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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August 27, 2025
Continuous Exposure to Breach of Contract Terms is an Occurrence

“Accident” Includes Continuous or Repeated Exposure to Conditions
Post 5176

“Occurrence” is an Accident & Includes Repeated Damage

See the full video at https://lnkd.in/gkvBuWGK and at https://lnkd.in/g9zsY8hi and at https://zalma.com/blog plus more than 5150 posts.

In The Cobblestone Lofts Condominium v. Great American Insurance Company, Admiral Indemnity Company et al., Appeal No. 4265, 2025 NY Slip Op 04749, Index No. 653189/21, Case No. 2024-01860, Supreme Court of New York, First Department (August 21, 2025) the court resolved the issues.

FACTS

The Supreme Court of New York, First Department (trial court) dealt with a declaratory judgment action concerning an insurance coverage dispute. The plaintiff, a condominium association, was being sued for property damage and bodily injury caused by unintended water and moisture infiltration, resulting in toxic contamination of a condominium unit. The infiltration was allegedly caused by the plaintiff’s breaches of its contractual obligations under its bylaws and condominium declarations, as well as violations of statutory duties under the Multiple Dwelling Law and the Administrative Code of the City of New York.

PRIMARY ISSUE

The was asked to resolve whether the Great American Insurance Company was obligated to provide coverage for the plaintiff under its policy. The policy covers liability for bodily injury and property damage caused by an “occurrence,” which includes continuous or repeated exposure to harmful conditions.

Great American argued that the alleged damages were caused by the plaintiff’s breaches of its bylaws and condominium declarations, and not by an accident. However, the term “occurrence” in the policy includes continuous exposure to harmful conditions caused by breaches of contract or statutory violations.

THE ORDER

The Supreme Court, New York County (Louis L. Nock, J.), order granted plaintiff’s motion for summary judgment on its second cause of action declaring that defendant Great American Insurance Company was obligated to provide coverage for plaintiff.

Great American issued a “direct, definitive notice” to plaintiff disclaiming coverage. By letter dated September 17, 2018, Great American notified plaintiff that its policy does not afford coverage because:

1. a breach of contract is not an accident and, therefore, does not constitute an “occurrence” under the Primary Policy or Umbrella Policy and
2. because the Primary Policy excludes coverage for breach of contract.

Contrary to Great American’s argument, the denial letter is a repudiation of plaintiff’s rights. Great American will be obligated to indemnify plaintiff for any liability imposed upon it in the underlying action that is in excess of the policy issued by Admiral Indemnity Company the primary insurer to Great American’s umbrella policy.

The Great American policy covers liability for bodily injury and property damage “that takes place during the Policy Period and is caused by an ‘occurrence’ happening anywhere…” The term “occurrence” is defined, in relevant part, to mean “an accident, including continuous or repeated exposure to substantially the same general harmful conditions.” Under this definition, the term “occurrence” includes within its scope continuous exposure to a harmful condition alleged, as in the underlying action, to have been caused by the insured’s breaches of contract or violations of statutory or regulatory duties.

Great American argued that the alleged “bodily injury” and “property damage” were caused by plaintiff’s breaches of its bylaws and condominium declarations, and not by an accident. The policy defines “accident” to include “continuous or repeated exposure to substantially the same general harmful conditions,” which is exactly what was alleged in the underlying action.

The court declared that Great American is obligated to indemnify the plaintiff for any liability imposed in the underlying action that exceeds the policy issued by Admiral Indemnity Company.

ZALMA OPINION

Fortuity is a required element of every liability insurance policy determined by the definition of “occurrence” in the policy. Since the cause of damage was found by the trial court to be a result of continuous or repeated exposure to harmful conditions, it concluded the loss was due to a fortuitous “occurrence” and Great American must pay damages that could be found against the Plaintiff Condominium.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:02
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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 ...

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July 03, 2026
Buying Insurance After the Accident is Fraud

It is a Crime to Lie to Your Insurer That Accident Happened After Policy Inception

Post number 5386

Posted on July 3, 2026 by Barry Zalma

Conviction for Fraud Affirmed Because Evidence Overwhelming

In State Of Washington v. Saleem Mumin Robinson, No. 87244-3-I, Court of Appeals of Washington, Division 1 (June 29, 2026) Saleem Robinson was involved in an automobile collision on May 18, 2021. The other driver, Mohamed Waggeh, photographed Robinson’s documents and later reported the collision to GEICO, identifying the time as approximately 12:40 p.m.

That same day, at 6:06 p.m., more than five hours after the accident, Robinson purchased Progressive insurance for the vehicle involved in the collision.

The next morning, Robinson called Progressive to report the claim and stated that the accident occurred around 6:15 p.m. Progressive recorded that call without advising Robinson that it was being recorded. Progressive later conducted a special investigative unit investigation the claim because it was submitted shortly ...

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July 02, 2026
Failure to Comply With Policy Conditions Defeats Claim

Deprive Insurer of the Ability to Properly and Timely Investigate Claim & Recover Nothing

Posted on July 2, 2026 by Barry Zalma

Post number 5385

No Contract Claim No Bad Faith Claim

In South Alexander Development I, LLC v.Markel American Insurance Co., Civil Action No. 23-1436-JWD-SDJ, United States District Court, M.D. Louisiana (June 24, 2026) South Alexander Development I, LLC (SADI) owned and operated a solar farm in Springfield, Louisiana that allegedly sustained significant Hurricane Ida damage.

After SADI submitted a claim, MAIC ultimately paid $1,099,614.02 for undisputed physical damage plus the $210,000 income-loss policy limit. SADI later sued for breach of contract and statutory bad faith, contending MAIC failed to fully investigate and adjust the claim; MAIC sought summary judgment, arguing SADI failed to cooperate and withheld material repair-cost information.

LAW:

Louisiana insurance policies are interpreted as contracts according to their plain meaning, and the insured bears the burden ...

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July 02, 2026
Failure to Comply With Policy Conditions Defeats Claim

Deprive Insurer of the Ability to Properly and Timely Investigate Claim & Recover Nothing

Posted on July 2, 2026 by Barry Zalma

Post number 5385

No Contract Claim No Bad Faith Claim

In South Alexander Development I, LLC v.Markel American Insurance Co., Civil Action No. 23-1436-JWD-SDJ, United States District Court, M.D. Louisiana (June 24, 2026) South Alexander Development I, LLC (SADI) owned and operated a solar farm in Springfield, Louisiana that allegedly sustained significant Hurricane Ida damage.

After SADI submitted a claim, MAIC ultimately paid $1,099,614.02 for undisputed physical damage plus the $210,000 income-loss policy limit. SADI later sued for breach of contract and statutory bad faith, contending MAIC failed to fully investigate and adjust the claim; MAIC sought summary judgment, arguing SADI failed to cooperate and withheld material repair-cost information.

LAW:

Louisiana insurance policies are interpreted as contracts according to their plain meaning, and the insured bears the burden ...

post photo preview
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