Zalma on Insurance
Education • Business
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.
Interested? Want to learn more about the community?
September 10, 2025
Insurer Liable but Only for $1 Damages

Life Insurer Took Advantage of Plaintiff But Damages not Proved

Post 5187

Read the full article at https://www.linkedin.com/pulse/insurer-liable-only-1-damages-barry-zalma-esq-cfe-chbnc, see the full video at https://rumble.com/v6yoz9y-insurer-liable-but-only-for-1-damages.html and at https://youtu.be/OaX51GsfLcg, and at https://zalma.com/blog plus more than 5150 posts.

In Malcolm Wiener v. AXA Equitable Life Insurance Company, No. 24-1316, United States Court of Appeals, Fourth Circuit (September 3, 2025) the Fourth Circuit’s opinion addressed the sufficiency of evidence for a jury’s damages award in a negligence case involving AXA Equitable Life Insurance and Malcolm Wiener. AXA was found liable for negligence yet the court affirmed the trial court’s conclusion that the jury lacked sufficient evidence to reasonably calculate Wiener’s damages beyond minimal damages.

AXA liable for negligence but damages unsupported:

The court affirmed AXA’s negligence liability but ruled the jury’s $16 million damages award was unsupported due to insufficient evidence on Wiener’s expected remaining lifespan.

Damages require reasonable certainty under North Carolina law:

Under North Carolina law, damages must be proved with reasonable certainty, requiring specific and complete evidence to allow a jury to reasonably conclude the amount. Speculative damages are not permitted.

Two key data points needed for damages calculation:

To calculate damages for increased insurance premiums, the jury needed evidence of (1) additional annual premiums Wiener would pay, and (2) his expected remaining lifespan after 2014. Wiener provided evidence only for the first.

Insufficient evidence on Wiener’s expected lifespan:

The jury lacked adequate medical or actuarial evidence to determine Wiener’s remaining lifespan, with only general health remarks and a video call observation offered, which the court found speculative.

Nominal damages awarded due to lack of damage proof:

Since Wiener established causation and injury but failed to prove damages with reasonable certainty, the court held nominal damages of $1 were appropriate.

Jury’s use of death benefit as damages measure rejected:

Wiener’s argument that the $16 million death benefit of a hoped-for replacement policy could serve as damages was rejected as it confused the injury type; the injury was increased cost, not loss of policy termination.

Prior rulings and procedural posture:

The case had prior appeals affirming negligence liability but remanding for damages evaluation. The district court granted AXA’s Rule 50(b) motion to reduce damages, which the appellate court affirmed, declining to address a conditional new trial motion.

In the second time the case come before the Fourth Circuit on appeal. The first time, the parties disputed, among other things, whether there was sufficient evidence for a jury to find AXA liable for causing Malcolm Wiener’s inability to find a life insurance policy. The Fourth Circuit held that there was but remanded to have the district court determine whether the jury had sufficient evidence to calculate the amount of Wiener’s damages. The district court found the evidence lacking.

DISCUSSION

With AXA’s liability settled, the sole question on appeal is whether the jury had sufficient evidence to determine that Wiener suffered $16 million in damages.

The Jury Lacked Sufficient Evidence To Calculate Damages

Taking the evidence in the most favorable light to the party opposing the motion the Fourth Circuit asked whether a reasonable jury could have arrived at its conclusion. Under North Carolina law, proof of damages must be made with reasonable certainty. Although absolute certainty is not required, damages may not be awarded where the evidence permits no more than speculation.

The evidence fell short. The injury is that Wiener could not obtain insurance at a reasonable price because AXA’s erroneous MIB codes prevented carriers from issuing a policy at the standard rate. In other words, Wiener would have had to pay increased premiums over the rest of his life to receive the same permanent life insurance coverage through death.

AXA argued that we cannot assume that Wiener could have obtained a policy at the standard rate in the absence of erroneous MIB codes. Wiener’s expected remaining lifespan in 2014. North Carolina courts have rejected damages awards from juries that had more medical information than the jury did here. Wiener needed to put forth evidence directly establishing his expected remaining lifespan. Because he did not, the jury should not be permitted to speculate how long, in their opinion, they think Wiener’s life will continue in the future.

The jury was not given sufficient evidence to determine Wiener’s expected remaining lifespan. And without that data point, the jury could not calculate Wiener’s damages with reasonable certainty. That leaves Wiener to recover nominal damages of $1.

ZALMA OPINION

Although the District Court and the Fourth Circuit agreed that AXA took advantage of the plaintiff in how it calculated its premium, since they did not prove Wiener’s life expectancy the calculation of damages failed and he was only entitled, after two appeals, to $1 in damages. The lawyers, if on a contingency, earned $0.40 to $0.45 cents of the damages. This case establishes that even if an insurance company does wrong does not mean that the plaintiff will get rich with large compensatory damages and punitive damages.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

Subscribe to my substack at https://barryzalma.substack.com/subscribe

Go to X @bzalma; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to the Insurance Claims Library – https://lnkd.in/gwEYk.

00:08:20
Interested? Want to learn more about the community?
What else you may like…
Videos
Posts
16 hours ago
ANTI-SLAPP MOTION SUCCEEDS

Convicted Criminal Seeks to Compel Receiver to Protect his Assets

Post number 5291

See the video at and at and at https://www.zalma.com/blog plus more than 5250 posts.

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...

00:06:14
placeholder
February 19, 2026
Who’s On First – an “Other Insurance Clause” Dispute

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 ...

00:08:46
February 18, 2026
Win Some and Lose Some

Opiod Producer Seeks Indemnity from CGL Insurers

Post number 5288

Read the full article at https://lnkd.in/guNhStN2, see the full video at https://lnkd.in/gYqkk-n3 and at https://lnkd.in/g8U3ehuc, and at https://zalma.com/blog plus more than 5250 posts.

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 ...

00:08:32
February 19, 2026

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...

February 19, 2026

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.

Available at https://www.amazon.com/Passover-Seder-American-Family-Zalma-ebook/dp/B0848NFWZP/ref=tmm_kin_swatch_0?_encoding=UTF8&qid=1584364029&sr=8-4

“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 ...

January 30, 2026
Anti-Concurrent Cause Exclusion Effective

You Get What You Pay For – Less Coverage Means Lower Premium

Post number 5275

Posted on January 30, 2026 by Barry Zalma

See the video at and at

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 ...

post photo preview
placeholder
See More
Available on mobile and TV devices
google store google store app store app store
google store google store app tv store app tv store amazon store amazon store roku store roku store
Powered by Locals