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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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10 hours ago
Demands for Reasons for Termination not a “Claim”

A Claim by Any Other Name is not a Claim
Post 5182

It is Imperative that Insured Report Potential Claim to Insurers

Read the full article at https://lnkd.in/gfbwAsxw, See the full video at https://lnkd.in/gea_hgB3 and at https://lnkd.in/ghZ7gjxy, and at https://zalma.com/blog plus more than 5150 posts.

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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00:08:22
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10 hours ago
Interpleader Helps Everyone Potential Claimant to Insurance Proceeds

Interpleader Protects All Claimants Against Life Policy and the Insurer

Who’s on First to Get Life Insurance Proceeds

Post 5184

See the full video at https://lnkd.in/gyxQfnUz and at https://lnkd.in/gAd3wqWP, and at https://zalma.com/blog plus more than 5150 posts.

Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://lnkd.in/gRthzSnT; Go to Barry Zalma on YouTube- https://lnkd.in/g2hGv88; Go to the Insurance Claims Library – https://lnkd.in/gwEYk.
Interpleader Protects All Claimants Against Life Policy and the Insurer

In Metropolitan Life Insurance Company v. Selena Sanchez, et al, No. 2:24-cv-03278-TLN-CSK, United States District Court, E.D. California (September 3, 2025) the USDC applied interpleader law.
Case Overview

This case involves an interpleader action brought by the Metropolitan Life Insurance Company (Plaintiff-in-Interpleader) against Selena Sanchez and other defendants (Defendants-in-Interpleader).

Key Points

Plaintiff-in-Interpleader’s Application:

The Plaintiff-in-Interpleader...

00:06:34
September 04, 2025
Demands for Reasons for Termination not a “Claim”

A Claim by Any Other Name is not a Claim
Post 5182

It is Imperative that Insured Report Potential Claim to Insurers

Read the full article at https://lnkd.in/gfbwAsxw, See the full video at https://lnkd.in/gea_hgB3 and at https://lnkd.in/ghZ7gjxy, and at https://zalma.com/blog plus more than 5150 posts.

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 ...

00:08:22
September 02, 2025
Zalma’s Insurance Fraud Letter – September 1, 2025

ZIFL Volume 29, Issue 17

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

Posted on September 2, 2025 by Barry Zalma

Subscribe to the e-mail Version of ZIFL, it’s Free! https://visitor.r20.constantcontact.com/manage/optin?v=001Gb86hroKqEYVdo-PWnMUkcitKvwMc3HNWiyrn6jw8ERzpnmgU_oNjTrm1U1YGZ7_ay4AZ7_mCLQBKsXokYWFyD_Xo_zMFYUMovVTCgTAs7liC1eR4LsDBrk2zBNDMBPp7Bq0VeAA-SNvk6xgrgl8dNR0BjCMTm_gE7bAycDEHwRXFAoyVjSABkXPPaG2Jb3SEvkeZXRXPDs%3D
Post 5179

See the full video at See the full video at and at

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 ZIFL Volume 29, Issue 17

THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL

The Contents of the September 1, 2025 Issue of ZIFL Includes

Misrepresentation Claim Requires Production of Representation

Not...

00:12:52
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September 03, 2025

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 ...

post photo preview
September 03, 2025
Barry Zalma, Esq., CFE Insurance Claims Expert Witness

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 and became a consultant and expert witness for lawyers representing insurers and lawyers ...

post photo preview
September 03, 2025
Evidence Required to Prove Breach of Contract

APPRAISAL AWARD SETS AMOUNT OF DAMAGES RECOVERED FROM INSURER

Post 5180

See the full video at https://rumble.com/v6yd2z0-evidence-required-to-prove-breach-of-contract.html and at https://youtu.be/2ywEjs3hZsw, and at https://zalma.com/blog plus more than 5150 posts.

It’s a Waste of Time to Sue Your Insurer if You Don’t Have Evidence

Evidence Required to Prove Breach of Contract

Read the full article at https://www.linkedin.com/pulse/evidence-required-prove-breach-contract-barry-zalma-esq-cfe-rfelc, see the full video at https://rumble.com/v6yd2z0-evidence-required-to-prove-breach-of-contract.html and at https://youtu.be/2ywEjs3hZsw, and at https://zalma.com/blog plus more than 5150 posts.

It’s a Waste of Time to Sue Your Insurer if You Don’t Have Evidence

In Debbie Beaty and Jonathan Hayes v. Homeowners Of America Insurance Company, No. 01-23-00844-CV, Court of Appeals of Texas, First District (August 26, 2025) Debbie Beaty and Jonathan Hayes filed a claim under their homeowner’s insurance policy with Homeowners of ...

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