Court Limits Lengthy Decision to Decide Case Can Go to Trial
USDC Tries to Keep it Simple
Post 5175
See the full video at https://lnkd.in/gbuRkvaj and at https://lnkd.in/gceNKPpG, and at https://zalma.com/blog plus more than 5150 posts.
In Todd F. Stevenson, an individual et al v. Massachusetts Mutual Life Insurance Company; et al, No. CV 24-109-M-DLC, United States District Court, D. Montana, Missoula Division (August 13, 2025) Plaintiffs alleged various claims including ordinary and professional negligence, negligent misrepresentation, breach of fiduciary duty, statutory violations, constructive fraud, actual fraud, fraudulent inducement, unjust enrichment, punitive damages, rescission and restitution.
Claims and Legal Theories:
Plaintiffs have alleged various claims including ordinary and professional negligence, negligent misrepresentation, breach of fiduciary duty, statutory violations, constructive fraud, actual fraud, fraudulent inducement, unjust enrichment, punitive damages, rescission and restitution, and a claim for an accounting.
Montana Law:
Under Montana law, punitive damages may be awarded when the defendant has been found guilty of actual fraud or actual malice. The Montana Supreme Court has recognized that allegations of agency generally involve questions of fact and therefore cannot be resolved summarily.
Constructive Fraud, Fraud, and Fraudulent Inducement
The Court found that these facts are sufficiently particular to state plausible claims for constructive fraud, actual fraud, and fraudulent inducement.
Punitive Damages
Under Montana law, punitive damages may be awarded “when the defendant has been found guilty of actual fraud or actual malice.” Mont. Code Ann. § 27-1221(1).
Conclusion
Under Montana law, Defendants owed Plaintiffs a duty of care. Taking the allegations in the SAC as true, Plaintiffs have pled sufficient facts to support plausible claims of relief.
ZALMA OPINION
Insurance fraud is a tort that can be brought by the victim of the fraud who seeks damages and punishment damages if the plaintiff can prove he was defrauded by his insurance agents and the insurers sold by the agents to the insureds. The plaintiffs in this very complex set of claims and legal issues resolved the motions to dismiss and has established that there were sufficient allegations of fraud that will allow this case to go to trial.
Court Limits Lengthy Decision to Decide Case Can Go to Trial
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National Flood Policy Bars Late Filed Suit
Post 5221
Read the full article at https://www.linkedin.com/pulse/one-year-suit-limitation-defeats-filed-two-years-zalma-esq-cfe-olr0c, see the video at and at and at https://zalma.com/blog plus more than 5200 posts.
No Excuse for Late Flood Suit After Claim Denial
In Domenico D’ambrosio, Michele D’ambrosio v. American Bankers Insurance Company Of Florida, No. 2:25-cv-155-KCD-NPM, United States District Court, M.D. Florida, Fort Myers Division (October 7, 2025) this is an insurance dispute stemming from Hurricane Ian. Plaintiffs Domenico and Michelle D’Ambrosio submitted a flood claim that Defendant American Bankers Insurance Company of Florida will not pay. To recover the funds allegedly owed, Plaintiffs sued for breach of contract.
Defendant’s moved to dismiss under Fed.R.Civ.P. 12(b)(6). Defendant presses one ...
ZIFL – Volume 29, Issue 21
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post 5220
Read the full article at https://lnkd.in/gRMJpi4s, see the video at https://lnkd.in/gwGSd6ZA & at https://lnkd.in/gbDiuFJy, and at https://zalma.com/blog plus more than 5200 posts.
See the video at & at https://rumble.com/v711hr0-zalmas-insurance-fraud-letter-november-1-2025.html
See the full 18 page issue of ZIFL at ZIFL-11-01-2025
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/
Conviction for Health Insurance Fraud Upheld
Physician Conspired with Bonavilla to Effect Health Insurance Fraud
Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on ...
ZIFL – Volume 29, Issue 21
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
Post 5220
Read the full article at https://lnkd.in/gRMJpi4s, see the video at https://lnkd.in/gwGSd6ZA & at https://lnkd.in/gbDiuFJy, and at https://zalma.com/blog plus more than 5200 posts.
See the video at & at https://rumble.com/v711hr0-zalmas-insurance-fraud-letter-november-1-2025.html
See the full 18 page issue of ZIFL at ZIFL-11-01-2025
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/
Conviction for Health Insurance Fraud Upheld
Physician Conspired with Bonavilla to Effect Health Insurance Fraud
Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on ...
The Professional Claims Handler
Post 5219
Posted on October 31, 2025 by Barry Zalma
An Insurance claims professionals should be a person who:
Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.
How to Create Claims Professionals
To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...