A Claim by Any Other Name is not a Claim
Post 5182
It is Imperative that Insured Report Potential Claim to Insurers
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In Jeffrey B. Scott v. Certain Underwriters At Lloyd’s, London, Subscribing To Policy No. B0901li1837279, RLI Insurance Company, Certain Underwriters At Lloyds, London And The Insurance Company, Subscribing To Policy No. B0180fn2102430, No. 24-12441, United States Court of Appeals, Eleventh Circuit (August 25, 2025) the court explained the need for a claim to obtain coverage.
Case Background:
This appeal arises from a coverage dispute under a Directors & Officers (D&O) insurance policy. Jeffrey B. Scott, the plaintiff-appellant, was terminated from his role as CEO, President, and Secretary of Gemini Financial Holdings, LLC in October 2019. Following his termination, Scott threatened legal action against Gemini, and Gemini sent him letters accusing him of misconduct and demanding the return of company property.
Insurance Policy:
The D&O insurance policy issued by Underwriters at Lloyd’s, London, provides coverage for directors, officers, and managers of Gemini. The policy defines a “Claim” as a “written demand for monetary damages, non-monetary, or injunctive relief against any of the Insureds”. It also provides coverage if the Chief Executive Officer, Chief Financial Officer, or Chief Actuary (or equivalent position) of the company gives “notice of circumstances . . . that may reasonably be expected to give rise” to a claim.
Legal Dispute:
Scott submitted a letter to Lloyd’s on November 23, 2019, entitled “Notice of Claim,” enclosing Gemini’s letters. Lloyd’s denied coverage, determining that no “Claim” against Scott had been made under the policy. Scott sued Lloyd’s for insurance coverage, but the district court dismissed the case. Scott’s arguments included that his documents reflected a “claim” or a “notice of circumstances” for a future claim.
Legal Principles:
In diversity cases arising under Florida law, a federal court is bound by the law articulated by the Florida Supreme Court. Unambiguous policy terms are interpreted according to their plain meaning as written.
If the Florida Supreme Court has not spoken on an issue, Florida District Court of Appeals decisions control absent persuasive indication that the Florida Supreme Court would rule otherwise. As a matter of Florida law, unambiguous policy terms are interpreted according to their plain meaning as written.
The letters cited by Scott do not contain a demand for relief against him. They explain why, in Gemini’s view, Scott was terminated and request that he preserve documents and return company equipment. The letters Gemini sent do not request monetary payment or legal remedies. Instead, they assert a cause for Scott’s termination and outline expectations for his post-employment conduct. Viewed in the light most favorable to Scott, these letters are anticipatory posturing for a future dispute-an intention to “[review] certain workplace conduct by [Scott].” But they are not present demands for relief.
Scott’s November 2019 letter did not identify circumstances that would lead to a claim against him. Instead, it mostly reflects his demands against Gemini over a putative wrongful termination. Scott was not one of the specified officers who could provide a notice of circumstances under the policy when he sent his November letter.
The district court correctly rejected Scott’s arguments that his documents reflected a “claim,” or, in the alternative, a “notice of circumstances” for a future claim.
Court’s Decision:
The district court held that no “Claim” as defined in the policy was made against Scott during the policy period and that Scott did not provide a “notice of circumstances” to trigger coverage. The court also noted that the letters from Gemini did not request monetary payment or legal remedies but instead asserted a cause for Scott’s termination and outlined expectations for his post-employment conduct. The Eleventh Circuit affirmed the USDC.
ZALMA OPINION
Insurance is nothing more than a contract like any other contract. It is interpreted by dealing with the usual meaning of the words used. Letters accusing a fired CEO of misconduct and demanding the return of company property was not a claim nor was the fired CEO’s request for detail was a “claim” as defined by the policy. The threat, if made to an intelligent corporate officer or insurance consultant should have resulted in a potential “claim” but the insured did not advise the insurers of the potential claim.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Convicted Criminal Seeks to Compel Receiver to Protect his Assets
Post number 5291
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The Work of a Court Appointed Receiver is Constitutionally Protected
In Simon Semaan et al. v. Robert P. Mosier et al., G064385, California Court of Appeals, Fourth District, Third Division (February 6, 2026) the Court of Appeals applied the California anti-SLAPP statute which protects defendants from meritless lawsuits arising from constitutionally protected activities, including those performed in official capacities. The court also considered the doctrine of quasi-judicial immunity, which shields court-appointed receivers from liability for discretionary acts performed within their official duties.
Facts
In September 2021, the State of California filed felony charges against Simon Semaan, alleging violations of Insurance Code section 11760(a) for making...
When There are Two Different Other Insurance Clauses They Eliminate Each Other and Both Insurers Owe Indemnity Equally
Post number 5289
In Great West Casualty Co. v. Nationwide Agribusiness Insurance Co., and Conserv FS, Inc., and Timothy A. Brennan, as Administrator of the Estate of Pat- rick J. Brennan, deceased, Nos. 24-1258, 24-1259, United States Court of Appeals, Seventh Circuit (February 11, 2026) the USCA was required to resolve a dispute that arose when a tractor-trailer operated by Robert D. Fisher (agent of Deerpass Farms Trucking, LLC-II) was involved in a side-impact collision with an SUV driven by Patrick J. Brennan, resulting in Brennan’s death.
Facts
Deerpass Trucking, an interstate motor carrier, leased the tractor from Deerpass Farms Services, LLC, and hauled cargo for Conserv FS, Inc. under a trailer interchange agreement. The tractor was insured by Great West Casualty Company with a $1 million policy limit, while the trailer was insured by Nationwide Agribusiness Insurance Company with a $2 million ...
Opiod Producer Seeks Indemnity from CGL Insurers
Post number 5288
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Insurers Exclude Damages Due to Insured’s Products
In Matthew Dundon, As The Trustee Of The Endo General Unsecured Creditors’ Trust v. ACE Property And Casualty Insurance Company, et al., Civil Action No. 24-4221, United States District Court, E.D. Pennsylvania (February 10, 2026) Matthew Dundon, trustee of the Endo General Unsecured Creditors’ Trust, sued multiple commercial general liability (CGL) insurers for coverage of opioid-related litigation involving Endo International PLC a pharmaceutical manufacturer.
KEY FACTS
Beginning as early as 2014, thousands of opioid suits were filed by governments, third parties, and individuals alleging harms tied to opioid manufacturing and marketing.
Bankruptcy & Settlements
Endo filed Chapter 11 in August 2022; before bankruptcy it ...
Passover for Americans
Posted on February 19, 2026 by Barry Zalma
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lost the ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah. Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and wonder how did all these wonderful things come into being. Jews believe the force we call G_d created the entire universe and everything in it. Jews feel G_d is all seeing and knowing and although we can’t see Him, He is everywhere and in everyone.We understand...
Passover for Americans
Posted on February 19, 2026 by Barry Zalma
Read the full article at https://www.linkedin.com/pulse/passover-americans-barry-zalma-esq-cfe-5vgkc.
“The Passover Seder For Americans”
For more than 3,000 years Jewish fathers have told the story of the Exodus of the enslaved Jews from Egypt. Telling the story has been required of all Jewish fathers. Americans, who have lived in North America for more than 300 years have become Americans and many have lostthe ability to read, write and understand the Hebrew language in which the story of Passover was first told in the Torah.
Passover is one of the many holidays Jewish People celebrate to help them remember the importance of G_d in their lives. We see the animals, the oceans, the rivers, the mountains, the rain, sun, the planets, the stars, and the people and ...
You Get What You Pay For – Less Coverage Means Lower Premium
Post number 5275
Posted on January 30, 2026 by Barry Zalma
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When Experts for Both Sides Agree That Two Causes Concur to Cause a Wall to Collapse Exclusion Applies
In Lido Hospitality, Inc. v. AIX Specialty Insurance Company, No. 1-24-1465, 2026 IL App (1st) 241465-U, Court of Appeals of Illinois (January 27, 2026) resolved the effect of an anti-concurrent cause exclusion to a loss with more than one cause.
Facts and Background
Lido Hospitality, Inc. operates the Lido Motel in Franklin Park, Illinois. In November 2020, a windstorm caused one of the motel’s brick veneer walls to collapse. At the time, Lido was insured under a policy issued by AIX Specialty Insurance Company which provided coverage for windstorm damage. However, the policy contained an exclusion for any loss or damage directly or indirectly resulting from ...
