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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July 30, 2025
Insurer Not Negligent in Causing Accident Caused by Its Insured

USDC Bends Over Backwards to Give a Pro Se Plaintiff Some Causes of Action
Post 5157

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When You Represent Yourself in Litigation You Have a Fool for a Lawyer

Plaintiff Gordon Clark, proceeding pro se, sued Defendant Olga L. Orengo and her auto insurance carrier, The Hanover Insurance Group, Inc. (“Hanover”), related to a motor vehicle collision between Plaintiff and Orengo. Plaintiff alleged that Orengo was at fault for the accident, but Hanover has refused to accept liability. In Gordon Clark v. The Hanover Insurance Group, Inc., No. 3:24-cv-348 (SVN), United States District Court, D. Connecticut (July 22, 2025)

Claims and Motions

Plaintiff has brought eight claims against both Defendants and a ninth claim against Hanover for alleged violations of Plaintiff’s rights under federal and state law. Defendants have both moved to dismiss Plaintiff’s amended complaint in full for failure to state a claim. The court granted Orengo’s motion to dismiss in part and denied it in part, while Hanover’s motion to dismiss has been granted in full.

Factual Background

The incident occurred on the evening of July 22, 2023, when Plaintiff’s vehicle was “T-boned” by Orengo’s vehicle at a highway onramp. Plaintiff alleges that Orengo was found to be at fault by the State Police Officer and issued a written warning for failure to maintain proper lane. Following the accident, Plaintiff experienced significant physical pain and suffering, which he attributed to the collision.

The court’s ruling addresses several legal claims:

Negligence:

The court dismisses the negligence claims against Hanover but finds that Plaintiff has stated claims for negligence and negligence per se against Orengo.

Intentional Infliction of Emotional Distress (IIED):

The court dismissed the IIED claims against both Defendants, finding that the conduct alleged does not rise to the level of extreme and outrageous required to sustain an IIED claim.

Negligent Infliction of Emotional Distress (NIED):

The court dismissed the NIED claims against both Defendants, noting that the claims are duplicative of the negligence claims and failed to state a claim.

Insurance Fraud:

The court dismisses the insurance fraud claims against both Defendants, finding that Plaintiff failed to meet the heightened pleading requirements for actions alleging fraud.

Assumption of Duty:

The court dismissed the assumption of duty claims without leave to replead, as the issue of assumption of duty is usually part of analyzing whether a duty exists to support a breach of contract or tort claim .

Breach of the Implied Covenant of Good Faith and Fair Dealing:

The court dismisses these claims, noting that Plaintiff does not allege that a contract existed between him and Hanover or Orengo.

Malice:

The court dismisses the malice claims, finding that malice is not a legally cognizable tort claim.

Violation of CUTPA:

The court dismissed the CUTPA claims against Hanover, noting that Plaintiff has neither alleged more than one act of insurance misconduct nor asserted a breach of contract claim.

CONCLUSION

The court granted Hanover’s motion to dismiss in full, and granted in part and denies in part Orengo’s motion to dismiss. Plaintiff may file a Second Amended Complaint by August 21, 2025, consistent with the court’s ruling.

DISCUSSION

Beginning with Hanover, Plaintiff does not articulate how Hanover in any way caused the alleged injuries. Plaintiff’s arguments as to negligence focus solely on the collision between Orengo and Plaintiff. Hanover was not a party to the car accident and the amended complaint does not allege that Hanover acted negligently in any manner to cause the collision to occur.

Even if the negligence cause of action against Hanover were based on its alleged denial of liability coverage for the accident, it must still fail. Absent a direct contractual relationship between the injured party bringing the action and the insurance company of the alleged tortfeasor, or a third-party beneficiary relationship, an injured party is precluded from bringing a direct action for negligence against the insurer until judgment is obtained against the tortfeasor. It was undisputed that Plaintiff has no direct contractual relationship with Hanover.

As to Orengo, however, the Court held that Plaintiff has plausibly stated a negligence claim.

Negligence Per Se

Negligence per se effectively engrafts a particular statutory standard onto the standard of care imposed by the duty element of a negligence cause of action. To establish negligence per se, a plaintiff need not prove that the defendant failed to act as an ordinarily prudent person would have acted under the circumstances.

Plaintiff has alleged sufficient facts to support a negligence per se claim.

ZALMA OPINION

Automobile Liability Insurance is a contract that promises to defend and, if necessary, indemnify its insured. When there is no evidence that the insurer was involved in causing the accident there can be no case against the insurer. Pro Se plaintiffs cause this kind of problem for courts by charging torts that don’t exist and suing parties that had no involvement. Giving the Pro Se plaintiff the benefit of the doubt the court allowed an amended complaint so that more judicial time can be taken to deal with incompetent lawyering by a non lawyer.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:09:16
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May 26, 2026
He Who Acts as His Own Lawyer Has an Idiot for a Client

Arsonist Tried To Represent Himself, Failed, and Sought Habeas Relief

Post number 5357

Read the full article at https://www.linkedin.com/pulse/he-who-acts-his-own-lawyer-has-idiot-client-barry-zalma-esq-cfe-d4bwc, See the full video at and at and at https://zalma.com/blog.

Karacson’s Arson for Profit Attempt Required Skill & Experience to Succeed

In Steve Ellis Karacson v. David Shaver, Warden, No. 25-1089, United States Court of Appeals, Sixth Circuit (May 20, 2026) Steve Karacson was convicted in Michigan state court of arson and insurance fraud after evidence showed he burned his own insured home. Investigators found multiple points of origin, gasoline odor, and evidence tying him to the scene, including cell-phone location data and a receipt showing he had purchased a gas can and gloves shortly before the fire.

FACTS

Karacson initially had appointed counsel, but his relationships with both appointed attorneys ...

00:08:55
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May 11, 2026
Severe Punishment for Failure to Obey Court Orders

Foolish to Repeatedly Disobey Court Orders

All That Remains For Trial Is Plaintiff’s Damages On Each Of These Claims And Establishing Proximate Causation Of Those Damages.

Post number 5348

See the full video at and at and at https://zalma.com/blog plus 5300 posts.

In Linh Wang v. Esurance Insurance Company, No. C24-0447-JCC, United States District Court, W.D. Washington, Seattle (May 1, 2026) John C. Coughenour, United States District Judge, found that throughout this case, culminating with its briefing on Plaintiff’s renewed motion and that Defendant has subjected Plaintiff to unnecessary motion practice for clearly discoverable information and made dubious representations (including to the Court).

FACTUAL BACKGROUND

This case involves an underinsured/uninsured motorist insurance bad faith claim arising from a 2017 motor vehicle collision. The plaintiff, Linh Wang, alleges that Esurance Insurance ...

00:08:27
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May 08, 2026
Ambiguous Contract to Repair not an Assignment

The Right to Negotiate with Insurer is Not an Assignment of Claims

Post number 5347

Read the full article at https://www.linkedin.com/pulse/ambiguous-contract-repair-assignment-barry-zalma-esq-cfe-2xppc, see the full video at https://rumble.com/v79is1s-ambiguous-contract-to-repair-not-an-assignment.html and at and at https://zalma.com/blog plus more than 5300 posts.

Nebraska Requires an Actual Assignment to Allow Contractor to Sue Insurer

In Millard Gutter Company, a corporation doing business as Millard Roofing and Gutter v. Farmers Mutual Insurance Company of Nebraska, also known as Farmers Mutual Insurance, also known as Farmers Mutual, No. A-24-818, Court of Appeals of Nebraska (May 5, 2026) Millard sued Farmers as an assignee of Jane Anzalone who had hired Millard Gutter to repair the roof of her home and agreed to allow Millard Gutter to coordinate with her insurer, Farmers Mutual, concerning reimbursement for repairs authorized under her insurance policy.

FACTUAL BACKGROUND

In ...

00:08:02
14 hours ago
Insurer Contended it was not Defrauded

Qui Tam Case Without Evidence to Prove Fraud Fails

Post number 5369

Read the full article at https://www.linkedin.com/pulse/qui-tam-insurer-contended-defrauded-barry-zalma-esq-cfe-pgfgc and at https://zalma.com/blog plus more than 5550 posts.

In People Of The State Of California Ex Rel. Heath & Yuen, APC v. Silver Bird Auto Leasing, LLC et al., B342847, California Court of Appeals, Second District, Eighth Division (June 5, 2026) Heath & Yuen, APC defended parties in an automobile collision case involving a McLaren and a tour van. After that case settled for $25,000, the firm filed a qui tam action under California’s Insurance Frauds Prevention Act (IFPA) against Silver Bird Auto Leasing, LLC, X-Law Group, PC, and Filippo Marchino. The firm alleged three fraudulent acts in the underlying litigation:

1. the complaint falsely stated the McLaren was making a “legal turn,”
2. respondents produced a fraudulent repair bill/estimate, and
3. respondents failed to disclose Marchino’s GEICO insurance and its payment for repairs....

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14 hours ago
Default Judgment Must be Respected by Federal Court

Full Faith and Credit Act Controlled

Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.

Posted on June 9, 2026 by Barry Zalma

Post number 5368

Posted on June 9, 2026 by Barry Zalma

In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.

After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...

post photo preview
June 09, 2026
Default Judgment Must be Respected by Federal Court

Full Faith and Credit Act Controlled

Read the full article at https://lnkd.in/evHXiiFE and at https://zalma.com/blog.

Posted on June 9, 2026 by Barry Zalma

Post number 5368

Posted on June 9, 2026 by Barry Zalma

In Prime Insurance Company, Inc. v. Medicab Transportation, LLC, Jason Rhodes, and Dale Johnson v. Prime Insurance Company, Inc and Prime Property & Casualty Insurance, Inc. No. 2:24-cv-421-SPC-KRH, United States District Court, M.D. Florida, Fort Myers Division (June 3, 2026) Medicab, a paratransit company, bought two policies in 2021: a Business Auto Policy from PPCI and a Commercial Liability Policy from Prime. Both policies, as originally written, appeared to cover injuries arising from loading and unloading patients from Medicab vans.

After a patient, Margaret St. Aubin, fell while being unloaded from a van and suffered injuries, her Estate made a $1 million demand. Prime and its claims administrator concluded that the Commercial Policy’s loading/unloading language had been included by mutual mistake, because...

post photo preview
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