army. After some searching I was hired as a claims trainee by the Fireman’s Fund American Insurance Company. For five years, while attending law school at night while working full time as an insurance adjuster I became familiar with every aspect of the commercial insurance industry.
On January 2, 1972 I was admitted to the California Bar. I practiced law, specializing in insurance claims, insurance coverage and defense of claims against people insured and defense of insurance companies sued for breach of contract and breach of the implied covenant of good faith and fair dealing. After 45 years as an active lawyer, I asked that my license to practice law be declared inactive ...